HomeMy WebLinkAboutMinor App. 7-23Locality 16w
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Permit Number _
Ocean Hazard Estuarine ShorelineRW Shoreline Public Trust Shoreline Other
GENERAL INFORMATION
LAND OWNER-1MAILING ADDRESS
Name
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(For official use only)
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City Iro`, State Zip G Phone 0 _
Email
AUTHORIZED AGENT
Name
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City State '
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Email_
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
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DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
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SIZE OF LOT/PARCEL: _ square feet acres
PROPOSED USE: Residential (Single-family[] Multi-Rllnily [] ) Commercial/Industrial [] Other []
COMPLETE EITHER (1) OR (2) BELOW (Contact your Locrrl Permit Officer if you are ml sure which AEC rq)plies
to yom, property;):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: 41A square Feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPR[NTAND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: _ Asquare Feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Manageme Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: _ _ /I/ square feet.
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Beating and Air Conditioning, Insulation and Energy Conservation, F1A
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile [Ionic Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a LAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent For purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
an owner or record title, Title is vested in name of ytjc:,/
see Deed Book f� y72 s ,Z page ds�: in the' '� County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in
County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACENT RIPARIAN PROPERTY OWNERS:
I fiirthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my nitent to develop this property and to apply for a CAMA permit.
(Name) (Address)
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(2) C��o r � q- !/�r� d,j jC
(3)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I am authorized to grant, and do in.fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
Landowner or person authorized to act
This the day of�1� - , 20
,23
is/her agent for pin -pose of filing a CAMA permit application
This application Mcludes: general information (this form), a site drawing as described on the back of this application, the
ownership siaternent, the Ocean Hazard AEC Notice where necessar}; a check.for• 3.100.00 made pa>>able to the locality, and
any i1?f0r-nurti0n as nray be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details vrill constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action,
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jeffrey Neil Skidmore
Mailing Address: 4460 Derwood Drive
Sherrills Ford, NC 28673
Phone Number: 704400-l531
Email Address: jskidmore@skidmorebuilders.com
I certify that I have authorized Charles Griffin
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: fixed dock
at my property located at 32 Newport Street
in Brunswick County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property QWner_ Information:
Jeffrey N69kidmore
Print or Type Name
Owner
Title
01 / 24 ! 2023
Date
This certification is valid through 12 1 3� 2023
LFEB 1 0 2023
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ADJACENT RIP -A
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This correspondence is to notify
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Postal
Service'm
CERTIFIED
MAIL°
RECEIPT
Domestic
Mail
Only
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Return Receipt (nanlcopy) $ . � 1 - -
❑ Return Receipt (electronic) S - -1 Postmark
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❑ Adult Signature Required S $II U0
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Sent To
Niii and Apt. No., or PO Box No.
-----------------------------
INOR PERMIT)
DELIVERED
:y�? 3 �
�— Date
Minor permit to
on my property at 3� c'V 4 S i' O e`!
in C o County, which is adjacent to your property. A copy of the applieation and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project_
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property Owner's Name
Address
City
Telephone Number
State
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature
Print or Type Name
Date
Telephone Number
Zip
Address City State Zip
Revised Juiy 2021
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ADJACENT RI L"
CERTIFIED I `°
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This correspondence is to notif,
ixtra Services & Fees (checkbox, �®ela� nateJ
❑ Return Receipt (hardcopy)
5 -
❑ Return Receipt (electronic)
❑ Certified Mail Restricted Delivery
$ y 11 Ul,l
❑ Adult Signature Required
$ lJ T(II_I
❑ Adult Signature Restricted Delivery
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total Postage ancVF es,v
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Sent To
Street and Apt No., or PO Box IV7o
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MINOR PERMIT)
r DELIVERED
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Postmark OF Date
Here
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Minor permit to
on my property at _3 a PJ e u) p_t'i t5i— /i C'. _
in County, which is adjacent to your property. A copy of the application and project
drawing is attachedienclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
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Property Owner's Name
Address
City
`7�;'y'Z/yu-/5.3�
Telephone Number
State
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature
Date
Print or Type Name Telephone Number
Zip
Address City State Zip
Revised July 2021
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