58-17 Wright, Margie

V/1/11) 4
Carteret County WO.58-17
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina,Department of Environment,
and Natural Resources and the Coastal Resources Commission for development
in an area of environment concern pursuant to Section 113A-118 of the
General Statutes, "Coastal Area Management"
Issued to Margie S. Wright, authorizing development in the Estuarine Shoreline - ORW (AEC) at 527 Neptune Drive, in
Cape Carteret, NC, as requested in the permittee's application, dated 11/03/17. This permit, issued on 11/09/17, is
subject to compliance with the application and site drawing (where consistent with the permit), all applicable regulations
and special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine,
imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Placement of fill dirt on lot,behind existing bulkhead,grade lot
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s)dated received on 11/03/17.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at 252-222-5833 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permittee or other qualified persons
within twenty(20)days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for JPD compliance. Any maintenance work or project modification not covered under
this permit,require further written permit approval.All work must cease when this
Jeff Cannon
permit expires on:
C MA LOCAL PERMIT OFFICIAL
DECEMBER 31,2020 701 Cedar Point Blvd
In issuing this permit it is agreed that this project is consistent with the local Land Cedar Point, NC 28584
Use Plan and all applicable ordinances. This ��1j /?_—" 1.his permit may not be transferred to another without the written app oval of the Division of Coastal
Management. / PERMITTEE
(Signatu required if conditions above apply to permit)

Name: Margie S.Wright
Minor Permit#WO-58-17
Date: 11109/17
Page 2
(5) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land-disturbing activities, a barrier line of filter cloth must
be installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area
has been properly stabilized with a vegetative cover,
(6) Any proposed for grading within the 30'buffer from the Normal High Water must be contoured to prevent additional
stormwater runoff to the adjacent marsh.This area shall be immediately vegetatively stabilized,and must remain in
a vegetated state.
(7) All other disturbed areas shall be vegetatively stabilized(planted and mulched)within 14 days of construction
completion.
SIGNATURE: �1� 1 C�. ��-.�' �'- DATE: //~ q — / 7
MI TEE

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Menhro , LL.C.
Mailing Address: 125 NOY'\on ‘>r .
r(lorehrnd CIk-y . N C 2g 55-4
Phone Number: (250 21-1 1 — cnbg
Email Address: 00.%;A1 __bldg@ eos. ne . wax\ . cam
I certify that I have authorized Chu\C.S C . 1phe ;PE
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: HPXIhrD .\ V C
Py
ex °IIO Avexy bk. K\cveheM ( \-t3 ,1.1C 2.955-i
at my property located at 1
in COY.PXe k County.
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.
Property Owner Information:
-
Signature
Print or Type Name
Title
Ll I In / /7
Date
This certification is valid through I / 3 / / i20/1

CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
1\ I IOU 12011
Town oV ThYe.hrad Gh.) Go' AeCPJeh W��crnefA 1 Date
Name of Adjacent Riparian Property Owner
o AYere.0 SF .
Address
(Y)Nctine.aci G h j , I.IC 28551
City, State Zip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
c& rip rap , rPkunlrIl w , house and driveux
p
on my property at Av eY L St• Marine ark G 9
in env I-el/el County,which is adjacent to your property. A copyof the application 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,
Neanbvd ,<< C_ (252) 24l-g5t�g
Property Owner's Name Telephone Number
• •' ess City State Zip
061110 I have no objection to the project described in this correspondence.
I ve objection(s)to the project described in this correspondence.
•
( (•• ( .
Adjacent Riparian Signature Date
Print or Type Name Telephone Number
•
Address City State Zip

CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
Date
17)Cil t)C. q (If ete0 0_,W1 KA' SO
Name of Adjacent Riparian Property Owner
(19 Area l l S}•
Address
i MOr)ead WI) , Ma 29 `}
City, State Zip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
(Ad r l p rc4 , reEuntrq NICE , Inouc cic i dv et,ua i
on my property at 0 C) P\j 9 s\-. moyeocciA Ca
in C.aY kfJ(P} County,which is adjacent to your roPer h• A copyof the application 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,
N f tYn ,t 1 C (252) 21-1 I - g5t9�
Property Owner's Name Telephone Number
s City State Zip
I have no objection to the project described in this correspondence.
I have objection(s)to the project described in this correspondence.
1))-
Adjacent Riparian Signature Date
-Da-a L We/ 4"5. 251)
Print or Type Name Telephone Number
•
•
Address City State Zip

•
FOR REGISTRATION REGISTER OF DEEDS
Karen S. Hardesty
Carteret County, NC
October 31,2017 11:53:03 AM
DEED # Pages:3
Fee:$26.00 NC Revenue Stamp:$340.00
FILE# 1591321
PREPARED BY AND RETURN TO: Howard,Stallings,From,Atkins,Angell&Davis,P.A.
P.O.Box 975,New Bern,NC 28563
NORTH CAROLINA PARCEL m 638615625717000
REVENUE STAMPS$340.00
CARTERET COUNTY
• o THIS DEED made and entered into this the day of � �•j�- 1C,, 2017, by and
o between JOHN C. CHAMBERS,widower,party of the first part;
L
M d)
P -TO-
c
N•r
E rn
N
HENBRO, LLC, a North Carolina limited liability company, whose address is: P.O. Box
do
2418,Morehead City,NC 28557,party of the second part;
mu
L.jJ
av WITNESSETH:
u ' That said party of the first part in consideration of the sum of ONE HUNDRED AND
ocw
LL.
U.WV
0,�c NO/100 ($100.00) DOLLARS and other good and valuable considerations to said party paid by
C
0 3
P said party of the second part,the receipt of which is hereby acknowledged,has bargained and sold,
NPv
0 cdE
Y' and by these presents does grant, bargain, sell, and convey to said party of the second part, its
cdcm
3cro
o•r
successors and assigns, a certain tract or parcel of land, lying and being situate in Morehead
u•r
Township, Carteret County, North Carolina, and being more particularly described in Exhibit A
r•LV1
UZv
incorporated herein by reference.
OP
L•r�-
N3o
TO HAVE AND TO HOLD the aforesaid tract or parcel of land, and all privileges and
NCL
cd
. •rp
v r
p e s Howard,Stallings,From,Atkins,Angell&Davis,P.A.
e PO Box 975
a v
c c New Bern,NC 28563

1591321 .
appurtenances thereto belonging to the said party of the second part, its successors and assigns, in
fee simple,to its only use and behoof forever,subject to the following:
1. Real property taxes for year 2017;
2 Rights-of-way,easements and restrictions of record,if any.
And the said party of the first part for himself and his heirs and assigns, covenant with the
said party of the second part,its successors and assigns, that he is seized of said premises in fee and
has the right to convey in fee simple; that the same is free and clear from all encumbrances except
as above set out; and that he does hereby forever warrant and will forever defend the title to the
same against the claims of all persons whomsoever.
IN TESTIMONY WHEREOF, the said party of the first part has caused this instrument to
be executed in such form as to be binding,this day and year first above written.
(SEAL)
HN C. CHAMBERS
STATE OF NORTH CAROLINA
COUNTY O1 ,te r,'M
a Notary Public, do hereby certify that JOHN C.
CHAMBERS personal y appe before me this day and acknowledged the execution of the
foregoing instrument.
WITNESS my hand and official stamp or seal, this cg-C_P, •: • 1
2017.
OTARY PUBLI
My Commission Expires:
t ` Anthony Dwight House
9 NOTARY PUBLIC
Durham ty,
My Commission ExPires 0/13/2019
Howard,Stallings,From,Atkins,Angell&Davis,P.A.
PO Box 975
New Bern,NC 28563

1591321
•
EXHIBIT A
BEGINNING at a point, an existing iron pipe in the intersection of the northern right-of-way line
of Avery Street and the eastern right-of-way line of 10th Street, and running thence North 5°45'
East 115.02 feet with the eastern right-of-way line of 10th Street to a point, an existing iron pipe
at the ordinary high water mark of Calico Creek; thence in a southeasterly direction with said
ordinary high water mark of Calico Creek 110 feet more or less to a point, an existing iron pipe
in the said ordinary high water mark; thence South 5° 45'West 101.5 feet to a point, an existing
iron pipe in the northern right-of-way line of Avery Street;thence North 84° 15'West 100 feet to
a point,the point and place of BEGINNING.
The above described property lies north of Block 156, as shown on the official map of the Town
of Morehead City as recorded in Map Book 1,Page 139, and would comprise Lots 6, 7 and what
remains of Lot 8 in said Block if the lots were numbered in accordance with the rest of the
Blocks shown on the aforesaid map. The subject Block is sometimes referred to as`Block A"or
"Blank Block".
For further reference, see survey for John C. Chambers and wife, Annie P. Chambers, dated
• August 6, 1986 attached to that deed recorded in Deed Book 544, Page 195, Carteret County
Registry.
Howard,Stallings,From,Atkins,Angell&Davis,P.A.
PO Box 975
New Bern,NC 28563

Locality L < MT\ CGar4-12,17- ' e( LLflFLj ermit Number 10 "
Ocean Hazard Estuarine Shoreline ORW Shoreline '" Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name MA t (
1 `)
7
Address "47 15aa x e, )r"
City ,. 5`'"r" State _4/2_` Zip, L Phone c � — " S74
EmailJ1OI'/E
AUTHORIZED AGENT
Name
Address_ _(57,1 7
CitYL"�ce,/q ' State 4�? Zip . Phone .„z�. — �
Email 4I,p,(JF
LOCATION OF PROJECT: (Address, street name and/or directions to site;name of the adjacent waterbody.)
ura 7 ti7140 .fir.
(lye- &r1e1 4 ag
DESCRIPTION OF PROJECT: (List all proposed construction nd land disturbance.)
� e ycei4m Qt
a
SIZE 011 LOT/PARCEL: (apPrX 40
square feet .9# acres
PROPOSED USE: Residential cgf (Single-family Multi-family ❑ ) Commercial/Industrial❑ OtherCOMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: n14- 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 FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square 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 Management 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: .. .square feet.

LAND UWNEK-MAILIINti ADDRESS
Name Ala e Q . • "r
Address , ` �'Z 477ii j,. •
CityetyrjA r"') e-r State de_ Zip IP 5 L Phone -' 3Qg"
Email /fon'E
AUTHORIZED AGENT
Name 14,44, j e - \Air; ht
Address ,S;1 7 jOTurpr •
city ear (.. dere± State 12 Zip,, St Phone .4 — 473 — �D 1-.5.)
Email r/,p,(jF
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
a 1 /N964110" .Orape_ der
DESCRIPTION OF PROJECT: (List all proposed construction d land.disturbance.) / ' LLA:Z
j`1( jaCe4c7) pi Lei k�
SIZE OE LOT/PARCEL: square feet ,9` acres
PROPOSED USE: Residential ( ' (Single-family Multi-family ) Commercial/Industrial[] Other [�
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(I) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: ii/4- 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 FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: -- square 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 t 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: square feet.

ed,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
listed is landowner on this application has a significant interest inithe real property described therein. This interest can be
described as: (check one)
/t
�/ an owner or record title,Title is vested in name of t ,
see Deed Book page in ill In 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 OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore 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 intent to develop this property and to apply for a CAMA permit.
(Name? (Address)
(I) c_41di .
(4) _.
ACKNOWLEDGEMENTS:
1,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susee,4tible 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 floodproofq,techniques.
nagement
1 furthermore oertify' that I am authorized to grant,and do in fact ant,permission to Divisionconnection with evaluating astal ainformation
dff
the Lpea1 Permit Officer and their agents to enter on the aCorement�oned lands in
related to this Flit avp11Ca11on. „I_day of__ ,L 20 J
Tiiic
.-...--- -'' use�ii�ng a
AMA permit application
er agent Cot pU licatian, the
iSlh as desc�bed an the hack o/this Opp
rson authozed to act a a site dr'ng
OC his f vrm)' ra c{�eck f"�' 0 Ot?madepaYul r these sources tzre
l,'dnc1O r ecessa ,i an as descr:be Y
ormutivn(t re n 1 of the apl
eneral inf C Notice whe he di ,vm t\,details will constitute u violation of
iota K licant'�
licatien in t .the pcean kla2ard�hby the Opp a,be issrled• ��a�t°�,il,cri��nd administrative action.
This uPp staternen � orn�mat which� y sub/
ownership , CgVI(��G� ermit is
in ortnation as may be in any an ABC without P
y f Terence
an rated ithvut ' '
led w developing .,.,.w;r.w°„
ineorpv ens .
tt Any p
any perm .

=i Ld<41711r, e- iIr(,,"",.1.
"�i'B> }ZCt�IIIR�;I); 'i�t?c� act,��`sv ,, ":-
��w��q I'c,l"=+;:" i r���,[ �• rnlnc,l development
i 6,,i i'l ir,�, 1 permit, ni lectrta0 1 { a are Planning nrr�1 rt�r�tiir,. k>r.rr n w r
______________GENERAL � !!�/�t ioJ(�It.;�: (,`il�i��. . "_°i.ic rl'SdtlnCnt>}< but not l(Il"iftC'll to: �)I11)l�l!"tom" Water ,,
RAh INFORMATION'
Stem), t perrrtt 7 I t cr'; iilafilar' w a ;1t 1 RNiATIt N r. tl ctris,�z(, 1'Irirrth�ns, �t�.r 1 r6(„ tip �"�rc�iffcr ��c��ta��t°�� t�ast�,
Certification, Sand lh+n�, `�� rank t LAND OWNER
Sediment Control, .� I is ttinr�.and„A jr t"'0Ii(htr„arrrat;5
Cetus. Check with ✓ Subdivision r? In,'ul;r;iora and C� cr��t C(�11sct�'3ti�'t1 1•°III
our Locaal Permit Officer fOr.moire intbrin rtion. 1
Name >>�ew«lx laoirile I lone Palk A����rc���a(, Highway�S�' (.unrr�ctic�>>>, and
t ��__,---„,-
STATEMrNi° -� �OWNERSHIP:
Address
G�J h the urlciersi t U1�
�,ncd rrn applicatrt for u
person authorized to act as an �agetrt C .ru� mi or�r
City
Aurp senior ap c_loprncnt permit_bein��
listed<e la s: (ch c ort this a 3 licaturn has
l 1 <ppIyin r J either the otivner crl� t c rti in rra AFC or a
____ State I p 1-
described as: (check one) 1�'r a CA cal raairlu.ir de �escribe rrt herritit, c°citify 1
Errtatl ZipL, �j� a significant interest in the teat pro Jea't, t rrtt.the��ersoat
= S
11:1;11ER PERMITS
Yhoric C2
52) 2y 1 e escri e,d I-herein.This iraterest can be
Email O AUTHORIZED AGENT �CY� -- -- page art owner or record title, ]tile is vented in
y Registry of Deeds,
�� ,, _ _ in the _ �-1� vD �'.
Name -� 4�x
(� _ ; see Deed Book
"'*� Count
Address l�{ —+- �� �} ______ar-t owner b .•
1 } virtue of iraherit<ancc..
1 probate was inppiictrnt is au heir to the estate of
City �- — —
County,
_
�t ( c7ther llrtereSt,,
State --
—— — such as written contract or ieasu, explain below
Zrnai( _ - �= ___— Lrlt_��� -___—
=� Phone
rQL� J� Lt�� 1_)�� �'OTIh`14' or use a separate sheet �� attach to this ap•hiic2tinir.
I [CAT! C)I'AD.IACE�II'hE (�
L(�+;'A'I7(�)I+.; C)1; -•` I fur thcrtnorc >_ .
PROJECT: - c:crtrfy that the
__
tollo«�in�> ,
`adjacent ti�'aterhoci Address, street name and/or directions to site, If A� T1JAI 1\'�?PIS J
per sans :ire cilt'ners ofi�ropc tpic;,s ad•oinin��
y-,l �a ��( --- .F to each of the-rrr concei nine t»v intent r
�J� Y[' 1 this I,�tol,e<<ty, t itfi,'rrr that I have give"
t oceanfaorrt (Name} o devc-lop this property and to apply for a LAMA prt`iuit.
1��1a�5�C"a�1I'1�fO. : � U hat-is tlae name of the
OF PROJECT:, (List all proposed construction (] 1©
n C lY1 (,Address)
SIZEEt) and land disturbance.) _C1C_ _ r�� _ Q. 1
�'LOT/PARCEL: (`)�=� �_
Al`� L y
a �a��'�� gyp_ r ll - _ _ _ _
.PROPOSEDQ� Y� _ ( � Ip, _, _ --Ar 1 'yell. s.• _ re a d C�
�'SE, Residential - --25� acres �C�t�IS� pine C�YI �otaii � �--�- AY�,(1��,1 •��• Y _
(Sirtgic_fanaily r
C'C�M �1_, i I Multi-family
to 1'�rar pro I, (I) OR (2) .RE LOW d) Corrtnrerc-ia111itdustrird ACKNOWLEDGEMENTS:1�.(��� �] Other IENT�S;
I, the tinders i >
p•'>'t1' ; {Ce��tttrrr`��rt�! Cf�c°�r1I'E°t°laltt`�) "
fled, `tcknok�ledge that the land owner is aware that
•
tttc�t rf)011 are not sure which may be susceptible to erosion audl'or'flooding. ] acknowledge
�I) OCEANI : fI` � I D /[![I!rt/%�J'rY Iris hazrtrd rohlen-rs at• the proposed development is planned lie an wed ��ltit`la
AEC"S: TOTAL 1:= /�lllicP,.e p acknowledge that the Local Permit Officer
fir conditioned living space, 1I FLOOR sociated "kith this lo(. This explanation a
1 : T parking R AREA OF POOPOSCH • tion raid tl©odhroofirr�> has (ions con to concerning
the }�articu
excluding ncirr-load-17earira , elevated ahcne `�'1f U(�T U tcchnidrtcs, 1 ion was accompanied by recontrt�cndatioras cvnc°crni-n titabiliza
attic Mound (e��e1, non-condition space v,ated above P�
space)
--- square feet(includes
I fitirthermor'e certif
( I E'OAS'1'Ai,S O r ground level but t that 1 ram autlurri�ed to >
101 C RELINE AEC'so the "cal Meer and theira
SL'R_PAC�Syq.© SIZE OF BUILDING �r tilt, and do in tactYratat,
square feet NC FOOTPRINT related to this permit�,pt)/icatic,t Crits to cuter on the aforementioned
to L7ivisiota of Coastal Managcmerll staff,
concrete or masonry patios, (includes the area of the root/dri rtioned lands in connection with
etc. that are within the AND OTHER ItVI-PE a,
p tine of all buildings, RVIOUS OR BUILT evaluating information
concrete
STC1 applicable AFC Attachs ith then driveways,MAN your calculations with the y` covered decks,Management Permit issued b MANAGEMENT PERMIT: project drawing.) �
;' YE' NO y the NCi M►T. Is the ) 1 This the
Division of Pr©Jett located in an area subject to l i day of 11��V 20
Water Quality? � _
a State Stornawatcr Landowner ncr•or parson authorized to act as his/her agent u
',ryes, list the total built upon area/urrperviuus surface • ����
Ce allowed for
S
This a/1/'licalso,, includes:general,_ t/;j) purpose_ of filing a / c� ib permit application
YF icatiou
your lot or parcel. O1�!rc'tshi 11C1 al i1r�r171clt1orr sduar'e •feet. ! •s'krtc 17tinc tllc Ocean 1lazarcl,1 F (this furu7), (1 site dr arr�ing as cle
Q1 . tar-hip ticut cts mcr c',Vottc e r>'here rlecess-ar' a cheek jot $100.Oed lt ma the epbac of this application, the
:. itic . , bcr pl r,r,ic/t'cl r�rrlll)'bi the: ai 41.cant The details •1 (J made payable to the loc.'a7./i alyd _.
p�ratc d without rE>f>
any E1ence in any penult arhiCI main I ' ' ' '- c./the NpphCc7flc?I"f a, c%,
pernrlt -�I1 t>person clevelr£jinn sci rbc c-1 b}>t/tcrsc>sort!rE's are
ccl, ec vto civil, m these detcril.�
4GC,'r vitlrout permit
_�"� � �"� �� �, in art. `aril!constitute u vinlatior7 of
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