64-17 Kokinchak, Denise

''\% \1 i 2.h 1_11
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Locali w 1 '^'t j 1 �i � Permit Number(A) � � OTHER PERMITS MAY BE REQUIRED:The activityyou are planningmayrequire permits other than the CAMA
tY Q ,
minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
ocean Hazard Estuarine Shoreline ORW Shoreline " Public Trust Shoreline Other treatment system).Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FtA
(For official acre only) Certification,Sand Dune,Sediment Control,Subdivision Approval.Mobile Home Park Approval,Highway Connection,and
others.Check with your Local Permit Officer for more information,
GENERAL INFORMATION
STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING ADDRESS { i,the undersigned.an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
Name (en I`>�- �{�.�A.C �+^/- 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
-fit4( Canno(15C Cd'k,, b described as:(check one)
Address�4���-``�S / l
City I`I Ct3 P0/4- State NC.. Zap A gs phone .%��- CW- �5�i T s an owner or record title,Title is vested in mame�oof Dg.r�t`.�•x- 1►1f.r1 4 k.. ,
Email h see Deed Book /5 1 page 7l't� in the ectr- rz,'4- County Registry of Deeds.
AUTHORIZED AGENT Ian owner by virtue of inheritance.Applicant is an heir to the estate of
NatneS YJ i I'(\e e �3 Probate was in Country
if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address y D 1p
1V\ar�t�letxal State N', Zip At(65 t Phone a 'rJ a,_it��. *act/ NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
CityI furthermore certifythat the following
7�,��._ } persons are owners of properties adjoining this property.I affirm that I have given
Email C).h YtfA v*tit L W,tt NIL CS&Y 3Q ✓J.t ✓i-.- ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a LAMA permit.
LOCATION OF PROJECT:(Address,street name and/or directions to site;rime of the adjacent waterbody.) (Narita) (Addrecs)y
t O �i t:�h 6C IA 4 V Ca J {,1 it!`iL �q.q t'�!I F)-0.+2,�f�lt.. �a1GG..
141 ra llfcttS ..t. :-tIA- r I (2) LA I ck "n hnSI)� ! .7 39 cpINe east,.-+. iyy'1,4...-
(3)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) ACKNOWLEDGEMENTS:
'I I. - I.the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
I y1,- 1j(a:- 1Y1 t rF tt.hf/LtPL tnay 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-
SIZE OF LOT/PARCEL: _1 c f_-k9. square feet acres lion and floodproofing techniques.
PROPOSED USE:Residential yis (Single-fatuity Multi-family 0) Commercial/Industrial 0 Other El 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
COMPLETE EITHER(I)OR(2)BELOW(Contact your Local Permit Officer if t'ou are not sure which AEC applies related to this permit application.
to your property):
This the day off t%i2O t 7
(I)OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes ri
air conditioned living space.parking elevated above ground level,non-conditioned space elevated above around level but r 1L)j,��� "}L A t L� r t r«
excluding iron-toad-hearing attic space) Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
41*,OASTAL SHORELINE AECs:Si7..E OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This application includes:general information(this farm),a site drawing as described on the back of this application,the
N SURFACES:_.,__ ,square feet(includes the area of the foundation of all buildings,driveways,covered decks, oawervhi the(keen N�n+rl AEC Ariur where acn essaav a cheek for$100.00 made
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.)
p statement, payable to the locality;and
any information as maybe provided orally by the applicant.The details of the application as described by these sounes are
STATE STORMWATER MANAGEMENT PERMIT:is the project located in an area subject to a State incorporated without reference in any permit which may he issued.Deviation from these details will constitute a violation of
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)7 any moat.Any person developing in an AEC without permit is subject to civil,criminal andarlmi»fsuntive action.
YES NO
If yes,list the total built upon areafrmpervious surface allowed for your lot or pared: square feet.

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Receipts for
Certified Mail
(Staple Here)
\19,R) 11
Date
Adjacent Property Owner
tc1Ot, Ftv.‹cwrl- i u
Mailing Address
-4-,.sue -"V 1SOS
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, )fa - \ ck nki have applied for a CAMA Minor
Property Owner
Permit on my property at__✓ 141 C O V Ror\SC3a- . ,in @arlere.ti'
Property Address
County. As required by CAMA regulations,I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project.No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project,please
5 coNA t t, Scp vs
contact me at d SA—to 4i - 7 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to: f�}},,,, ,
3a.a aa,,,,r~ u-
Sincerely,
TtiiSP Kokir7(Jta.
Property Owner
Mailing Address
1111 -001ai LAg 7
City,State,Zip Code

r
M«hae( Ktul Gyp r
��� rowtor,A, t ..

1A9UU1 10 lib AUS Tax System Parcel Inquiry
Parcel Number R 6305.04.84.2033000 2017
*
Tax Codes District Code 1015 Taxpayer 529388
Twn / Sch 0015 DENISE I TRUSTEE KOKINCHAK
Spec Dist 31 48 110 BRIGHTON DRIVE
User Codes
Deed Book/Page 1589 490 1521 20
Plat Book/Page 30 780 AURORA OH 44202
Property Addr : House# 741
Street Name CANNONSGATE Alternate More? N,
Street Type DR Dir Unit
CiStZp NEWPORT NC 28570
Escrow More? N,
Legal Description
Plat Other More? N
Lot/Block
Deeded Acres .44 Previous 481939 More? N
LOT 460 PHASE 1 CANNONSGATE STREAMLINE DEVELOPERS LLC
Deed? N Values? Y,
Delete ? Action ?

i 2M C"1
Locality1, rr i rClAfThli Permit Number( -Fl OTHER PERMITS MAY BE REQUIRED:The activity are planningmayrequire permits other than the CAMA
Q ty you
/....." minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
Ocean Hazard Estuarine Shoreline, ORW Shoreline Public Trust Shoreline Other treatment system).Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation.FIA
(For official use only) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION,
STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING ADDRESS i,the undersigned.an applicant for a CAMA 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 fora CAMA minor development permit,certify that the person
Name Dell I`e- ' `C)Kl ACI C`1'C*- listed as landowner on this application has a significant interest in the real property described therein.This interest can be
Address 14( ( r r c 11S(3 c,.t, C., i.✓I}4-t- described as:(check one)
v :452' -firUC{- -�gZ
City Qµt ✓" State NC- Zip T bane ✓an owner or record title,Title is vested in name of rtjS-� KQu I nr,I't It IL ,
Email et
sec Deed Book /5Q9 pagefO in the <ct r-/PrLf County Registry of Deeds.
AUTHORIZED AGENT an owner by virtue of inheritance.Applicant is an heir to the estate of
Si-r ink me -e� ;probate was in County.
Name
O !� if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address . L7 f� "
CityIY\orenf'OL State NC- ZipAt557Phone a52-r,/fyci • VaK! 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
Email O.t' Vi)() ci�rt&Vl4,`t NA.,citoAett.}j f✓.>.t-:)✓}-.•-- ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) r f' (Address)
LOCATION OF PROJECT:(Address,street name and/or directions to site; erne of the adjacent waterbody.) (I) M t t-h a i 4 1Cx !t j arse_ 1'12 (a r)/�4J g a �'t'�-
ILIl (LIl.atfESC,�(t ,,. It's-Q-i �51 l.l+� (2) G< A TIC` LS�JilC1 J 13q ext.nruty$ i�y�cti-
(3)
421'if17ti:✓) l wJL (4)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) ACKNOWLEDGEMENTS:
i��_( l��j�Y r y,1_ - _ I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
`f '(L{,t J') t LhiC. !kat: P may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the jL{ tparticu-
lar
-h hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
SIZE OF LOT/PARCEL: r 't I W V square feet acres lion and floodproofing techniques.
PROPOSED USE:Residential (Single-family 0 Multi-family❑) Commcrcial/lndustriat 0 Other 0 I furthermore certify that i am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
the Local Pennit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
COMPLETE EITHER(I)OR(2)BELOW(Contact your Local Permit Officer if are not sure which AEC applies related to this permit application.
to your property):
r� .f i
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes � This the a{ day of/t1 L')(/ -•20 f
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level hut (J(�(�arr?/slr,L A tir.c..(l {p Lt C
excluding non-load-bearing attic space) Landowner or person authorized to act as his her agent for purpose of filing a CAMA permit application
OASTAL SHORELINE AECs:SiZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
II N SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks, This application includes:general information(this form),a.site drawing as described on the hack of this application,the
ownership statement,the Ocean Hav m
ant AEC Notice where necessary.a check for made payable to the locality,and
concrete or masonry patios,etc,that are within the applicable AEC.Attach your calculations with the project drawing.)
any it{formation as may be provided rnnlly by the applicant.The details of the application as described by these sources are
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in any permit which may be issued.Deviation from these details will constitute a violation of
Stormwater Management Permit issued by the NC Division of Energy.Mineral and Land Resources(DEMLR)7 any permit..4rry person developing in an AEC u ithout permit is subject to civil,criminal and admrnistrwth'e action.
.YES NO
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

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Receipts for
Certified Mail
(Staple Here)
t1 1,9.cti t�
Date
M Ci
Adjacent Property Owner
tcl0 (fit„- ,,
tvlailinn Address
V7a5C > —5c 16 �1
.
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, b'tt I t. 44k V C have applied for a CAMA Minor
Property Owner
Permit on my property at_ "1'4 k COLA n or TA-4-e- ,in @Artetti-
Property Address
County. As required by CAMA regulations,I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form.If you have any questions or comments about my proposed project,please
5in,c4,AAli Lr.Jpvs
contact me at zi S--to 4 bz;k6t ti ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
ear 4e+ -'t 0,tkt"+1tart 1.1 t
Sincerely,
N.eiilkg KOkinJtom:
Property Owner
P BOX
Mailing Address
City,State,Zip Code

112/9/4
BUJ
AP-°, 101
writ hra)1 yo2\1-11
2...c9A?
+D rr-orAitio

1A9UU1 1U lib AUS tax System Parcel Inquiry
. . •
Parcel Number R 6305.04.84.2033000 2017
*
Tax Codes District Code 1015 Taxpayer 529388
Twn / Sch 0015 DENISE I TRUSTEE KOKINCHAK
Spec Dist 31 48 110 BRIGHTON DRIVE
User Codes
Deed Book/Page 1589 490 1521 20
Plat Book/Page 30 780 AURORA OH 44202
Property Addr : House# 741
Street Name CANNONSGATE Alternate More? N
Street Type DR Dir Unit
CiStZp NEWPORT NC 28570
Escrow More? J
Legal Description
Plat Other More? N
Lot/Block
Deeded Acres .44 Previous 481939 More? N
LOT 460 PHASE 1 CANNONSGATE STREAMLINE DEVELOPERS LLC
Deed? N Values? y
Delete ? Action ?