20-18 Beakerly, Terry

Locality Q.1 `.Qum Permit Number- W
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name Z74144 /Q ei4 \
�j�Address / 27Z V-e-- G/g,� 1/0/ C
City A4w�,Q-Z State � e. Zip Phone �V-" p2Q/- 6y,3i
Email
AUTHORIZED AGENT
Name �in9 / 1-� /7` 72/4;7
Address
''jam/ "tie
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City�i/ �� 1-{�. State "iye Zip./Phone
Email Q f, 7b2 fq'..�-S l.--de4/*iL• t7
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterhody.)
3 6 3 Fit,-e_lailek. Tr
bay
DESCRIPTION OF PROOJJEC/T:(List allL
proposed construction and land disturbance.) /
SIZE OF LOT/PARCEL: square feet acres
PROPOSED USE:Residential Single-family❑ Multi-family❑) Commercial/Industrial 12 Other
COMPLETE 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: 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.

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N.C. HWY.24
• GEORGE TAYLOR RD.
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VICINITY MAP
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ACREAGE
BY COORDINATE METHOD
LOT = 25512.50 SF. - 0.59 AC.
�ONC.PAD & BRICK WALK - 314.26 SF.
HOUSE = 3339.56 SF.
DRIVEWAY 2451 .83 SF.
NOTES;
HOUSE SQUIRE FEET DOESN'T INCLUDE OVERHANG
DRIVEWAY DOESN'T INCLUDE RIGHT OF WAY
SURVEY FOR
Earl and Terry Berkley

' ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to fi'R ` r I ,21A7 y s
/ Name of P y Owner)
property located at 1 I /Gv-L///`,1 e fi yod k-
(Address, Lot,Block,Rod,etc.)
on lJ�y-f n
.5;r, �� � ��i� ,, in iu ''C �&We'v 1- , N.C.
(1Naterbody) / (City/Town nd/or County)
The applicant has described to me, as shown below, the development proposed at the above
Ir)
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
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4Dt-- il."'i Z- "6-e— „i4.C 4%,,A. ('-'.-/e"(-) e e fa/
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15'from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Ad. c t P�erty O er Information)
{�.e�Y,I e. -
�� _
Si na r•e l Signature*
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Print S V)'-- Nara 2 PrintTy /NQama 7 lit,A
Mailin Address Mailing Address'
tA��v1 �t'C- S)D Ai tuPOk NC ZSs5-70
City/ tate t City,/sfate
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Telephone Number/email address Telephone Number/email address
a- I �. -I Aaf3
Date Date*
(Revised Aug.2014)
"Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT/
I hereby certify that I own property adjacent to- f2 y � .1 J
.,( / ee 1
,"/� c 's
/ of Property Owner)
property located at -?/ _j �j/�.- L_ Name �/��
eT7' c (Address, Lot Bloc R ad,etc.)
on 7 d .>��ti . ,in A -- �;? -l-.C'. �i(7 trii?e'9, N.C.
6 (Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
�f I have no objection to this proposal.
/� I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
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Ac, L (,v;fL nc4/Q-,L.. Ge71-u/eer1-)
/I i.� v e 15(..,/e1 ei L © n/ -7
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WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15'from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Q ner Information) 1 (AdjacenttPPro _ rty Owner-Information)
Jy'p� 1l //��
Signature_ Sigr:attn•e**
ark ct «11 �k /i - Nico MONfb'54AJd
Print or Type Name Print or Type Nam
_ h.3 .atii 2'-tin 351 73AY/ , y
Mailing Address Mailitpo Address
City/State/Zip City/State/Zip
a`7II- in332 25-Z- 7z‘-6"s 9
Telephone Number/email address Telephone Number/e ail address
a- ► a l y Z- 5 -/J Date
vate
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home 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 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 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 jR R ,i. L wj,4/„4 v
see Deed Book _�/ page 9c in the/ 414 eie - County R%gistry 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:
1 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)
(2) 10
(3)
(4)
ACKNOWLEDGEMENTS:
1,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. �J
This the G.P day of 'JJTh,20 I�1
r
1
Lan ner or person authorized actact as agent for purpose of filing a CAMA permit ap
plication
This application includes:general information(this form),a site drawing as described on the back of this application,the
ownership statement,the Ocean Hazard AEC Notice where necessary,a check for$100.00 made payable to the locality,and
any information as may 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 will constitute a violation of
any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.