05-101_Smith, Danny, Jones, Michael, & Howard, Dennis_20060131

LocalGovernment
c 1
LAMA
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"
fiber
Issued to DANNY SMITH, MICHAEL JONES & DENNIS HOWARD, authorizing development in the Ocean Hazard
(AEC) at 9309 OCEAN DR., in Emerald Isle, as requested in the permittee's application, dated NOVEMBER 10, 2005.
This permit, issued on JANUARY 31, 2006, 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: Construction of single family residence wlseptic, pool and driveway.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on January 26, 2006.
(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 252-354-3338 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. From the date of an appeal, any
work conducted under this permit must cease until the appeal is resolved. This
permit must be on the project site and accessible to the permit officer when the
project is inspected for compliance. Any maintenance work or project
modification not covered under this permit, require further written permit
approval. All work must cease when this permit expires on:
DECEMBER 31, 2009
In issuing this permit it is agreed that this project is consistent with the local land
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal
Management.
James W. Taylor
CAMA LOCAL PERMIT OFFICIAL
7500 Emerald Drive
Emerald Isle, NC 28594
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Smith/Jones/Howard
Minor Permit # 05.101
Date: 01/31106
Page 2
(5) The structure must set back a minimum of 60 feet from the first line of stable natural vegetation, as determined by
the DCM, the LPO, or other assigned agent of the DCM.
(6) The permittee Is required to contact the Local Permit Officer 252-354-3338, shortly before he plans to begin
construction to arrange a setback measurement that will be effective for sixty (60) days barring a major shoreline
change. Construction must begin within sixty (60) days of the determination or the measurement is void and must
be redone.
(7) All buildings constructed within the ocean hazard area shall comply with the NC Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage
Prevention Ordinance as required by the National Flood Insurance Program. If any provisions of the building code
or a flood damage prevention ordinance are inconsistent with any of the following AEC standards, the more
restrictive provision shall control.
(8) All buildings must be elevated on pilings with a diameter of at least 8 inches in diameter if round, or 8 inches to a
side if square; and the first floor level of the sills and Joists must meet the 100-year flood level elevation.
(9) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(10)Dune disturbances will be allowed only to the extent necessary for development and if the dune's protective value is
not weakened or reduced. Disturbed dune areas will be immediately stabilized.
(11)AII unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetatatively stabilized (planted and
mulched) within 14 days of construction completion,
(12)Any structure authorized by this permit shall be relocated or dismantled when it becomes Imminently threatened by
changes in shoreline configuration. The structurefs} shall be relocated or dismantled within two years of the time
when it becomes Imminently threatened and in any case upon its collapse or subsidence, However, if natural
shoreline recovery or beach renourishment takes place within two years of the time the structure becomes
imminently threatened, so that the structure is no longer imminently threatened, then it need not be relocated or
dismantled at that time. This condition shall not affect the permit holder's right to seek authorization of temporary
protective measures allowed under CRC rules.
(13)Pool may be placed as proposed provided no excavation to the toe of primary dune.
SIGNATURE: DATE:
PERMITTEE

: ► o x•va-zno o
Name DAMN S �t MLGI-kA�L JOhit N S OW
Address Zaw
PI City TnN State Zip Phone ?� 2-�aZ1-3232
AUTHORIZED AGENT
If : Name
Address 1310 J flu- L /�
City'��'P.}�S(.'Fr---State Zip Phone 252 -24�' i0�33
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of
If the adjacent waterbody?) 13DR er)Gs Y[L-1 Ve
�T iNTfl 1iE� 1-�,o t3 (,pik Cogsi G Rc.�i Csb Te ENO �� SZtf 7 P. Ad�D g3cx ory L.
DI
N(
Ha
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
�5�� AT7� StT,� DLAc� A40 PF-c�►'�S l.l°�`f�t�T
SIZE OF LOTIPARCEL• 101,915 square feet
PROPOSED USE: Residential ✓ (Single-family Z Multi -family
acres
_) Commerical/Industrial
Other
TOTAL ENCLOSED FLOOR AREA OF A DING IN THE OCEAN HAZARD AREA OF ENVI-
RONMENTAL CONCERN (AEC)' UH square feet (includes all floors and roof -covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUNT UPON SURFACES IN
THE COASTAL SHORELINE AREA OF ENVIRONMENTAL. CONCERN (AEC): sq. &
(Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios,
etc, that are within the applicable AEC. Attach your calculations with the project drawing.)
the AEC area that applies to your property:
(Ib$dthin 75 feet of Normal High Water for the Estuarine Shoreline AEC
(2) within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding
Resource Waters
(3) within 30 feet of the Public Trust Shoreline AEC
(Contact your Local Permit Officer if you are not sure which AEC applies to your property.)
STATE STORMWATER MANAGEMENT PERIVIIT: Is the project located in an area subject to'a
State Stormwater Management Permit issued by the N.C. Division of Water Quality?
YES NO
If yes, list the total built -upon area/impervious surface allowed for your lot or parcel. square feet.
R

l
& EIt POWITS MAY 13E Imi:OItED:'Ilse act vity you art. lttartnittg tray require pirntits other than the CAMA minor
development permit. Asa service we have compiled a list ofthe kinds ofpertnits that anigiat be requircd. Wesuggest you chec:lc over the list
with your LPO to determine ifany ofthesc apply to your projmt; Zoning, Drinking Water Will, Scl)ticTartk (or other sanitary waste
treatment system), ii uilaig, Electrical, plumbing, Heating and Air Conditioning, Insulation and EttcrU Conservation, FIA Certification,
Sand Dune, Sediment. Control, Subdivision Approval, Mobile Home PA, Approval, Highway, Connection, and otters.
STATEMENT OF OWNERSHIP: ..
1, 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 GWA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. "fins interest can be
described as: (check one)
all owner or record tide. Title is vested in Qmw SIN,
F{ � I SdV c Deed Book 2
page -9-1— in the SA--7t7t�T County Registry of Deeds.
art 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 Ie»ase, explain below or use a separate sheer and attach to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given.
ACIVAL NOTICE to each of there concerning my intent to develop this property and to apply for a LAMA permit.
(Name) (Address)
(1) %4 uggy LLr- -40!911 A W-TA f2911 ' AIZ CA C1W TQWr C 2,0 5_,,t 4
(2) DEWiTT 6 MU 2 CASCA CT Dr? C7 Q �n�513Cx2o n1C Z7 410
(3)
(f )
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I 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 particular hazard problems associ-
at a with this lot. nis explanation was accompanied by recommendations concerning stabilization and floodproofing tech-
niquo.
PERMISSION TO ENTER ON LAND:
t furthermore certify that t am authorized to grant and do in fact grant permission to the local pcnnir officer and his agents to
enter on the aforementioned lands in connection with evalwiting information related to this permit application.
'This application includes: general information (this form), a site draining as described on the back of this application, the
ownership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any infor-
mation as may be provided orally by the appucan mic details of the application as described by these sources are incogwrated
without reference in ally permit which may be issuA 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.
r day of , 2042L5
r
Landowner or person authorized to act as h'ts­�or purpose of filing a CAMA permit application.

Project Is In An: /Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Date Lot Was Platted: I q-1
This notice is intended to make you, the applicant, aware
of the special risks and conditions associated with
development in this area, which is subject to natural
hazards such as storms, erosion and currents. The rules of
the Coastal Resources Commission require that you
receive an AEC Hazard Notice and acknowledge that
notice in writing before a permit for development can be
issued.
The Commission's rules on building standards, oceanfront
setbacks and dune alteration are designed to minimize, but
riot eliminate, property loss from hazards. By ranting
permits, the Coastal Resources Commission Sloes not
if maranteethesafet of the development and assumes no
ability for future safety
to the development.
The best available information, as accepted by the Coastal
Resources Commission, indicates that the annual ocean
erp;ion rate for the area where your property is located is
feet per year.
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as
much as -15� feet I andward in a major storm.
The flood waters in major storm are predicted to be about
_Z2. feet deep in this area.
Preferred oceanfront protection measures are beach
nourishment and relocation of threatened structures.
Hard erosion control structures such as bulkheads,
seawalls, revetments, groins, jetties and breakwaters are
prohibited. Temporary devices, including sand bags, may
be allowed under certain conditions.
This structure shall be relocated or dismantled within two
years of becoming imminently threatened.
The applicant must acknowledge this information and
requirements by signing this notice in the below space.
Without the proper signature, the application will not be
complete. Kh I
Date
SPECIAL NOTE: This hazard notice is required for
development in areas subject to sudden and massive
storms and erosion. Permits issued fordevelo mentinthi
area expire on December 31 of the third year following the
' L "ar in which the permit was issued. Shortly before work
begins on the project site, the Local Permit Officer will
determine the vegetation line and setback distance at your
site.If the property has seen little changeand theproposed
development can still meet the setback requirement, the
LI'0 will inform, you that you may begin work. It is impor-
tant that you check with the LPO before the permit expires
.for official approval to continue the work after the permit
has expired. Generally, if foundation pilings have been
placed and substantial progress is continuing, permit
renewal may not be necessary. If substantial progress has
not been made, the permit must be renewed and a new
setback line established. It is unlawful to continue work
after permit expiration without this approval.
For more information, contact:
Local Permit Nicer
Local CAMA Permit Officer
Address "I -"
7500 Enwmld Drive
Locality -
, "';]? 5 2 / 3 5 4 -3 3 3 8
Phone
Revised 11193

;zEes-SyeTrm
A' APqON
FIRE�T PQU�-ARr CtNE

I of 1
05-101
TOWN OF EMERALD ISLE
7500 EMERALD DRIVE
EMERALD ISLE, NC 28594
DATE: November 18, 2005
TO: Renee, Classified
FROM: Kim Haut, Planning & Development
SUBJECT: CAMA Permit Notification
■•rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr•rrrrrrrrrr�
Please publish on Wednesday, November 23, 2005
CAMA PERMIT NOTICE
Pursuant to NCGS 113A-119(b), Emerald Isle, a locality authorized to issue
permits in Areas of Environmental Concern, through the Coastal Area
Management Agency (LAMA), hereby gives NOTICE that on November 18,
2005 Danny Smith, Michael Jones and Dennis Howard applied for a Minor
CAMA Permit to construct a single-family dwelling, driveway, and install a
septic system on a lot within the Area of Environmental Concern, at 9309 Ocean
Dr., Block 43., Lot 12 Emerald Isle.
The application may be inspected at the address below. Public comments
received by December 3, 2006 will be considered. Later comments will be
accepted and considered up to the time of permit decision. Project modifications
may occur based on further review and comments. Notice of the permit decision
in this matter will be issued upon written request.
Kim I-lubbard-l-laut
Local CAMA Permit Officer
Town of Emerald Isle
7500 Emerald Drive
Emerald Isle, NC 28594
252.354.3338

7a 4 E890 003 4770 06ub
0 2890 0003 4770, 612
a
i �"•. G7 M O
r C*
V
PROPERTY OWNTER STATEMENT
awn property adjacent to DEWITT 6 EIAL MVRP-�'s
(Name of Properly Owner)
005A4 Dig f I, ?8�9q L{3 643
(Lot, Block, Road, etc.)
in GMI D .xS1:F , N.C.
(Town and/or County)
Ls shown below, the development he is proposing at that location,
proposal.
Issue PVI: $4.42
DR DRAWING OF PROPOSED DEVELOPMENT
total: $8.84 led in by individual proposing derelopment)
)aid by,
.ash
;hange Due
$8.85
-$0.01
3111#: 1000100798593
',lerk: 01 /�"�`f GE-( q PLOT NAW N&".
- All sales final on stamps and postage. --
Refunds for guaranteed 'services only •
Thank you for your business.
Customer Copy
..... , Pit,....
P
Date: /lam
J

Dec 14 2000 2:35PM
HP LRSERJET FAX
p.2
P1
Pe
rej
Pl GENERAL INFORMATION
Name b_ A_ NN 5N11'i cl MMWAU, QMIES r DENNI SADWWR
Address Z
Pl City � imsma Stain Zip :ZB6 & Phone M-51.E-3232
AUTHORIZED AGENT
If: Name MUM- M- skZWS
Address LA
City rQ_�51z: , State Zip Phone 252'24�- (Q03'i
LOCATION OF PROJECE. (Address, street name and/or directions to site. If not oceanfront, what is the name of
If ; the adjacent watetbW.) CIOR OCAM PLa V£ �TZAA EVA -D 1519 —1651 -
J -� iNTa t)EEtz- lag)a' �oF� co s-r G 9d) Gb Tn Nn s7tAmT A Aso q3r� opt .
Dl DESCRIPTION OF PROJECT% (List all proposed construction and land discutbance.)
. �. Ee--tx.P14 MID Emamo t>Y-
SIZE OF LOTIPARCEL: I k915 square Beet acres
PROPOSED USE Residential (Single-family - Multi -family ) Commerir;alllndrutriad
Other
N( TOTAL ENCIA6ID ELOOR AREA OF A UILDING IN THE OCEAN HAZARD AREA OF ENVI-
Ha RONMENTAL CONCERN (AEC): square feet (iadudes all Hoots and roof -covered decks)
SIZE OF BUILDING FOOTPRmr AND OTnm Il4II"EBVIOUS OR BUILT UPON SURFACES IN
THE COASTAL SHORE ENE AREA OF FNVIRONhU NTAL CONCERN QWQ: sq. IL
(Calcu ations include the area of the rooYdrip line of all buildings, driveways, covered decks, concrete or masonry patios,
etm d= are within the applicable AEC. Attach your calculations with the project &mnn&)
chnnm the AEC area that applies to your proper T%
40475 feet of Normal 040k Water for the Esu adne V"cl nc AEC
(2) within 575 feet of Normal High Warcr for the Estuarine %ordine AEG adjacent to Otusrm&ng
Resource Watm
(3) within 30 feet of the Public Trust Shoreline AEC
(Contact your Local Permit Ofccr if you are not sure which AEC applies to your paoperty.)
STATE SMRMWATER PFjthM- Is the project locamd in an area subject to a
A. Stage Swmwuw Management Permit issued by the N.C. Division of Water Qt WW.
YES NO
f
l£yes, list the total built: upon area/impervious stu6ce allowed for your lot or parcel. sq= feet
R

Dec.14 R000 2:35PM HP LASERJET FAX p.3
OTHER PERMITS MAYBE : The actm7you arc planning may require permits other than the CAMA minor
dcr &pmmt permit. As a servicewe have compiled a list of the kinds of permits that nt�& be required. We suggest you check over rite lot b
with your LPO to detuminc ifany of these apply to your project Zoning. Drinking Water Wdl, SepticTank (or other saniurywaste
a mtsyatem), Building. Elo doL Plumbing, Heath g=AAirCm&tioning, InadationardFmcWConsemiwn, FIACertifica n,
Sand Dune, Sediment Control, Subdivision Approval, M&ilc Home ParkApprmL H'ighvray, Conn=m, and others
STATFIAENT 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 thL- application has a significant interest in the real property described therein. This interest can be
described as: (check one) r
✓ an owner or record tide. Title is vested in QAWq Mh 341IXmil Sed Book 112- - V
page 93 in the _C"MWT County Registry of Deeds.
r
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 and attach to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACT[IALN03TCE to racb'of.thcm concerning my intent to develop this property and to apply, for a LAMA punuit
(Nam) (Address)
W. SCA• UU1171 LL r— ATE - AR cApE CA¢ "%tom MC 285794
(2) eiAl if E MuZ9" l2 CASCADE C7 DR GfkgN-113999 , NC. Z74!O
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I admawledge 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 particular hazard problems assod-
ated with this lot This explanation was accompanied by rcaommendativns concerning stabilization and fioodproofing tech- fi
niques-
PERMMION TO ENTER ON LAND:
I furthermore certify tint I am authorized to grant and do. is faa grant permission to thelop/ permit officer and his agents to
enter on the aforementioned lands in connection with evaluating information related to this permit application.
This application includes: general information (this form), a site drawing as described on rfie back of this application, the
ownership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any infor-
mation as may be provided orally by the applicant. The details of die application as described by Luse sources are incorporated
withomt reference in any permit which may be issued. Deviation from these details will constitute a violation of my permit Any
pamon developing in an AEC witbom permit is subject to then/, criminal and administrative action.
Tit t / -
Q day of , 2042r
L
Landowner or person authorized to act as his r purpose of filing a CAMA permitapplication.

Dec.14 2�000 2:36PM HP LRSERJET FRX
p.4
AEC HAZARD NOTICE
Project Is In An: ✓ Ocean Erodible Area
Date Lot Was Platted: ( q-1
High Hazard Flood Area inlet Hazard Area
This notice is intended to make you, the applicant, aware
of the special risks and conditions associated with
development in this area, which is subject to natural
hazards such as storms, erosion and currents. The rules of
the Coastal Resources Commission require that you
receive an AEC Hazard Notice and acknowledge that
notice in writing before a permit for development can be
issued.
The Commission's rules onbuilding standards, oceanfront
setbacks and dune alteration are designed to minimiz e,but
not e]iminate, roperty loss from hazards. By granting
permits, the Coastal Resources Commission does not
guarantee the safety of the development and assumes no
liability for future damage to the development
Thebest available information, as accepted by the Coastal
Resources Commission, indicates that the annual ocean
erfr on rate for the area where your property is located is
feet per year.
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
Studies also indicate that the -shoreline could .move as
much as.50_ feet landward in a major storm.
The floodwaters in amajor storm arepredicted to be about
_02,feet deep in this area.
Preferred oceanfront protection measures are beach
nourishment and relocation of threatened structures.
Hard erosion control structures such as bulkheads,
seawalls, revetments, groins, jetties and breakwaters are
prohibited. Temporary devices, including sandbags, may
be allowed under certain conditions.
This structure shall be relocated or dismantled within two
years of becoming imminently threatened.
The applicant must acknowledge this information and
requirements by signing this notice In the below space.
Without the proper signature, the application will not be
complete. I
Date
SPECIAL NOTE: This hazard notice is required for
development in areas subject to sudden and massive
stormsand erosion. Permits issued for developmentinthis
area expire on December 31 of the third year following the
pear in which the permit was issued. Shortly before work
begins on the project site, the Local Permit Officer will
determine the vegetation line and setback distance at your
site.If thepropertyhas seen little change and theproposed
development can still meet the setback requirement, the
LPO will inform you thatyou may begin work.Itis impor-
tant that you check with the LP O before the permit expires
for official approval to continue the work after the permit
has expired. Generally, if foundation pilings have been
placed and substantial progress is continuing, permit
renewal may not be necessary. If substantial progress has
not been made, the permit must be renewed and a new
setback line established. It is unlawful to continue work
after permit expiration without this approval.
For more information, cont; id:
Local Permit Officer
Local CAMA Permit Officer
fSje
Address r
7500 Emerald Drive
Loca'iry252 /354-3338
Phone
Revised 11193

Dec.14 2D00 2:36PH HP LRSERJET FRX P.5
1 of I
05-101
TOWN OF EMERALD ISLE
7500 EMERALD DRIVE
EMERALD ISLE, NC 28594
DATE: November 18, 2005
TO: Renee, Classified
FROM: Kim Haut, Planning & Development
SUBJECT: CAMA Permit Notification
Please publish on Wednesday, November 23, 2005
CAMA PERMIT NOTICE
Pursuant to NCGS 113A-119(b), Emerald Isle, a locality authorized to issue
permits in Areas of Environmental Concern, through the Coastal Area
Management Agency (CAMA), hereby gives NOTICE that on November 18,
2005 Danny Smith, Michael Jones and Dennis Howard applied for a Minor
CAMA Permit to construct a single-family dwelling, driveway, and install a
septic system on a lot within the Area of Environmental Concern, at 9309 Ocean
Dr., Block 43., Lot 12 Emerald Isle.
The application may be inspected at the address below. Public comments
received by December 3, 2006 will be considered. Later comments will be
accepted and considered up to the time of permit decision. Project modifications
may occur based on further review and comments. Notice of the permit decision
in this matter will be issued upon written request.
Kim Hubbard -Haut
Local CAMA Permit Officer
Town of Emerald Isle
7500 Emerald Drive
Emerald Isle, NC 28594
252.354.3338

Dec.14 2,000 2:37PM HP LRSERJET FAX
PUU.'
7004 2890 0003 477a 0612
P.6
l RIAN PROPERTY OWNER STATEMENT
• • • wn property adjacent to DEWITT 6 FETAL m=Aj 's
�, • • (Name of Property Owner)
Total: $8.84
i Paid by:
I Cash $8.85
Change Due: -$0.01
Bill#; 1000100798593
Clark: 01
} — All sales final on stamps and postage. —
Refunds for .guaranteed services only.
Thank you for your business.
i Customer Copy
it
icAtJ DIZ 6 q L-13 5 93 ,
(Lot, Block, Road, etc.)
in aJuTiZAt.D .ZS& , N.C.
(Town and/or County)
shown below, the development he is proposing at that location,
proposal.
)R DRAWING OF PROPOSED DEVELOPMENT '
'ed in by individual proposing development)
A17KRED FW—t D14AW i NC>'`
8 13fatza-:M., Ii s W C,� N sliwcaf; o-4
—29—
1Y11U�� E. Jo��s
Print or Type Name
Telephone Number
Date: I/— E » 0 'r

Dec.14 2,000 2:35PM HP LASERJET FAX P.1
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