04-24 PERQ - Lee, Albert and Cynthia

Perguimans County 04-24 PERQ
Local Government Permit Number
CAMA°``'4`'�
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environmental Quality and the
Coastal Resources Commission for development in an Area of Environmental Concern
pursuant to the Coastal Area Management Act, Section 113A-118 of the General Statutes.
Issued to Albert & Cynthia Lee, authorizing development in the Estuarine Shoreline (AEC) at 153 Tuscarora Trl., in
Hertford, as requested in the permittee's application, dated April 4, 2024, received on May 6, 2024 and received
complete on May 20, 2024. This permit, issued on June 10, 2024, 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: Installation of a poll and grading of a portion of the lot.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on May 20, 2023. [GS 113A-1201
(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. [GS 113A-1201
(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. [GS 113A-1201
(4) A copy of this permit shall be posted or available on site. Contact this office at 252-264-3901 for a final inspection at
completion of work. [GS 113A-120]
(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
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, 2027
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.
Check # 1507, in the amount of $100, was received on 517/2024 for the
permit fee.
Cynthia Rountree
Field Reoresentativ
401 So Griffin St Suite 300
Elie Beth Citv,d�1C 27909
PERMITTEE
required if conditions above apply to permit)

Name: Albert & Cynthia Lee
Minor Permit # 4.24 PERQ
Date: June 10, 2024
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 wetland or open water areas,
until such time as the area has been properly stabilized with a vegetative cover. [07H .0209(d)(3)]
(6) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of Normal Water Level,
in this case,1,538 square feet is authorized. [07H .0209(d)(2)]
(7) All development shall comply with the following mandatory standards of the North Carolina Sedimentation
Pollution Control Act of 1973: [07H .0209(d)(3)]
(8) This permit does not authorize development within any wetland or open water areas. [GS 113A-120] and [07H
.0205(d)]
SI
NtKml I I Lt
DATE:

GENERAL INFORMATION
LANDOWNER - MAILING ADDRESS
Name A tb-e� k Gzncl C v n Fn a (. (2 e
Address
20% Sc\r�
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12d.
City
State
N • C-
Zip 2't ct lq Phone ES (Auzc,O 40 1- 9141 - O oLl l
Email gd- C'^AJ - Ctndvir,eusc(, Ganccll. Cows
AUTHORIZED AGENT
Name
Address
City
State
Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
i53 Tt�scerorU Trc��( NZrk�orct Nc. �P16144
(-ok -se 28 ( ,Hte P—tuc,r o4 lle .r `cope Qd.
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) 13 wild 3 b cd.ms,
(nu.[kJ,.uJ cA-GUuwab4. yzcb" of 4 b�tr1 all o-UowahLe,
4�01 dock"5.
SIZE OF LOT/PARCEL: i5 � 6 Q 0 square feet acres
PROPOSED USE: Residential [Z' (Single-family [vT Multi -family 0) 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):
(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 IMPERVIO
UPON SURFACES: 164 square feet (includes the area of the foundation of all buildings, driveways,
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
MAY 0 0 2024
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DE R �+
YES NO +/' 9r/6'#r
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: 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, 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) C�"a 6.0V- ram
A 14
3' ti / (9a�_ eet
man owner or record title, Title is vested is name of Atbcr+ 6. f.e.c c nct Cyn+kz" U. C" 5's'5- / (.571
see Deed Book page 20 5 in the Ike r c� , County Registry of Deeds.
C P toY t3.,ow�
_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) I (Address)
h ,(1) r1i."i0 i-4 Ay ra"%L Corpara-h , 92(". `Tke- A.l et.wc i �&c"cLG ' VA 22003 C Pam{ ea�7
�(2) tithtr+ E �' eY('(.. t� i.._. (.EE. (.tl�pt'er,.,t-s1- �'IA. An0\ } e,..n� .r�,j r Ra . ra.,y Y?m
rnk(3)* S�os 2 iT i I©\ Cnr�'i C rV }}}rr44 rJ iNt a��4u 126R
(4)
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.
This the — q _rA day of rl ( 20
or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this,�Pplication, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made paya 6Ce Ri�
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 constituNAq ValaiM of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.
DCM-EC

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PARCEL IDENTIFIER:
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LITTLE RIVER SHORES, LOT 28, SECT
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Date Issued% 06/11/96 S it rs < L a-_
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CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
4 /y /aoa,4
Date
0— 1 -Foy—q A VA Corp —
Name of Adjacent Property Owner
r62t=,S
Address
Annc ,dale F VGA 22003
City, State Zip
To Whom It May Concern:
RECEIVED
MAY 0 0 2024
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit
to biuteA Gl 3 1br-Aro7urr S%ac frLw.il �\o....., 4 v\;b tl C..11o "L6 �J lkk[nd�[Ioc(c.
on my property at 163 in
County, which is adjacent to your property.
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 any questions about the
project, please do not hesitate to contact me at my address/number listed below.
If you have objections or concerns about the project, please mark the appropriate statement below and send your
correspondence to the NC Division of Coastal Management (DCM) at 401 S. Griffin St., Ste 300, Elizabeth
City, NC 27909. The staff at DCM can be reached at 252-264-3901.
A lb<r-k I C�^�k o`e l.a e.
Property Owner's Name
R>6Q
Sincerely,
40-1-A41—oo4t /q,ro-1- La-1 -GLtoS
Telephone umber
NC
a11
V I have no objection to the project described in this correspondence.
(I�haave objection(s) to the project described in this correspondence.
22q:�- 90j6?70'73
Adjacent Riparian Signature Telephone Number
Print or Type Name / Date
Irrv�
Email Address
ess city State rp

•. Complete items 1, 2, and 3.. A. Signalyri
■ Print your name and address on the reverse X C_
so that we can return the card to you. _
■ Attach this card to the backof the mailpiece, B. Received
or on the front if space permits. if i r
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❑
9590 9402 8640 3244 9665 58 11
2_Adirf9 Number _?ransferfrom _Service label) ❑
7020 2450 0001 0556 1930 ❑
PS Form 3811, July 9020 PSN 743Q-02-000-90$3
D. Is -delivery ad
If YES, enter
p Agent
Addressee
Name) ._,�_Ler_
�L2 / A
different from Item 1? ❑ Yes
�ry address below: �No
uenineo Mall Restricted Delivery 0 Signature Confirmatlon*u
Coiled on Delivery ❑ Signature Confirmation
Collect on Delivery Restricted Delivery Restricted Delivery
insured Mail
Insured Mail Restricted Delivery
e. ccnm
Domestic Return

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY RECEIVED
(Top portion to be completed by owner or their agent)
Name of Property Owner: A lbe,rk E. j Cyr\,46�o- L. xr .
Address of Property:
Mailing Address of Owner: _
MAY 2 0 2024
L
C 2--1 Iq tCI
Owner's email: ctlloerk-el (r3 &LAcJAo.Lxe Owner's Phone#: 4o l ^ q LI"1 -OOL{ I
Agent's Name: Agent Phone#: QJA
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
411— I -DO NOT have objections to this proposal. I DO have objections to this proposal.
N you have objections to what is being proposea, you musr noury me n.�. v,v.aluu v, —0-1—
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail
WAIVER SECTION (Choose only one)
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments)). (if you wish
to waive thheesse"tback, you must sign
the appropriate blank below.) Riparian
✓
I DO wish to waive some/all of the 15' setback
Signature of Adjacent iparian Property Owner
_OR -
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: 101 _LA 0 1 l o � ,
ARPO's emaily 1 U A C I I� ARPO's Phone#: 931
Date: (] I I U _ �' *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign -off by the owner on this form) or certified mail return
receipts (showing delivery of notice) are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15' setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the streettroad could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out toDCMStaff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. if the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: httos://www.sosnc.ciov/search/index/Corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR.
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised August 2022

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