04-24 PERQ - Lee, Cynthia and Albert

Perguimans County 04.24 PERQ
Local Government Permit Number
CAMA
MINOR DEVELOPMENT x
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-120]
(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-120]
(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-120]
(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-1201
(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 q 1507, in the amount of $100, was received on 5/712024 for the
permit tee.
Cynthia Rountree
Field Reoresentati%
401 So Griffin St Suite 300
Eli . eth CitvZC 27909
PERMITTEE
required if conditions above apply to permit)

Name: Albert & Cynthia Lee
Minor Permit # 4-24 PERQ
Date: June 10, 2024
Paget
(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-1201 and [07H
.0205(d))
SIGNATUR
PERMITTEE
DATE: a�L

Locality E1'?--kx` k c: IL' (1)(-f'L"> ee!Jul ^` s 00Permit Number
Ocean Hazard Estuarine Shoreline ZORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Name At6e_rk (; C�.c4 CYt�i11i0. (. (e e-
Address 20% .Sc-,
City
State N - C-
Zip
2-1gtq Phone 9d6pug-rk)
`i9-1- 9 I -O0141
Email Ed- c lberl clG3 F2Nal
oo. C
C �`�-
Cindvlr�eusc6
Gmaii. Gowv
AUTHORIZED AGENT
Name
Address
City
State
Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
i 5 3 -ru 5 Cc r-o e-c. 0 e-,- rd tN C 2.15 44
CLolt *1= 28 (^ifllr_ (Zcocr 5t,orc.) of Qe. z "O?e- P—d.
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) Ltd 3 bcd.rns,v,
s i [sn' ( 1/ irrnG I'r15k[ U hu L"a r1 c j-c.11owa64, ve.cc" oo,;,t bwirl all &UowGbk
�b dockt.g.
SIZE OF LOT/PARCEL: 16,000 square feet acres
PROPOSED USE: Residential g (Single-family v� Multi -family Q ) 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 U,V
UPON SURFACES: 1664 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.)
MAY 0 6 2024
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 (DE'ff8I Y I _ E C
YES_ NO
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) °w° - / p"r`
a6v 141
man owner or record title, Title is vested in name of At bcrk 8. ut C nd Cy n-R%4. C. L" SSA / v 5-9
see Deed Book =} page 20 5 in the I7a rf\u nv w s County Registry of Deeds.
CPto.V
_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)
yAw(I)G1T01GcF �i Vera �r.ta. Ciro wz�-ho�t $2toS 'TI.� t.l.d.wc. 11rncnd,�� VA 22003
�(2) i.2.(. Cc,ppt;c. _,t-sl "'14 —j Ape \, h.!d..,ecnr k.ns ...., �,��,'.i1.1 14h1
nk(3)* Saw it L su 1T� I©1 i ocl�is� (� ri i fKrh{�� i)Jt 2�`�44 �A, R
(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 -r;., day of i 20
br 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'�!Vplication, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100. 00 made paya VIG&`'V
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 constitukp4'0`B'agg, of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.
Dr I —EC

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RECEIVED
MAY 2 0 2024

Pasquotank-Perquimans-Camden-Chowan District Health Department 11
—
DATE:
PARCEL IDENTIFIER:
COUNTY:
REFERENCE NUMEEfl: ..c.�+`
Alternative
PERMIT
09/06/95
D056,AO28
PERQUIMANS
12O4S IMPROVEMENT
REOUESTEE:
MILLWOOD, WILLIAM AND CATHERINE
OWNER:
MILLWOOD, WILLIAM AND CATHERINE
RT 3 BOX 458A
RT 3 BOX 458A
HERTFORD, NG 27944
HERTFORD, NC 27944
426-3039
426-3039
TELEPHONE:
LOCATIONMIRECTIONS:
LITTLE RIVER SHORES, LOT 28, SECTION A; CLITTLE RIVER DRIVE IV
GO DOWN NEW HOPE ROAD', LEFT ON LITTLE RIVER DRIVE
FEE ATE.: 6 E,R'. flEMAR
150.00 PUBLIC PRI ATE
Bill 14405
xxxx
This im NOT to be used for installation unison accompanied by a valid
permit
Authorization for Wastewater System Construction-
8 Bedrms 3 Disposal 0 S People 2 Type Bid R
Tank 1000 Line Len 90 # lines 6 Width Bot 3 MAY 0 6 2024
Size
Backfill 4.50 ft Q C M- E C
n,ur_ec
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CI'
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Date Issued: 06/11/96 1 Sanit ri -I FL r'
Date Approved �17 nature
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CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Date
C I T()Kq A VA Cn_p_
Name of Adjacent Property Owner
S21eS 11Ic M14412141
Address
IAnnc,,da.le. VA 2-2003
City, State Zip
To Whom It May Concern:
RECEIVED
MAY 0 6 2024
DCM-EC
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit
to bL4.tLct 0�- 3 X.. J t d L^&V t OLLL""Lc;
on my property at t 5 3 M atl �42 r L kurd ? N G Zn G 4 S(
jJe,r� l U✓v�Gn S County, which is adjacent to your property. 44060 ppl
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. Griffm St., Ste 300, Elizabeth
City, NC 27909. The staff at DCM can be reached at 252-264-3901.
Rt)o'e-+ 11 Cyr4�i Uet
Property Owner's Name
Sincerely,
Ikon-q4�-ooy\ /4v�-4'J1-G�foS
Telephone Kimber
Ld.er<, IJ G
_19I
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
2� 70)6?7/97_7
Adjacent Riparian Signature Telephone Number
M(cr/ae-,_ J, tl�-I r)t / y 'Zy
Print or Type Name / Date
M 1e•T I21. :M4•/ ty
Email Address
-Address rlty State ip

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER 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 l bcr-k e. � Cv r%4L a L. LA-e
Address of Property:
Mailing Address of Owner:
L Z.'
MAY
�20 2024gC
c 21 a LCI
Owner's email: CaUberkel & 3 @ cth:j eo-c&�Owner's Phone#: 401 ^ q 14'1 -Ody (
Agent's Name: Agent Phone#: Q/A
Agent's Email: N
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
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
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposea, you must nonry the n.�. uiviawn u, vvaa,a,
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
notifed by Certified Mail.
WAIVER SECTION (Choose only onel
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 the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian 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:
ARPO's Phone#: 'I j)��y .�7) )-
*
waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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