HomeMy WebLinkAbout76834A_Smith, Gerry & Barbara_20200812/CAMA / -/DREDGE & FILL "Ili ' 1 6 ` i A (9/ B C D
-. GENERAL PERMIT Previous permit #
1 �!`Vew Modification - Complete Reissue . Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
-Rules attached.
4pplicant Name _.Jecr1_Y_ 'a' 13c4c,,
4ddress 1 _� 3 Lov 1 `J-
city c. _ c?s�State.N_C_ ZIP 2}hI _--
Project Location: County LC_ -_
Street Address/ State Road/ Lot #(s)
phone # 55_- S-fizS E-Mail ►3cr&c,c f���-+v.-b-fru-co^ Subdivision
4uthorized Agent __e
_
_��a �. — -..
City C;+ �J — --- ZIP 2 ?Ta j _ --
CW
�
APTA As PTS
Phone # ( )__._... River Basin
° -
te
4ffeded _ oEn
4EC s : -
_- HH1F
_ 1H usA
Adj. Wtr. man kn)
I Body_���h _ �•Vd - - --fit
PWS:
1
PHA
/
Closest Mal. Wtr. Body -
TRW: yes / r�i
yes
Type of Project/ Activity 2, I r lAn 4 Qd P�� ,ter.; ,c/ �c �16' �I sari r tX Ib C4%1 dre_ N"'.i,. A�
f1tx2n Rl 4 , (( 1� 1 1.! d U lD�t iN�( �. �4:n1 (Scale: A)TS
Pier (dock) length _�' V tVq _ y
Fixed Platforms) JC'c 11, 16 , 16r � �� (ALLof
�< �GtO
Platform(s) _I? 6' ..�. I
Finger Pier(s)-
Groin length
number
Ikhe Riprap length
avg distance offshore
max distance offshore J - Pro'7'
Basin, channel _ - j -- ajL
cubic yards
Boat ramp �:Ic n/ 'w ,+
Boathouse�1
Beach Bulldozing f1t�t'L{�l (,'� Jf6f(' Itcr Y \ �' o %� • su
Other I CKIG' JfYda.,.. vlo4tt . Pr.t";1aJ hlk►O ems' . . `.gi
Shoreline Length _ .- •Z .� iLt4t
SAV: not sure yes (� �� ��—k �t
Moratorium:
Photos: no
Waiver Attached: no
A building permit may be required by: r See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions kl,.'s Rv 't' a44 o Z She u.-� ��• 'I i�� S! %s dl� C6- ��u�� % 7�
vcwll` 2 �uLv 1 e _ 1 �r Sn..: ►^ ! %tar% _ _ . . t, --
Agent or ppl' Primed Name Permit Officer's Printed Name
�c
Signature Please read compliance statement on back of permit Signature
Application Feels) Check # Issuing Date
Expiration Date
Received
41-
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION JUL W2020
DCM-EC
Name of Property Owner Requesting Permit: 0 "ati
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
N' � . C
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at f J3
inaMiYe-l? County.
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. ''1�
Print or Type Name
Title
�l �>2r
Date
This certification is valid through
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • REJURN MCEIRT REQUESTED or HAND DELIVERED
Name of Property
Address of Proper
6_+ t "/ G)" I
Agent's Name #: Mating Address-
• Agent's phone #: _ e 1l j r - -
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 f is or drawing with dimensions must be provided v+tfi this fetter.
I have no objections to this proposal. I have objections to this proposal.
If you here objections to what is being proposed, you must notify the Division of Coast&/ Management
(DCAtj in writing within 10 days of receipt of this notice. Correspondence should be malted to 401 S.
GrMiM St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contactedat(252) 264-
3901. )(b_ gponse is considered the same as no objection if you have been notlRed by Cet ftdMall.
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.)
��l do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
"formati
nature
r2g 4?4e Print oName
Mailing Address
�/UZ
c/ry/stat&rzP
Telephone Number / ErnaN A ss e, ear»
Date
'Valid for one calendar year after signature`
3
( ce Pro t?wner l fortnat{on}
1
Sature te
Pratt or Type Name
1( )�q )\0 Pi JD Cq is pt-)
Mailing Address
itylstoftwo
2� 4?03 ee �e 5--_O� ^ m>�ek�Nfj, l4�6
Telephone Number / Emad Address eo
/S
Date •
Revised Jan. 2017
T /T d 4QQ%&A9.f Cd
7nTAU7C N'"n7UM Q7,,t1rW TC:CT n?A7-9A'6MJ
ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent tott •? rr % T'y1 's
(Name of Property Owner)
property located at 3 3 CO pK,s Lc.r� ( i .ac, 12e O tit
�� ��� Address, Lot, Block, Road, etc.)
on 0�uI��� , in _ N.C.
{ aterbody) (Town and/or ounty)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
A�&J,k S
It,
S�igfnature j
(Y� NSF160 SONS, t.tG ( e •a�'s*}
Print or Type Name
?sr- 311-Alt
Telephone Number
C) _
Date
.� o Received
JUI 27
DCM-EC
M
Received
P, 7
' e- V---s- .o
Received
J
PJ*,s
btz--\ow•
V o
J ( J 1 2 7 'r' -,1
DCM-EC
LISA S. ANDERSON
Tax Administrator
landerson0camdencountvnc.gov
guar
Pin#-V3 - V- Coco
BOARD Of COMMISSIOMRS
G. TOM WHITE, Chairrmip :
CLAYTON D. RIGGS, Vice ChaUMaTI
GARRY W, %1FIGCS
RANDY KRAINIAK
ROSS B. NAUNRO
399-93c�
aAA
Congratulations on your recent purchase of real property. We extend our invitation to you to contact us
help.
or visit our office if you have any questions regarding your new property. In turn, we need your
North Carolina law requires that each county conduct a sales -assessment ratio study measuring the
sales price of real property in relation to the county's appraised value. This is used to determine
equitable assessment of all properties.
Please complete the questions below and return it within ten (10) days. This information will be
confidential and not open to the general public. Please contact my office at (252)338-1919 Ext. 225 ?if
you have any questions. Thank you for your assistance.
Sincerely
Lisa S. Anderson
Tax Administrator
Camden County
including down $-Q-Lp coo
1. Total purchase price payment:
2. Was the property financed by a lending institution for owner financed or by a cash
transaction ? (Please mark the appropriate space.)
3. Was there a land trade or any other personal property other than Land and buildings included in
e, furniture, machinery, livestock, etc.). If yes,
the sale price? (Mobile home, _Yes ---wKo
Value of trade— Cost of personal property
4. Was the sale between relatives or related companies? Yes o If yes, please
explain:
5. Do you consider the purchase price to be market value? es No If no please
explain:
purchased at a public auction (Result of
6. Was the prope� foreclosure, bankruptcy,etc)?
Yes No.
7. property type at the time of purchase? Residential/Land Vacant ResidentiaLfHouse t-'�
Commercial/Land Vacant Commercial/Building— Farmland Woodland
8, Were there any improvements made to the property prior to the sale? YesW If Yes,
please explain
n,"37) -
9. Please provide a contact number and name:
P. 0. Box 125 ♦ 117 North 343 ♦ Camden, North Carolina 27921 ♦ Telephone (252) 338-1919 4 Fax (252) 333-1603
www.camdencountync.gov
NFIP Policy Number: 0020199850 WIN
Company Policy Number: FL110020199850
Agent: MARK E TILLETT
off
NORTH CAROLINA FARM BUREAU MUTUAL INS CO
PO BOX 1592 Policy Term: 05/15/2020 12:01 AM through 05/15/2021 12:01 AM
RIDGELAND, MS 39157 Renewal Billing Payor: INSURED
To report a claim https://sfb.managemyfloodpolicy.Gom
Agent Phone: (252) 449-2109 visit or call us at: (800) 647-8052
REVISED FLOOD INSURANCE POLICY DECLARATIONS
STANDARD POLICY - DWELLING FORM
DELIVERY ADDRESS INSURED NAME(S) AND MAILING ADDRESS
GARRY SMITH / BARBARA SMITH
WELLS FARGO BANK NA #936 131 COOKS LANDING RD
ISAOA
P O BOX 100515
FLORENCE, SC 29502-0515
COMPANY MAILING ADDRESS
SFB INSURANCE PROGRAMS
PO BOX 912519
DENVER, CO 80291-2519
Refer to www.fama.gov/costof-flood for more information about flood risk and policy rating.
RATING INFORMATION
ORIGINAL NEW BUSINESS DATE: 05/15/2020
REINSTATEMENT DATE:
N/A
BUILDING OCCUPANCY:
SINGLE FAMILY
CONDOMINIUM INDICATOR:
NOT A CONDO
NUMBER OF UNITS:
N/A
PRIMARY RESIDENCE:
YES
ADDITIONS/EXTENSIONS: N - NO ADDITIONS/EXTENSIONS
BUILDING TYPE: ONE FLOOR
BASEMENT/ENCLOSUREICRAWLSPACE TYPE: ENCLOSURE WITH PROPER OPENINGS
MORTGAGEE / ADDITIONAL INTEREST INFORMATION
FIRST MORTGAGEE: WELLS FARGO BANK NA #936 ISAOA
P O BOX 100515 FLORENCE, SC 29502-0515
SECOND MORTGAGEE:
ADDITIONAL INTEREST:
DISASTER AGENCY:
PREMIUM CALCULATION —
CAMDEN, NC 27921-9643
PROPERTY LOCATION
131 COOKS LANDING RD
CAMDEN, NC 27921-9643
DESCRIPTION: N/A
DATE OF CONSTRUCTION:
COMMUNITY NUMBER:
COMMUNITY NAME:
CURRENT FLOOD ZONE:
GRANDFATHERED:
FLOOD RISK/RATED ZONE:
07/07/2011
370042 8943 K REGULAR PROGRAM
CAMDEN COUNTY
AE
NO
AE
ELEVATION DIFFERENCE: 9
ELEVATED BUILDING TYPE: ELEVATED
LOAN NO: 0603876962
LOAN NO: N/A
LOAN NO: N/A
CASE NO: N/A
DISASTER AGENCY:
Standard
COVERAGE DEDUCTIBLE BASIC COVERAGE BASIC RATE ADDT COVERAGE ADD-L RATE DED. DISCOUNT/SURCHARGE PREMIUM
BUILDING $150,000 $1,250 $60,000 0.310 $90,000 0.080 ($5.00) $253.00
CONTENTS $15,000 $1,250 $15,000 0.380 $0 0.120 ($1.00) $56.00
Coverage limitations may apply. See your policy form for details.
Endorsement Effective Date: 07/01 /2020
ENDORSEMENT PREMIUM: $0.00
IN WITNESS WHEREOF, we hhaave ssiig'ned this policy below and hereby enter into this insurance agreement.
ANNUAL SUBTOTAL:
$309.00
INCREASED COST OF COMPLIANCE:
$8.00
COMMUNITY RATING DISCOUNT: 15%
($48.00)
RESERVE FUND ASSESSMENT: 18.0%
$48.00
PROBATION SURCHARGE:
$0.00
ANNUAL PREMIUM:
$317.00
HFIAA SURCHARGE:
$25.00
FEDERAL POLICY SERVICE FEE:
$50.00
TOTAL:
$392.00
PRORATA PREMIUM ADJUSTMENT:
$0.00
ADJUSTED ANNUAL PREMIUM:
$392.00
Shawn Harding / President Phillip Jake Parker / Secretary Zero Balance Due - This Is Not A Bill
This declarations page along with the Standard Flood Insurance Policy Form constitutes your flood insurance policy.
We appreciate the opportunity to service your flood insurance needs.
Southern Farm Bureau Casualty Ins. Co. (NAIC 18325)
IIIIIIIIIIIIIIJill III Jill File: 16587040 Page 1 of IIIjIIIIIII�IIflIIjIInNIIIj DocID: 133943726
PRIVACY NOTICE
THE NORTH CAROLINA FARM BUREAU INSURANCE COMPANIES COMMITMENT TO PRIVACY
At the North Carolina Farm Bureau Insurance Companies, maintaining our policyholders trust and confidence is a high priority.
The information you provide to us is critical to providing superior products and service to you. That is why we want our
policyholders to understand how we protect your privacy when we collect and use information about you, and the measures we
take to safeguard the information you share with us. To help you understand how we protect your personal information, this
Privacy Notice describes our current privacy policy and privacy practices. During the continuation of your relationship with the
North Carolina Farm Bureau Insurance Companies and any affiliates, we will advise you of our privacy policy and privacy
practices at least once annually, as required by law.
OUR SECURITY PROCEDURES THAT PROTECT POLICYHOLDER INFORMATION
We have and maintain strict policies and procedures to protect the confidentiality of your information during all stages of your
relationship with the North Carolina Farm Bureau Insurance Companies. We use technology to manage and maintain customer
information more effectively so that we may offer various insurance products and services to our policyholders. We maintain
physical, electronic and procedural safeguards to protect your personal information from unauthorized access and anticipated
threats or hazards. Access to your information by employees and other authorized representatives is restricted to those
individuals having a legitimate business need for such information. We do not sell a list of our policyholders, nor do we disclose
policyholder information to marketing companies outside our company, with the exception of companies we may hire to provide
specific services for us, which must also contractually agree to our privacy policy with respect to handling information about our
policyholders.
INFORMATION WE MAY COLLECT AND USE
We collect personal information about you in order to provide, administer and service insurance products and services. The
risk appraisal process involved in the business of insurance makes it critical for us to ask for and collect information from you
and about you. We could not do our job without it. The type of information we collect depends on the products and services
you are interested in and whether you are the proposed insured. For example, we may collect identifying information such as
your name, address, and telephone number, and we may collect other personal information such as your motor vehicle driving
record and credit history, depending upon the type of policy you apply for.
We may gather information from you in the application or claim form, electronically, by telephone, or in writing. We may also
acquire information about you from other sources; such as, medical professionals and consumer reporting agencies. While
most information is collected at the time of application or claim, additional information may be required if you request changes to
your policy or other service. We also record personal information from your transactions with us, such as information about your
insurance policies, premiums and claims.
INFORMATION WE MAY DISCLOSE
The North Carolina Farm Bureau Insurance Companies regard all your personal information as confidential. However, in the
course of conducting our business, there are circumstances in which we may disclose to other parties information we have
about you. These disclosures are only made as permitted by law; such as, disclosures to reinsurers, administrators,
consultants and regulatory or governmental authorities. In addition, your Farm Bureau agent, and other Farm Bureau personnel
authorized to assist your agent, have access to the personal information needed to administer your business and provide
services to you. They may also use this information to advise you of additional insurance products and services offered within
the family of Farm Bureau companies and its affiliates.
Periodically, we may work with entities outside the Farm Bureau companies to help us develop our products, services, computer
systems and marketing approaches. As permitted by law, we may share with such entities certain identifying and non -medical
information, as described in this notice. Whenever we hire other non-affiliated parties to help assist us in our business, we
require them to maintain the confidentiality of your personal information and abide by all applicable privacy laws. Entities with
which we share personal information are required to maintain the confidentiality of that information. We do not authorize these
parties to use or disclose your personal information for any purpose other than for the work they are performing on our behalf or
as required by law.
The North Carolina Farm Bureau Insurance Companies do not sell, rent or disclose any of your personal information, other than
as previously noted. Should your valued relationship with our company end, we will continue to limit any disclosures of your
personal information in accordance with our stated privacy policy and practices just as we would if you continued to be a
policyholder with our company.
This Privacy Notice describes the privacy policy and practices of The North Carolina Farm Bureau Insurance
Companies in accordance with the Gramm -Leach -Bliley Act, 15 U.S.C. 6801, and with various state -specific
privacy/financial information laws and regulations in the states in which our companies are licensed to sell insurance.
This notice applies to the following North Carolina Farm Bureau Insurance Companies: North Carolina Farm Bureau
Mutual Insurance Company and Farm Bureau Insurance of N.C., Inc. Direct inquiries concerning this Privacy Notice to
North Carolina Farm Bureau Insurance Companies, P.O. Box 27427, Raleigh, NC 27611.
IIIIIIIIIIIIIIIIIIIIIIIII File: 16587040 Page 2of2 DOCID: 133943726
NFIP Policy Number: 0020199850 p Sm
Company Policy Number: FL110020199850
Agent: MARK E TILLETT
NORTH CAROLINA FARM BUREAU MUTUAL INS CO
PO BOX 1592 Policy Term: 05/15/2020 12:01 AM through 05/15l2021 12:01 AM
RIDGELAND, MS 39157 Renewal Billing Payor: INSURED
To report a claim https://sfb.managemyfloodpolicy.com
Agent Phone: (252) 449-2109 visit or call us at: (800) 647-8052
REVISED FLOOD INSURANCE POLICY DECLARATIONS
STANDARD POLICY - DWELLING FORM
DELIVERY ADDRESS
GARRY SMITH / BARBARA SMITH
131 COOKS LANDING RD
CAMDEN, NC 27921-9643
COMPANY MAILING ADDRESS
SFB INSURANCE PROGRAMS
PO BOX 912519
DENVER, CO 80291-2519
Refer to www.fema.gov/costof-flood for more information about flood risk and policy rating.
RATING INFORMATION
ORIGINAL NEW BUSINESS DATE: 05/15/2020
REINSTATEMENT DATE:
N/A
BUILDING OCCUPANCY:
SINGLE FAMILY
CONDOMINIUM INDICATOR:
NOT A CONDO
NUMBER OF UNITS:
N/A
PRIMARY RESIDENCE:
YES
ADDITIONS/EXTENSIONS: N - NO ADDITIONS/EXTENSIONS
BUILDING TYPE: ONE FLOOR
BASEMENT/ENCLOSURE/CRAWLSPACE TYPE:. ENCLOSURE WITH PROPER OPENINGS
MORTGAGEE / ADDITIONAL INTEREST INFORMATION
FIRST MORTGAGEE: WELLS FARGO BANK NA #936 ISAOA
P 0 BOX 100515 FLORENCE, SC 29502-0515
SECOND MORTGAGEE:
ADDITIONAL INTEREST:
DISASTER AGENCY:
PREMIUM CALCULATION —
INSURED NAME(S) AND MAILING ADDRESS
GARRY SMITH / BARBARA SMITH
131 COOKS LANDING RD
CAMDEN, NC 27921-9643
PROPERTY LOCATION
131 COOKS LANDING RD
CAMDEN, NC 27921-9643
DESCRIPTION: N/A
DATE OF CONSTRUCTION:
07/07/2011
COMMUNITY NUMBER:
370042 8943 K REGULAR PROGRAM
COMMUNITY NAME:
CAMDEN COUNTY
CURRENT FLOOD ZONE:
AE
GRANDFATHERED:
NO
FLOOD RISK/RATED ZONE:
AE
ELEVATION DIFFERENCE:
9
ELEVATED BUILDING TYPE:
ELEVATED
LOAN NO: 0603876962
LOAN NO: N/A
LOAN NO: N/A
CASE NO: N/A
DISASTER AGENCY:
Standard
COVERAGE DEDUCTIBLE BASIC COVERAGE BASIC RATE ADD'L COVERAGE ADD'L RATE DIED. DISCOUNT/SURCHARGE PREMIUM
BUILDING $150,000 $1,250 $60,000 0.310 $90,000 0.080 ($5.00) $253.00
CONTENTS $15,000 $1,250 $15,000 0.380 $0 0.120 ($1.00) $56.00
Coverage limitations may apply. See your policy form for details.
Endorsement Effective Date: 07/01/2020
ENDORSEMENT PREMIUM: $0.00
IN WITNESS WHEREOF, we have signed this policy below and hereby enter into this insurance agreement.
; - 4W1 _ _ -
ANNUAL SUBTOTAL:
$309.00
INCREASED COST OF COMPLIANCE:
$8.00
COMMUNITY RATING DISCOUNT: 15%
($48.00)
RESERVE FUND ASSESSMENT: 18.0%
$48.00
PROBATION SURCHARGE:
$0.00
ANNUAL PREMIUM:
$317.00
HFIAA SURCHARGE:
$25.00
FEDERAL POLICY SERVICE FEE:
$50.00
TOTAL:
$392.00
PRORATA PREMIUM ADJUSTMENT:
$0.00
ADJUSTED ANNUAL PREMIUM:
$392.00
Shawn Harding / President Phillip Jake Parker 'Secretary Zero Balance Due - This Is Not A Bill
This declarations page along with the Standard Flood Insurance Policy Form constitutes your flood insurance policy.
We appreciate the opportunity to service your flood insurance needs.
Southern Farm Bureau Casualty Ins. Co. (NAIC 18325)
IIIIIIIIIIIIII IIIIIIIIIII File: 16587040 Page 1 of Dil 133943726
PRIVACY NOTICE
THE NORTH CAROLINA FARM BUREAU INSURANCE COMPANIES COMMITMENT TO PRIVACY
At the North Carolina Farm Bureau Insurance Companies, maintaining our policyholders trust and confidence is a high priority.
The information you provide to us is critical to providing superior products and service to you. That is why we want our
policyholders to understand how we protect your privacy when we collect and use information about you, and the measures we
take to safeguard the information you share with us. To help you understand how we protect your personal information, this
Privacy Notice describes our current privacy policy and privacy practices. During the continuation of your relationship with the
North Carolina Farm Bureau Insurance Companies and any affiliates, we will advise you of our privacy policy and privacy
practices at least once annually, as required by law.
OUR SECURITY PROCEDURES THAT PROTECT POLICYHOLDER INFORMATION
We have and maintain strict policies and procedures to protect the confidentiality of your information during all stages of your
relationship with the North Carolina Farm Bureau Insurance Companies. We use technology to manage and maintain customer
information more effectively so that we may offer various insurance products and services to our policyholders. We maintain
physical, electronic and procedural safeguards to protect your personal information from unauthorized access and anticipated
threats or hazards. Access to your information by employees and other authorized representatives is restricted to those
individuals having a legitimate business need for such information. We do not sell a list of our policyholders, nor do we disclose
policyholder information to marketing companies outside our company, with the exception of companies we may hire to provide
specific services for us, which must also contractually agree to our privacy policy with respect to handling information about our
policyholders.
INFORMATION WE MAY COLLECT AND USE
We collect personal information about you in order to provide, administer and service insurance products and services. The
risk appraisal process involved in the business of insurance makes it critical for us to ask for and collect information from you
and about you. We could not do our job without it. The type of information we collect depends on the products and services
you are interested in and whether you are the proposed insured. For example, we may collect identifying information such as
your name, address, and telephone number, and we may collect other personal information such as your motor vehicle driving
record and credit history, depending upon the type of policy you apply for.
We may gather information from you in the application or claim form, electronically, by telephone, or in writing. We may also
acquire information about you from other sources; such as, medical professionals and consumer reporting agencies. While
most information is collected at the time of application or claim, additional information may be required if you request changes to
your policy or other service. We also record personal information from your transactions with us, such as information about your
insurance policies, premiums and claims.
L` 1 �•I d , ; Ict i [•1:1'.'t � : I_\ L�16�•�•�9 d
The North Carolina Farm Bureau Insurance Companies regard all your personal information as confidential. However, in the
course of conducting our business, there are circumstances in which we may disclose to other parties information we have
about you. These disclosures are only made as permitted by law; such as, disclosures to reinsurers, administrators,
consultants and regulatory or governmental authorities. In addition, your Farm Bureau agent, and other Farm Bureau personnel
authorized to assist your agent, have access to the personal information needed to administer your business and provide
services to you. They may also use this information to advise you of additional insurance products and services offered within
the family of Farm Bureau companies and its affiliates.
Periodically, we may work with entities outside the Farm Bureau companies to help us develop our products, services, computer
systems and marketing approaches. As permitted by law, we may share with such entities certain identifying and non -medical
information, as described in this notice. Whenever we hire other non-affiliated parties to help assist us in our business, we
require them to maintain the confidentiality of your personal information and abide by all applicable privacy laws. Entities with
which we share personal information are required to maintain the confidentiality of that information. We do not authorize these
parties to use or disclose your personal information for any purpose other than for the work they are performing on our behalf or
as required by law.
The North Carolina Farm Bureau Insurance Companies do not sell, rent or disclose any of your personal information, other than
as previously noted. Should your valued relationship with our company end, we will continue to limit any disclosures of your
personal information in accordance with our stated privacy policy and practices just as we would if you continued to be a
policyholder with our company.
This Privacy Notice describes the privacy policy and practices of The North Carolina Farm Bureau Insurance
Companies in accordance with the Gramm -Leach -Bliley Act, 15 U.S.C. 6801, and with various state -specific
privacy/financial information laws and regulations in the states in which our companies are licensed to sell insurance.
This notice applies to the following North Carolina Farm Bureau Insurance Companies: North Carolina Farm Bureau
Mutual Insurance Company and Farm Bureau Insurance of N.C., Inc. Direct inquiries concerning this Privacy Notice to
North Carolina Farm Bureau Insurance Companies, P.O. Box 27427, Raleigh, NC 27611.
IIIIIIIIIIIIIIIIIIIIIIIII File: 16587040 Page 2of2 DOCID: 133943726
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