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HomeMy WebLinkAbout20041307 Ver 1_COMPLETE FILE_20040805Hand Wanagement Group, Inc. Environmenta(Consuftants Post Office Box 2522 WiCmin? ton, North CaroCna 28402 ?IeTephone: 910-452-0001 Main Office. Suite 15 Downey Branch Office (Park 3805 WrightsWkAvenue WiCmington, 9VC 28403 Ms. Cyndi Karoly Division of Water Quality, 1650 Mail Service Center Raleigh, NC, 27699-1650 f!(f cop;01 O? (Branch Office. ?+ P. O. Box 1120 041307 504 Croatan Street Wanteo, 9VC 27954 Phone. 252-473-3400 August 3, 2004 WETLANDS 1401 GROUP 401/Wetlands Unit AUG 0 5 2004 WATER QUALITY SECTION Re: 401 Water Quality/Nationwide #18 Permit Application 1144 N. Anderson Blvd., Topsail, Pender County Dear Ms. Karoly, Please find enclosed a 401Water Quality permit application for development of the lot at 1144 N. Anderson Blvd., Topsail Beach. The property is a single-family residential lot which abuts Topsail Sound. The applicant proposes to construct a home and associated driveway. An on-site wastewater system and part of a dirt driveway currently exist onsite. The lot is located on an old dune/swale system. Non-coastal wetlands are located within the swales which are 2'-3' below the adjacent upland (former dunes). These swales are largely unvegetated. The applicant requests to fill approximately 600 sq.ft. of one swale in order to construct the home. This impact is covered under a Nationwide No. 18 Permit (minor discharge) request. Rip rap is requested just landward of the coastal marsh to retain the requested fill material. No impacts to coastal wetlands are being proposed. Two (2) copies of the complete application package are enclosed. If you would like to discuss this application, please do not hesitate to call. Sincer ly C aura Stasavich Environmental Scientist Office Use Only: 04 130 7 Foam Version April 2001 USACE Action ID No. DWQ No. If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than leaving the space blank. I. Processing WETLANDS/ 401 (3 )ROi.lP 1. Check all of the approval(s) requested for this project: ? Section 404 Permit AUG 0 5 2004 ? Section 10 Permit X 401 Water Quality Certification WATER QUALITY SECTION ? Riparian or Watershed Buffer Rules 2. Nationwide, Regional or General Permit Number(s) Requested: 18 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: ? 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII - Mitigation), check here: ? H. Applicant Information 1. Owner/Applicant Information Name: Mr Bailey Jacobs Mailing Address: P.O. Box 2846 Surf City, NC 28445 Telephone Number: 910-262-5319 Fax Number: E-mail Address: 2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached if the Agent has signatory authority for the owner/applicant.) Name: Laura Stasavich Company Affiliation: Land Management Group, Inc Mailing Address: P.O. Box 2522 Wilmington NC 28402 Telephone Number: 910-452-0001 Fax Number: 910-452-0060 E-mail Address: Istasavich@lmgroup.net Page 3 of 11 ]II. Project Information Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and development plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes, the USACE. requires information to be submitted on sheets no larger than 11 by 17-inch format; however, DWQ may accept paperwork of any size. DWQ prefers full-size construction drawings rather than a sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final version is illegible, the applicant will be informed that the project has been placed on hold until decipherable maps are provided. 1. Name of project: 1144 Anderson Blvd. 2. T.I.P. Project Number (NCDOT Only): N/A 3. Property Identification Number (Tax PIN): 05648 4. Location County: Pender Nearest Town: Surf City Subdivision name (include phase/lot number): N/A Directions to site (include road numbers, landmarks, etc.): From Wilmington US I ig_hway 17 north past Ogaden Continue to HWY 50. Right onto HWY 50 South Lot is approximated 5 mi on right Existing dirt drive. 5. Site coordinates, if available (UTM or Lat/Long): Latitude: 34.3785°N, Longitude 77.6137 °N' (Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the coordinates for each crossing of a distinct waterbody.) 6. Describe the existing land use or condition of the site at the time of this application: Tract owned by Mr Jacobs and is zone for residential development. 7. Property size (acres): 8. Nearest body of water (stream/river/sound/ocean/lake): ICW (Topsail Sound) 9. River Basin: Cape Fear River Basin (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at http://h2o.e-tir.state.nc.us/admin/maps/.) Page 4 of 11 10. Describe the purpose of the proposed work: Fill 613 ft2 (0 014ac.) of 404 wetlands to allow for construction of single family residence and driveway. 11. List the type of equipment to be used to construct the project: Front end loader and dump 12. Describe the land use in the vicinity of this project: Residential IV. Prior Project History If jurisdictional determinations and/or permits have been requested and/or obtained for this project (including all prior phases of the same subdivision) in the past, please explain. Include the USACE Action ID Number, DWQ Project Number, application date, and date permits and certifications were issued or withdrawn. Provide photocopies of previously issued permits, certifications or other useful information. Describe previously approved wetland, stream and buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project, list and describe permits issued for prior segments of the same T.I.P. project, along with construction schedules. V. Future Project Plans Are any additional permit requests anticipated for this project in the future? anticipated work, and provide justification for the exclusion of this work application: VI. Proposed Impacts to Waters of the United States/Waters of the State It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to wetlands, open water, and stream channels associated with the project. The applicant must also provide justification for these impacts in Section VII below. All proposed impacts, permanent and temporary, must be listed herein, and must be clearly identifiable on an accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a delineation map, whether or not impacts are proposed to these systems. Wetland and stream evaluation and delineation forms should be included as appropriate. Photographs may be included at the applicant's discretion. If this proposed impact is strictly for wetland or stream mitigation, list and describe the impact in Section VIII below. If additional space is needed for listing or description, please attach a separate sheet. If so, describe the from the current Page 5 of 11 1. Wetland Impacts Wetland Impact Area of Located within -year 100-year Distance to *** Site Number Type of Impact* Impact odplai Nearest Stream Type of Wetland (indicate on map) (acres) ( ) (linear feet) 1 trench and 0 014 Yes -700' Unvegated freshwater backfill . swale * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, ills, excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding. ** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps (FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or online at httn://v.T.,w.f ma..ov. *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) List the total acreage (estimated) of existing wetlands on the property: 0.04ac freshwater, 0.27ac coastal marsh Total area of wetland impact proposed: 0.014 ac to freshwater swale 2. Stream Impacts, including all intermittent and perennial streams N/A Stream Impact Site Number (indicate on map) Type of Impact* Length of Impact (linear feet) Stream Name** Average Width of Stream Before Impact Perennial or Intermittent? (please specify) List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap, dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain), stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included. Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest downstream named stream into which it flows. USGS maps are available through,the USGS at 1-800-358-9616, or online at www.usas.aov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com, wvwv.mapquest.com, etc.). Cumulative impacts (linear distance in feet) to all streams on site: N/A 3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any other Water of the U. S. N/A Open Water Impact Area of Name Wate Type of Waterbody Site Number Type of Impact* Impact e) applicable) ( ap (lake, pond, estuary, sound, (indicate on map) (acres) bay, ocean, etc.) * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: till, excavation, dredging, flooding, drainage, bulkheads, etc. Page 6 of 11 4. Pond Creation If construction of a pond is proposed, associated wetland and stream impacts should be included above in the wetland and stream impact sections. Also, the proposed pond should be described here and illustrated on any maps included with this application. Pond to be created in (check all that apply): ? uplands ? stream ? wetlands Describe the method of construction (e.g., dam/embankment, excavation, installation of draw-down valve or spillway, etc.): N/A Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond, local stormwater requirement, etc.): N/A Size of watershed draining to pond: N/A Expected pond surface area: N/A VII. Impact Justification (Avoidance and Minimization) Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide information related to site constraints such as topography, building ordinances, accessibility, and financial viability of the project. The applicant may attach drawings of alternative, lower-impact site layouts, and explain why these design options were not feasible. Also discuss how impacts were minimized once the desired site plan was developed. If applicable, discuss construction techniques to be followed during construction to reduce impacts. Following the layout of the septic system, limited square footage was available to construct the proposed home (50'x 25') The current layout represents the smallest impact to existing wetlands possible Impacts to wetlands outside of the homesite footprint are necessary to reduce erosion of existing fill material into coastal wetlands VIII. Mitigation DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Permits, published in the Federal Register on March 9, 2000, mitigation will be required when necessary to ensure that adverse effects to the aquatic environment are minimal. Factors including size and type of proposed impact and function and relative value of the impacted aquatic resource will be considered in determining acceptability of appropriate and practicable mitigation as proposed. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing and maintaining wetland and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of aquatic resource functions and values by creating, restoring, enhancing, or preserving similar functions and values, preferable in the same watershed. Page 7 of 11 If mitigation is required for this project, a copy of the mitigation plan must be attached in order for USACE or DWQ to consider the application complete for processing. Any application lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as incomplete. An applicant may also choose to review the current guidelines for stream restoration in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at hnp://h2o.enr.state.nc.us/ncwetlands/strmgide.html. Provide a brief description of the proposed mitigation plan. The description should provide as much information as possible, including, but not limited to: site location (attach directions and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet) of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view, preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a description of the current site conditions and proposed method of construction. Please attach a separate sheet if more space is needed. 2. Mitigation. may also be made by payment into the North Carolina Wetlands Restoration Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that you would like to pay into the NCWRP. Please note that payment into the NCWRP must be reviewed and approved before it can be used to satisfy mitigation requirements. Applicants will be notified early in the review process by the 4011Wetlands Unit if payment into the NCWRP is available as an option. For additional information regarding the application process for the NCWRP, check-the NCWRP website at htt-o://h2o.enr.state.nc.us/ikTp/index.htnL If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: Amount of stream mitigation requested (linear feet): N/A Amount of buffer mitigation requested (square feet): N/A Amount of Riparian wetland mitigation requested "(acres): N/A Amount of Non-riparian wetland mitigation requested (acres): N/A Amount of Coastal wetland mitigation requested (acres): N/A IX. Environmental Documentation (DWQ Only) Does the project involve an expenditure of public funds or the use of public (federal/state/local) land? Yes ? No X If yes, does the project require preparation of an environmental document pursuant to the requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)? Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA coordinator at (919) 733-5083 to review current thresholds for environmental documentation. Yes ? No ? If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a copy of the NEPA or SEPA final approval letter. Page 8 of 11 Yes ? No ? X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only) It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to required state and local buffers associated with the project. The applicant must also provide justification for these impacts in Section VII above. All proposed impacts must be listed herein, and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ Regional Office may be included as appropriate. Photographs may also be included at the applicant's discretion. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Neu se), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify )? Yes ? No X If you answered "yes", provide the following information: Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer mitigation is required calculate the required amount of mitigation by applying the buffer multipliers. Zone* Impact (square feet) Multiplier Required Mitigation 1 3 2 1.5 Total * Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an additional 20 feet from the edge of Zone 1. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as identified within 15A NCAC 2B .0242 or .0260. XI. Stormwater (DWQ Only) Describe impervious acreage (both existing and proposed) versus total acreage on the site. Discuss stormwater controls proposed in order to protect surface waters and wetlands downstream from the property. Total impervious surface will 2,660 fI2 or 13% of the property. A low-density stormwater application was submitted on June 28, 2004 Page 9 of 11 XH. Sewage Disposal (DWQ Only) Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from the proposed project, or available capacity of the subject facility. XM. Violations (DWQ Only) Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules? Yes ? No X Is this an after-the-fact permit application? Yes ? No X XIV. Other Circumstances (Optional): It is the applicant's responsibility to submit the application sufficiently in advance of desired construction dates to allow processing time for these permits. However, an applicant may choose to list constraints associated with construction or sequencing that may impose limits on work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and Threatened Species, accessibility problems, or other issues outside of the applicant's control). US Army Corps Of Engineers Field Offices and County Coverage Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union US Army Corps of Engineers Avery Clay Jackson Polk Watauga 151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey Room 208 Burke Gaston Macon Rutherford Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley Telephone: (828) 271-4854 Caldwell Haywood McDowell Swain Fax: (828) 271-4858 Catawba Henderson Mecklenburg Transylvania Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin 6508 Falls of the Neuse Road Ashe Franklin Nash Surry Suite 120 Caswell Forsyth Northampton Vance Raleigh, NC 27615 Chatham Granville Orange Wake Page 10 of 11 (Agent's signature is valid only if an authorization letter from the applicant is provided.) Land Management Group, Inc. Environmental Consultants Wilmington, NC Nationwide #18 Vicinity Map Bailey Jacobs Surf City, NC 9 inch equals 2.4 miles August 2004 Page ( of i Ca l Ca N 0 500 1,000 Land Management Group, Inc. Environmental Consultants Wilmington, NC August 2004 Nationwide #18 USDA Soil Survey Bailey Jacobs Surf City, NC Page/of -41 j { - A? g C) t - 0 / r. .; .' z ,:. it4? T i 0 1000 2000 2000 SCALE 1" = 2000' Land Management Group, Inc. Nationwide #18 Permit Application Environmental Consultants USGS TOPOGRAPHIC 1144 Anderson Blvd, Surf City P.O. Box 2522 Wilmington, NC 28402 MAP Applicant: Mr. Bailey Jacobs 910-452-0001 Hampstead & Holly Ridge Quads Location: Topsail Sound, Pender Co. of LMG # 02-03-652 Date: 5/19/2004 Sheet j> C. ?oroject filesyacobsVnajor T -1 0lb W 11 Z 0 0 core Q - A ? U _ CUU c? Y N A cn 0 a a ccw to a? to Q O J m v ? caw 8 c0 ~ ? a cco c d O -tzl o 0 0f..' O O j0 y v 1 EL W OJ H ?YN MEJJi dt WA d, t?-i 1 ?3 W W N 05Sv ? V) 'to lo 'to F4 Lrd M z z / aNnos iIdsdol 0 O goo W V o v? M 0 (Onend-lIVHdSV) MIN ,09 aNVA3in08 NOSH30NV HlaON - 09 XVMHDIH „? OC CGISN ?? p9519 ? l0't9 .?L SN M DO 0£.15S : ? ,00'05 sarn a3nwd (,4L = NOLLVA373) „3tl, 3NOZ 000-U a? w zz 00 N F O W W v Q 3 0U? o P,4 PO cew M N°- _ .-, ai^ v cC ? ~O w 00 JC6 g OO N F vNv O O> w 3 _j x 5 ? ? ccw U `22Q!?t-1013 PENDER COUNTY NC 08/22/2003 6 $600.00 sTOTE OF OATH /k Real Estate INA Excise Tax , ' " i NORM CAROLINA GEl?.TRAL WARRANTY DEED Excise Tax: S 600.00 P IvfailBox to Verified by County on the day of 20 airy, P.C., Post UttIce box Fuss and Fairley, P.C., Post Office Box 2550/114 N. Topsail Drive, Surf City, NC 28445 This instrument was prepared by: Brief description for the Index: THIS DEED made this 22nd day of August , 20 03, by and between GRANTOR GRANTEE Stanley R. Strong and wife, Bailey G. Jacobs, Unmarried Neva H. Strong Post Office Box 28461 PO Box 3461 Surf City, NC 28445 Topsail Beach, NC 28445 The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simpl , all fhat certain lot or parcel of land situated in the.City of Topsail each Topsail Township, Pender County, North Carolina and more particularly described as follows'. See attached Exhibit "A" for legal description The property hereinabove described was acquired by Grantor by ins-, rent recorded in Book 1492 page 260 68 A map showing the above described property is recorded in Plat Book 5 page NC Bar Association Form No. L-3 © 1976, Revised © 1977, 2002 Printed by Agreement with the NC Bar Association - 1981 SoftPro Corporation, 333 E. Six Forks Rd., Raleigh, NC 27609 Exhibit A RQ20 f PGQ14 Being the Northwestern portion (i.e., that portion lying between the Surf City-Topsail Inlet Highway and Topsail Sound) of Lot Number Twenty Four of the Subdivision of the Lands of Mrs. Elizabeth W. Parsley et als in Topsail Banks, according to a map thereof made by Charles H. Foard, C.H., on or about the 28ffi day of February, 1953, which said map or plat is recorded in Map Book 5 .at Page 68 of the Pender County Registry which said Northwestern portion of said lot is more particularly bounded and described as follows: BEGINNING at a point in the Northern line of the right-of-way of the road or highway leading from Topsa? Inlet to Surf City, which said Beginning point is North 51 degrees 30 minutes East 1150 ft from the dividing line between the lands of Elizabeth Westbrook Parsley et als and the lands formerly belonging to John C. Adams; running thence North 38 degrees 30 minutes West to the high-water mark of Topsail Sound, thence Northeastwardly along said high-water mark of the Topsail Sound 50 feet, more or less, to a point which lies North 38 degrees 30 minutes West of a point North 51 degrees 30 minutes East 50 feet to the Beginning point of this description; thence South 38 degrees 30 minutes East to the said northern line of the right of way of said Surf City-Topsail Inlet highway; thence South 51 degrees 30 minutes West along the said line of the right of way of said highway 50 feet to the BEGINNING. tan rNTWITNESS WHEREOF, the Grantor has duly executed the TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the sane fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever, other than the following exceptions: The provisions of all applicable zoning and land use ordinances. statutes and regulations; ad valorem taxes for 2003 and subsequent years; and all applicable restrictive (Entity Name) By: Title: By: Title: By. Title: 13Y, 2 _ Q???75 as o the day an? first above written. !fip.A Neva H. Strong` `-= .? (SEAT ) Emilie T. Ferrell {SEAL) C arles B. Fe ell: - State of ?h ('liua - County of V,` tq i of k I, the undersigned Notary Public of the County and State aforesaid, certify that Stanley R. Strong and wife Neva N. "Strong personally appeared before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my hand an ,Notarial stamen or seal this 21st 'day of July 20 ' .4 % My Commission Expires: - 3 i a 00? 6 D ' Notary Public STATE OF VIRGINIA r? .. L COUNT,?`OF . ?'?1 ?rilL z. oR I, ?t?` ,. / ?'T!G/? aNotary Public of the County and State aforesaid, ceTLiiy tha %' • tt?° -lRc? EMILIE T. FERRELL AND HL AND, CHARLES B. FERRELL, personally appeared before me' day and acknowledged the execu ion of the foregoing instrumelAfor the purposes therein expressed. + Witness my hand and official stamp or seal this/ &y of Z'(1/ lUi? , _ ; ?003 L211 ZJ? Notary Public ,?•i,?P_ommission expires: /- _?. k S . NZ -,J S e<<?•rr?r?1•pR?., OJT ?lllllf7L711H1dt\\` The foregoing Certificate(s) of i c.- isiare certined to be correct This instrument and this certificate are duly restm: at the date and ape and in the Book and Page shouT on the Ent page hereof. J Ccunry UL) Register of Deeds for J_; jOYCE _ s tzE /Assistant - Resister off Deeds NC Bar Association Form No. L-3 © 1976, Revised © 1977, 2002 Printed by Agreement with the NC Bar Association - 1981 Sof},Pro Corporation, 333 E. Six Forks Rd., Raleigh, NC 27609 5wc96, Ac- &u 9W Cgiw -'&x 2522 9Vd.;, , Sodh Va"-. 28402 6 al WO-452-0009 ?I l! ? ..lfa?n AGENT ^ES?LO SURE FORM TO WHOM IT MAY CONCERN: gaik94 93..y A.4 0 gaa 3805 V-k4&,'W& ,14rmae Wd6a,g6n, AV 28403 Vwe, the undersigned, hereby authorize Land Management Group, inc., to act as our agent in the preparation and representation of information submitted within the _4041401 and/or CAMA applications and/or septic permits. All questions in regards to this application should be directed to Land Management Group, inc. Sincerely, bw`i/er/Applicant Date