HomeMy WebLinkAbout20140487 Ver 1_Riparian Buffer Authorization_20140515 = 20140487
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources Division of Water Resources
15A NCAC 028.0233(8)(b),.0243(8)(b),.0250(11)(b),.0259(8)(b),.0267(12)(c),.0607(e)(2)-Buffer Authorization
FORM: BA 10-2013
Riparian Buffer Authorization Form
A. Applicant Information
1. Project Information
1a. Name of project: ,- _ ,
1b. County: 1U,Aocz
1c. Nearest municipality: /-' acw
1 d. Subdivision name: AI
1e. Is the project located in any of North Carolina's Yes ❑No
twenty coastal counties. If yes, answer If below.
1f. Is the project located within a NC Division of Coastal es ❑No
Management Area of Environmental Concern (AEC)?
2. Owner Information
2a. Name on Recorded Deed: 3 Aw-6,,
2b. Deed Book and Page No. B-k /g , s 7 3
2c. Map Book and Page No.
(include a copy of the recorded
map that indicates when the lot
was created):
2d. Responsible Party
(for Corporations):
2e. Street address: 3 2 5'3 tJ. a-,(,p
2f. City,state,zip: a r� ,�C- z 7 f z y G
C
2g. Telephone no.: � 7.s g so y -,. z s� r
2h. Fax no.:
2i. Email address: „rq��u a t. cd a L z G. e-&P 1"
3. Applicant Information(if different from owner)
3a. Applicant is: ❑Agent ❑Other, specify:
3b. Name:
3c. Business name
(if applicable):
3d. Street address:
3e. City, state,zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
4. Agent/Consultant Information(if applicable)
4a. Name:
4b. Business name
(if applicable):
4c. Street address:
4d. City,state,zip:
4e. Telephone no.:
4f. Fax no.:
4g. Email address:
FORM: BA 10-2013 Page 1 of 2
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. tax PI or parcel ID):
Sro 9
Latitude: ;S,S-p S Longitude: 714 2 117
1b. Site coordinates (in decimal degrees):
1 c. Property size:
0.5 1 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
LrT 10 P Lto
2b. Water Quality Classification of nearest receiving water:
o� %�; ��'(t�. -f� ¢rva��� a s'r.`
2c. River basin:
mm Lc to)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application: R�S��r• -•r�i. MoA�iG' 146:1 C- �'lF FAA G11411 £�N• �+stlllaJ��t�'
5LN40 �ZY
= 0,-%, -G0- Awn &,9 y0`(- k0E-L&V5,
3b. Attach an 8 Y x 11 excerpt from the most recent version of the USGS topographic map indicating the location of
the site
3c. Attach an 8 Y� x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map
depicting the project site
3d. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
ev a3r,� 4-L C &,--
3e. Explain the purpose of the proposed project: ��� �� .� ��� c�" j d s ° "J ` �""' `I '` `` _' '
w.if„ Gad= f,...- of ..��ceo C. s -1'1 '`" -cv ... i ,a0el�i�t✓ k �:.� eL, p: �t'��j �:. Ati 4.'J w.
L A 4;0 : IOIV 4 J, :.H
3f. Describe the overall prLLoject in de {((``ail, including the nr type of equipmTpnt to a used: ifi<
4cf pC 1t—.2 (,y rii Lm Wi y•'r- inn..+ ti wi llrO b't' ,
v L •t I`L vd. � T•VL � •� ��... t• J. a ,
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property/
project (including all prior phases) in the past?
❑ Yes o ❑ Unknown
Comments:
4b. If yes, who delineated the jurisdictional areas?
Name (if known): A
Agency/ Consultant Company:
I Other:
4c. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
6. Project History
5a. Have permits or certifications been requested or obtained for this
project (including all prior phases) in the past?
❑ Yes Dwo ❑ Unknown
5b. If yes, explain and detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes o
6b. If yes, explain.
wj 1
/tl '
A. k. c . t/1 ,,
C U ► - lam Y. is ii'.. r ,r
y.G AA, 4�r y G�/''� Y v. .w r
�y�
n
itSa.P
A
jtG cQvi .tJa 4-6k
/
�I: t� "�• ! c a K+i it..�.
e �•
r� yCw�l "J ti f �t C•ldI-% I � �e�� /� ��'IG�
-1<
1�-�I
��'�' �`-<!l� avo�.e��
9t"i..�Z'�r.✓
o� %�; ��'(t�. -f� ¢rva��� a s'r.`
fit,.
,����1�,-
���.� �, -�kA;
�,�•ll �e u�t ✓� s�� -� nl�«
< ^,.-J ei v je( ✓ !j 3.tc�
a " v7 et f ' N f C.
FORM: BA 10 -2013 Page 2 of 2
ropos�Impacts ven tory
Impact Justification and Mitigation
1.
uffer Impacts
Fa.
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
PA.V�� u(�i � �)tt,•.(sn `� n^/MN� ter w (C,a+tp ?a,`� � n -�T M2w�14Z paf ^
1 b.
roject is in which protected basin? ❑ Neuse
i
0 Tar- Pamlico ❑ Catawba
Buffer Mitigation
❑ Randleman
❑ Jordan ❑ Goose Creek
1 b. Individually list all buffer impacts below. If any impacts require mitigation, then you MIUST fill out Section D of this
form.
If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation and
calculate the amount of mitigation required in the table below.
Zone
Buffer impact
Reason for
Type of impact
Stream name
Buffer
Zone 1
Zone 2
number—
impact
(exempt, allowable,
mitigation
impact
impact
Permanent (P)
1.5
allowable w/ mitigation)
required?
(sq ft)
(sq ft)
or Tem ra T
2c.
If buffer mitigation is required, is payment to a
mitigation bank or NC EEP proposed?
❑ Yes ❑ No
2d.
If yes, attach the acceptance letter from the mitigation bank or NC EEP.
2e.
B1 qP ❑ T
G . yv
A,
P.40 c
❑ Yes o
S�
B2 P ❑ T
„ p6
A wn c is
�� r'
❑ Yes No
`o
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
B5 ❑ P ❑ T
❑ Yes ❑ No
B6 ❑ P ❑ T
❑ Yes ❑ No
Total
buffer impacts
1c. Comments:
D.
Impact Justification and Mitigation
1.
Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
PA.V�� u(�i � �)tt,•.(sn `� n^/MN� ter w (C,a+tp ?a,`� � n -�T M2w�14Z paf ^
1 b.
Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
i 1tiz. u� c1f �zLt6� ��` q r n„r ANO car
2.
Buffer Mitigation
2a.
Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation?
❑ Yes ❑<0
2b.
If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation and
calculate the amount of mitigation required in the table below.
Zone
Reason for impact
Total impact
(square feet
Multiplier
Required mitigation
square feet
Zone
1
3 (2 for Catawba)
Zone
2
1.5
Total buffer mitigation
required:
2c.
If buffer mitigation is required, is payment to a
mitigation bank or NC EEP proposed?
❑ Yes ❑ No
2d.
If yes, attach the acceptance letter from the mitigation bank or NC EEP.
2e.
If no, then discuss what type of mitigation is proposed.
2f.
Comments:
FORM: BA 10 -2013 Page 3 of 3
:; . wr
r,2G A,,q
i Oi �Z_
^A47 ,L
FDiffuse Flow Plan
All buffer impacts and high ground impacts require diffuse flow or other form of
Diffuse flow
stormwater treatment. Include a plan that fully documents how diffuse flow will be
Supplementary Information
maintained. If a Level Spreader is proposed, attach a Level Spreader Supplement Form.
❑Other BMP
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
Gui'Jri Kpoc- /)-'o
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
�� nLpr,,�
!ianua! and attach a BMP Supplement Form.
via the US Postal Service
public (federal /state) land?
Jrc c,(-'
pplicant/Agent's Printed Name Applicant/Agent's Signature
(Ai6a'o signature is valid only if an authorization letter from the applicant is provided.)
Send 3 complete sets of this form and accompanying documents to the following:
For government transportation projects sent
For government transportation projects sent
I (JrTC.....
F.
Supplementary Information
OR NC DWR, Transportation Permitting Unit
1.
Environmental Documentation
Raleigh, NC 27699 - 1650
12.
Does the project involve an expenditure of public (federal /state /local) funds or the use of
❑ Yes ❑ No
via the US Postal Service
public (federal /state) land?
Karen Higgins
1 b.
If you answered "yes" to the above, does the project require preparation of an
❑ Yes ❑ No
1650 Mail Service Center
environmental document pursuant to the requirements of the National or State (North
Raleigh, NC 27699 - 1650
Raleigh, NC 27604
Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document been finalized by the State
❑ Yes ❑ No
Clearing House? (If so, attach a copy of the NEPA or SEPA final approval letter.)
Comments:
2.
Violations
2a.
Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated Wetland
❑ Yes ❑ No
Rules (15A NCAC 02H .1300), DWR Surface Water or Wetland Standards, or Riparian
Buffer Rules (15A NCAC 02B .0200)?
2b.
Is this an after - the -fact permit application?
❑ Yes ❑ No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
pplicant/Agent's Printed Name Applicant/Agent's Signature
(Ai6a'o signature is valid only if an authorization letter from the applicant is provided.)
Send 3 complete sets of this form and accompanying documents to the following:
For government transportation projects sent
For government transportation projects sent
by First Class Mail via the US Postal Service:
by delivery service (UPS, FedEx, etc.):
NC DWR, Transportation Permitting Unit
OR NC DWR, Transportation Permitting Unit
1650 Mail Service Center
512 N. Salisbury Street
Raleigh, NC 27699 - 1650
Raleigh, NC 27604
For all outer projects sent by First Class Mail
For all odder projects sent by delivery service
via the US Postal Service
(UPS, FedEx, etc.):
Karen Higgins
OR Karen Higgins
NCDWR — 401 & Buffer Permitting Unit
NCDWR — 401 & Buffer Permitting Unit
1650 Mail Service Center
512 N. Salisbury Street
Raleigh, NC 27699 - 1650
Raleigh, NC 27604
FORM: BA 10 -2013 Page 4 of 4
,
i
1 s '
r 9 s
, s .
"
! =t'
,
iii
I
-•- r � ��>�D - - - F - - -- -; _ � - - - - -- - - - lam/ - -- -,- -, _ - .� -- - -: �_ _ -, -; -- ,: '
'
, • ,
'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J % �, , s 4r -1,4 -f w =I—r. s
(Name of Property Owner)
property located at /0 4 A -6 ^/
(Address, Lot, Block, Road, etc.)
on Pam l • ct in C t' c-c C;,; 4,1 N C
(Waierbody) (City/Town andf& County)
The applicant has described to me, as shown below, the development proposed at the above
location
I 'have no objection to this proposal
I 'have objections to this proposal
DESCRIPTION AND /OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site - drawing)
" � i.: � .` � '� �
� /' ! I ( � �%✓ �
J
� �!� lr C'�i..i L' �' C �' � /✓ t� �"
l' (,i /.� CC .`s_ -� G�PCF
r V --
WAIVER SECTION'
I understand that a pier, dock, mooring pilings, 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 )
I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement
(Property Owner Information) (Adjacent Property' Owner Information),
-&�nat/Iure / Sijg'n/ature/ j
V�Dkf' C• 1 hJc�'YrG y� C_!1`aY /FS Z' A U yS eL7PP��
Print or Type Name Print or Type Name
.Y Z 3 i,/. 5—d /y 9 '�/1-1 - k A 1 -r1'/ L I.IV
Mailing Address Mailing Address r
City /State/Zip City /Statelzi
z 5-7-- 7s 3� 3 5- 6Y3 7 T J
Telephone Number Tele phone�Number /
Date Date
(Revised 611812012)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to .% % �e s %/� Y = r. s
(Name of Property Owner)
property located at -/ -e_
(Address, Lot, Block, Road, etc.)
on Pa," 1, y in CXt,C.o� 4 ,NC
(Waterbody), (City/Town and,6r County)
The applicant has described to me, as shown below, the development proposed at the above
locatio
I 'have no objection to this proposal
,I have objections to this,prop,osal
DESCRIPTION AND /OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
i '1- l' Y t� G
J
'�
a I r �• S T
7 �c
r� r ..' r� r-� /�i
I<, . �- 7L
WAIVER_SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by rrie (If you,
'wish to waive the setback, you must initial the appropriate blank,below )
I do wish to waive the 15' setback requirement
.I do not wish to waive the 15' setback requirement
(Property O ner Information') (Adjacent Property Owner Information)
ty -
nat//ure Signature
-77-
�r7 ht Cc 1 1ffi��'r L- r lJ�trfuc v �YOI✓a��t�cz
Print or Type Name Print or Type, Name
Mailing Address Mailing Address
City/StatelZtp CitylState/Zip
z s z-_ 7S3 35 9/9 -2 s"'7 -3 -13
Telephone Number Telephone Number
3 /Z -z6 /f"
Date
Date
(Revised 611'812012)
*# re (C)
• •+\ �R
•
�I; tir
■ s •
•� 4
tiy. t* f. \
i Y
6
•
• r.
•
•
•
■ •
•
104 Blackbird Lane
;ngifl (C ..� o Light
Whiehard% ..
• each
„ei
ag etic Dechnati. n
10 IW
•
•
•
Copyright (C) 1998, Maptech, Inc.
0
100
200
*� -('•
0 4
SCALE 1:8000
300 400
600 YARDS
1000 FEET
0 100 200 300 400 500 METERS
— — — -- _ - -- _ — - - - - - - -= U.M.ti. NO. J Uti / -UU /7
NATIONAL, FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION' CERTIFICATE
Irri ortant: Read the instructions-Ion pages 1 - 7.
0 102
SECTION A - PROPERTY,O_ WNER INFORMATION - :For- Insurance,Company Use:
BUILDING OWNER'S NAME - -
D o►n no r+ ' Ro b e c+ Policy Number
BUILDING STREETADDRESS,(Including Apt.;:Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. --Company_ NAIC= Number, ,1 _- ' - -
loy SIaGKb;rd Lane
CITY STATE ZIP CODE
G h6Go w in ►tm Nbc --t'h ccotaiili�n,o. 2.781 -
PROPERTY'DESCRIPTION (Lot an&Block Numbers, Tax'Parcel Number, Legal Description, etc.)
Pa CG e: I 10 *# 56$4 - 75 = 1911
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section'd necessary.)
Residen-lIC%I
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: LI,GPS (Type):
or ft"o# #�1 LJNAD 1927 LI NAD 1983 LJ USGS QuadMap I_I Other
SECTION B - FLOOD,INSURANCE RATE MAP (FIRM) INFORMATION
B1.,NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2. COUNT,Y NAME B3. STATE
vtlir�co; oca ed 7004.5 Beou•far=t A/ C_
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
DATE
EFFECTIVEIREVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
3.7oo/, oi'95
8
12-4-8 -7
2- 4.-'8-7
B10. Indicate,the sourcelof the Base Flood Elevation (BFE) data or base flood depth entered in B9.
I FIS Profile I-XJ FIRM , LJ Community Determined LJ Other (Describe)-
B11. Indicate the elevation datum used for the BFE in B9: IJ NGVD 1929 1J NAVD 1988 U Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? IJ °Yes L cg,No,
"Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED),
C1. Building elevations are based on: [JConstruction Drawings' LlBuilding Under Construction* IXJFinished Construction
'A new Elevation Certificate will be,required when construction of the budding is,complete.
C2 -.,Building Diagram Number —, (Select th�e;building diagram most similarto the building for which this certificate �is_being completed -see
pages 6 -and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations —Zones Al -A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO
Complete Items C3a -i below according to the building,diagram specified in Item C2. State the datum used. If the datum is different from,
'the datum used for the BFE in Section B, convert the datum to that usedfor the,BFE. Show field, measurements,and datum conversion
calculation. Use the space provided or thetomments area of Section D or Section G. as appropriate, to document the datum conversion.
Datum IJGVD 29 Conversion/Comments
Elevation reference mark used_NC65"BEflGH 196S' Does the elevation reference"mark used appear on the FIRM? IJ Yes 1X1 No
24 a) Top of enclosure)GcouM'(1 -A G)- LI 3 ft.60) ���► �r,,�
b) Top of'nekt higher floor 7 f3 2 ft:(1n) �' .�`��(H CARD �''•
O c) Bottom of lowest horizontal structural member (v'zones only) _ N'ra . _ ft.(m) o o �`���� �FSSS %`�y9'';
❑ d) Attached garage (top of slab) N'IA _ft.(m) E , , �L'; _ '
IN e) Lowest elevation of machinery�and /or equipment w s _ "SEA.
servicing the building See GoVAmehk$ %(m) E � � Z r - L -3831
f) Lowest adjacent grade (LAG) 4 3 -ft.(m) 'z'
g) Highest adjacent grade (HAG) ►'� 'I ft.(t�y1 9,Q •.&URN -o k,
4a
h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade, • °
. _ "3 � ,q MP �
i) Total.area,offiall permanent openings (flood vents) in,C3h, 3151 sq.,in . (sg4m) '���� „,,,;►► ►``�
SECTION D - SURVEYOR; ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized; by law to certify elevation information.
1 certifythat thejinformation in Sections A, B, and C on -this certificate represents my best efforts to interpret the data available:
I understand that any false statement may be punishable -by fine, or imprisonment under 18 U.S. Code, Section 1001. ~
L-
V
vo
FEMA Form,81 -31, AUG 0 - SEE REVERSE SIDE FOR CONTINUATION REPLACES ALLPREVIOUS EDITIONS
IMPORTANT: In thesespaces, copy the,corresponding information from Section A. 'For Insurance Company Use:-
- ,
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or, Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number,
_ I o 1 o� c b ► f 1 s d
Cl 4 ar►e
N STATE 9P CODE Company NAIC Number_;
O G f
-
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner,
No Access to c t-aw1 .5ema__
Gas Po,cK 5 +and at- Ele,\)rL -;on 7.7'
HyIRC DUG+ at tleVoLtion {-1,'7`
E lec -ve;a Me"tejr o t Elevo kAo n '7JJ' ' - 1_1 Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO and ZONE A,(WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E3..Ifthe,Elevadon Certificate, is intended,foruse,as supporting
information fora L-OMA,or LOMR -F, Section C must,be=mpleted. ' F - '
E1. Building Diagram Number (Select'the�building diagram,.most similar to,theTbuilding for which this certificate is being completed —
see pages 6 and 7. If no diagram accurately represents the building, provide a-sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is I i I ft.(m) I I lin.(cm) Li above or U below
(check one) the highest adjacent grade.
E3. For Zone AO only: If no flood,depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance? 1_1 Yes 1_I No 1_1 Unknown. The local official must certify this information in,Section G.
SECTION F - PROPERTY OWNER (ORAWNER% REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A;'B, and E for Zone A (without a FEMA- issued or
community- issued, BFE) or Zone AO must'sign here.
PROPERTY OWNER'S,OR,OWNER' &AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
1 -1 Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
TheJoca[official whois authorized by law or,ordinanceto administer, the community's floodplain management ordinance,can complete
Sections,A,�B, C (or E),,,and G of this Elevation Certificate. Complete'the applicableiterri(s) and.sigmbelow.
G1. 1-1 The information in 'Section. C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2. I I A community official completed Section E for a building located in Zone A (without a FEMA - issued or community- issued BFE) or
Zone AO.
G3. 1_1'The following information (Items G4-G9) is provided for community floodplain management purposes.
G7. This permit has -been issuedJor: I I New Construction 1_1 Substantial Improvement
G8. Elevation ofeas -built lowestfloor (including basement) of the building,is: _ ft.(m) Datum:
G9.,BFE or (in Zone AO) depth of flooding at,the building-site is: _ ft.(m) Datum:
LOCAL OFFICIALS NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
1_1 Check here if attachments
FEMA Form, 81 -31, AUG 99 REPLACES ALL PREVIOUS EDITIONS
Q' 11331:277
gpv4 'PA
14AX gym
� IVA SITE
����� u lb
f R . -xi6w��
� ♦� �V' C Y1pM7TEIaW
y/ A
•� O p6Tmpg1 W PIPE
,(/ 0 E7uftetOfAttE
f72Ste1f,1RC115m
a JS i oaTrie uip+ we,nT oasT 1c'Atu Iwawt.e)
`?. fl• a 0 to *NCW'Utat PPE
a NO PW %a'
'7J Jjj 4 i9 MAMR VrRP
A`4�r ati _X- FAKE
/ •�2�J ��� ♦ 5,VEtl1RE 06N
U0. b` ; �, 6 '!6 n VJLA
Rey" ) )O �JO�a• 'Ai i sro°r aivA -t ai
s a.
a4vAT!66SAErEn�SeEC ro
kD N J 9r �• RM 'BEAL7+JIP6s•
v� pJ• j RLVAI" 3.27"'
/ � � } uqa tt ±w.IThnuM
QI.i� N'sj. G� J•0 Ca tV,cl :ct�Platl
rn-t. _ ' _
'r .V�J Nom, aj ej ^y. 4e• I "fa1.Q, K9.6 Fir,_ ' ,1 h.
R ,a' J 'ems tTa,t:, lau tr ro Ca ta'e •I tp,trnn• `,1 « Iona
eQj a+�, / O n.1y/t41 la �ut� OX! .«laol/a Il,a9 1 'r.11u
J[��aa � L 3 ,ut: i.an••!aC•ul count «tw,
4Rw Ortk« ,
C� aw ,� yc1.41 as
N
bet
b
O
6
•�i
F4
• v
J WILTDRi COUIM, LARD R(
,ACCEPTED
b� s•
`SURV;ci yki
•jJ
wo e>•+m ...I ,� n'.r:� uw,:
°t�yNOH
vw ,'V'0i.�o�..t[eto+ 1tw[tMCW rl.w AM'KNa fiJtd (A
?e
tItSCM'110ai,RCO.ptp w pL} I[t{
y nMl �! [YO)R [L011.a(N CNCVA20 h
a1.0 OT1.AT1A[t K.. amt M tovorRS
R
�•0
wlASUW `
q�lA/ a�D A00. K� WC7fR�•IIOiI!w Kp1-
40 0 40
..CR � rf `wow* toMt'.rR : W-101 -AA" a.0 ° Wa
Iw e.. v .u.o. ee •�)w . �-/
s 27•a1'se•Ir, na^ 1•
°x�etex•ts•v 72.5)•
°
_
GRAPHIC SCATS - -MEI
_ __
- -
11 +e1'29,14, 11.1)7
a ti�
i..�'l w -PAN" a O' . OSSr1A awct ta. a;M.
am,w p[J,It A Y>• 7T..C.17M 11Y.00
.Iai,ILfyupaTC
IR)MAD Ml(M .uR r
{ttAgaOaq
du7TY 1 b a-
r r
N
bet
b
O
6
•�i
F4
• v
J WILTDRi COUIM, LARD R(
,ACCEPTED
REVISIONS _ -
SURVEY FOR- IMUVS nVY 0'5" . V.w ~* 'd -tKC• 4o - 26 G14 2 -1 =2251'
2utc• r � •r
Donnon Robert .Jeffeisoin AAYO "D :FATE, ,c
" ASSOCIATES. P;A, Wj(IT,ICW7){ *,
,t22e) 146 -2112 V{{N+e1tf...,ML IV►, OQbVWlTY_ _ _ 1
CM) L32 RV w. , KC
10l 21acA►tr� a{.v OvcaaM J, IC us" •)2 =27% 7Y fltl 1d e,eHJf.iwi2 I
�P '
b� s•
`SURV;ci yki
cP
RLL EN,
1` "'``
R
�•0
BCAitItlC OIfTAAKC�
40 0 40
80, 120
-- - C A,
s 27•a1'se•Ir, na^ 1•
°x�etex•ts•v 72.5)•
°
_
GRAPHIC SCATS - -MEI
_ __
- -
11 +e1'29,14, 11.1)7
REVISIONS _ -
SURVEY FOR- IMUVS nVY 0'5" . V.w ~* 'd -tKC• 4o - 26 G14 2 -1 =2251'
2utc• r � •r
Donnon Robert .Jeffeisoin AAYO "D :FATE, ,c
" ASSOCIATES. P;A, Wj(IT,ICW7){ *,
,t22e) 146 -2112 V{{N+e1tf...,ML IV►, OQbVWlTY_ _ _ 1
CM) L32 RV w. , KC
10l 21acA►tr� a{.v OvcaaM J, IC us" •)2 =27% 7Y fltl 1d e,eHJf.iwi2 I
�P '
NORTH CAROLINA Prepared by James A. Nelson, Jr
BEAUFORT COUNTY
Revenue Stamps: $200.00
Tax Parcel No.: Mail: Grantee, 3283 N. Waverly St.
Farmville NC 27828
The Preparer is informed that no portion of the property herein
conveyed includes the principal residence of the Grantor.
This DEED, made this -2,y day of April, 2014, by and between
Donnon Robert Jefferson, unmarried, hereinafter called "GRANTOR ";
and John D. Andrews, Jr. and wife, Maria Marta Andrews, hereinafter
called "GRANTEES "';
W I T N E S S E T H:
THAT GRANTOR, in consideration of'Ten Dollars and other good
and valuable consideration to GRANTOR in hand paid, the receipt of
which is hereby acknowledged,, has bargained and sold and by these
presents does hereby bargain, sell, grant, and convey, to GRANTEES,
their heirs and assigns, in fee simple, all that lot or parcel of
land lying and being in Beaufort County, North Carolina, and,more
particularly described as follows:
Being that parcel or tract of land containing 0.510 acre
together with right of egress and ingress with SR 1182 (Bayside
Shores Road) along an existing 30 foot right of way as platted on
survey map dated March 1, 2001 entitled " Donnan Robert Jefferson"
by Mayo and Associates, P.A., to which map is of record in that
Deed of record in Deed Book 1193„ Page 276, Beaufort County
Registry, further reference is herein made and incorporated for a
more complete and detailed message.
TO HAVE AND TO HOLD the aforesaid tracts or parcels and all
privileges and appurtenances thereto belonging to GRANTEES, their
heirs ,and a"s'si.gns, to their only use and behoof, in fee simple
forever.
And the GRANTOR, for himself, his heirs, executors and
administrators„ covenant with the GRANTEES, that the GRANTOR is
seized of the premises in fee simple, has the right to convey the
same in fee simple, that title is marketable and free and clear of
all- encumbrances, and that GRANTOR does hereby warrant and will
defend the title to the same against the claims of all persons
whomsoever except for the exceptions hereinafter stated.
1. 2014 ad valorem taxes and assessments.
2. General utility easements, restr- active covenants, and
rights of way of record.
The plural number as used herein shall equally include the
singular and vice versa. The masculine or feminine gender as used
herein shall equally include the`neuter.
IN TESTIMONY WHEREOF, GRANTOR has adopted the word "SEAL" as
their seals and has hereunto set their hand and seal, this the day
and year first above written.
I
Donnon Robert, e0 on
NORTH CAROLINA
COUNTY OF ell
I, ��Y' ^� �� -����0 V a Notary Public in and for the
aforesaid County and State, do hereby certify that Donnon Robert
Jefferson personally appeared before me this day and acknowledged
the due execution of the foregoing instrument,.
Witness my hand and Notarial Seal, this the day of
2014.
Notary /Public
My Commission Expires: 7—Z�- 2c.cy' NOTARY SEAL
IR2�
. r7E150N. R.
Ix
�M
To S 1
®SR I�6�
2Cl_AS, halt
8 e To Whic'hardS Beach
° 1 .
1 °
° 1
e 1 ,
I� 1
1 �
1 '
1 1
1 388.00 A 14'6. <68�
1 ®
N69-34W - N KS'-34W -
1 ° Existing 30 YW
e °
1
1 ° •
1 Whichard Property
Iry °
1 a01
!°n Oy -
i1
N°
1 , �• e
x•-30 -�-3Q-
PROPERTY^ C)F
R" U N AL U J,
AND WIFE,
mA V READ::�7
OR& "
I
1
°
North CarolinA
November
1976
1
e
1 60
Q 30 60
MEMO MEMONJ
120 180
I, William R° Harding, certify that this
�00oaro
1
made by ,me from an actual survey
C- A
®�
made by
me and that it is- accurate and
'N
i
o
Canal
53'7 3E
= SEAL
�
1
1
1
22 5.•92. -
-
O
•.� °osuv`A°
�',���' ° °
1
1
Registered Lend Surve r
L 1655
' "��o� ��e®0"��,•
"W
3-. Whichard Prop.
W
;ol
it
.,A 0 0
060.°58 Sq. I't
•O
I
a
66
IT
Z
Z
1
1
I
r1 Q1
O n
1 �
1 '
1 1
1 388.00 A 14'6. <68�
1 ®
N69-34W - N KS'-34W -
1 ° Existing 30 YW
e °
1
1 ° •
1 Whichard Property
Iry °
1 a01
!°n Oy -
i1
N°
1 , �• e
x•-30 -�-3Q-
PROPERTY^ C)F
R" U N AL U J,
AND WIFE,
mA V READ::�7
OR& "
°
rd
C
it
U
A
Chodowinity Township
Beaufort County
North CarolinA
November
1976
Scale
1 60
Q 30 60
MEMO MEMONJ
120 180
I, William R° Harding, certify that this
�00oaro
map was
made by ,me from an actual survey
C- A
®�
made by
me and that it is- accurate and
��,•�`�,`�� °�sTER ®�,a
correct
to the best of my knowledge and
belief.
= SEAL
WITNESS
my hand and Seal this_,ff day of
L -1655 e s
.S
•.� °osuv`A°
�',���' ° °
Registered Lend Surve r
L 1655
' "��o� ��e®0"��,•
°
rd
C
it
U
A