SW8960404_HISTORICAL FILE_20160308 (2)

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 'iU 0 404
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
C�7 HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2 01 \-c p ,� 0 8
YYYYMMDD

Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
March 8, 2016
Dr. Odell DeCarol Williamson, President
The Islander Inn, Inc.
2618 New Village Way
Wilmington, NC 28405
PAT MCCRORY
Gow,,.,
DONALD R. VAN DER VAART
Secretary
TRACY DAVIS
Director
Subject: Permit Transfer subject to Session Law 2013-121, Project Name Change, Notice of
Inspection, Permit Renewal, and Permit Correction
State Stormwater Management Permit No. SW8 960404
The Islander Inn
Brunswick County
Dear Dr. Williamson:
Effective August 1, 2013 the State Stormwater program was transferred from the Division of Water
Quality (DWQ) to the Division of Energy, Mineral and Land Resources (DEMLR). All previous
references to DWQ will remain in older stormwater permits issued prior to August 1, 2013 until they are
modified. Please note that any updated pages or addendums to this permit will now reference DEMLR as
the Division responsible for issuance of the permit
On January 13, 2016, the Wilmington Regional Office received a complete request to transfer ownership
of the subject state stormwater management permit under the provisions of Session Law 2013-121.
Additionally, a change to the project name was also requested. Staff of DEMLR has inspected the project
and reviewed the available documentation, and determined that the project is currently in compliance with
the terms and conditions of the state stormwater permit.
The Division has determined that the provisions of SL 2013-121 have been met as indicated by the
supporting documents and findings listed below:
1. The successor -owner of the property has submitted a written request for the transfer of the permit.
Reference is made to the attached signed Name/Ownership Change Form;
2. The original permit holder, Odell Williamson with Ocean Isle Beach Realty, sold the property on
which the permitted activity is occurring.
3. The successor -owner holds title to the property on which the permitted activity is occurring.
Reference is made to the deed recorded on May 14, 1997 in deed book 1146 on page 701.
4. The successor owner has not proposed any substantial changes to the permitted activity.
5. The updated permit does not impose new or different terms — it merely restates some of the
previous terms to provide you with a better understanding of your obligations under the permit.
By signing the Name/Ownership Change Form and acknowledging receipt of a copy of the permit, which
includes the application and supplement forms, a copy of the approved plans and a copy of the required
Operation and Maintenance agreement, you have accepted the responsibility for complying with the terms
and conditions outlined in this permit. The Division is hereby notifying you that the subject permit has
been transferred per the requirements of SL 2013-121 and the project name has been changed on March 7,
2016.
Permit Renewal
On March 7, 2106, the Wilmington Regional Office received two (2) complete 8 year Stormwater
Management Permit Renewal Application for the subject project. The Division is hereby notifying you
that permit SW8 960404 has been renewed on March 8, 2016, and shall be effective until .October 17,
2022. The plans originally approved on October 17, 1996, will remain in full force and effect in
accordance with the regulations set forth in Title 15A NCAC 2H.1000 effective September 1, 1995.
State of North Carolina [ Environmental Quality I Energy, Mineral and Lend Resources
127 Cardinal Drive Extension I Wilmington, NC 26405
910 796 7215 T 1 910 350 2004 F I ban '//oortal nedenr ora/web/Ir/

State Stormwater Permit No. SW8 960404
Page 2 of 2
Permit Correction
Please note that during the review and update of this permit, it was discovered that the original permit
contained errors. This permit correction is intended to correct the receiving waters, correct the total
amount of built -upon area approved for this project and correct the number of approved stormwater
control measures. The receiving waters has been corrected to the Eastern Channel with an index of 15-
25-6 and a classification of SA, HQW. The previously issued permit listed 34,575 square feet of built -
upon area to be treated in a single infiltration trench. However this permit clarifies that there are 3
approved stormwater control measures: two (2) infiltration trenches and one (1) infiltration basin treating
the runoff from a total of 36,159 square feet of built -upon area as documented in the calculations from
East Coast Engineering dated August 6, 1996.
For your records, please find enclosed an updated permit, a copy of the Name/Ownership Change form, a
copy of the renewal application, and a copy of the inspection report. Please keep this permit on file at all
times. This permit is subject to the conditions and limitations as specified in the updated permit
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings
(OAH). The written petition must conform to Chapter 150B of the North Carolina General Statutes, and
must be filed with the OAH within thirty (30) days of receipt of this permit. You should contact the OAH
with all questions regarding the filing fee (if a filing fee is required) and/or the details of the filing process
at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit their
website at www.NCOAH.com. Unless such demands are made this permit shall be final and binding.
If you have any questions concerning the requirements of the permit or need additional copies of the
permit or approved plans, please do not hesitate to call Christine Hall with DEMLR in the Wilmington
Regional Office at [phone].
Sincerely, f N
�
eC� Z-s � (
. , Tracy Davis, P.E., Director
Division of Energy, Mineral and Land Resources
GDS/cash: \\\Stormwater\Permits & Projects\1996\960404 HD\2016 03 permit 960404
cc: Sabrina Babson, East Coast Engineering & Surveying, PC
Wilmington Regional Office Stormwater File
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
127 Cardinal Drive Extension I Wilmington, NC 28405
910 796 7215 T 1 910 350 2004 F I htlz /om al ncdenr.org4eb/h/

State Stormwater Management Systems
Permit Number SW8 960404
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
The Islander Inn, Inc.
The Islander Inn
57 West First Street, Ocean Isle Beach, Brunswick County
FOR THE
construction, operation and maintenance of two (2) infiltration trenches and one (1) natural
dune area acting as an infiltration basin (hereafter referred to as infiltration system or
stormwater control measures) in compliance with the provisions of 15A NCAC 2H .1000
(hereafter referred to as the "stormwater rules') and the approved stormwater management
plans and specifications and other supporting data as attached and on file with and approved
y the Division of Energy, Mineral and Land Resources (hereafter referred to as the Division
or DEMLR) and considered a part of this permit.
This permit shall be effective from the date of issuance until October 17, 2022, and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater runoff
as described in Section 1.7 and 1.8 of this permit. The runoff from all built -upon area
within the permitted drainage areas of this project must be directed into the permitted
stormwater control measures. The stormwater controls identified as Area 1-8, 10; Area
9; and Area 12 have been designed to handle the runoff from 32,981, 1,594, and
1,584 square feet of impervious area, respectively.
3. The maximum built -upon area allowed for the entire project is 36,159 square feet.
4. The drainage areas will be limited to the amounts of built -upon area indicated in
Sections 1.2, 1.7, and 1.8 of this permit, and per approved plans.
5. The excess design storm overflow from the infiltration system labeled Area 1-8,10
must be directed into a 50 foot vegetated filter strip and level spreader, designed per
Section .1008 (f) of the stormwater rules.
Page 1 of 6

State Stormwater Management Systems
Permit Number SW8 960404
6. The infiltration systems labeled Area 9 and Area 12 are permitted per the Alternative
Design Criteria under Section .1008 (h). These proposed systems provides equal or
better control, equal or better protection of surface waters and results in no increased
potential for nuisance conditions. The infiltration systems has been designed to handle
the 25 year storm without discharging therefore neither an LSNFS nor an offline
bypass are required.
7. The following design criteria have been permitted for the two (2) infiltration trenches
and it must be provided and maintained at the design condition:
Areas 1-8,10
Area 9
a. Drainage Area, acres:
Onsite, ft2:
Offsite, ft2:
38,334
38,334
0
1,741
1,741
0
b. Total Impervious Surfaces, ft2:
Onsite, ft2:
Offsite, ft2:
32,981
32,981
0
1.594
1,594
0
c. Design Storm, inches:
1.5
1.5
d. Trench Length, feet:
313
40
e. Trench Width, feet:
6.0
6.0
f. Trench Depth, feet:
3.0
3.0
g. Perforated Pipe Diameter, in.:
2 x 24"
2 x 24"
h. Perforated Pipe Length, ft:
313
40
i. Bottom Elevation, FMSL:
8.5
8.5
. Bottom Surface Area, ft2:
1,878
240
k. Bypass Weir Elevation, FMSL:
11.5'
n/a
I. Permitted Storage Volume, ft3:
3,434
439.25
m. Exfiltration Volume, ft:
1,033
585.5
n. Total Volume, ft :
4,467
1024.75
o. Type of Soil:
Sand
Sand
p. Expected Infiltration Rate, al/sf/hr:
11.2
11.2
q. Seasonal High Water Table, FMSL:
6.5
6.5
r. Time to Draw Down, hours:
1.22
1.22
s. Receiving Stream/River Basin:
Eastern Channel / Lumber
t. Stream Index Number:
15-25-6
u. Classification of Water Body:
SA, HQW
'this elevation is unclear from the plans
Page 2 of 6

State Stormwater Management Systems
Permit Number SW8 960404
The following design criteria have been permitted for the natural dune area acting as
an infiltration basin and it must be provided and maintained at the design condition:
Area 12
a.
Drainage Area, acres:
Onsite, ft2:
Offsite, ft2:
6,711
6,711
0
b.
Total Impervious Surfaces, ftz:
Onsite, ft2:
Offsite, ft2:
1,584
1,584
0
c.
Design Storm, inches:
1.5
d.
Basin Depth, feet:
unknown
e.
Bottom Elevation, FMSL:
12.0
f.
Bottom Surface Area, ft2:
2,099
g.
Bypass Weir Elevation, FMSL:
n/a
h.
Permitted Storage Volume, ft3:
1,533
i.
Type of Soil:
Sand
j.
Expected Infiltration Rate, al/sf/hr:
11.2
k.
Seasonal High Water Table, FMSL:
6.5
I.
Time to Draw Down, hours:
0.49
m.
Receiving Stream/River Basin:
Eastern Channel / Lumber
n.
Stream Index Number:
15-25-6
o.
Classification of Water Body:
SA, HQW
II. SCHEDULE OF COMPLIANCE
No person or entity, including the permittee, shall alter any component of the approved
stormwater system shown on the approved plans unless and until the Division has
approved of the revised plan.
2. The stormwater management system shall be constructed in its entirety, vegetated
and operational for Its intended use prior to the construction of any built -upon surface.
3. During construction, erosion shall be kept to a minimum and any eroded areas of the
system will be repaired immediately.
4. The permittee shall at all times provide the operation and maintenance necessary to
assure that all components of the permitted stormwater system function at design
condition. The approved Operation and Maintenance Agreement is incorporated by
reference into this permit and must be followed in its entirety and maintenance must
occur at the scheduled intervals.
5. Records of maintenance activities must be kept and made available upon request to
authorized personnel of the Division. The records will indicate the date, activity, name
of person performing the work and what actions were taken.
6. The facilities shall be constructed in accordance with the conditions of this permit, the
approved plans and specifications, and other supporting data.
7. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and
prior to operation of this permitted facility, a certification must be received from an
appropriate designer for the system installed certifying that the permitted facility has
been installed in accordance with this permit, the approved plans and specifications,
and other supporting documentation. Any deviations from the approved plans and
specifications must be noted on the Certification. A modification may be required for
those deviations.
Page 3 of 6

State Stormwater Management Systems
Permit Number SW8 960404
8. The permittee shall submit to the Director and shall have received approval for revised
plans, specifications, and calculations prior to construction, for any modification to the
approved plans, including, but not limited to, those listed below:
a. Any revision to any item shown on the approved plans, including the stormwater
management measures, built -upon area, details, etc.
b. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
C. Further development, subdivision, acquisition, lease or sale of any, all or part of
the project area. The project area is defined as all property owned by the
permittee, for which Sedimentation and Erosion Control Plan approval or a
CAMA Major permit was sought.
d. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
e. The construction of any future BUA listed on the application.
9. Prior to transfer of the permit, the stormwater facilities will be inspected by Division
personnel. The project and the stormwater facility must be in substantial compliance
with all permit conditions. Any items not in substantial compliance must be repaired,
replaced or restored to design condition prior to the transfer. Records of maintenance
activities performed to date will be required.
10. The Director may notify the permittee when the permitted site does not meet one or
more of the minimum requirements of the permit. Within the time frame specified in the
notice, the permittee shall submit a written time schedule to the Director for modifying
the site to meet minimum requirements. The permittee shall provide copies of revised
plans and certification in writing to the Director that the changes have been made.
III. GENERAL CONDITIONS
Any individual or entity found to be in noncompliance with the provisions of a
stormwater management permit or the stormwater rules, is subject to enforcement
action as set forth in NCGS 143, Article 21.
2. The issuance of this permit does not preclude the Permittee from complying with any
and all statutes, rules, regulations, or ordinances, which may be imposed by other
government agencies (local, state, and federal) having jurisdiction.
3. In the event that the facilities fail to perform satisfactorily the Permittee shall take
immediate corrective action, including those as may be required by this Division, such
as the construction of additional or replacement stormwater management systems.
Additional or replacement stormwater management systems shall receive a permit
from the Division prior to construction.
4. This permit is not transferable to any person or entity except after notice to and
approval by the Director. The permittee shall submit a completed and signed
Name/Ownership Change Form, accompanied by the supporting documentation as
listed on the form, to the Division at least 60 days prior to any one or more of the
following events:
a. An ownership change including the sale or conveyance of the project area in
whole or in part;
b. The sale or conveyance of the common areas to a Homeowner's or Property
Owner's Association, subject to the requirements of Session Law 2011-256;
C. Bankruptcy;
d. Foreclosure;
e. Dissolution of the partnership or corporate entity;
f. A name change of the current permittee;
g. A name change of the project;
h. A mailing address change of the permittee;
Page 4 of 6

State Stormwater Management Systems
Permit Number SW8 960404
5. The permittee is responsible for compliance with all permit conditions until such time
as the Division approves the transfer request. Neither the sale of the project, in whole
or in part, nor the conveyance of common area to a third party constitutes an approved
transfer of the stormwater permit.
6. The permittee grants DEMLR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until modified, revoked, terminated
or renewed. The permit may be modified, revoked and reissued or terminated for
cause. The filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Approved plans, calculations, supplement forms, operation and maintenance
agreements and specifications for this project are incorporated by reference and are
enforceable parts of the permit. A copy of the approved plans and specifications shall
be maintained on file by the Permittee at all times.
9. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit as
allowed by the laws, rules and regulations contained in Session Law 2008-211, Title
15A NCAC 2H.1000, and NCGS 143-215.1 et. al.
10. The permittee shall submit a permit renewal application request at least 180 days prior
to the expiration date of this permit. The renewal request must include the appropriate
application, documentation and the processing fee.
Permit transferred, updated, renewed, corrected and reissued this the 8th day of March 2016.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 960404
Page 5 of 6

State Stormwater Management Systems
Permit Number SW8 960404
Ocean Isle Beach Motel
Stormwater Permit No. SW8 960404
Brunswick County
Engineer's Certification
I, , as a duly registered Professional Engineer in the
State of North Carolina, having been authorized to observe (periodically/weekly/full time) the construction
of the project,
ect)
for (Project Owner) hereby state that, to the best of my
abilities, due care and diligence was used in the observation of the project construction such that the
construction was observed to be built within substantial compliance and intent of the approved plans and
specifications.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
Page 6 of 6

DEMLR USE ONLY
D* beived
Fee Paid
Permit Number
/
AState of NfYI Carolina
Department of Environment and Natural Resources
Division of Energy Mineral and Land Resources
(NCDENR DEMLR)
STORMWATER MANAGEMENT PERMIT RENEWAL APPLICATION FORM
_This form nmy be photocopied for use as an original
that stormwater management permits, issued for projects that require the construction of engineered stormwater
control measures (Eiigh Density Permits), shall be regwred to submit an application to renew the permit 180 day:
prior to expiration of the permit. Renewed_ permits_ are validfo_r a period_ of 8years per Session Law 2011-398 (LB
781) Section 60. (c).-
J
I. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the North Carolina Department of
Environment and Natural Resources (NCDENR) Division of Energy Mineral and Land Resources (DEMLR). A
complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DEMLR Regional Office. (The appropriate office may be found by clicking on the
interactive online map at http://nortaI.ncdenr.or /g web/guest/regional-offices. Copies of the original permit can be
obtained from the Regional Office of the Division of Energy, Mineral and Land Resources.)
This Renewal is for STORMWATER PERMIT #: SW 8 960404
Please check which of the following permit renewal scenarios apply. Initia 44o_yj0AKIkhatyou have
provided the required information. AV
❑ A. Renewal Only: `,I BAN 13 2016
-$505 fee RY:—
-Renewal Form - Sign and complete all sections (send original & 1 copy)
-Recorded Documents Required By Permit: Deed restrictions, covenants, condominium/planned
community declaration & easements (if not already submitted to NCDENR DEMLR). Copies are
acceptable.
-Designer's Certification (if required by permit and not already received by NCDENR DEMLR) (See the
last page of your permit for a copy of the certification form.)
-1 Have a Copy of the Current Operation and Maintenance Agreement (O&M): Please Keep this on File
with your permit.
-I Do Not Have a Copy of the Current O&M: Initial This Line to Request a copy. (If NCDENR DEMLR
does not have a copy on file, then you will be notified to submit a new O & M form.)
❑ B. Renewal and Modification:
-$505 Fee and Pages 1 & 2 of this Renewal Form
-SWU-101 Application Form (http://vo-tal ncdenr.orgdweb/wrt/ws/su/stateszu/ orms does)
-Recorded Documents Required By Permit: Deed restrictions, covenants, condominium/planned
community declaration & easements (if not already submitted to NCDENR DEMLR). Copies are
acceptable.
- Under #11. 1. on SWU-101 Application Form —Check Box for Modification w/Renewal
-Designer's Certification (if required by permit and not already received by NCDENR DEMLR) (See the
last page of your permit for a copy of the certification form.)
- O&M Agreement ( http:1117ortal ncdenr.orshoebhnglwslsu/bmp-manual)
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page I of ORIGINAL

®' C. Renewal and Either: 1.) Permit Transfer to a New Permittee, or 2.) Project Name Change:
Please submit all items in I.A. and: _D Q_Qne,_ _ (�
bequest a NCDENR DEMLR site inspection iLtransferring permit to new property owner.
Submit One of the Two Following Forms below (forms available at http://12ortal.ncdenr.org/web/Ir/state-
stormwater-forms dots).
t. HOA Name/Ownership Change Form: For planned communities (per Chapter 47C or
Chapter 47F of the General Statutes)
_ 2. Name/Ownership Change Form: For all other transfers _
Please make sure all required information is submitted with the Name/Ownership Change form (as
¢fated to each of the available forms) and that all required signatures and initials are filled in properly
Otherwise the name change or transfer can not be processed and the original owner will remain as the
permit holder
❑ D. Renewal. Modification, and Transfer (or Name Change): Please submit pages 1 and 2 of this
Renewal form along with all items listed in I. B. and C. above (check this box and initial items in B.
& C. that you are submitting to NCDENR DEMLR.
11. APPLICANT'S CERTIFICATION
wags
Note: Ilie legally responsible party is the current permittee and/or the legally responsible representative until such time that the permit is
officially transferred through a request to DEMLR by the permittee.
I, (print or type name of permittee or person legally responsible for the permit ) Dr. DeCarol Williamson. President
certify that I have a copy of the DEMLR Approved Permit and O&M Agreement on -site (OR I have obtained a copy
from DEMLR and it will be kept on site), that I am responsible for the performance of the maintenance procedures
and the site has been, and will be, maintained according to the O & M Agreement. I agree to notify DEMLR of any
problems with the system and prior to any changes to the system or changes in ownership I will (or have through
this renewal application) notify NCDENR DEMLR and submit the proper forms to modify or transfer the permit.
All information provided�on this permit renewal application is, to the best of my knowledge, correct and complete.
Permittee Title:President
NOTARIZATION:
1, I(jCAlfl W. r%ne a Notary Public for the State of fln({-h (' VAS .
County of Pe nde r . do hereby certify that DP Card I tJ M, (' m�,crn
personally appeared before me this day of 1-1 4iN 17 (t Yw� ✓ . and acknowledge the due execution of the
forgoing stormwater BMP maintenance requirements. Witness my hand and official seal,
My commission expires: 6) 1S
Notary Signature:
SEAL
Io�OPN W. Cl/,j,�
NOTARY
V
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 2 of4 DER

III. - GENERAL INFORMATION
1. Stormwater Management Permit Number: SW8 960404
2. Permit Holder's name (specify the name of the corporation, individual, etc.):
Wilmington, North Carolina 29405
3. Print Owner/Signing Official's name and title (person legally responsible for permit):
Dr. DeCarol Williamson, President
4. Mailing Address for person listed in item 2 above:
2618 New Village Way
City:Wilmington State:NC Zip:28405
Phone: (9IO ) 251-8543
Email:[e-mail]
5. Project Name: The Islander Inn
6. Location of Project (street address):
57 West First Street
Fax: (910 ) 251-1369
City:Ocean Isle Beach County:Brunswick Zip:28469
7. Directions to project (from nearest major intersection):
From the intersection of NC179 (Beach Drive) , SR1184 (Ocean Isle Beach Road) and NC904 (Causeway Drive)
travels east along Causeway Drive over IntraCoastal Waterway to barrier Island of Ocean Isle Beach. At round
about turn right, project approximately 750 ft on the left on the ocean front.
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 3 of4

IV. PERMIT INFORMATION:
1. Specify the type of stormwater treatment: ❑Constructed Wetland ❑Bioretention ❑Wet Detention Pond
❑Dry Detention Basin ❑Infiltration Basin ®Infiltration Trench ❑Sand Filter ❑Other.
2. If any changes were made to the original DEMLR approved project list them in the space below (attach additional
pages if needed and provide "As -Built" drawings with this application). If major changes have been made to your
project please request a plan revision or modification of the permit and submit "As Built" drawings along with a
final or updated stormwater system engineer certification (if not already provided to NCDENR). DEMLR Engineer
and Designer Certification Forms are available from each NCDENR DEMLR Regional Office.
See attached Engineer's Certification by David B. Bowman provided 7-14-98 with noted diviations
rJ
E" Y9'AW 13 2016
BY:
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 4 of4

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number:
2. Project Name: Ocean Isle Beach Motel - The Islander Inn
3. Current Permit Holder's Company Name/Organization: Ocean Isle Beach Realty
4. Signing Official's Name: Odell Williamson
5. Mailing Address: 2 Causeway Drive
Title: Owner
City: Ocean Isle Beach State: NC Zip: 28469
6. Phone: ( 910 ) 579- Fax: ( )
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
[WName change of project (Please complete Item 5 below)
Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: The Islander Inn, Inc.
2. Proposed permittee's signing official's name: Dr. Odell DeCarol Williamson
3. Proposed permittee's title: President
4. Mailing Address:_ _2618 New Village Way
City: Wilmington State: NC Zip: 28405
Phone:( 910 ) 251-8543 Fax: (gin) 251-1369
5. New Project Name to be placed on permit:
The Islander Inn
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
JWThe property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
'eiNie
10 i 3 vvo
SSW N/O Change Rev24Sept2012 Page 1 of 4
IGINAL

oblelmvr,

III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement.
❑ Check here if the current permittee is only changing his/hedits name, the project name, or mailing
address, but will retain the permit. I, , the current
permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, Odell Williamson the current permittee, am submitting this application
for a transfer of ownership for permit # SW8 960404 . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature: Deceased
County of
a Notary Public for the State of
do hereby certify that
personally appeared before me this the
day of , 20, and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
SSW N/O Change Rev24Sept2012 Page 2 of 4
(Notary Seal)
ECEIVE
JAN 13 2010'
BY:

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, Dr. Odell DeCarol Williamson hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
,Rfthe most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
the DWQ approved plans and/or approved as -built plans
Sr the approved operation and maintenance agreement
8 past maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are no in I ed t�li �n package will be returned as incomplete.
Signature: Date: /�?'/7 /S'
I, . )prrlr-n ki . Cti ne_ , a Notary Public for the State of
North Carolina County of Ven& r , do hereby certify that
Dr. Odell DeCarol Williamson personally appeared before me this the
I'7 H, day of Dye✓nhe r 20 f5' , and acknowledge„Xhe„clue execution of the
forgoing instrument. Witness my hand and official seal, pPN W. C4*.,A
F
Notatgc Y
Not r ignature PUBLIC
% .o ?0
'FR COUP
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
ECEIVE
JAN 13 2011)
SSW N/O Change Rev24Sept2012 Page 3 of 4 BY:

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections 11 and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
93
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWO Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
Date:
, a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of 20, and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
SSW N/O Change Rev24Sept2012 Page 4 of 4
(Notary Seal)
ECEIVE
JAN 13 201u
BY: �—

The Islander Inn - SW8 960404
DA 1
DA 2
DA 3
DA 4
DA 5
DA 6
DA 7
DAB
DA 9
DA 10
DA 11
DA 12
Building
1235
2607
2607
2607
2607
2607
2607
1303
0
70
0
0
Pavement
1700
2610
2470
2470
2470
1714
162
80
1594
1055
0
1584
Vegetation
2168
296
296
296
296
720
763
_ 488
147
30
678
5127
Total DA
5103
5513
5373
5373
5373
5041
3532
1871
1741
1155
678
6711
Total BUA
2935
5217
5077
5077
5077
4321
2769
1383
1594
1125
0
1584
Areas 1-8,10
Total project
18250
18250
14731
17909
5353
11305
38334
47464
32981
36159

Compliance Inspection Report
Permit:
SW8960404 Effective: 10/17/96
Project:
Ocean Isle Beach Motel Islander Inn
Owner:
Ocean Isle Developing Co
County:
Brunswick
Region:
Wilmington
Contact Person: Virginia Williamson
Directions to Project:
Type of Project: Stale Stormwater - Infiltration System
Drain Areas:
On -Site Representative(s):
Related Permits:
Expiration: 10/17/06
Actress:
City/StatelZip:
Title: Vice President
Inspection Date: 03/07/2016 Entry Time: 11:30AM
Primary Inspector: Jean Conway
Secondary Inspector(s):
Christine A Hall
Reason for Inspection: Follow-up
Permit Inspection Type: State Stormwater
Facility Status: ® Compliant ❑ Not Compliant
Question Areas:
0 State Stormwater
(See attachment summary)
Phone: [phone]
Exit Time: 12:OOPM
Phone: [phone]
Inspection Type: Transfer Renewal
page: 1

Permit: SW8960404 Owner - Project: Ocean Isle Developing Cc
Inspection Date: 03/07/2016 Inspection Type Transfer Renewal Reason for Visit: Follow-up
File Review Yes No NA NE
Is the permit active? ® ❑ ❑ ❑
Signed copy of the Engineer's certification is in the file? ® ❑ ❑ ❑
Signed copy of the Operation & Maintenance Agreement is in the file? ® ❑ ❑ ❑
Copy of the recorded deed restrictions is in the file? ❑ ❑ 00 ❑
Comment: The permit has been renewed.
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? ® ❑ ❑ ❑
Is the drainage area as per the permit and approved plans? ❑ ❑ ❑
IM
Is the BUA (as permitted) graded such that the runoff drains to the system? ❑ ❑ ❑
Comment:
SW Measures Yes No NA NE
Are the SW measures constructed as per the approved plans? ❑ ❑ ❑ EM
Are the inlets located per the approved plans? ® ❑ ❑ ❑
Are the outlet structures located per the approved plans? ® ❑ ❑ ❑
Comment:
Operation and Maintenance Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? ® ❑ ❑ ❑
Are the SW BMP inspection and maintenance records complete and available for review or provided to ❑ ❑ ❑
DWO upon request?
Comment:
Other Permit Conditions Yes No NA NE
Is the site compliant with other conditions of the permit? Is ❑ ❑ ❑
Comment: The permit has been transfered to the current property owner.
Other WQ Issues Yes No NA NE
Is the site compliant with other water quality issues as noted during the inspection? M ❑ ❑ ❑
Comment:
page: 2

Completeness Review Checklist
Project Name: n. f Received Date:
Project Location: (26. Accepted Date:
Rule(s) ®2008 Coastal ®1995 Coastal ®Phase II (WiRO.) ®Universal
of Permit: New or Mod or PR I Existing Permit # (Mod or PR):
-3 Z,,�) r (a
1'3 ?�cta
1:11988 Coastal
MPE Cert on File?
Density: HD or LD
Type: Commercial
or Residential
�NCG:
%:
OK?)
Stream Class:
®SA Map
�Offsite to SW8
Subdivided?: Subdivision
or Sinele Lot
nORW Map
F JExempt
Paperwork
Emailed Engineer on:
®Supplement(s) (1 original per BMP) BMP Type(s):
0&M with correct/original signatures (1 original per BMP except LS/VFS SZecl
ole y
® pplication with correct/originalsignatures�, s vS
�p or LLC: Six. Aut . per S- OS or letter T `� ❑Email Address: Design Engineer
ithin 6mo) /01 Email Address: Owner
®Soils Report with SHWT c%u'r''— Not
®Calculations (signed/sealed)
No obvious errors
Density includes common areas, etc l0ly C-'-4
Deed Restrictions, if subdivided:
—ISlxned & Notarized
Plans
®2 Sets
Map
1-
1
®Details (roads, cul-de-sacs, curbs, sidewalks, BMPs, Buildings, el
®Wetlands: Delineated or No Wetlands
®Layout (proposed BUA dimensions)
®DA Maps ®Project Boundaries
S;'
Infiltration
Wet Pond
Offsite
Soils Report
Soils Report
❑PE Cert for Master Lot #:
SHWT:
®Deed Rest for Master ®Lot # Matches Master
Bottom:
®SHWT:
PP:
BUA Permitted (Master): sf
Visited:
BUA Proposed (Offsite): sf
Information:
Permitted Proposed:
BUA (sf)
DA (sf)
PP (el)
SHWT (el)
Depth (ft)
SA (sf)
Proposed:
Proposed:

East Coast Enginndereerr
ENGINEERS•PCAN
January 7, 2016
& Surveying, P.C.
ERS•SURVEYORS
Ms. Georgette Scott, Regional Engineer
NCDEQ - Division of Energy, Mineral & Land Resources
127 Cardinal Drive Extension
Wilmington, North Carolina 28405-3845
Subject: The Islander Inn
Ocean Isle Beach, Brunswick County
Name/Ownership Change & Stormwater Permit Renewal
On behalf of our client, The Islander Inn, Inc., please find enclosed the following items required for the
Stormwater Permit Name/Ownership Change and Stormwater Permit Renewal for the subject project:
Item No.
Copies
Description
I 1
Original Stormwater Permit Name/Ownership Change Form
2 1
Copy of the Stormwater Permit Name/Ownership Change Form
3 1
Original Stormwater Mgmt Permit Renewal Application Form
4 1
Copy of the Stormwater Mgmt Permit Renewal Application Form
5 1
Project Narrative
6 1
Copies of the Property Deeds reflecting Ownership transfers
7 1
NC Sect. State Cert. of Authority for The Islander Inn, Inc.
8 1
Copy of Existing Stormwater Permit 4SW8 960404
9 1
Copy of the September 9, 2015 Notice of Inspection
10 1
Copy of the July 14, 1998 Engineer's Certification
I I 1
Checks # 1803 & 1804 in the amount of $505.00 each to cover the
required renewal fees
As always, we appreciate your assistance. Should you have any questions or require additional
information please contact our office at your convenience.
Sincerely,
k--CEi E
Sabrina Bennett Babson JAR! 13 2016
Enclosures BY:
PC: Dr. DeCarol Williamson —The Islander Inn, Inc. w/attachments - via email
File: (1900.54) Ocean Isle Beach Motel —The Islander Inn
4918 MAIN STREET • POST OFFICE BOX 2469 • SHALLOTTE, NORTH CAROLINA 28459 • TEL: [phone] • Fax: [phone]
FIRM LICENSE NUMBER: C-3014

East Coast Engineer "ng & Surveying, P.C.
ENGINEERS•PLAN NERS•SURVEYORS
Narrative
The Islander Inn
57 West First Street
Ocean Isle Beach, Brunswick County
SW8 960404
PROJECT DESCRIPTION
The project consists of a stormwater infiltration system along West First Street of Ocean Isle
Beach within Brunswick County. The original stormwater permit was issued in October of 1996
for eight separate parcels in the name of Ocean Isle Beach Realty, with property ownership in the
name of Odell and Virginia Williamson. Original permit expiration was October 2006. Project
was constructed and a substantial compliance certification was submitted by David B. Bowman,
PE on July 14, 1998.
Ownership of said property (eight parcels) was transferred in April of 1997 to Odell DeCarol
Williamson. Ownership was transferred to The Islander Inn, Inc. on May of 1997. An Instrument
of Combination combining the eight separate parcels into one single tax parcel number with
ownership still reflected as The Islander Inn, Inc. in August 2013.
Dr. Odell DeCarol Williamson is listed with the North Carolina Dept. of the Secretary of State as
President of the Corporation.
JAN 13 2016
BY'.------'
4918 MAIN STREET . POST OFFICE BOX 2469 • SHALLOTTE, NORTH CAROLINA 28459 • TEL: [phone] • Fax: [phone]
FIRM LICENSE NUMBER: C-3014

BHI 146
a.— Tar
0701
a,a � G'ISIRAlwt
zaar_I PACE`j_
'97HAY 14 AHID153
l"Uhi -I. luillsom
BRUNSWIC RCOUfnr H a
Back and
Tax Lot No. ............. . ................................. ....................... ........... ..... Parcel Identifier No. 257, DA 037 038 039 040.041.042.
D43 ahil'04d..............
varidedby . .. ......................... .................. ......... --......... County on the .......... day of - .......... ......................... ......... ......... la.... ..__.
by-...._ ............ ..._...._...._..................._._...... ._......___. ................._........._........... ...................................................................... _...__
Nailafter recording to ..... ..... .... .......... .......... _...... . ..... .,.......... ....... ......... ............. ..... ........... .......... ................. ....................... ..
....... ....... ... .r_............................ ................. ............. I ......... ........ ........ . -............. ..... ........... .......... ............... .................................. _
Thixinshr ntwupmpamdby_BggY and_TREST,,_Attorneys at ... Law,,Po.Boz 36,,,_Shallgtte, NC....28459.
Brief description for the Index Lots 3 thru 10, Block 11, Sec C, Oc an Isle Beach
NORTH CAROLINA GENERAL WARRANTY DEED
THIB DEED made WV ...130.., day of ... ........... .. .. ..... may ...... ......... 19-.97.. by and between
ODELL DECAROL WILLIAMSON and wife,
JAN M. WILLIAMSON
GRANTEE
THE ISLANDER INN, INC., a
North Carolina corporation
0UOU3.0
15 Causeway Drive
Ocean Isle Beach, NC, 28469
m/ In app,amlaw black tar each peril, arm&, aaerou, ana, it app,amtate, cbanctw W aulr. aq. ra, ogusn fir partaneblp-
The dealgostion Greater and Grantee u used herein shall include said parties, their hein. successors, and assigns, and
shall include singular, plural, muculiee, feminine or neuter as required by eonlert
WITNBSSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
admowledged, has and by these presents does grant, bargain, sell and convey unto the Grant" in fee simple, all that
certain lot or parcel of land situated In the city of .Ocean .Isl B, Bea ch ..,_, Shallotte..... .... .. Township,
................. BtLnSNI Ck„ County, North Carolina and more particularly described as follows:
BRING all of Lots 3, 4, 5, 6, 7, 8, 9, and 10, Block 11, Section C,
Ocean Isle Beach, as more particularly described in a survey plat
recorded in Nap Hook 3 at Pages 179 and 179A in the Office of the
Register of Deeds for Brunswick County, North Carolina, to which
plat reference is hereby made and which is incorporated herein by
reference for greater certainty of description of said property.
3-7 0
Lr— S7D 039 v-
0
cr to r}�'16,n? Sloi(PyF _ a� a57 fF ot/O
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MC'
'"a F.Nw3e197'.aa.ve0al+n-r�r,•u.�.r m.r.+.cns• ��j

BK 1146 P60702
OF
The property bereinabove described was acquired by Grantor by instrument recorded In .. . ........................................... __..._.__
Book._1140 at. Page 519,r__Brunswick,_County._ Rgq!§&ry_.,,_,_...............
........................... ......
A map %bowing the above described property is recorded in Plat Hoot ... ... .... ?.................... pagaVR-and._179A
TO HAVE AND TO HOLD the aforesaid lot .r parcel of land and all privileges and appurtenances thereto belonging to
the Crane in fee simple.
And the Grantor wvenenta with the Craolm that Grantor I. seised of the premises in fee simple, has the right to convq
the same in fee simple. that title ie merltelaMe and free and clear of all encumbrances. and that Grantor will warrant and
defend the title against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property hereinabove described Is subject to the following exceptions:
rM wrrNua wutnleor, w Grow ... be,... .0 tW a..a u. .w..1 of ..n...u. au owa tee LYrameet eb bee .1e.w he b
•err./.Y W. M W go, .eY1eMN elk.. .ea w ..A u be h.n.u. .oUed by eeW We 4 ue W J .4..eve.
.M. watwa.
_ .. .. _—ramar�
0 � - C.fiil:u b�
o c�hG1.
______..___(asAu
._.� __..____.__..a..at N N. MILLI SON
Aeram O
................................ ..------ ..........____...__. p
Al n1F. WAF........at.nYa q lebreaw seal 7 --------------------------------------------- _....._.......
n••..
tr' R fq'!�''s Brunswick — career.
QTq . L . N.w> rseY a Me cevar .ea aYl..nenala .eruh Met
Odell DeCarol Williamson and wife. Jan M._Williamson
_________________ __....----- _...............__- ___.___________ arut.r.
p(/9U0 a a aeneublw .ayemd .el.r. me WY d0 seed actxawltes.d We n.evum a We M1nraer .wvmmt wimw w
)�� .TwL jWaua .NKW .Yny.e.eLL iLY th",b, ___BM . �_ --Ir
�/CK COt1....\� we...lm1.e..o4..:. S'/8_97 - �-- - --- _ _� _"v____ N.w> ee.ur
ata4R"' Naare ceaeLMA,..... —.._---- _--- ..---- ___ cWV.
L a Naery PAMc a We county ben eeWt a.enad. caul, Met ..................
be "nonedey .as. bet n m. tale day bed .clm.wlNr.d Wag __ be Y ant. yr by
be ................_------ _........ ____...... — a awn, caralua eeeeeaLe. ava IW by au Weeny day
sb— sad u W...1 O Wee .eevenu®. W. Wegener YNeum.e wee ara.- N W Gam. by .b
heWeaL "" b"M IY e.rMnY ..a bed stein.,@ N .________
wlW.m my Wa sees .rpcW damp by eeaL t41. __.W by .............
u>c.mmYa.a
'STATE OF NORTH CAROLINA
COUNTY OF BRUNSWICK (�
The Foregoing(or annexed) Certificate(s) of F, l 0.YAI Le L,.i;-
Newry rebwe
I

Bit ! I l; Q f! 0; 19
Ercur Taa
To. fat Nn.
Verified by .
by
97 OR I II PH 12: 10
S�aS
11ec ding Tome. Wok and race
1'nrcrl Idndifier \:..
Cnmrty ou Ihr day of
. Is
Mail after re ... ding to DeCarol Williamson, 15 Causeway Drive, Ocean Isle Beach, NC 28469
This instrument .rn. preq,ared by Odell Williamson'
Brief descriplisn Lrt the hdex
Lots 3-10, Bik 11, Sec L, Ocean Isle
NORTH CAROLIN,1 L.I.NI:RAL \Cf,1RRANTI' DEED
THIS DEED mad. this 1st day of April
GRANTOR
ODELL WILLIAMSON and wife,
VIRGINIA WILLIAMSON
S
2 Causeway Drive
Ocean Isle Reach, NC 28469
I997 . by and hehveen
GRANTEE
ODELL DeCAROL WILLIAMSON
n/
15 Causeway Drive
Ocean Isle Beach, NC 28469
Fble la appnpdals Week lee cash party: name, adar_. and, it ,pproptsutr, ttunrlrr .1 runt]
T. re. carpondan or parinmhlµ
The dedpaation Gralnor and Grantee as used herein shall indoor also parties, their hero, successors,
shall include aingulaq plural, mmseuline, feminine or neuter n. r psireJ by and aaeisna, ladcontext.
1PITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of o-hich is hereby
acknowled7ed, has and by these y..cuts does Scant, bargain sail and nnn-ey unto the Grantee in fee simple, sit that
certain lot or pares] of Inns] MWIWd is the Cite of Ocean Isle Beach
Brunswick
Shallotte 'yownship,
Vocally. North hrotina and m"ae parlirulally described us fnlln.rs:
BEING all all of Lots 3, 4, 5, 6, 7, 8, 9, and 10, Block 11. Section C.
according to a map of the same which is duly recorded in Book of Maps
3 at Pages 179 and 179A in the Office of the Register of Deeds for
Brunswick County, North Carolina. a`g
7n 1-7
0-- a o38 �-- cl Aid 93 2011i0.10 10
o y3 BY:
o y3 ^'
o yy
..

The property hereinal.we described was acquired hp Grantor by in,,oun.nt ecom.d in Book 120. Page 187 .. ...
the Brunnritk County P.egistry.
A map showing the above described properly is recorded in iXY1 Rook Of MAPS 3 page 179 and 179A
TO HAVE AND TO It OI.D the aforesaid WI nr parcel of land and all privileges Anil appurtenances thereto belongine to
the Grantee in fee simple.
And the Crantor envennots with the Orantee, that Grantor is seized of the premises in fee simple, has the right to tonrcp
the same in fee simple, that title is marketable and free and clear of nil enuimbraneer, and that mentor will warrant and
defend the title against the lawful claims of all person whnm>oerey except for the e.reptlnnn hereinafter stated.
Title to the properly hereinhlwe deacrilied 1. subject to the fntlolving esreptions:
EASEMENTS. RESTRICTIONS AND RIGHTS -OF -HAY OF RECORD AS MENTIONED IN THE AFORESAID REGIs my.
. Is on
eeleusl. •n en ee.ne .aa..1 II I.I Wra l.. .—d I... I..ounin 1... uM
rx rfrtNgfs wnrarnL le. G000., era Wb
—11..
ewwn 1 .1 by III evq .m .o.o. .aSn.. In e. ...1 I. .. n......m•. .1 ..W..I • nt . o—o..I A1.o, me nor ... sur xnt
•Me.I111r..
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........................................... !
� � .�� �"
�"ru.LONw:o-��.ti.........IrGle
tt•.v.I•r. n.Ln
U�/E/1 L NI IQMSONN
�.............................
by; .........................:... ;e
V ��. Lletexi lN. . ... _.. .. .... ........ .....Iful.l
i
Y1R NIA N1LL)AM5nN
.. .................
.............. ..................
I. r swatY hwlr at Air county and .t... ...... 11..niry Inn ............ .............................
Mn.vnY .... alone me tel. 4> And uk... lreree In...... he 1. ...1-1-1 ... ............. a...., ut
y....................................................... Mu.m .'slnl.n. InlMl.A... and Ie.l by atolotllr CY1r
lac .. me art W Is......f..i.e. the ou".lel te.11Ymeul .a. 000,d In A. ... nY 111 ...............
rn11e.o1..1.1.4 ..on m .•....... 1. 1 ..d .nnad by ............1 III ........................... senlLq.
r
w111v.. I.r e.sa •.a atuw w..s •r wrl, Ietl ....... any •t ........................... te....... _
u>rwmLoa .aeon. ............................... xrwrr route
STATE OFNORnI CAROLINA
COUNTY OF BMUNSR'ICI:
The Foregoing(oranncsed) Ccrliftcme(s) of �,.t.nlLL. i'bwa.
Notary(ies) Public is (are) Certified to he Correct. , ;
This Instrument wvs filed for Registration on this_ 14 Dap of (—I IBB�7
in the Book and Page shown on the Fiml Page he cof. d�a•.Y Rr199
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ROBERTJ. ROBII SONJ Regtster rDeed, "d

Corporations Division
https://www.secretary.state.nc.us/Search/profcorp/4622468
Click Here To:
North Carolina
Elaine F. Marshall DEPARTMENT OF THE
Secretary SECRETARY OF STATE
PO Box 29622 Raleigh, NC 27626-0622 [phone]
View Document Filings File an Annual Report Print a Pre -Populated Annual Report form
Amend a Previous Annual Report
Corporate Names
Legal: THE ISLANDER INN, INC.
Business Corporation Information
Sosld:
Status:
Annual Report Status:
Citizenship:
Date Formed:
Fiscal Month:
State of Incorporation:
Registered Agent:
Corporate Addresses
0424982
Current -Active
Current
Domestic
4/22/1997
December
NC
Williamson, Odell Decarol
Mailing:
2618 New Village Way
Wilmington, NC 28405
Principal Office:
2618 New Village Way
Wilmington, NC 28405
Reg Office:
2618 New Village Way
Wilmington, NC 28405
Reg Mailing:
2618 New Village Way
Wilmington, NC 28405
Officers
President: Decarol Williamson
2618 New Village Way
Wilmington NC 28405
Stock
Class:
Common Non Voting
Shares:
1900000
No Par Value:
Yes
Class:
Common Voting
Shares:
100000
No Par Value:
Yes
ECEIVE
JAN 13 2013
Account
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Register
I of 1 1/7/2016 1:13 PM

North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
September 9, 2015
Mr. Odell Decarol Williamson, President
Ocean Isle Beach Realty AND The Islander Inn, Inc.
2618 New Village Way
Wilmington, NC 28405
Subject: Notice of Inspection - Not Compliant
Ocean Isle Beach Motel Islander Inn
State Stormwater Management Permit No. SW8 960404
Brunswick County
Dear Mr. Williamson:
Donald van der Vaart
Secretary
On September 9, 2015, the Wilmington Regional Office of the Division of Energy, Mineral and Land
Resources (DEMLR) conducted a file review inspection of the Ocean Isle Beach. Motel Islander Inn
permit, located off First St, Ocean Isle Beach in Brunswick County to determine the status of
compliance with the State Stormwater Management Permit Number SW8 960404 issued on October
17, 1996. DEMLR file review revealed that the site is not in compliance with the terms and conditions
of this permit. Please find a copy of the completed form entitled "Compliance Inspection Report"
attached to this letter, which summarizes the findings of the recent inspection.
As indicated in the attached inspection report, the following deficiencies must be resolved:
15A NCAC 21-1.1003 (h): This permit expired on October 17, 2006 and must be renewed. The
current renewal period is 8 years. In order to bring this permit into an active status, two
renewals are required to be submitted as demonstrated below:
Renewal 1: October 17, 2006 + 8 years = October 17, 2014 (new expiration date)
Renewal 2: October 17, 2014 + 8 years = October 17, 2022 (new expiration date)
The renewal application is available on our website at: http://Portal.ncdenr.org/web/Ir/state-
stormwater-forms docs.
2. Permit conditions 1.6 and 111.1: According to the Brunswick County GIS website and tax records,
it appears that the property associated with this permit has been transferred to The Islander Inn,
Inc. Per the aforementioned permit conditions, a request must be submitted to the Division to
transfer the ownership of the permit.
In order to transfer the permit, please submit the appropriate Name/Ownership change form
available on our website at: http://portal.ncdenr.oM/web/ir/state-stormwater-forms docs along
with the documentation necessary to transfer the permit to the new owner. Please note that the
"HOA Name/Ownership Change Form" is only for use by permittees that have developed their
project under the Planned Community Act. The other "Name/Ownership Change Form" is for all
other projects planning to change the name of the project or transferring their permit to the new
owner of the project.
Please inform this Office in writing before October 12, 2015, of the specific actions that will be
undertaken and the time frame that will be required to correct the deficiencies. Failure to provide the
requested information, or to respond to this letter by the due date, may initiate enforcement action
including the assessment of civil penalties of up to $25,000 per day. If a written plan of action is not
submitted to this office by October 12, 2015 then DEMLR staff will re -inspect the site and issue a Notice
of Violation if the listed deficiencies have not been addressed.
Division of Energy, Mineral, and Land Resources
Land Quality Section - Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405
(910) 796-72151 Fax: [phone] • Internet: htto://portal.ncdenr.oM/webllr/

Ocean Isle Beach Motel Islander Inn
September 9, 2015
If the property covered by this permit has been/will be sold or legally conveyed to another entity
or if the permit holder has changed its name and/or mailing address, or if the project name has
been changed, it is your responsibility as the permittee to submit a completed and signed
Name/Ownership change form to DEMLR at least 30 calendar days prior to making the
changes. These forms are available on our website at: http://portal.ncdenr.org/web/Ir/state-
stormwater-forms docs.
If you have any questions, please contact me at the Wilmington Regional Office, telephone
number (910)-796-7215 or via email at [e-mail].
Sincerely,
a(i
rct- U• �I C
Christine Hall
Environmental Engineer
Enc: Compliance Inspection Report
o�gGDS\canh: \\\Stormwater\Permits & Projects\1996\960404 HD\2015 09 CEI_deficient 960404
1° cc: Georgette Scott, Wilmington Regional Office Stormwater Supervisor
WiRO Stormwater File
Page 2 of 2

Compliance Inspection Report
Permit:
SW8960404 Effective: 10/17/96
Project:
Ocean Isle Beach Motel Islander Inn
Owner:
Ocean Isle Developing Co
County:
Brunswick
Region:
Wilmington
Contact Person: Virginia Williamson
Directions to Project:
Type of Project: State Slormwater- Infiltration System
Drain Areas:
On -Site Representative($):
Related Permits:
Expiration: 10/17/06
Adress:
CltylStatelZip:
Title: Vice President
Inspection Date: 09/09/2015 Entry Time: 02:OOPM
Primary Inspector: Christine A Hall
Secondary Inspector(s):
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: ❑ Compliant EU Not Compliant
Question Areas:
State Slormwater
(See attachment summary)
Phone: [phone]
Exit Time: 02:30PM
Phone: [phone]
Inspection Type: Transfer Renewal
page: 1

Permit: SW8960404 Owner - Project: Ocean Isle Developing Co
Inspection Date: 09/09/2015 Inspection Type Transfer Renewal Reason for Visit: Routine
Inspection Summary:
In order to resolve these items of deficiency.
1. Renew the permit per 15A NCAC 02H.1003 (h) (the stormwater rules). The current renewal period is 8 years so in
order to bring this permit into an active status, two renewals are required as demonstrated below:
Renewal 1: October 17, 2006 + 8 years = October 17, 2014 (new expiration date)
Renewal 2: October 17, 2014 + 8 years = October 17, 2022 (new expiration date)
2. Transfer the permit to the current property owner, which appears to be The Islander Inn, Inc.
File Review
Is the permit active?
Signed copy of the Engineer's certification is in the file?
Signed copy of the Operation & Maintenance Agreement is in the file?
Copy of the recorded deed restrictions is in the file?
Comment. The permit exoried on October 17, 2006.
Other Permit Conditions
Is the site compliant with other conditions of the permit?
Comment: According to the Brunswick County GIS website and tax records it appears that the property
associated with this permit has been transferred to The Islander Inn Inc
Yes No NA NE
❑ ❑ ❑ ❑
page: 2

Brunswick County NC GIS
O
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Y r ? Ocean isle Be
13"
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-
September 9, 2015
PIN: 106520907044 PARCELID: 257DA037`�WNER: THE.ISLAN DER INN INC
1 = 100 Feet ADDRESSI: ADDRESS2: 2618 NEW VILLAGE WAY CITY: WILM I NGTON STATE: NC ZIPCODE: 28405
�N PARCELDESC: L-3-101.38ACRES PLAT 80/31 DEEDDATE: 7/2812013 DEEDBOOK: 3448 DEEDPAGE: 0240 PLATBOOK: 0080
W PLATPAGE: 0031 PLATDATE: 7/28/2013 ACRES: null TOWNSHIP: SHALLOTTE DEFERREDVAL:0
LANDVAL: 3300000 OTHERVAL: 210870 HOMEVAL: 2277140 TOTALVAL: 5788010 FIRECODEID: 11 FIRECODENAME: Ocean Isle
S
P W anal: W p n<peml OeY ew Cela»E b !e eavnM1. !rt ettvnry le nn gufaNeaC. TeY Ie m� a Igel E¢unen� nE fYatl nd>e fuprteNSJ Ip a I[Y feerti, appeal W mT, o(a[onrg wnlulon

Corporations Division
Page 7 of 1
North Carolina
Elaine F. Marshall DEPARTMENT OF THE
Secretary SECRETARY OF STATE
PO Box 29622 Raleigh, NC 27628-0622 (9191807-2000
Click Here To:
View Document Filings File an Annual Report Print a Pre -Populated Annual Report form
Amend a Previous Annual Report
Corporate Names
Legal: SGEAN--ISLE-BEACH:REA6TY.:INC)
Business Corporation Information
Sosld:
Status:
Annual Report Status:
Citizenship:
Date Formed:
Fiscal Month:
State of Incorporation:
Registered Agent:
Corporate Addresses
0329766
Current -Active
Current
Domestic
8/24/1993
December
NC
Williamson, Odell Decarol
Mailing:
2618 New Village Way
Wilmington, NC 28405-7426
Principal Office:
2618 New Village Way
Wilmington, NC 28405-7426
Reg Offioe:
2618 New Village Way
Wilmington, NC 28405-7426
Reg Mailing:
2618 New Village Way
Wilmington, NC 28405-7426
Officers
President: Odell Decarol Williamson
2618 New Village Way
Wilmington NC 28405
Stock
Class: COMMON
Shares: 100000
No Par Value: Yes
Account
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Register
http://www.secretary.state.nc.us/Search/profcorp/4678780
9/9/2015

Corporations Division
Page 1 of 1
Elaine F. Marshall
Secretary
Click Here To:
North Carolina
DEPARTMENT Or THE
SECRETARY OF STATE
PO Box 29622 Raleigh, NC 27626-0622 [phone]
View Document Filings File an Annual Report Print a Pre -Populated Annual Report form
Amend a Previous Annual Report
Corporate Names
Legal:.= THE-ISLANDER:INN-INCH
Business Corporation Information
Sosld:
Status:
Annual Report Status:
Citizenship:
Dale Formed:
Fiscal Month:
State of Incorporation:
Registered Agent:
Corporate Addresses
0424982
Current -Active
Current
Domestic
4/22/1997
December
NC
Williamson, Odell Decarol
Mailing:
2618 New Village Way
Wilmington, NC 28405
Principal Office:
2618 New Village Way
Wilmington, NC 28405
Reg Office:
2618 New Village Way
Wilmington, NC 28405
Reg Mailing:
2618 New Village Way
Wilmington, NC 28405
Officers
President: Decarol Williamson
2618 New Village Way
Wilmington NC 28405
Stock
Class:
Common Non Voting
Shares:
1900000
No Par Value:
Yes
Class:
Common Voting
Shares:
100000
No Par Value:
Yes
Account
Login
Register
http://www.secretary.state.nc.us/Search/profcorp/4622468 9/9/2015

IIIIIIIIIIIIIIIIIIIIIIIillllllllllll . g024a„ �'
8rv,s"lek eowlY. 11e �91�l�r of Daad� V.9. I of 2
Prepared by:
Fletcher, Toll & Ray, LLP
131 Racine Drive, Suite 201
Wilmington, NC 28403
INSTRUMENT OF
STATE OF NORTH CAROLINA
COUNTY OF BRUNSWICK
Presenter °I Pot: 7S
Total lol
Refund:
❑ Portwnao�Juu,.:memaieuue.leeu •IiMa10
9fonG�na:.
rC;.^CR; atm'+aM.r,�, wT+.r.orom,na
I,.: ;,^.;.m l:u:�xrou,., virJpyggjbJxiEa
This INSTRUMENT OF COMBINATION, made this 2'I*" day of August,
2013, by The Islander Inn, Inc., a North Carolina corporation, hereinafter referred to as
"Owner";
WITNESSETH:
WHEREAS, Owner owns those certain lots or parcels of land described in
Warranty Deed recorded in Book 1146, Page 701, Brunswick County Registry, bearing a
street address of 57 West First Street, Ocean Isle Beach, North Carolina 28469 and
identified as Tax Parcel #'s 257DA037, 257DA038, 257DA039, 257DA040, 257DA041,
257DA042, 257DA043, and 257DA044 in the Brunswick County Tax Office (hereinafter
the `Islander Inn Property"); and
WHEREAS, Owner wishes to combine the Islander Inn Property into a single tax
parcel; and
WHEREAS, Owner has caused a survey of the Islander Ito Property to be
prepared which depicts the Islander Inn Property as a single tax parcel with a total
combined area of 1.38 acres or 60,023 square feet and has recorded a map of such survey
in Map Cabinet '90, Page J_, Brunswick County Registry (the "Combination
Survey"); and

East Coast
Engineering Company, P.A. a9t
Fax: [phone] Consulting Engineers Post Of C ' 9
Office: 910,754,8029 Shallot e, NC 28459
Fridnv, July 10, 1
Ms. Linda Lewis, Environmental Engineer
NCDENR-Division of Water Quality
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Re: Ocean Isle Beach Motel
Permit No. SW8 960404
Ocean Isle Beach, North Carolina
Dear Ms. Lewis:
Construction of the stormwater management system has been completed for the
above mentioned project. Enclosed is the Engineer's Certification, in compliance with the
stormwater permit. For your records, the name of the motel has been changed to the
Islander Inn.
Should you require any additional information, or have any comments, please do
not hesitate to contact either Alan Lewis or myself at our office.
Sincerely,
David B. Bowman, P.E.
President
East Coast Engineering
Company, P.A.
Enclosures
pc: DeCarol Williamson, Islander Inn
File: 96-0008

Brunswick County NC GIS
1 = 60 Feet ADDRESSI: ADDRESS2: 2618 NEW VILLAGE WAY CITY: WILMINGTON STATE: NC ZIPCODE: 28405
iY:-
N PARCELDESC: L-3-10 1.38 ACRES PLAT 80/31 DEEDDATE: 8/29/2013 DEEDBOOK: 3448 DEEDPAGE: 0240 PLATBOOK: 0080
PLATPAGE: 0031 PLATDATE: 8/29/2013 ACRES: null TOWNSHIP: SHALLOTTE DEFERREDVAL:0
LANDVAL: 3300000 OTHERVAL: 210870 HOMEVAL: 2277140 TOTALVAL: 5788010 FIRECODEID: 11 FIRECODENAME: Ocean Isle
s
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