20151260 Ver 1_Wilson-Parker Minor Mod Request_20170927

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DCM:; MN
-. APPL*1CAT1:0N
ajor e o en,t Perg it
Past revised 12127106}
North Carolina DIVISION OF COASTAL MANAGEMENT
� ? �Oollcer�tl L r�dc��nrner lnf rm ti .
Business Name
.............. ..............
Project Name (if applicable)
Applicant 1: First Name MI
Last Name
John F
wilson
ARplicant 2: First Name MI
Last Nana
William : Itilt
Parker
It additional applicants, please attach an additional pages) with names fisted.
Mailing Address Ptd Box City
State
970 Manteo
N -
ZIP Country Phone NO.
FAX No.
27954 USA - 904-494-1080 ext.
..
Street Address (if different from above) City : State
ZIP
505 Croatan Ave. Man teo NC
Email
jfwrnanteo 0 mac.cbm
............. .....................................
.77
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7
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Business Name
Quible & Associates, IAC.
Agent/ Contractor 1: First Name
MI Last dame
Warren
D Eadus
Agent/ contractor 2: First Name
ML Last Name
.........................................
MailingAddress PO Bax City
State .
870 Kitty_ Hawk
NC
ZIP Phone No. 1 : Phone No. 2
27949 252 - 2G 1 - 3300 ext.
-ext
...................................................... ... . ........................ ............ ...............................................................
FAX No. Contractor #
Street Address (if different from above) city Stab
ZIP
8466 Caratoka Highway Suite 40 Powells Point N0
2796£.,
Email
[e-mail]
continues on back
C
E<Form
=arm
SEP z 201
252-508-2805 -888- C *S ` �� WW. Das a I m a nt. '
D n CITY

Form DCM MP-1 (Page 3 of 4)
AP'PrLICATION #or
Major Development Permit
m. {i} Are there wetlands on the site?
Oyes :[]No
(11) Are there coastal wetlands on the situ
Oyes ONo
(iii) If yes to either (i) or (0) above, has a delineation been conducted?
Yes [:]No
(Attach documentation, if available
. Describe existing wastewater treatrnent facilities.,
Town of (tantoo central sewer system.
AvigWAR
Describe xi n d
ooils bee s#i g rt n king water supply source,.
.
Town of Manteo water
P� Describe existing storm water management or treatment systems,

Forma DCM MP4
P -LAND EVE PM�E�NT
(Construction and/or land disturbing activitis)
Attach this form toJoint Application for CAMA Major Permit, Form DCVI MP-1. Be sure to complete all other sections of the Joint
Appftaflon that relate to this proposed project. Please include all
supplemental information.
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a. Type and number of buildings, facilities, units or structures
b.Number of 10t& or parcels.
proposed.
One new single family residence on pilings.
c. Density {give the number of residential units and the units per
d. Side of area to be graded, filled, or disturt ed including roads,
acre .
}
ditches, etc.
Two per acre
131798 SF
----------------
-it the the proposed project will disturb more than one acre of land, the
f. List the materials (such as marl, paver stone, asphalt, or ccncWfe)
Division of Land Resources must receive an erasion and
to be used for impervious surfaces,.
sedimentation control plan at least 30 days before landodisturbing
Concrete and Gravel
activity begins.
(i) If applicable, has a sedimentation and erosion control pian been
submitted to the Division of Land Resources
C3Yes ®No (INA
-
0) If yes, dist the date submifted
,
g. Give the percentage: of the tract within the coastal shoreline AEC to
h Projepts that .require a CAMA Major ev+elopment Permit may: also
be covered by impervious and/or built-upon surfaces, such as
require a Stormwater Certification.
pavement, building- rooftops. or to be used for vehicularririveways
i Has a site -development-planbeen submitted to the I3iision.of
()
or parking
Water :dual ty for review?
Existing Coverage: 1,760.17 SF
C1Yes ONO [INA
Proposed Demo: 346.80 SF
Proposed Coverage: 3!645.35
Total: 5,058.72 (2$.4%
#i) If yeso list the date submitted
i Give the percentage of the entire tract to be covered by impervi+�us
3
andlo built-upon surfaces, such as pavement, building,. rooftops
r`
� p g P
or: to be used for vehicular driveways or parking:
Existing Coverage: 2768.06 SFSEP
2, 6, ZO 17
Proposed Demo: 346.60 SF
Proposed Coverage: 3,983.4
n MHUC
Total: 6,422.7 (28.a i j
j. Describe proposed method of sewage disposal
k. Have the facilities described in Item 0) received .state or local
The site is tied into the town of Manteo central sewer
approve!?
system.
❑Yes ONO ❑NA
If yes, attach appropriate documentation.
8 AST ammtt -12126106