For my campaign I needed to make some changes to Sandpoint. They are going to be extensive enough to warrant a name change so I chose Dawnpoint. My campaign is 1/3 swashbuckling naval adventure(later), 1/3 a very edited RotRL, and 2/3 custom. Yeah I suck at math.
What I have started to do is rework Sandpoint into Dawnpoint in map form. I moved Chopper's Isle northwest, expanded the coastline to include a high bluff and cliffs upon which a naval fortress has recently been constructed. I changed (and will continue to rework) the river and have started to grow the town on the eastern and southern shores.
The biggest change, besides redoing every building, but keeping the same feel, is I remodeled and moved the cathedral.
I have posted a demo image on my blog and would like feedback on what you would change if this were your 'mostly blank' town.
The cathedral move was integral to the change and will not change based on feedback. For fun on a Friday, bonus points to anyone who recognizes the cathedral. In my opinion it is the most stunning building in the world.
A runelord simulacrum has already risen, but is frozen behind magical barriers and trapped in a form of elemental ice deep in the Sea of Fallen Stars in a partial Dead Magic/Wild Magic area 1,000 feet below the surface. I started with the Beginners Box, Blackfang to start the story with pregens, followed by Crypt of the Everflame set in a large moor. The 'sister' held prisoner at the end was Nualia as a child. I used her torment received as the impetus for the beginning of her fall. Father Tobyn moved her to Dawnpoint shortly thereafter to oversee the cathedral construction. He was secretly a Runelord cultist and tortured Nualia for years. She finally snapped and events happen much as the RotRL backstory.
My kick started campaign takes place 12 years later. It started with an attack upon the ship the PCs were on escorting a noble named Aldern Foxcloven to (a CITY)when they were attacked by Sahuagin and a Kraken (all toned down for BB characters) and were saved by another ship but were forced to dock in Dawnpoint for repairs. While in town the cathedral was attacked by Nualia's Goblins. Next a brief wilderness encounter series then Glassworks and Catacombs of the Hidden. Followed by Thistletop as a submerged coral complex against Sahuagin (Goblin stats) blah blah blah leading to a race against pirates, Thayvian Cultists and the Pathfinder Society throughout the Fallen Sea before eventually going aquadic for the BBEG events. That's the shortest version I can give.
Thanks for asking.
ps- For clarity my campaign world is a cut/paste hodgepodge of Golarion/Forgotten Realms Heartlands and my own politic notes from an old homebrew campaign setting from the 90s I made.