71140_Gary Ellexson_20180815

J
K CAMA / DREDGE & FILL
GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N271140 C B C D
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality!/
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7 N o-2 U.,
0 Rules attached.
Applicant Name r ���e X r)
Address W
City Q cy 'i j (Q tat- MD zlP dCA5 3
Phone # (5_11) 2 54 (o ICI E-Mail CU ,, J5U r +' @0101
Authorized Agent '# 2le h n , Y ?, iC2
Affected ❑ CW ❑ EW fl PTA 29ES [RFTS
AEC(s): C OEA ❑ HHF ❑ IH ElURA ❑ N/A
❑ PWS:
ORW: yes / 6o,, PNA yes
Project Location: County
Street Address/ State Road/ Lot #(s)
C, ohtiSubdivision Sur G n d Sn u r-' d
City zip ;?qq_i6
Phone # ( ) -- River Basin/ PG S c10
Adj. Wtr. Body 13am /, n r, Sou r_ a' nat� /unkn)
Closest Maj. Wtr. Body Pei m /? (I o Sam' r-rl
Type of Project/ Activity
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Pr , �f
- '1:��4 III n Atent or Applican P 'ntkd Name
Signature ** P78ase read compliance statement on back of permit **
S e�w'00fly
Application Fee(s) Check #
0, ,1 )� , c, k2c:A- n v�
Permit0f0c er,'s Printed Name
o
Signature
8I/SI/0 ►1-/lS/llb
Issuing Date Expiration Date

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: � u r y E� ( eX S3n Permit #:
Date: ti/15-11fs
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Oro woe -
Dredge ❑ Fill ❑ Both ❑ Other V1
h 5 ( 5tJ4
415 [ slip
Loo mo%r,�l
Dredge ❑ Fill ❑ Both ❑ Other ©
'46s }ff
ZSS,i 4
Dredge ❑ Fill ❑ Both ❑ Other ®
a to sQAP'
dw
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanaAement.net revised: 02/03/10

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner (s) Applying for Permit: Gary Ellexson
Mailing address: IC
Telephone Number: 51g.254.6819
I certify that I have authorized Gary Price & Jennifer Price (agent)
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the proposed development of construct concrete driveway
at my property located at 54128 Surf or Sound Dr.
Frisco NC, 27015
This certification is valid through 121-7I/2018 (date)
(Pro a er Information)
(7
Sig Lure
r� V
rint Name
51.3.2.r,4.68xg
Telephone Number
r-
ul ihhur\ t, t@ Cu •Ulm
Email AVress
I I
DaTLA

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to G7, "-i EYLCySo--1 's
(Name of Property Owner)
property located at 3'fi128 SurFyr $owed ar.
(Project Site: Address, Lot, Block, Road, etc.)
on . Aamts en Sdisra d , in N.C.
(Waterbody)
Sersn.Ftr Prig
Agent's Name #: _ 67erz Price
(City/Town and/or County)
Mailing Address:
Flo s Boti 275-
Agent's phone #: ITz- 3v9%&3k7 AV.-44 Ad C, zl gM
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
If you have objections to what is being proposed, you must notify the Divislon of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 1357 US
17 South, Elizabeth City, NC, 27909, DCM representatives can also be contacted at (252) 264-39(M. No
response is considered the same as no objection if you have been noted by Certified Mail.
(Property Owner Information)
Signature
C•r EIIe SOA
Print or The Name
1/0/3 Ueticr1!7 ".
Mailing Address
I26,GkyEile, M�, 2085'?
Ci4qStatw7ip
.a13• % 6BlR
Telephone Number/Email Address
Date
"Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature"
Print or Type Name
Mailing Address
City/Stotamp
Telephone Number I Email Address
Date*

(�p
/.-
P�� CAMA PLAN FOR:
GARY ELLEXSON
o: LOT 30, PHASE III,
pR°posEo� � � SURF &SOUND
P�EXH2�O '
54128 SURF OR SOUND DRIVE
FRISCO, NC
p1ER' DATE: 07l24118
T�
11 P�o�YjP�K `,
.i` eppR�
APO: 1
1 KETELS
LOT 31
APO:
CREWS
LOT 29
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USPS.com® - USPS Tracking® Results
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Tracking Number: 70170190000083321727
On Time
Expected Delivery on
FRIDAY
27JULY by
2018 O 8:00pm p
OV Delivered
July 27, 2018 at 1:03 pm
Delivered, Left with Individual
LINTHICUM HEIGHTS, MD 21090
Get Updates \/
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Tracking History
July 27, 2018, 1:03 pm
Delivered, Left with Individual
LINTHICUM HEIGHTS, MD 21090
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Your item was delivered to an individual at the address at 1:03 pm on July 27, 2018 in
LINTHICUM HEIGHTS, MD 21090.
July 27, 2018, 8:14 am
Out for Delivery
LINTHICUM HEIGHTS, MD 21090
July 27, 2018, 8:04 am
Sorting Complete
LINTHICUM HEIGHTS, MD 21090
July 27, 2018, 5:19 am
Departed USPS Regional Facility
LINTHICUM HEIGHTS MD DISTRIBUTION CENTER
July 26, 2018, 4:03 pm
Arrived at USPS Regional Destination Facility
LINTHICUM HEIGHTS MD DISTRIBUTION CENTER
July 26, 2018
In Transit to Next Facility
July 26, 2018
In Transit to Next Facility
July 24, 2018, 10:04 pm
Arrived at USPS Regional Origin Facility
WEST PALM BEACH FL DISTRIBUTION CENTER
July 24, 2018, 6:37 pm
Departed Post Office
STUART, FL 34994
July 24, 2018, 11:43 am
USPS in possession of item
STUART, FL 34994
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Tracking Number: 70170190000083321710 Remove X
Your item was delivered at 1:36 pm on July 30, 2018 in GEORGETOWN, KY 40324.
G Delivered
July 30, 2018 at 1:36 pm
Delivered
GEORGETOWN, KY 40324
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Tracking History
July 30, 2018, 1:36 pm
Delivered
GEORGETOWN, KY 40324
Your item was delivered at 1:36 pm on July 30, 2018 in GEORGETOWN, KY 40324.
July 27, 2018
In Transit to Next Facility
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July 27, 2018, 11:23 am
Notice Left (No Authorized Recipient Available)
GEORGETOWN, KY 40324
July 26, 2018, 8:00 pm
Departed USPS Regional Facility
LEXINGTON KY DISTRIBUTION CENTER
July 26, 2018, 1:28 pm
Arrived at USPS Regional Destination Facility
LEXINGTON KY DISTRIBUTION CENTER
July 26, 2018
In Transit to Next Facility
July 25, 2018
In Transit to Next Facility
July 24, 2018, 10:04 pm
Arrived at USPS Regional Origin Facility
WEST PALM BEACH FL DISTRIBUTION CENTER
July 24, 2018, 6:37 pm
Departed Post Office
STUART, FL 34994
July 24, 2018, 11:43 am
USPS in possession of item
STUART, FL 34994
Product Information
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Page 1 of 1
a
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10 rl
`30
ft
-
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dam used r uk nvantoynr
54128 Surf Or Sound Dr
*
Tax Ownership
Current Tax Value
a, =I Property for bee
Frisco, NC 27936
Gary Allan Ellexson
Land 155,600
pu poses. Prima y iNomutlon
parcel: 030532000
Kellene K Ellexson
Building 323,100
urces such ss reecrded
deeds, pleb, Wilk, and other pommy public
w-6,haaldbeconawtodfor .r,;rcatmraf
Pin: 050514443906
(!O j Q-4P—T-
Misc 0
the UdomuUnnenn�ea.this map.
Tax District: Frisco
Total 478,700
DARECOUNTY
Subdivision: Surf & Sound Ph 3
ASSUMES NO LEGAL
RESPONSIBILUY FOR
THE INFORMATION
Lot-Blk-Sect: Lot: 30 Blk: Sec: 3
y Svo
Property Use: Residential
CONTAINED IN THIS
MAP.
Building Type: Beach Contemporary
Year Built: 2003
F1 Leaflet
Scale: 1:533
Basemap: Aerials(2012)
Parcel Lines
— Property Line
❑ Selected Parcel
http://gis.darecountync.govlreport.html?parid=030532000&lat=35.22849954327059&ing=-75.63651977778136&2=20&bas=2012&layers=Par... 8/ 14/2018

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