71111_Alan & Linda Scott_20181016

� CAMA / rV.-, DREDGE & FILL NQ 71111
GENERAL PERMIT Previous permit # B C °
�New _.Modification ❑Complete Reissue ❑Partial Reissue 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 -q N . 1
Rules attached.
Applicant Name A o r, (_ , ., a �. S L o t i Project Location: County i^ ,, r .7.,� ►C
Address ►UCH Czfe ,.., s, R � Street Address/ State Road/ Lot #(s)
City ���io State s^ t ZIP _V LI-4
Phone # (ate) 9 N3-41a E-Mail
Authorized Agent
Affected ❑ CW IIEW II PTA [ ES ❑ PTs
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A
C PWS:
ORW: yes / ins,' PNA yes /
A
Subdivision —
City i'o r roc k ZIP
Phone # ( ) River Basin PAN
Adj. Wtr. Body r,,,K- Ste, c� man /unkn)
Closest Maj. Wtr. Body Cvr k S�
ixe form(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
max distance offshore
Basin, channel
cubic yards
Boat ram
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes
Moratorium: (3 yes no
Photos: no
MEN
POPP
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Agent or Ap t Pri teddNNNaame
Sign re ** Please read compliance statement on back of permit*
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Application Fee(s) Check #
Permit Officer's e
Si e
Issuing Date Expiration Date

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Sao i-�-
Date:
Permit#: --�- I ) I )�
Describe beloN the HABITAT disturbances'forthe 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
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
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Dredge ❑ Fill Both ❑ Other ❑
330
330
Dredge ❑ Fill ❑ Both ❑ Other"1101
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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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAS7 :: www.nccoastalmanagement.net ravised: 021031' 10

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ALAN SCOTT
Mailing Address: 1412 WATERLILY RD
COINJOCK , NC
Phone Number: 203-943-4235
Email Address:
I certify that I have authorized LAYDEN MARINE,INC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
TO CONSTRUCT 323/FT BULKHEAD
at my property located at 1412 WATERLILY RD
in CURRITUCK
County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
ALAN SCOTT
Print or Type Name
OWNER
Title
07 / 05 / 2018
Date
This certification is valid through 11 I 05 I 2018

■ Complete items 1 21K, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
;C%a/d t T34�,tc We65
1 & 5 eq x4el- 15�54Q4LO5
A.
B. Received by (Printed N
k NC 27g
D. Is deliv ry di tern 1?
If YES, a pr�eliv address bel :
❑ Agent
�!;Mdre
aye of D
Q Yes
M
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IN
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El AAdultdult Signet ure R ad Delivery ice Typ
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nO S ered Mail Rerity stricted
9590 9402 3611 7305 3947 65
O Certified Mail®
Certified Mail Restricted Delivery
❑ Collect on Delivery
10 Collect on Delivery Restricted Delivery
8 719 iestdcted Delivery
ivery
❑ Return Receipt for
Merchandise
❑ Signature ConfirrnationT
❑ Signature Confirmation
Restricted Delivery
2. Article Number (Transfer from services lahall
7 017 2620 0000 4280
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
1412 WATERLILY RD
ALAN SCOTT
(Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on CURRITUCK SOUND . in COINJOCK
I
, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatioV
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)
TO CONSTRUCT 323/ FT BULKHEAD
DRAWING ATTACHED
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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)
Signature
ALAN SCOTT
Print or Type Name
1412 WATERLILY RD
Mailing Address
COINJOCK, NC
City/State2ip
Telephone Number / email address
7/05/2018
Date LAYDEN MARINE,INC
PLEASE RESUBMIT TO P.O.BOX 1125
ELIZ.CITY, NC 27906
Property Owner Information)
Signature * l f V
Print or Type Name
LD 700 /�CIfOi� �jii�
Mailing Ar���� / rL
�� T7
City/State2ip
757 -7ogo
Telephone Number/ dmail address
i a Ju/y 2ar8
Date *
(Revised Aug. 2014)

Currituck County GIS Online Mapping
Addresses
•`
Communities
1412
•
Currituck County GIS
[phone]
www.co.currituck.nc.us/Geographic-information-Services.cfm
Aydlett
Baroo
Coi njock
Corolla
Currituck
Gibbs Woods
Grandy
Harbinger
Ja rvisbu rg
Knotts Island
Ma pie
Moyock
Point Harbor
Poplar Branch
Powells Point
Shawboro
Sligo
Wate rl i ly
°_-
County Boundary
-- state
— County
Streets
Major Streets
�.
N
— Arta ria I_Pri nci pa I
C ,
—ArterlaI_Major
— Col lecior_Major
Parcels
v
Currituck County
Aerial Photography (2016
ERed: Band_1
❑Green: Band-2
Blue: Band-3
This map should be used for general reference purposes only.
Currituck County assumes no legal liability for the information
shown on this map.

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