71281A_Walter B. Gray, III_20181121

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L bAMA / DREDGE & FILL N2 71281 A B C � D
GENERAL PERMIT Previous permit#
lew '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 ' {/ 2 —�
, \\ QXRules attached.
Applicant Name W 4k e-
Address 74• 3ttilX 9 `1
City Q S ex"d State N� ZIP-1�j5 j
Phone # E-Mail
Authorized Agent 06 • r f Fr o „ k 3 ,-�- S-7J %
Affected ❑ CW EW A El ES ElPTS
AEC(s):
ElOEA toHHF Y❑ IH ElURA ElN/A
❑ PWS:
ORW: yes / no PNA yes / no
Project Location: County '�D a C ---
Street Address/ State Road/ Lot #(s) L C_-,'t /
Subdivision d ``N a d <_'-s v Sec D
City NG55 f�@a. + ZIP 7 '7`J S
Phone # ( ) - River Basin u t�
Adj. Wtr. Body f: o 0 11�� <1 nat man unkn
Closest Maj. Wtr. Body IL" L^ .'.
Type of Project/ Activity ¢ .-I e e
. ( Q ` S " r•h
' +cS ,TaT J (Scale:
Pier ( �� � �
Fixed
Floati
Finge
Groir
Bulkh
Basin
Boat
Boats
Beacl
Othe
Short
SAV:
Mora
Phoo
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number
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avg distance offshore—
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ENEVA,
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cubic yards
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ramp
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Waiv_ v_
A building permit may be required by: /VCR g S 1 so, d ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) J �// /
Notes/ Special Conditions szli �ct c a o—O s � /� �t = rc d ( <z ,O V % S -it,< Tom_ ( 5 G-ta' - lYh- a
Agent or ant rimed C
v
Signature ** Please rea compliance statement on back of permit*
Fee(s) Check #
il-'> /t 1 'C- �� Q-1
Perfnit rOfficer's Printed Name
Sjgriature
Issuing ate— Expiration Date

- taw
'2018-11-21 2018-11-21

08/19/2010 20:41 2524411233 NAGS HEAD REALTY PAGE 01/01
NOV-15 2016 1Z:E4 From:C0A5THL MHN.%TMENT 252 312951 To:25?4411233
C i oni ��p r ►'�
Receivers v ► , s , �. A- dr,� t ��
AUTHOFiI�ATION FOR C A p Rrd IT APt)LICAM
DCM-EC
Name of Property owner Requesting Permit: t:UR 11
Mailing Address: 7o �—
Phone Number:
.—
Emall Address:
I certify that I have authorized
Agent/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development.
—� -
�k� O !.— � I,`��` .t�P '�►;1 YYi /4 -�,v ,
at my property located at ©iv
in -_County.
I furthermore certify that I am authorized to grant, and do in fraot graltt permission to
Divisron of Coastal Management. staff, the Local Permit Officer and thele agents to et?ter
on the aforementioned ianhs in connection with evalueti»g information related to this
p&'rmlt application.
Property owner Information:
Aj
Sign,
�1r�U1,tt or. Type, ame
Title
Orate
This certifiration is valid through

I
18.09
M
This map is prepared 4706 S Roanoke WAY Owners: Gray, Walter B Iii Tax District: Nags Head
from data used for the Nags Head NC, 27959 46
inventorySubdivision: Old Nags Head Cove Sec D
of the real
property for tax Parcel: 006329000 Building Value: $236,500 Lot BLK-Sec: Lot: 4 Blk: Sec: D
0 7i purposes. Primary Pin: 989116933608 Land Value: $219,700 Property Use: Residential
information sources such
as recorded deeds, plats, Misc Value: $11,100 Building Type: Beach Contemporary
L e" Total Value: $467,300
wills, and other primary Year Built: 1990
public records should be
consulted for verification
of the information
contained in this map.
N
i-

L.