71299A_Patricia & Steven Smylie_20190108

CAMA / ❑DREDGE & FILL N2 / 1299 / p 1 B C D
GENERAL PERMIT Previous permit# �J
New ❑Modification ❑Complete Reissue El 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 I SA NCAC i / y
♦Rules attached.
Applicant Name e t//. c c. �F S-4e ven SMY �i F
Address �� �ShQr Lca n4
State ^,) - ZIP Z-�
Phone # (Z-S.Z) rj (A�, Y` 2 7 E-Mail
Authorized Agent / V - 4� �Z G S �ok (n 6A �e
Affected ❑ CW P�Off 24TA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: \
ORW: yes / no PNA yes / no)
Project Location: County ° Q
Street Address/ State Road/ Lot #(s) &z4 Z7
// Z J" -�'A-f Ca^�
Subdivision 8<7k I c
City �i y � w �-� ZIP Z' %
Phone # ( - ) - River Basin AqS U 'A' Li
Adj. Wtr. Body , w nat man unkn
Closest Maj. Wtr. Body 1z, , r,4 V
Type of Project/ Activity C o� 5'� r
(Scale: ! Z4 1 )
Pier (
Fixed
Floati
Finge
Groir
BulkF
Basin
Boat
Boad
Bead
Othe
Shon
SAV:
Mora
Photi
.
Waiv_ -_
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
k,, 7:6 HN—A K ❑ See note on back regarding River Basin rules.
,_Tt � m e Er n ru
ent or Applicant Printed Name
Si
yr�
ture Please read compliance stat ent on back of permit
�
z� - ��
�6
Application Fee(s) Check #
yi/��ns Ca.r✓A�
Pe it Officer's Printed Name
ft,r�--�---vim--------
Sign `/,g / / 1 �
Issuing Date Expiration Date

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Patricia & Steven Smylie
Date: 01 /08/2019
Permit #: 71299A
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
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
Open Water
Dredge ElFill ElBoth ❑ Other ®
—impact
90
90
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date '7
Name of Property Owner Applying for Permit:
Mailing Address:
I !2 —Pos�e/,.
<'
I certify that I have authorized (agent) /t/r �� �� s�°rov 1 lqJ-to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ,
at (my property located at) ,�/� `yG�5-�r A"-
This certification is valid thru (date) /Z A / / / j
Property Owner Signature 1Z Date

■ Complete items 1, 2, 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.
1. Article Addressed to:
Chas: ' Su sal, Kilo, vie
�;ka y 16 0� 5 6T-ar& -DY.
yor1L}-ma3 r,, U (A :)3 (bq Q-
IIIIIIIIII'I IIIIII1III ('llll II II I IIII
9590 9402 3871 8060 8626 36
A-flWo Number (transfer from service label)
7018 0680 0001 5647 0571
PS Form 3811, July 2015 PSN 7530-02-000-9053
A.
-1. ti... , 9r; ❑ Agent
X ❑ Addressee
B.Received y (P4 A Name) C. Date o ep /
D 6:vI7 e
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered Mail"'
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
Certified Mail®
Delivery
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
❑ Signature ConfirmationTM
❑ Insured Mall
❑ Signature Confirmation
Mail Restricted Delivery
Restricted Delivery
100)
Domestic Return Receipt

`0
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner:
Address of Property:
L©i 0-n 1 I ',), -Dcy5� -e r L-� - k�,4
(Lot or Street #, Street or Road, City & County)
Agent's Name #: 11V Q-," r- I f) f Mailing Address: i� U -E-15o`g '[ o�
Agent's phone #: U$u 4q iV0-WY ,1 IJ C 2-2011-1 9
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has dascriUGd to me as shown on ti he attached drawing the development
they are proposing. A description or drawing,with dimensions must be provided with this letter.
l U k-7 (. Cqt . 15 x, ) L, d r o p -:Ac� u�—, 1 Uri t _ ► J r ;3 t cAr p".t be �Or-e—
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management a-ReL
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
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 setb ck, you must si n the appropriate blank below.)
f do wish to waive the 15' setback requirement.
i
(Property Owner Information)
Signature
Print or Type Name
I 1 a Dash ter -
Mailing Address
Qtyl&aWeip
Telephone Number/Email Address
►1A
Date
I do not wish to waive the 15' setback requirement.
(Adjacent Property Ovyner Information)
Signature
Print or Type Name
Zz y Z11-17r
Mailing Address
City/State2ip
Telephone 7Nuumber/Email Address
j L-`C/��
Date*
*Valid for one calendar year after signature*
Revised 2017

PD 1�
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner:
Address of Property:
io �_ ar� ,
,r L r) I6�
(Lot or Street #, Street or Road, City & County)
Agent's Name #: N �, ()(�
Agent's phone aLP) - 36,�a
Mailing Address: Po RbbX 4Q-
I hereby certify that I own property adiacent to, the ar_.ove referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
!Fn
A description or drawing, with dimensions, must be provided with this letter.
objections to this proposal. I have Ajections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management a CK-,g
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
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 sign 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 !nformat;
ture
Print or Type Name
.I. I c sh--e r' Lira .
Mailing Address
_49-i �1gy G
City/Sta e/Zip
t `J, t-A1A;L 9
Telephone Number/Email Address
►aj toy►
Date
(Adjacent Property Owner Information)
Signature*
v �o
Print or Type Name f
Mailing
aP0fiL7_rw;4
Address
�-
City/State ip
Telephone Number/Email Address
Date
"Valid for one calendar year after signature*
Revised 2017

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112 Dosher LN
Kitty Hawk NC, 27949
Parcel: 018229031
Pin: 987511663468
_ r x
4�#a,
17
72
Owners: Smylle, Patncla M Tax District: K1tty Hawk
Smylle, Steven R Subdivision: Bay Ridge Sec 3
Lot BLK-Sec: Lot: 27 Blk: Sec: 3---
SS.
low Property Use Residential �►— ?( {I �s �a'^ y
Bwld!ng Type: Beach Contemporary
WOMMMIMM Year Built: 2001
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This map is prepared 112 Dosher LN `' Owners: Smylie, Patricia M Tax District: Kitty Hawk
from data used for the
?,inventory of the real Kitty Hawk NC, 27949 Smylie, Steven R Subdivision: Bay Ridge Sec 3
• �� property for tax Parcel: 018229031 Building Value: $285,100 Lot BLK-Sec: Lot: 27 Blk: Sec: 3
u • purposes. Primary Pin: 987511663468 Land Value: $213,200 Property Use: Residential; r ! S
information sources such
as recorded deeds, plats, Misc Value: $36,100 Building Type: Beach Contemporary
y_ wills, and other primary Total Value: $534,400 Year Built: 2001
public records should be
.�~ consulted for verification ^ s
k�/f { ru�iti of the information
contained in this map.

t 1 1
2019-01 8 r . M-.�~ 2019-01-08
mac,.
-� -01-08