73830A_Molster, John & Janie_20190820

❑CAMA / DREDGE & FILL
No. 73830
A B C D
GENERAL PERMIT
Previous permit#
t�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 15A NCAC�
ff 1
Applicant Name �D h A } ,� a n e �S 7 l
'.Rules attached.
Project Location: County_ C
Address- & O � 4 f o r /, /Q c rt
Street Address/ State Road/ Lot #(s)
L o y
City �„C c ,n� State V A Z//IP� 6
Z2_-j 62
Phone # (X� S3� - 8 Ys�E-Mail r' ° 15 fFr,� M e c orkA
Subdivision
Authorized Agent Qra it /f? 1, A u kA,,t4S
City s
ZIP
Affected ❑ CW ZEW NPTA aSES t1PTS
Phone # ( ) River Basin G .3 LA o
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body
t man unkn
El PWS:
ORW: yes / no PNA yes / no
Closest Maj. Wtr. Body � G ^
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Type of Project/ Activity ZJ o 11
7- + (Scale: �; 46 )
Pier
Fixei
Flom
Fingi
Groi
Bulk
Basil
Boat
Boat
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Othi
Shor
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MEMEMMENERFAZZZINVE
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r pier(s)
i length
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number
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cubic yards
ramp
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line Length 7
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A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
AJa (I 1-11 ❑ See note on back regarding River Basin rules.
G
Y 7�
Agent or Appl'cant Printed Name
1
JI 7
Signature "Please read compliance statement on back of permit"
-;0yZ�, -�,. � - / D3s
Application Fee(s) Check #
Permit Officer's Printed Name
Si titure
1(, )2��
Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal. ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
10-1
Email 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:
at my property located at
in /: //4 County.
/ furthermore certify that l 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
Print or Type FJarne
Title
_1lAt
Date

This certification is valid through
Revised Mar. 2016

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DIVISION OF COASTAL MANAGEMENT 2,
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or NAND DELIVERED
Name of Property Owner.re
Address of Property: �'� Z� 1 � � ZAk
- A
(Lot or Street #, Street or Road, City & County)
Agents Name #: 19evn wI/d1rfc-41511 Mailing Address:
Agent's phone #: �44— L4
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are propos description or drawing with dimensions must be provided with this letter.
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 (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 [phone]. 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 15from 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 Information) (A 'a e t Property Owner Information)
Signature ignat ure
Print or Type Name
l67Q�
M Address
Prir}t or�T,yie Na1n 11t(5 46t L�
I7-7�V5����,g.6AJ4r
Mailing Address
S,00 u S t 3 SO-t,(rd
j *2 1 Iss

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner. 1`; n � s t r
Address of Property: 7 !_ ' ;�- �'� �� 1 i ` _ �o L15 Aetj . {(`/(
(Lot or Street #, Street or Road, City & County)
Agent's Name #r'r.l%"
Agent's phone #: Z2(k-41
Mailing Address.
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing, with dimensions must be provided with this letter.
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 (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 [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
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.)
(Property Owner Information)
Mgroture
Print or Type Name
Mailing Address-4�f �-J
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Property Owner Information)
Signature
Pv. •it P $ flayst,s , at
Print or Type Name
Mailing Address

�. ,,,� ,� `•""fit r �
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This map is prepared
from data used for the
\' (y. inventory of the real
�J property for tax
purposes. Primary
information sources such
as recorded deeds, plats,
wills, and other primary
1� public records should be
/ff f 1K�A- consulted for verification
of the information
contained in this map.
k
7726 S East Shore RD
Nags Head NC, 27959
Parcel: 029092004
Pin: 070905099416
}... -�igr• �� 1
Owners: Moister, John S - Primary
Owner
Moister, Janie S - Primary Owner
Building Value: $314,300
Land Value: $342,900
Misc Value: $12,700
Total Value: $669,900
n
13.'13 i
7.15
Tax District: Nags Head
Subdivision: Pond Island
Lot BLK-Sec: Lot: 4 Blk: Sec: 3
Property Use: Residential
Building Type: Old Nags Head _
Year Built: 1997
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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Molster
Date: 08/20/19
Permit #: 73830A
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
Shoreline
Dredge ❑ Fill ® Both ❑ Other ❑
100
100
Shallow bottom
Dredge ❑ Fill ® Both ❑ Other ❑ 200
200
High ground
Dredge ❑ Fill ❑ Both ElOther
1500
1500
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 cc 1-888-4RCOAST :c www.nccoastaimanagement.net revised.0203"10