75659A_Lancsek, Michael_20191113

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CAMA / I DREDGE & FILL
GENERAL PERMIT
ew Modification ❑Complete Reissue El Partial Reissue
No. 75659
Previous permit #
Date previous permit issued
fC r ` 1/
B C D
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 C-.L� f ✓' I '),
G;Rules attached.
Applicant Name /V `,Ckoke
Address—) 3 k1--00V I Aji I C-7 y
'City <1 W r State�C ZIP
Phone # ( S aC,4; i�S E-Mail
Authorized Agent
Affected EJ CW ❑ EW M/PTA ❑ ES APTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ WA
❑ PWS:
ORW: yes / n PNA \ es ) no
Project Location: County Obi e
Street Address/ State Road/ Lot #(s) �psr,o�f
Subdivision
city S�GreS ZIP a,?9g9
Phone # River Basin
Adj. Wtr. Body' Ic{K{nat /unkn)
Closest Maj. Wtr. Body
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Si nature If* Please re compliance statement on back of permit"
Application$ee(s) Check #
Pier ider's'Pr'
Signature
II -►3 1` -
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/ I-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico Tyrrell and Washington Counties)
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)
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

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 5 T c�TP_�4-��� 11�l l I 's
��//
(Name of Property Owner)
property located at Q ,; 0jL-<2LEe—+ Tf-a I r)+ 43
(Project Site: Address, Lot, Block, Road, etc.)
on C /a V ti in SGU 171n D re S N.C.
(Waterbody)
Agent's Name #:
Agent's phone #: — �-------
(CitylTown and/or County)
Mailing Address: 1$3 11Q9V7L1A(,'j1- C,�
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
(Individual proposing development must fill in description below or attach a site drawing)
1 X10 c# 0 oi�,
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 (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
(Pro O ner In /r i ) (Adjacent Property Owner Information)
i�gn/atu r Signature*
t t
{C YIaP LV1C Cc�
Print or Type Name Print or Type Name
t�'3
Mailing Add Mailing Address
S dARC-�, �6,,e 3 N L-
City/State/Zip Z-7qL I City/State/Zip
1�52- U7 —030 S Qu-6r 6&,c9 ,
Telephone Number / Email Address k� re k, , C Crw� Telephone Number / Email Address
QL 2r') i I
Date Date*
*Valid for one calendar year after signature` Revised Jan. 2017

LEGEND
EX PPE
CURRITUCK
- EX REBAR
0 - CALCULATED POINT
- EX CONC. MOH.
OONC. MOH. SET
- EX P/1f NAIL
SOUTHM-
INA NAIL SET
A%O*
SEWER SERVICEWATER
METER
PNOfE PEDESTAL
CATVUTIUTY
POLE
OUY WARE
FIRE HYDRANT
[1LCT.
®- TRANS
r�
Pitt
ST. SPOT ELEVATION
HAM
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VICINITY MAP NTS
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�N CARD
= a� SEAL
L-4554
N RR%Novel is
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TURKAROUND
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1 VEY IS SUB.ECT TO ANY FACTS THAT MAY BE
DISCLOSED BY A FULL AND ACCURATE TITLE SEARCH.
L AREA BY COORDINATE COMPUTATION - *29.239 SF.
3. F.I.R.M. ZONE -AE- (EL 70)
4. PIN NO.: 20 9ee711 5e 2D20
A RECORDED REFERENCE: 48 7, PO 8
e. 14NMUM WWNC LINES (MBL) SHOWN HEREON ARE PER THE
CURRENT LOCAL ZONING REGULATIONS OTHER SETBACKS
AND/OR RESTRICTIONS MAY APPLY AND MUST BE VERIFIED
PRIOR TO CONSTRucn(*L
7. ELEVATIONS (NAVD 1966): N/A
B. TOTAL PROPOSED LOT COVERAGE - 4,61E S.F. (I&W
CURVE TABLE
CURVE
LENGTH
RADIUS
DELTA
CHORD
CI
164.47
344.65
27'20'33'
162.92
C2
1OL40
344b5
16'51'27'
101.04
C3
137,04
892.77
8'47'41'
136.90
C4
54752
89a77
35'08'20'
538.98
1 COMMON
ELEMENT
ers
rom ■
S7510'00'W f
t88.71'
1y' M_B.L U
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PROPOSED I
WEP®0 AW D
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30 ONORES
!
LOT
Pow, 434 1
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PARMNO
(TWCAL)
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— — — —
15' M.81.
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73'20'00' E ±176.22'
Ow +1
LOT
435
SURVEY FOR
MICHAEL LANCSEK & MAR IMMENTOWICH
LOT 434 - CHICAHAUK - TOWN OF SOUTHERN SHORES
ATLANTIC TOWNSHIP — DARE COUNTY — NORTH CAROLINA
40 20 0 40 MESA
PROFFESIONAL CORAORATION
1 inch = 40 ft. P.O. BOX 1731 - KITTY HAWA( - NORTH CAROLINA - 27949
RENSFD: o0�2W�19 DMELUNo RElOCA�OI�) —„ 252-619-1620 C-2832

Wood Retaining Wall with
Side View Vertical Retaining Boards
Back
Retaining Boards Top View
Boards
Retaining
Filter Fitter Boards
Cloth Cloth �\
Post oo��oo �o
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Post Back
Boards

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For delivery information, visit our website at www.usps.com".
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Certified Mail Fee 7`• rl_I
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$ .I ilil
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Extra Services & Fees (check box add ree p re)
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❑ Return Receipt (hardcopy) $
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❑ Return Receipt (electronic) $ - •
❑ Certifled Mail Restricted Delivery ${,(�
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❑Adult Signature Required $
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❑ Adult Signature Restricted Delivery $
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Postage $i I e rc
Total Postage and s -
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3. Sent To G jr� A
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Tracking Number: 7019 0160 0000 7951 7148
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95 POTESKEET TRL
Address KITTY HAWK, NC 27949
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This map is prepared
from data used for the
�, N' ( I inventory of the real
�J property for tax
purposes. Primary
..ro X ..
information sources such
as recorded deeds, plats,
wills, and other primary
�! public records should be
�'� Ili t ,ttaf��^~ consulted for verification
of the information
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93 Poteskeet TRL Owners: Lancsek, Michael -Primary Tax District: Southern Shores
Southern Shores NC, 27949 Owner Subdivision: Chicahauk
Parcel: 022383434 Klementowich, Diane -Primary Owner Lot BLK-Sec: Lot: 434 Blk: Sec:
Pin: 986711562020 Building Value: $0 Property Use: Vacant Land (Private)
Land Value: $158,100 Building Type:
Misc Value: $0 Year Built:
Total Value: $158,100

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