75683A_Read, Donald T_20191205

CAMA / 'XDREDGE & FILL
GENERAL Pr; MIT
❑ nNew Modification Complete Reissue ❑Partial Reissue
No. 75683
OA B C D
Previous permit #
Date previous permit issued_
As authorized by the State of North Carolina, Department of Environmental Quality 11 Q� r'
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �� I I f��'
p Rules attached.
Applicant Name Door' lcI T.
Address, P. Zd X CA 2-0
City t !&a iq erA K_ State VA zip Z 2
Phone # ( -4 ?2 2 $_ 1k?;t;_Mai1 d f C1 =4 (CD . G (I M
Authorized Agent CA N e
Affected ❑ CW kEW )C PTA XEs XpTs
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWs:
ORW: yes / no) PNA yes / <nc!
Project Location: County Oart
Street Address/ State Road/ Lot #(s) LO
13C6 Sir Q2 A'kn,CA WeS4
Subdivision W1I I NQ To N t+w }b t r S E C
City K U 9ev'i l IWI ., zlp ll ly g
Phone # ( — ) River Basin q MaK
Adj. Wtr. Body COr4 nat unkn
Closest Maj. Wtr. Body l b e Ar
MOM
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Agent Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit*
Application Fee(s) Check #
oaLA 9e-00te S
Permit Officbf s Printed
Signature
1 ; x/s/vAre)
Issui g 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 -
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: DoAla /d T I eaud
Mailing Address: ; 0. 6 (;� 9 v�o
—Oh c; 3-3 3
Phone Number: 75 7 - 3,79 - l0 73
Email Address: _ C1 i` C 3 r ea<Y 0 0-01, eon
I certify that I have authorized WaV&& a rdt ,
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
(1O1/NGi �04,' 1- ok 4 e ax—
at my property located at 130 5t fi-1 'Ri'c4z/igJ W& s „ , �C I � i'- R0S 1
in k,lf Deyj Wifs County.
1 furthermore certify that ! 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:
/J Signature
Do,v,z14 ! , --R eaA
Print or Type Name
Title
l Z I Z- I ?019
Date
This certification is valid through 1 I,
lot]

■ d - i" fete items 1, 2, and, A.
0 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:
111111111111111111111111111111111111111111111111
9590 9402 4944 9063 2125 81
7018 1130 0001 7153 1292
D. Is delivery
If YES, en
❑ Agent
❑ Addresses
)y In ted a . Date of Deliver.
dlffbre' 1T�1 Yes
eilve addriolai :# obVE Cj No
z
1
3. Service Type
❑ Priority Mail ExpressO
❑ Adult Signature
❑ ROOMered Mail-
0 Adult Signature Restricted Delivery
El Certified Mail®
❑ R� .bred Mail R6sb"
Delivery
❑ Certified Mail Restricted Delivery
Cl R fa
El Collect on Delivery
dRecelpt
❑ Collect on Delivery Restricted Delivery
❑ SignatureCtlnfl nn
I Mail
❑ Seaftle ConDe lrt on
i Mall Restricted Delivery
rinm
Restricted
PG Fnrm 3R11 . h dv 9nl R acti 7ssn_no_nnn_onaz
rierdM

i�iiii��iii�Aiir IIIIII
9590 9402 4944 9063 2125 81
United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box*
n-Q- &vch
0 4X LC -/IQ ,
ft, yOQ1-- A) (° 975',S�

■ Complete items 1, 2, and 3. A
■ 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:
Agent
E
M-delivery address d erent from item 1? U fye:
If YES, enter deliverp address below: ❑ No
Service Type
O Priority Mail Express©
II
I
I I
II III
II
I III I
IIIII
III
I
I II
I III
El
❑ Adult Signature
❑Registered MaiIT"'
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restrict
❑ Certified Mail®
Delivery
9590 9402 4944 9063 2125 98
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
o nrfiria w imhar (Transfer from service label)_
❑ Collect on Delivery Restricted Delivery
❑ Signature ConfirmationT
7 018 1130 0001 715 2
_a Mail
8858 ^ Mail Restricted Delivery
0 Signature Confirmation
Restricted Delivery
DC Cnrm 3Ai i I, ih, Oni
Roncinl

USPS TRACKING #
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 M4063 2125 98
United States
Postal Service
• Sender: Please print your name, address, and ZIP+4® in this
117 ►q I-P-}c Lon-e-
(1 LQ wL 97S5-1--
,IllItitti,'illlilllIIIII III 'liIIIIoil IIIIl1it$III)IIIi,l)1it11�1

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: %��T� f c 11q,
Address of Property: % S�� �7C1%.9/��c-3 % l(/c,- /)evic. ///—e- -.5F Pv�
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
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.
CK I have ii�-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 (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 initial the appropriate blank below.)
X r� do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number / Email Address
Date
(Adjacent Property Owner Information)
/ ✓t r c�
Signature* 110,
Print or Type Name
Mailing Address
Slue. t-/,00 r . llr� z ° / d
City/State/Zip
Telephone Number / Email Address
PLi tv�s'( e.� ie�i (%G-7� / �L.�: a iU t T
Date*
*Valid for one calendar year after signature*
Revised Jan. 2017

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:
Agent's Name #:
Agent's phone #:
(Lot or Street #, Street or Road, City & County)
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 (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 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
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number / Email Address
Date
"Valid for one calendar year after signature`
ner Information)
u •b.•u nary• ..
Print or ype Name `
/—�Z 6�(—
y
Mailing Address
c 5 Alc c� 7� 4(a
City/State/Zip
8 916 - 70Yf LIA0C CDC"
Teleph7�71
ber / Email Address
I IM
Date
Revised Jan. 2017

44
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This map is prepared
from data used for the 130 Sir Richard West DR Owners: Read, Donald T -Primary Tax District: Colington
�� \ ()� inventory of the real Colington NC, 27948 Owner Subdivision: Colington Harbor Sec R
`\,. • �),I property for tax Parcel: 020347000 Lot BLK-Sec: Lot: 81 Blk: Sec: R
purposes. Primary
'�!O 'n information sources such Pin: 987305183146 Building Value: $0 Property Use: Vacant Land (Private)
X.as recorded deeds, plats, ")Q, ( Land Value: $104,100 Building Type:
wills, and other primary Misc Value: $0 Year Built:
public records should be Ckes o qe,,;k , \jC, TotaI Value: $104,100
it/ t \K��t consulted for verification
of the information 23 5 t,3

�T w-40a
Untitled Map
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1.
Legend
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