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Home My WebLink About75694A_Richard E Davis Declarion of Trust_20191210❑ CAMA / '❑ DREDGE & FILL GENERAL PERMIT lNew El Modification ❑Complete Reissue ❑Partial Reissue No. 75694 v A ; �B ` c D Previous permit # 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� ules attached. Applicant Name �Iv; t ►fc I,,«l,, , o+ Iris t Address �9 - �C &X.JC (_71,'154l,c_ S; Ive- City Ha le;wC,_ StateZIP`]6-71�_-`]S�J Project Location: County f"I'a Street Address/ State Road/ Lot #(s) r' kf l� Tt Fr 1 1 Phone # (�)�Sq - SIG I E-Mail�1� r:54'Nc�,-I �:Ivei &A,,,,,; I.Cc�Subdivision S�4 <ic�rr Authorized Agent A/ P My r i ; nc_-, City sa o, i5> 0 C S ZIP a 7) Affected ❑ CW ❑ EW ® PTA ., ❑ ES %PTS Phone # ( ) River Basin l V ElOEA ❑ HHF ElIH ElUBA El N/A AEC(s): Adj. Wtr. Body % -,I 4, �,-r_ (n_; fP L eek.(nat (mc �unkn) ❑ PWS: ORW: yes / no PNA yes / no Closest Maj. Wtr. Body r<,I C C �� Type of Project/ Activity tj ! (}-,C %Z r (Scale: � r Pier q Fixec Float Finge Groir ..Bulk[ Basin Boat Boad Bead Othe Shory SAV: Mora Photr Ro■ ■■■■■■■�e■■�I■��■■■■■■■■■r■■■■ ■A■■■ ■■■■�■�Ii!7i■■■■■■■■■■■■�■�■■��,' ■■■r■■■■.ni ■■■■■■■■■■■■■■■■■■■■■■■■■■■� length number ■■■■■■■■■■■■G�� i1�lY!lRIA■■■■■■■■■■■■■■■■■ avg distance offshore ■■■■■■■■�■iiii■■■■■■■■■■■■■■■■■■■■■■■■ ■�:TI Iwl■■■�iJ■ /�/�■■■■ frii■■■■■■■■■■■!l1�1■!■�■■■ max distance offshore ■■■■■■■lY■ rGY��/�■ �S■■■■■■■■■�iiii�l�l`iiiY■■■ cubic yards ■■■■■ ■■�1i:1Y1 �—■—■■■■■■■■ ■■■■■ ■■■■� ■_■■■■ ■■■■■ ramp ■■■■■■■��I��■■■■■■■■■■■■■■■��■■■■■■■ ■■■i■i■■!!I�IJM��!'■■■■■■■■■■■■�■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■i■■■i■■■■■■■■■■■■ii ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ notsure yes (DO Q_I/a)(:; no no ■Y■■■■■■■■■■trYlij�:�7Y:�:l■■■■■■■YY�■■ Waiv- - A building permit may be required by: ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions �'AN 0� , t mores Agent or Applicant Printed Name V Signatur "Please read compliance stat ent on back of permit" Application Fee(s) Check # hPlt Permit Officers Printed Name Sigp�,tuFe 1 ` 1Ic) Issuing Date Expiration bate 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 1) 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 (9 10-796-72 15) 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: 252-247-3 3 30 Fax: 252-948-0478 (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: 252-264-3723 (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: 910-395-3964 (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 N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date r.9 Name of Property Owner Applying for Permit: Mailing Address: 1PD_ E77 �c��c��orvrr c7- 0&F,;2 ? 12�C �Arc,j C, viSTruSrt I certify that I have authorized (agent) 1] E , Man C) -e to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to �,. 2-�+ vver lcu�� install or construct (activity) �� 1 1� I a c )�1�,� L} f4- O V'f ►�' L�Jc� 2 at (my property located at) ' I Y� V� - Mkj—r0—,Lj S) shvm-'s This certification is valid thru (date) Property Owner Signature Date 1o�q DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED Pk l Clr-lo-YCA C J` 1L�; tS I hereby certify that I own property adjacent to �hr t SYt n e C•� lip v 's (Name of Prop" Owner) (Project ske. Addtesa, Lot, Block, Road, etc.) y S�ttltr`� 06i QQA in lL� ��r )1 '�� Yr-_� , N.C. (qyaftrbody) (CityiTown and/or County) Agent's Name*. fl--) I_ r r Mailing Address: PC) V�CA — Agent's phone 1A D q 9 q �1 He/She has described to me as shown below the development he/she is Proposing atthat location, .and I have no objections to the proposal. naer•_Ixt MM AMrMR DRAWING OF PROPOSED DEte'El.t?PMEf�IT (s3 k ti a :hoc ►�. " �=�- C> .vcr JAL of—r K you have objections to what /s be/ng proposed, you must noft the DivWon of Cosstal Mnruagenrent (I?CA9 in wdting w/th/n 10 days of receipt of this note& Correspondence should be nulled to 401 & Grtlf)n SL, Ste 300, Elizabeth Clty. NC, 27909. DCM rWMsw tmdv" can also NraI r F 1 l i s<(�1 �- wa„ hs— .�,,.,.. to mnmmmvwd the same as no oblect6n if yyu hays been ed by Cerdiied Nell. (Property Owner Information) Signature Print or Type Name Pa ►yak P)rj7 t_ ck,►,�,� MaXry Address •slur � �l?I � ,� , CT t� co �S� �i Cil y6i 'p �kG3 - of ? 1 COtYtSt,nc Telephone Number l Emal Address tr�l��t � ICE Dale r e 'Veld for one calendar yew after signature' information) 4JIt,- , A/ 1 �% �.1�9•lS Print or Type Name Muting Address Telephone Number/ Emal Address bete* Revised Jan. 2017 ,10tic\ DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED ;,Cc Lord E ZO-11,311's I hereby certify that I own property adjacent to ir' Iiri,6-h n e_ !!&1 J UP ✓ ,$ (Name of Property Owner) property located at W, I (Project SkeAddrisse, tt Lot, Block, Road, etc.) on Sh0h'� n na in 6Dut hPrnl S1gnrc s N.C. (yyaterbody) (City/Town and/or County) Agent's Name #: 41F rS)a_My- r . Mailing Address: POE" 40 q Agent's phone #: Late 1-.3bl% v.L lA,4 t4a 1.1 y f11-1 C, 2 19 L 1 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 (lrrdmakiat �rwst ilil ird ibn below or attach a s I MAL - a J4 oVc r I CLJn ctnd LA �k oar Wa.�. - P5 1 ad r� `�'--► 8o c,1C1 ��rnoJi�S CIA Je( y. Ovi fro r � Sec - tn5 tf you have objections to what is being proposed, you must no0y9be Division ofQseatal 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 saifme as no objection you have been no~by Certified Mail. (Property Owner Information) Signature (Adjacent Property Owner Information) i--, a Signature Richard Cpis I(la>iioc S')Iier n11t.4A-FL G <1A,isers PnW or Type INtune I Print or Type Name Po 1�m ing (Chi+,.-) Mashg Address Cxl,roeCT ntao ,ay citylstallilimp \ '�c� a�- 51 L� I (chdibhnG ) Telephone Number / Email Address e ,-) l 0 cc I I C', Date 1 I 'Valid for one calendar year after signature` l %8n 141757'a -)F- R104E C,0eL1,¢ Marling Address fARPom, FL 3Ga$ City/Stateop 7)L _ q1n - 044g AD✓A-rs tr/ pw aL AoL.ra-- Telephone Number/ Email Address Date- Lu 2 ofg Revsed Jan.2017 212.53 1'7 This map is prepared from data used for the inventory of the real property for tax purposes. Primary information sources such as recorded deeds, plats, wills, and other primary public records should be consulted for verification of the information contained in this map. 129 W Holly TRL Southern Shores NC, 27949 Parcel: 026112000 Pin: 986706287369 (218) (245) (216) (245) Owners: Davis, Richard E Trustee Of The -Primary Owner Richard E Davis Declaration Of Trust - Primary Owner Building Value: $180,700 Land Value: $169,700 Misc Value: $21,800 Total Value: $372,200 Tax District: Southern Shorts Subdivision: So/sh Soundside Blk 106 Lot BLK-Sec: Lot:17 Blk: 106 Sec: Property Use: Residential Building Type: Traditional Year Built: 1975 y. • A4 � a j This map is prepared from data used for the inventory of the real property for tax to r purposes. Primary information sources such as recorded deeds, plats, wills, and other primary public records should be consulted for verification of the information 129 W Holly TRL Southern Shores NC, 27949 Parcel: 026112000 Pin: 986706287369 Owners: Davis, Richard E Trustee Of The -Primary Owner Richard E Davis Declaration Of Trust - Primary Owner Building Value: $180,700 Land Value: $169,700 Misc Value: $21,800 Total Value: $372,200 M Tax District: Southern Shores Subdivision: So/sh Soundside Blk 106 Lot BLK-Sec: Lot: 17 Blk: 106 Sec: Property Use: Residential Building Type: Traditional Year Built: 1975 Y s