78505A_Brickhouse, Ann_20200214

CAMA / . DREDGE &FILL N9 78505 /A� B C D
-. GENERAL PERMIT Previous permit #
,New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality —7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC T t
[� Rules attached.
Applicant Name NN ' j r t c.K VIo u sE,
Address i-4-5 A T �OM p RO Q d
City (QU )0 61CA StateZIP 9 25
Phone # (Z,�?Z) Z 10 - (01 ids E-Mail
Authorized Agent (-� Ibe l-Glde Py11<, Heads
Affected ❑ CW ❑ EW ❑ PTA '%ES MPPTB
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ WA
❑ PWS:
ORW: yes / no PNA yes
Type of Project/ Activity /I
Project Location: County6r,9—
Street Address/ State Road/ Lot #(s) �03 9,
A0 kjpC ,
LOk a SLG
Subdivision Bu f N St 4 e 'FU I L 5 t
city__AAQqJEcv zip 21959
Phone # ( ) River Basin 90Stu GfiQN K
Adj. Wtr. Body C ,-4(k (nit /unkn)
Closest Maj. Wtr. Body Crc)c.ti t4 Su g tV
tki!c. ,.,ZK (Scale: )
Pier (dock) length
Fixed Platform(s)
i
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore -
Basin, channel
cubic yards - —
Boat ramp
Boathouse/ Boatlift —�
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes (�n;
Moratorium: n/a yes n)
Photos: yes no
Waiver Attached: yes C'�
A building permit may be required by: 'co,(`e ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) n' wlif ` �
Notes/ Special Conditions No MQ� J (AN ` 1 W Cif Ck Off" I"Aj Wq1 er lt�a ` 5 r
tie C:I ��P� P O ( 0 I
M Y mho 4
Ag t or App�pliccaant' rimed Name , n ' /
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #

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
41 �
Name of Property Owner Requesting Permit s,
Mailing Address: ���J �� QCc Al i�rl
21civs
Phone Number: -2-5 2-1 t L-C (C 1 C
Email Address: G 9y,4Ck%T d2- Cl�
I certify that I have authorized 1�t k�iG( it't rjt.t. L�� 126i
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: VIzwo
Ij
at my property located at w, �-
in 4 County.
1 furthermore certify that 1 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:
-,4, &A, -,I
/�
signature
Am �riC,�pCcSL
Print or Type Name
Title
Wx
This certification is valid through -,/ 1 30 1 2041)

Albemarie BLdkhcads and House Pilings
POst Office BOX 50
Kill Devil Hills, NC 27948
(252) 2961.7466 Offee
[phone] Fax
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Whit Pa terson
Owner/ Opm tor
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Narne of Property Owner. Ann
Address of Property: w, -&'t>i tT'W N n �.
(t of or Strut s. Street or Road. City & Countyr
Agent's "dame r Aik]/►'f ug ix h 4_!1 S Maiing Address. DJK cJD c1
Agents phone x Z`_�'L ' 2 lC ( t r cr _ k t� ter t ri * tl� N L 2 "lct'•1 �s
f hereby certify that i own property adjacent to the above reterencM- property The individual
apptyrr,t, for life permit has described to me as st►awn on the anacMed drmAwvg_the oevetopmen;
they are
epproposing. A deLsv—Pn ion �!_4raunnc. with dirttgnriQns_ rMst be provided with this letter.
i hare no objections to this prolxxai I nave obiccuons to this prtgxxal.
tf you have objections to what is being propcucci, you must notitj the Div►won of Coastal Management
(OCM) in wnting within 10 days of receipt of this notice. Contact information for DCM offices is
3v3N3ble.�f''* _ vwr?`, ":-•� •?, ;� � �s Fri M.a , -"+ "7-q of bycWti lg 1-888-4RCOAST.
No response is considered the same wt no objection if you have 4 been notified by CertMod Mail.
WAIVER SECTION
I understand that a pie►, dark. rnoctinq pilings, boa' 7arnp breakwater, boathouse. 01 nit ^gust
be set back a rummurr. distance of 15' from my area or riparian access unless waived by me (if
yo:; wish to waive the setb&:k, you must initial the approonate blanx below
I do wish to waive the 15' setback requirement.
1 do not w►sh to waive the 1 r' u1back requirement.
(Property Owner Information)
Signalurc
Ann -i�r t cKkmAp-
I'nnt or Type h*m
1-15 A burn Rel -
M&*V A ttess
c�y/SYafrJ.tip
Le l,r�uS
Tefephorie Num0er / Emair Adr res
Dale
(Ripauperty Owner Infnrnwvion
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flint or rype & me
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M&OV Address
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Citylstatefzip
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Telephone Number/Email Address
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(Revwd Aug- 2014;

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: a h n (1( Y �h o o s,:�=
Address of Property: D �) FAD AD lW U`Y mm oteo c M L-
,,,� (Lot or Street #, Street or Road, City & County)
Agent's Name #: Y�GI d LQ LA kkoaQ. S Mailing Address: Pb 60 x `J U
Agent's phone #: Z� L - ZtP 1-14 Ce (o � (� � � � � l 1 1 � S � /U L 21 1 `t b
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 dimensionsmust beprpvided 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. Contact information for DCM offices is
available athttpJ/www.nccoastalmanactement.net/weblcm/staff-listing orby calling 1-888-4RCOAST.
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, or lift 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
tic) h flam p PJ
Mailing Address
00 0 MU Ck 2- �Ci
CHy/State1Zip
2-52- Z i (10- l0—I 0 S
Telephone Number/Email Address
Date
(rn Prop a Info atio )
t ature
W++VL ,- G1, lt)/,,\I1A .t 0
Print or Type Name
Q� n 2>
Mailing Address
�AAv� :tb , A& z-1 s�1
City/State)Zip
Z52- 305 - & 8' Col
Telephone Number/Email Address
- 30 - 2 2D
Date
(Revised Aug. 2014)

Google Earth
2010 Google

ry
�T
"Wit
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.
A
103 Bartow DR
Manteo NC, 27954
Parcel: 022981000
Pin: 987020813228
Owners: Brickhouse, Ann -Primary
Owner
-Primary Owner
Building Value: $137,100
Land Value: $118,500
Misc Value: $0
Total Value: $255,600
Tax District: Manteo Out
Subdivision: Burnside Forest Sec 3
Lot BLK-Sec: Lot: J1 Blk: Sec: 3
Property Use: Residential
Building Type: Traditional
Year Built: 1981

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