78547A_Molster, John & Janie_20200303

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i❑LAMA / ❑ DREDGE & FILL N9 78547 aB C D
GENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑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 I SA NCAC 2— Z'
[&Rules attached.
Applicant Name So n ti- SQ n I5 to Project Location: County :D o.r -t-
Address (f1a o i Y12 r-
City06 <_ State VYA ZI/P 3 2 Z
Phone # )-s37-$y-sa E-Mail m 15J' <Q Meg Ca✓v`
Authorized Agent _0Q^d 4-LC
Affected El CW i 4W 21�TA ❑ ES El PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH O URA ❑ WA
❑ PWS:
ORW: yes / no PNA yes no
Street Address/ State Road/ Lot #(s) / o'f Y
Z(' _56o.�f SA re Rc1
Subdivision �. n d Z s /G n c� . sec 3
city ZIP Zi 9 S
Phone # ( ) ff River Basin 4c S u t QJn,, (
Adj. Wtr. Body a n d n man nkn
Closest Maj. Wtr. Body— o <-%. 4 : kF -' Z" `^ ' '7 J
i
■moo■c��n■■� ■■■■■■■ ■c■■■■■■■■■
�■■■■■ w M�■MU■■ ■MEMO ■■■■
■ % ■■■■i■� �■/RIIS ■tip■ �■■ ■■■■■■■■
■■■■■■■ ■ ■■■a %%■■ ■■■■ E■■■■■■■■
cubic yards
■■■■■■Boat ramp
�e���s�■sad■■■■■■■■■■■■■■■■■
■■■■■■�.:�■ni■■■■ems■■�■�■■■■■■■■■■■■
ON °1�iiiiiO: ■ ■■■
OE ■■M■��■1■■■�EE■■���r..Beach Bulldozing in 110. 1 ■■■■■■■
®MEMO■EEE:�:■:::�:�E�EEE■E:.EE
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes no
Photos: no - - -
t._....
Waiver Attached: es no
A building permit may be required by: A S Qo-�
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
Permit Officer's Printed Name
-
Signature
Issui gr 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 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 (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/ 1-888-411COAST 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
1-0/
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary_ for the following proposed development:
at my property located at l71
in ./���— 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 acme
,?uvoe. �
I
Date

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner. -
Address of Property: ` t Wep ClY-
(Lot or Street #, Street or Road, City & County)
Agent's Name #: QM IMP/rlcf/��d�✓•Z Mailing Ad ress:
�105 3ce."'a&A
;.-�,
Agent's phone'6 Z N(- ), ?
I hereby certify that 1 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 pr�osing. A description or drawing with dimensions must be provided with this letter.
-V
1 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 15' from my area of riparian access unless waived by
me. (if ou�wi%sh to waive the setback, you must sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Pro erty ner Information) (Ad'acent Property Owner nformation)
Signature zgnature
Print or Type Name
Mailing Address
ilV►'Il ti t?m R , Rl ewcp
Print or Type Name
0
z° uS i 3 2 T9=
Mailing Address
iY J% �n'rer JeS

.acaa.�s..— .; •�.:..vaae.sx.,s...aaeax-;, �:-..:a�.w..uac: - x�iw�.a� _--.-
a�.-c:_,
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: , AAA S- `'1��15 tG�l�
Address of Property: J -eS i-- -5 ,twe dy- IVa S tic xd A1
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Mailing Ad ress:
j[o.5 s�d>sh
Agent's phone #: lk Z T ?If�
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.
1 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. Grffffn 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 15' from my area of riparian access unless waived by
me. (If you wish to waive t e setback, you must sign the appropriate blank below_)
I do wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
I do not wish to waive the 15' setback requirement.
(Adjacent Property Owner Information)
.Signature *
Print or Type Name
Mailing Address
U

This map is prepared
from data used for Me
Dof
inventoryofthereal
property for taspurposes. primary
information sources such
as rxordd deeds, plas,
wills, and other primary
public records should be
consulted for veriliubon
the information
contained in this map.
S EAST SHORE R
061. +
N
7726 S East Shore RD
Owners: Moister, John S -Primary
Nags Head NC,27959
Owner
Parcel: 029092004
Moister, Janie S -Primary Owner
Pin: 070905099416
Building Value: $314,300
Land Value: $342,900
Misc Value: $12,700
Total Value: $669,900
st.a
ar�s.s.
lb
e
1d,73
Tax District: Nags Head
Subdivision: Pond Island
Lot BLK-Sec Lot: 4 Blk: Sec: 3
Property Use: Residential
Building Type: Old Nags Head t
Year Built: 1997

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2020-03-03 020-03-03
2020-03-03