76804a_W.R. Malbon Family 2003 LLC_20200803

ACAMA / ?DREDGE & FILL 'N :) 76804. B C D
GENERAL PERMIT Previous permit #
New Modification '.'Complete Reissue _-.Partial Reissue Date previous permit Issued
As authorized by the State of North Carolina. Department of Environmental Quality �1
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC � f-f . ISC Cy
Appiicant Name_4J cl ._ .c::. �+C'.Cr�.i Project Location: Cou
Address_1:Z9.2 _....Gc:S iG ._ ,c d----- t t_._ G _ . _ Street Address/ State Road/ Lot #(s) 2t
StateY4 ZIP aNfS Iy /
Phone # ()_—_:_,_..,;� E-Mail ____.._ _. _�: Subdivision q r
Authorized fit.ZIP.�,.f'i1,9y_, -- ---
Affected CW x'PTA :_Es :1PTS Phone # (..... ) __...._._ River Basin
OFA HHF :- 1H 2 URA :.'N/A
AEC(s): , PWS. Adj. Wtr. Body.L.Lv_Q L _10.i1-11;t.—J._&-jK _ `nkn)
ORW: yes lino } PFiA yes / _...�
-^ Closest Mal. Wtr. Body.P"`�!#
Type of Project/ Activity i/r c �ilncn. -/1/it-v{Q
(State: )
Pier (dock) ingth.
Fixed Piatform(s)
Flaarir>z
Finpiwfs) ._. _ Q
Groin length
fJto
number
Bulkhead( R+prap iength_
avg distance offshore
max distance offshore
1
cubic yards
,
y
Boat ramp .........
Boathause/ Boast ft
_
Beach Bulldozing
Other_._.._.:_._...::... /....__ ._ ..._ ll�l
a
,-,a^r- [ '�!C+ •-
� 1
Shorefine Length
-•--�j"`-`"`—"""'
SAV: not sure yes µo
Moratorium: no '
Photos: ( no
yey
Waiver Attached: yes Cno�
r
A building permit maybe required by:.:See
note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions j d tIe4v
f''pow
40i4, A16A ,'
Age:ic or Apprcant
Na i'ermkOff ear's Printed iwme
r
Sig,aw�e ` s Please read compliance statement on back of permit** Signature
ApoicadonF*e) Check# issuing Date Expiration Date

HCDM
-th CaroTirka Depatnent of Environment and natural Resources
Division of Coastal Mariagement
Samiy Eaves Fatae, Gove or James H. C gson, Diwector Dm Fmmm, seaetw,r
Bate 6 /I, /2-o
-Name of Property Owner Applying for Permit:
R M �ft7601V OW t " LLB
Mailing Address:
19'9 �9- S '1"f 4/ kh : !)Alt Z1oo
i terms- that I have authorized (ag4st) L ( I r l !i f, 5 c-N: ✓l to act on my
hehaM for the purpose of applying for and obtaining all CAMA Permits necessary to
instaEs or cGustruct (activity)
at (my Property located at) l 7 !
This certification is 'AN dw a (date) 1 Z/31 AV
Property Owner Signature
400 Commerce Avenue, Morehead City, North Carorm 2&%7
PMne: 252-8W28Q8 t FAX: [phone]=X Internet waw.
SnEqtaOppaft*kP&Ma6M--AcfimEm*)M-M-,Q RwIdeM10%Poo Caa PaW

■ Complete Items 1, 2, and 3.
■ 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:
A. Sig ture
Agent
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B. elveSLby (Printed Name) CO—
D. Is delivery address different from item 1? yesr
If YES, enter delivery address below: ANo
Service
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Registered MaLI17
❑ Ado I Signature Retricted Delivery
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9590 9402 3813 8032 3055 94
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Merchandlt.
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7015 1660 0 0 0 0 Y 7 5 2 2 4 4 8 0
Insuredon
1 Insured Mall Restrictd Delivery
t.J lgnntre Conflirllatloll
Nnetrictd Dullvery
- (- (over $5091_
PS Form 3811, July 2015 PSN 7530-02-000.9063
Domestic Return Receipt ,
U.S. Postal Service
CERTIFI::D MAIL' RECEIPT
Domestic Mail Only
For delivery information. visit our websde at www.uspscorn-.
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❑AdutlSlgnatuu, Restricted Delivery $ _ -- .. _
Postage $0.55
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06/19/2020
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■ Complete items 1, 2, and 3.
e 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 mailptece,
or on the front If space permits.
41. de Adder to:
II I iiiiii iiii iii I ii I II II II � I IIIU I iio I IIII III
9590 9402 3813 8032 3056 00
2. Article Number Mansfer fYryn arlrvlrw i-%.n
7015 1660 P.ggP 7522 4473
PS Form 3811. July 2015 PSN 7630-02-000-9053
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ru certified all Fee
Ln $ $3.55
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A.
❑ Agent
❑ Addle
Received by fPrfnted Name) I C. Dat of Dell
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Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express®
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Certified MINIS
Delivery
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Merchandise
[-J Collect on Delivery Restricted DeMery, ❑ Signature Conflnnation—
Insurd Mail
❑ Signature Confirmation
Insured Mall Restricted Delivery
Restricted Delivery
—(over$500)
r VA 23455
0087
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r%fRturn Receipt (had, py) f SV UU
C3 [3ece Ror— Ript IAnctrurka $ _ moo Postmark
❑ Certified M W w=.tn ter I euvmy 1_ ".00 Here
C3 []Adult Siynatue Rauuiad 6
❑ Adult Signatur. Restricted Delivery $
.A Postage $ $0.55
.A Total Postage and Fees
r-1 $ . 1 $6.95
ra rT;i I? 1 O e end Apt Np., or Fs �
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06/19/2020
__--•------------------ --•-------•-
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Domestic Domestic Return Receipt

DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own propertY adjaoenf to i : 'S
(Name of Property Owanet)
property IDcated at
(Address, Lot, Blwk Road, etc.)
in Cz-rc;
on I
(Waterbody) (City/Townandlor County}
Agent's Name #: -t 1l a MaiGngAddress:
Agents phone
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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below oraftach a site drawing)
J_
�e--�..�
It you haVq*WcV=sjo WjW Is bet W pmposed, You mustthe Division afCoastat Aft=gemmnt
(DCAq in Mfg wo nhln 10 days orrecelptof this notke. Correspondence should be maifad fo 1367 US
97 South, EftabeM Gity, NC, 279M DCU reprsseniahves can also be contacted at (252) 2644M. No
response is carrsidered the same as no objectian ifyou u have been nofifled by CerWed M K
(property Ouwmer Infommtion) (Riparian Property Owner kdonnadion)
Signature Signature
Print or Type Mwne •-� c` 1 F or 7y Name
1 ! l,��� i r� I� fl G'T t� i t;J lJ T� •,'� �� i �4 ?rr'�
A�iifrtp Address - Meft
),,a,,,J- VA C*nit-k k - fjr-, J-/v-)
/Sfate* I G'y/Stare 'p
Telephone Alamher
41 O • Iv,
Date
Telephone Number
Date

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Currituck
County GIS Online
Mapping
Addresses
C.C)F71rYlllnlflf' i
AYdiett
ba rco
A
�un,lla
I
Currituck
Gibbs Woods
r3 ra ndy
Jarylsburq
Knotio Island
U.1 pie
2149 "'�
s
Mapcic
S.�
='
font Harbor
RVAnr Bmnc.h
CFvaells
RAW
5 hawboro
b l lvo
wek-rlily
County Boundary
—r btaEa
—rrnlnly
OStreets
y
Y
r
Mnjor Streets
• OA
8
—Ananal Major
• �`�
— r:nl Inricx_Mnjnr
Parcel Lnnd Hooks
2147
Parcels
❑
Currituck County
i
00
Aerial Photography (2016
Band 'I
x
121
2
00re
rlrcr.n• Rnnr1-.2
.Muir. Maivd 3
Currituck County GIS
This map should be used for general reference purposes only.
[phone]
Currituck County assumes no legal liability for the information
www.co.currituck.nc.us/Geographic-Information-Services.cfm
shown on this map.

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