78789A_Kelleher, James & Anne_20201124

a 7, ?Y,
/CAMA / YDREDGE & FILL
ENE L PERRY" Previous permit # B C D
.New Modification iComplete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina. Department of Environmental Quality 17
and the Coastal Resources Commissiort in an area of environmental concern pursuant to I SA NCAC I. Q+J
aides attached.
Applicant Name s t►- i., K-e11e Ker
Address 4,4 h / „_,n
City k: tz� +_6w r StateA t, zIPD�7clI. fq
Phone # ( ) E-Mail _
Authorized Agent Qr;-
Affected Cw ''&W ✓PTA -IS - M
AEC(s): OEA HHF IH :_USA _ _ N/A
P'WS:
ORW: yes / O PNA yes /a
Type of Project/ ActMty (Z �p6cen, e"
Pier (dock) length
s
Fixed Platform(s) _
Floating Platforms) _-- --
Finger pie(s) +'
Groin length
number
Bulkhead RiPrap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse! Boadift
/
Beach Bulldozing y
r
Other x'
Shoreline Length ± f 01 r
SAV: not sure yes
Moratorium: L J, Yes ono
Photos: /t �j no
Waiver Attached: yes
A building permit maybe required by: _ er1 ��/C S See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Project Location: County PVC,
Street Address/ State Road/ Lot #(s)1E6r�i,�
Locp f
Subdivision
Cityax,pker, gkoleS zip ';t_ -99
Phone # ( ) River Basin
Adj. Wtr. Body 0_tr:4frf-/man /unkn)
Closest Maj. Wtr: Body r�l tc
- (Scale: n i ; S }
f4 :z 'v S"s EXcc_119�b,
Agent or Applicant Printed Name
7•r
Signature ' Please read compliance statement on back of permit'"
YC'O. Do 13 t9L�
Application Fee(s) Check #
2 forfly.
Permit Officer's Printed Name �f
Signature L�
Issuing Date Expiration Date

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
' S
e
ay�t-
.y
21 North Dune LOOP Owners: Kelleher, James R -Primary Tax District: Southern Shores
Southern Shores NC, 27949 Owner Subdivision: So/sh Blk 61-a Lots 26-44 Ph
Parcel: 022523032 Kelleher, Anne M -Primary Owner 2
Pin: 986805082685 Land Value: $406,900 Lot BILK -Sec: Lot: 32 Blk: 61-a Sec:
Misc Value: $59,100 Property Use: Residential
Building Value: $513,300 Building Type: Traditional
Total Value: $979,300 Year Built: 2000
too

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Receivcd
Date Nov 2 3 2e:t
DMEC
Name of Property Owner Applying for Permit:
Mailing Address;
k,
I certify that I have authorized (agent)Si",S�Y►J , XC LLC
to act on my
behalf, for the purpose of applying for and obtaining all CA.MA permits necessary to
install or construct (activity)
at (my property located at)� ��Qi1ln
This certification is valid thru (date)
Owner Signatqre
Date

CERTIFIED r
City, State Zip
Whom It May Concern:
This correspondence is to notify
on my property at Z4 N
in �v UJ ,
drawing is attached/enclosed for your review.
as a riparian pi,.
ry�h
which is adjacent to your property.
et�r�9
�At
.1cation and project
If you have no objections to the proposed activity, please mark the appropriate statement below and return to
me as soon as possible. If no comments are received within 10 days of receipt of this notice, it will be
considered that you have no comments or objections regarding this project. If you have any questions about the
project, please do not hesitate to contact me at my address/number listed below.
If you have objections or comments, please mark the appropriate statement below and send your
correspondence to: Dabni Shelton / Wes Haskett, Town of Southern Shores, 5375 N. Virginia Dare Trail,
Southern Shores, NC 27949. Telephone: [phone]; Fax: [phone].
Sincerely,
(; ll�her66
Property Owners Name Tele hone Number / Email Address
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Val 11Z 4�
'Adjacent R ari Signature Date
arr Flo G R/ �� Cct �o �� �0
Print or Type Name Telephone Number / Email Address
Address City State Zip

Receivcd
NOV 2
DCM-EC
141
I I

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