HomeMy WebLinkAbout77941A_Clinkscales, David & Deborah_20201210I Avg
GE & FILL a C D
PERMIT Previous permit
't4 7E comptew Remsue Pantal lketsuw Date previous permit tuutd__----
As authot ized by the State of NonhCarojma, Depanme"t of Envroof-wital Qualdy iZoo
and the C"Ntaj Rrsotirces CGmmmston w in jreA of erivironnwrital comer n pw warit to I SA NCAC
Applicant Narne D,)LVICJ + ��ooirq�l CUrA4tj(4UJ5 Protect LocationCounty
Address of itA 9-0441 Street AddresVState RoA&Lot #(%) t444t
City v State ve,, Lo+
Phone #i(p1j) E)rO5-tXoJOE.mai1 CUY04,56(e(i)��w Subdmovon CC) U V11 lviq H&V
Authorized gent C�jrj4j Ct,,4,vv-AOev' Co" City COUl'\1— R&A
HY1 ZIP 2-Ti?
Affected CW XEW XPIA ES PTS Phone # k — ) --�ver in
AEC(s) OEA HHF IH UOA . N A Adl, Wtr Body Y-i)rL- Haw K- 1�5aA4
rws
ORW' yes aG PNA yes (S) Closest Mal Wtr Body
Type of Project/ Activity O"vey'e
T, — - - ------- (Scale:
Pier J*Kkj ltAgth
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at rages
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Wmvtr AtTAcked 0 LA, r:) 9,0- H 0 LA Z:' e—
A bu4tdipg permft may be requwed try See note on back tegarding Rr-er Basing rules,
(Note Local PlanninSjonsdicuon)
Notes) Special Conditions . ...... . .. . . ........
Please
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s4gfuture
101 Uzo
Is U"f4 Date
'1--4 1 1 o 12 62 1
E-Apration Date
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
Mailing Address:
i
��� to act can m
l certify that l have authorized (agent) � ��� � b'y'? Y
behalf, for the purpose of applying
g for and obtaining all CAMA Permits necessary to
install or construct (activity) C G{rPfP(� clCrCle %Dfi
at (my property located at)
[-4 l 11s, mc-" 7?�(R
This certification is valid thru (date) l 0
I ��
Property Owner Signature
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN P"OprI"lly OWNUR NOTIF-ICATIONIWAIVU tE
_R FORM
}2 40,)L'
9 9
Agent's Name # I iz 11 DO(zC
j
Agent's Phone #
tv
1avc no o�jej:tjolls t(I III,x propo,,al- I havtobjeclions to this
1f you have Objections to what is b �
[DCA14) in writing within 10 days of el"q proposes'!, You must "Otify the Division Of Coastal Manageme-ni
receipt of this rtot'ce. COITCVOndence should be mailed to 401 S.
ariffin St., Ste 300, L-1;zabeth City, NC, 2zq09. DCM rep
1pol. No MWO, 17se is rnn,�Ziri^naei the - -—n i"esentativ0s can also be contacted at (252) 264-
� as no Obiectinn if You have been notified by Certified Mail.
WAIVER SECTION
alcv+ boat rarnpr ;a�
Xlcil' �ICCC
of y �jrr,�,j
Tr-'�,--'�'--,'back. you Must initial the, appropp<j,,e
,%,-ive the 1
!,do not thn 1,)',-,0back
(7ppperty Owner Information)
S�gnature
Date
#'�-j Lz�- IVA L-1
(Ad' cent Property Owner Information)
Signature
S"17,
Hra,,, Ak
241-)
� -1 11 1) I
'Valid for one calenda, yr,,ar,�.illter sqjrJi�re1' -'J"' -1, , ,
Received
DIVISION OF COASTAL MANAGEMENT SEP 9 91C"D
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM `
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
EC
Name of Property Owner:G.vi
Address of Property: Hq( Ki++\l I�WK jc►-w bf-, �, 1( pttli I R1,115
(Lo for Street #, Skeet or Road, City & County)
Agent's Name #: /`/S (_ G �� Mailing Address: 6(/.3V IanzfCAkP l►'/���-
Agent's phone #: ,� Sa y5 �6e26 �A�G✓ 61-/t cl Iye ) 7 cl45
r
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.
/Yor 1r--W19u4g;#
I have no objections to this proposal. I have objections to this proposal. IIWW4P41)0101v-
10D7`,�// /(f
If you have objections to what is being proposed, you must notify the Division of Coastal Management #,Alt
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S. ✓1�
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264: `� p
3901. No response is considered the same as no objection if you have been notified by Certified Mail. 1�16#4*41r�
5vv/714/Y +LC
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 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
Dam of A 011 v\e. �--SGaA ea
Print or Type Name
16 3T Ta w c I & I �4A-
Mailing Address
0$0VA NX
City/State/Zip
Telephone Number/ Elhail Address
Date
(Adjacent Property Owner Information)
rl
Signature*
Print or Type Name
1066o���r� i=
Mailing Address
City/Sta ip
9'i9-ks7-7T7%p�sti>/
Telephone Number/Email Address
�S ' ��
Date*
*Valid for one calendar year after signature*
Revised Jan. 2017
Na2'1'A1m Y7 .90A-OMAqA TW�`)AVJA Co
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: DaA/ j J C Li VA 15 C aim. S
Address of Property: q f' G V ) NC,
(Lot or Street i, Street or Road, City4 County) D,,V,, Q0L v14-N 2, T9 B
Agent's Name #: CVi Yi S Cv-yyd0- r Mailing Address: (nU3 2 CO..yct 4-0)Ge 1-i,� ,�)N
Agent's phone #: 262 - 4419$95' IB(e2G PoD1 a- - P2fa ic. -L, NC
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.
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. 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 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 the setback, you must sign 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) (Adjacent Property Owner Information)
Signature
Ch,y i d C U v-vk-SCaA-e 5
Print or Type Name
I (a3-s2�''fomvv,-;P- Day-L�el 1
Mailing Address
6x Fo vd . Nc 2 4-5(o15
City/State/Zip
No i ��andd
Telephone Number/ Ema 1 Address co VVL
Signature *
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/Email Address
Date
*Valid for one calendar year after signature*
Date *
Revised 2017
, k ,
j i 6 ttifJ5
/?i(; n s rrmised
k,11 Dept gAl C ;�7%/fJ
Receiljcd
SEP .3) 1'.3
DCM-Fe
S+rudu(f 010 �C,, flovtf fAlf aj I t e K a 14L 5 C,4 i or A .
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klij cool
NC A7911�
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a
PC
ral
i
194
This map is prepared
from data used for the
inventory of the real
property for tax
purposes. Primary
1A
%
Ow.
1 Kitty Hawk Bay DR Tax District: Colington
ofington NC, 27948 Subdivision: Colington Harbour Sec H
Lot BLK-Sec: Lot: 151 Blk: Sec: H
IF*
ON"
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