78137A_Ashton, Scott & Sharon_20210416

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Name of Property Owner Applying for Permit:
soc-,'�:' 1 ft�� �C -
I certify that I have authorized (agent) �� �� �.. to act on my
behalf, for the purpose of appl ng for and obtaining all CAMA: Permits necessary to
install or construct (activity)
at (my property located at) � +' W � 42�.
This certification is valid thou (date)
M
Property Owner Signature Bate

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I
I hereby certify that I own property adjacent to Cc s
property located at q-�
(Name of Property Owner)
��(IAXN-VvLo (�"CfAfmgs
I (Project Site: Address, Lot, Stock, Road, etc.)
on LI.M JJJ C-S in CA:� y-C, X , kti C— N.C.
(Waterbody) (City/Town anclifor County)
Agent's Name Mailing Address'. VIC)
( ? 1,(4-9
Agent's phone ri I
He/She has described to me as shown below the development he/she is proposing at that location,
and i have no objections to the proposal.
— — — — --- ------------------
'0"�)
ov ble-
If you have objectilons to what is being proposed, you must notify the Division of Coastal Managoirmnt
(OCN) in writing wAhin 10 days of receipt of this notice. Corr pondence should be mailed to 401 S.
Griffin St, Ste 300, Elizabeth City, NC, 27909. DACK mpresenta6ves can also be corrWcted at f2521264-
3901.No sponse is conWdered d* same as no objection if cur have been noted b Certified i�il.
Telephone Number/ Email Address
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
(7.
Print or Type Name
Wiling Address
Telephone Number Email AddrM
't -

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIO FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to iA Is
property located at
Project Site: Address, Lo� Block. Road, etc.) C- IO IYL
.n Lvv��u dL U in ILLI=� NL C
(Wabwbody) (City/Town and/or County)
1---N
MailingAddress,AgentIs Name
Agent's phone #
HelShe has described to me as shown below the development Wshe is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
-W, n-CA ov,
volY
ff you have objections to what is being proposed, you must notify the C� vjsjon of Coasul Management
(OCY) In writing within 10 days ofrecoipt of this notice. Correspondence should be mailed to 401 S,
Griffin St., Ste 300, Elizabeth City, NC, 27909, DCM representatives can also be contactedat (252) 264-
3901. No ryes p2nse is considered the same as no 2YJ!F!Yqn if you have been notified by Certified Mail.
(Property Owner Infonnation)
Signature
Print or Tyoe Nsime
q t LAL�
Aillading Addressi
, Kee5e
113 Cort kno 4v Ir-
Telephane Number Email Address
Dote I I
*Valid for one calendar year after signature,
(AIJec nt Propq ry QWi*r Information)
�%gh­otijre*
Phr-0 cr Type Name
t,.t+ <
4 C ov
Mailing Addmw
to !LA o # , I& �� f
cloy1ftmizip
32- '46 4>e rcn, -vrA
T"phom Number/ Email Address
3/,
Date,
Revised Jan. 2017

Currituck County GIS Data Viewer
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PADW rto
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County boundary
ry
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girt
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f umluck COuOty
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Skeels
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Parcel Land Hooks
Parcels
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Currituck County
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■ewe. 1W(W .3
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