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.CAMA/trDREDGE&FILL
ENER/AL PERMIT
EModification ICompleteReissue EPa.tial Reissue
As by the State of North Carolina, Department of Environmental euality
and the Resources Commission in an area of environmental concern pursuant to I 5A
Applicant
Previous permit #
Date previous permit issued
Project Location: County
Street Address/Road/ Lot #(s)
Subdivision
City
Phone #
Adj. Wtr.
N9 79693 A B D
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Phone #
Authorized Agent
Affected tr cw UES
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yes /PNA yqr'l Closest Maj. Wtr. Body
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Agelror Applicant Printed Name>(-I **,lar(
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Type of Proiect/ Activity
Pier (dock) length
Fixed Platform(s)
Floating
Finger
Groin length
numtler----
Bulkhead/ Riprap length Iavg distance offshore
max distance offshore
Basin, channel
--
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r---_Nlo fficubic yards
Boat ramp
Boathouse/
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Beach
Other
Bulldozing
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Moratorium: nla yes ..1...........i.... ......rttl
I 1.;
E S"" note on back regarding River Basin rules.
( Note Local PlanningJ
Notes/Special Conditions
Fee(s)
read cgmpliance statement on back of Signature
Date
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A building
Statement of Compliance and Consistency
This permit is subiect to compliance with this application, site drawing and attached Seneral and sPecific conditions. Any
violaiion of these terms may subject the permittee to a fine or criminal or civil action; and may cause the Permit to become
nulland void.
This permit must be on the proiect site and accessible to the permit officerwhen the proiect is insPected forcompliance. The
applicant certifies by signing this permit that I ) prior to undertaking any activities authorized by this Permit, the applicant will
confer with appropriate loial authorities to confirm that this proiect is consistent with the local land use plan and all local
ordinances, ,na Z; " written statement or certilied mail return receipt has been obtained from the adiacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this Permit under the best available
information and beliel certifythatthis proiect is consistentwith the North CarolinaCoastal Management Program.
River Basin RulesApplicable ToYour Proiect:
L ] Tar - PamlicoRiver Basin Buffer Rules
f Neuse RiverBasin Buffer Rules
L I ott ".'
lf indicated on front of permit, your proiect is subiect 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 (910-795-7215) for more information on howto comPlywith these buffer rules.
Division of Coastal Management Of,ices
Morehead Ciry Headquarters
400 Commerce Ave
Morehead Ciq/, NC 28557
252-808-2808/ | -888-4RCOAST
Fax:[phone]
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth District
401 S. Griffin St.
Ste. 300
Elizabeth Ciq/, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washin4on Square Mall
Washington, NC 27889
2s2-946-6481
Fax:[phone]
(Serves: Beaufon, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 2M05-3845
910-796-7215
Fax: 9 I 0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
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:
\
R.
Phone Number;(\
Email Address:
I certify that I have authorized hPt\l a \pescrv-
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
\-l€kP{
at my property located at 2O\?6HEk\U\6f
in OFCIZW
I furthermore certify that I am authoized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their a-gents to enter
on the aforementioned lands in connection with evaluating information ietatea to this
permit application.
Property Owner lnformation:
\
Pint or Type Name
e
e{
Title
-J-rj-rzsapDate
This certification is valid through
AOJACENT RIPA .P ROPERTY E R STAT MENT
I hereby certify hat I own property adjacent to A G''.trLe-(-\S S
3
of Pro Owner)
perty located at tpro
on \s tn N.C
(Wate (Clty/T d/or unty)
Th€ applicant has described to me, as shown below, the development propos€d at the above
location,,,\/ I have no objection to this proposal.
I have objeclions to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndividuat proposing developmatt must fill in description below or attach a sita drawing)
etcLot,
<.-- r.\\x\.\
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distanc€ of 15'from my area of riparian accgss unless waived by
me. (lf you h to waive the setback, you must lnltial the appropriate blank below.)
do wish to waive lhe 15' setback requirement.
_ | do not wish lo waive the 15' setback requirement.
(Property Owner lnformationl (Adjacent P
,\i re
orG Name
Mailino Address\lD(L\or{C
$€S*'bo:\o-11q
Telephone Number / email addrcsscP'16 &tJ\/ email
55
Date
..alid for one calendar year after signature"
Dale'
(Revised Aug. 2014)
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNEN UOrrrrcArION/WAIVER FORM
Name of Property Owner: lJ,EY\ '5 i.E$f,
Address of Pmpert
(Lot or Stre€t #, Steet or Road, City & County)
Agent's Name #:
Agenfs phone *l
Mailing Addr€ss:
I hereby certify that I own property adja cent to the above referenced property, The individuajeDDlying for &is permil has described to me as shown on the attached draMing-the dev6lopment
v I hale oo objections to this proposa'l- t have oblectiotrs to tbis protrk saL
ffWu have otiectlo{lrs to what is heing proposed,you must noErr th€ Division ofCoasial Management(DCM) ln :yy.l|lthtg within 10 daw of receipt of this notice- C.;ontact lnfonation for Dcllt ofrces tsavaitable at or by ca tng 14B84RCOAST-IVo ,s cottsldered the same as ,o have been notitied Certified Meit,
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I und€rstand that a pier, dock, ,*n"nHffi:o::t#X brear$aier, boarhouse- or rn mustbe set bu,Qk a minimum disnca of t s; tom-rpv aiei #iii"-#'""".", ,nress walved bv m6- f rfvou w1sf toTatye the setadq p, .r"iinit{ir n;;pi,6'i}Ji6x u"'riii
CKl o" wish ro waive the 1s serback requirement.
--
i do not wish to wai\re the 1s'setback requiremert_
a
{Prop€rty Owner lnformation)(Ri
Signature Sigranare
Prirx or Narne
Mailing
Talephone Number /Addlsss
I
'S.:<.
Pint or Typa Narne
t,,tailing Add.ess
City6tate/Zip
4\rz\2\Dae
Number
Date
1-0
(Revised Aq. 2011)
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Tax Parcel Information:Carteret County, N.C. S{
Printed May5, zozr1 in=4o ft
Ovvner: GIBBS,MERI GONNER
Cument PIN: 6386r7r16o0oooo
Site Address:
zor3 SHEPARD ST
MOREHEAD CITY
ANNAPOLIS MD zr4or z8z6
Legal Description:
L79 rlz L8 Brrg MOREHEAD CITY
Prior PIN: 4ogNoSor
City Limits: MOREHEAD CITY
Rescue District:
Flre District:
Tax District: r35r
Township: MOREHEAD
Use: RESIDENTIAL
LandValue: $683,775
BldgValue $399,486
Other Vahre: $5z,165
Total Value: 9r,135,426
Sale Price: $t,9oo,ooo
DeededAcres: 0.137
PlatRef: | /L39
Deed Ref: 1637 I z5g
Bedrooms: 4
NBHD: S1oo13
Bldg Htd Sq Ft: 3266
BldgTotSqFt: r,736
Year Built: zor4
Noise Level:
AICIJZZonet
GIS Acres: o.278
RoIl Tlpe: R
Deed Date: 2or9o51o
Bathrooms: 4.5
Mailing Address:
z5 SOUTHGATEAVENUE
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