79302A_Twiddy, Clark & Anna_20210630

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: C brk ° Ann4 vy4t y
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
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kr.
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D� - H S 0 -1 11:)oIi
Ltrftl ! 1""errf 1VI'7rj
Agent / Obntractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: 1r,)17 t & iWet'rr7eal'
arld wettgngl r e, too 'firor7
at my property located at i
in 0 4 ri
County.
i furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
gnature
Aon4 wl ,-
Print or T pe Name
owne'-
Title
C 1nt
Date
This certification is valid through 1 1.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacentto Chrk -Anna Tw idd i-s 's
(Name of Property Owner)
property located at 13 5 2 nd L.9ad,+ 7q fro?d
(Address -, -Lot, Block, Road, etc.)
on Alkem'7,rle S'Uiji d in kitty H,?vvk / f.)re. N.C.
(Waterbody) — ' (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
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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. Jlf y wish to waive the setback, you must initial the appropriate blank below.)
14 I do wish to waive the 15' setback requirement.
I do not, wish to waive the 15' setback requirement.
Owner Information)
Telepho e 77d
ber / email address Telephone Number / em it address
6 /-ci 67 � .6�-'`l 0 ^A I
Dare Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C n 111 Atli 411Y
(Name of PropertyOwner
property located at q I?v, �.J i� — 4 ri
(Address, Left, Block, Road, etc.)
on AILetnarj& in r ty 1- f 1),/ r'e N C
(Waterbody) (City/TdWn and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
•1% I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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 )
� e 1 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)
Print or Type Name
Print or Type Name
Lv '74
Mailing Address
Mailing Address I
K, e t q ja & , I/ 0 Z- 7 114 17
f ,7 if tli C 27YZ1—
,ZStaferg 0
CityState fp
�)72- S7-7C;
Telephope *mber /email address
Telephone, Number /email address
i 4�)
i'Revised Aug 2014)
'Valid for one calendar year after signature*

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CLARK kANN,4,
TwIDDY

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
contained in this map.
1348 Sound Landing RD
Kitty Hawk NC, 27949
Parcel: 011282000
Pin: 986506398525
Owners: Twiddy, Clark S -Primary
Owner
Twiddy, Anna M -Primary Owner
Building Value: $0
Land Value: $352,800
Misc Value: $38,300
Total Value: $391,100
Tax District: Kitty Hawk
Subdivision: Dennis A Perry Estate
Lot BLK-Sec: Lot: 2 Blk: Sec:
Property Use: Secondary Improvement
Building Type:
Year Built:

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