79306A_Clissold, Tod_20210729

*CAMA / DREDGE & FILL B C D
{GENERAL PERMIT Previous permit # _
)(New Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �{ r► 1 �, ``i
and the Coastal Resources Comrrtss�on in an area of environmental concern pursuant to I SA NCAC j � • wV
S�/N�I.. j YRules attached.
Applicant Name "c, .._� I l SJ giQ �A ._._ Project Location: County t)n.lr,,e. _ _
Address _..-,G• •'!i ._._Y">'.+" .__... ..__ _. Street Address/ State Road/ Lot #(s) .
City-._ ..u.w - sjStateN_01 zip TZ.r,'4 Pav_t_wccv��-Tr_YLi-
t
Phone # (ZQ B05 -" 14g(oM_Mail ,n_�� Subdivision
Authorized Agent _NoYYVua_t, WK N111.+ i , _ City r jt
h` _ _.. zip_ L 7_Y63'T.._.
Affected CW XEW X PTA _ ES PTS
AEC(s): OEA HHF IH UBA N/A
PWs:
ORW: yes I no PNA yes ii)
Phone # (-••.) River Basin Prgs5.4wofo*t*.
Adj. Wtr. Body__ i h &J' hR Ilow klai �(na{t' ma _unkn)
Closest Maj. Wtr. Body .P__OCL*taVe,-._.-
Type of Project/ Activity ! 31 x 1 2' 5Ltll LA 4t V1 C U "it4' i1 e7 +y1 r7i G' * I10
o � ftA t.Ly/� i j U Lj K A- Allwt Y1 --- --- — - ------ — (Scale: N 'r9 )
Pier (dock) length y
Fixed Platform(s)
Floating Platform(s)
Fingerpiens} ✓`' ` _ ya.
Groin length t
number 4 .��- -'�� L�) w ' r /
Bulkhead/ Riprap length
avg distance offshore
13:
max distance offshoreBasin, channelM z M AS ►iv LAC
cubic ands ,
y
— Q✓�
a
Boat ramp r Q
Boathous /8oactih � � i �� � t
Beach Bulldozing
Other v
Shoreline Length
SAY not sure yes '•:.: d
Moratorium: ..�' ( yes no
Photos: `�—' es no /
Waiver Attached: � no
ii..41- ]�
A building permit may be required by' e "Y— ; 1-41i/ c
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
oRl�nS_ Nrfa"me �m��
Signal A "Please read compliance statem back of permit
Application Fee(s) Check #f
I/
See note on back regarding River Basin rules.
�ry
PermitOFfter's Printed Name
Signature
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Issuing Date Expiration ate

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20ZD
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIM MIAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner.
Address of Property: S ax
* (tot or Street 4, Street or Road, City County) �j
Agent's Name #: lV E, (-Y- �a r k (-W, Mailing Address: � �i � � C�
Agent's phone 0: o/ a�,� -3�C�a� l til l �'L 2-9 9
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
with this letter.
��in rAcco ?o0_.
I have no ob*tions to this proposal. — I have objections to this proposal.
H you haw o f jecthons to what is being proposed. You must notify the Drvt Jon of Coastal AAaraOwmeW
(DCA)iin wr/tfig wttl►hn 10 days of i of this nad m Coffespondencs should boo, to 401 S.
Gd M St, SIr 300, EMmh o ,ply, NC, 27M. DCU representatives can also be confaeird at i M 284-
3001 No rstportse is coraildened the same as no ohNcffon Nyou /are bean no6i/ied by C&-~ NaN.
WANER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must back a minimum distance of 16 from my area of riparian access unless waived by
me., wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(PropwW Uwner Information} ( Property Owner Irfornation)
a�bc�t;
S>gnahim VL Ik0oie(- . PLC_
Print or type Name
McAing Addrees
vy)at-ji,z,, ocJ a)jQ5
City/SYatarZip
`96� 3c s— L q 63
Telephone Number/Emas Address
D&s
'Valid for one calendar year after slgnaWm*
Print or Type Nar"b -
1,�
AftJ*V Address
Z52 -WA( - 9003
Te/ephone NumberAEm811 Address
Dare
Revised Jan 2017

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This map is prepared
from data used for the
�-
inventory of the real
property for tax
_
rpurposes.
Primary
'-
information sources such
L
as recorded deeds, plats,
wills, and other primary
r
public records should be
consulted for verification
of the information
contained in this man_
221 Compton ST
Manteo NC, 27954
Parcel: 027249007
Pin: 988019515201
Owners: Clissold, Tod B -Primary
Owner
Building Value: $370,100
Land Value: $155,300
Misc Value: $0
Total Value: $525,400
Tax District: Manteo In
Subdivision: Marshes Light Homesites
Lot BLK-Sec: Lot: 7 Blk: Sec:
Property Use: Residential
Building Type: Bungalow Or Old Style
Year Built: 2012

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