79404A_Russell, Dean_20210818

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PERMIT Previous permit#_ a
Modification Complete Reissue iPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality -7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
PMules attached.
Applicant Name�Ct /l s,T a _.�_� Project Location: County__ -
Address__.. " , %� c, /'7 '� 1 C.4ct5 1', Street Address/ State Road/ Lot #(s)_G,_-
--r
City.__ fa.n Y r n State V 4- ZIP ZS f(S LLTJ � i lc••� r —
Phone#(js7) G-5t--YW- E-Mail _ Subdivision.-___
Authorized Agent _%J b L c ��s n fl�r'i ^s� � City' lei
CyyA RTS Phone # (=) River Basin
Affected OBA L) HHF .a IH E USA N/A
AEC(s): Adj. Wtr. Body_ j� O y.-A _�_fc Z G... nat n unkn)
❑ PM:
Closest Ma'. Wtr. p
ORW: yes J'no J PNA yes I�p I Y -/�- - —
Type of Project/ Activity u 1 h t mot( �. / ,t c P_.,t st: r77 / l
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger piers)
Groinlength
--number —
(Bulkh.'I Riprap length.1 7 d
-avvggg distance offshore 7
max distance offshore- f
Basin. channel -
cubic yards
Boat ramp
Boathousel Boatlift
Beach Bulldozing
Other
(Scale: A( -i--5 )
All
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Shorerne Length __1.9_' -- — j (� / /Ch •/o. 4 ,
SAM not sure yes
Moratorium: n/a yes no i S S � /
Photos: �y. 1
Waiver Attached: yes no
A building permit may be required b), CrA n+
( Note Local Planning Jurisdiction)
Notes/ Special Conditions Ex -3 t na tt r . if q--
J'1,14c All . AJ O 4v1- 'A 1 -i %c:
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Agent or Applicant Printed Name
S " Please read compliance statemen on back of permit 00
Application Fee(s) Cheek I
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❑ See note on back regarding River Basin rubs.
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I�✓on e C - vr
Pei.. tOfftcer's Printed Name
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IssuirlgDate Expiration Date

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This map is prepared
from data used for the
inventory of the real
property for tax
i purposes. Primary
information sources such
as recorded deeds, plats.
wills, and other primary
public records should he
consulted for verification
of the information
contained in this map.
141 Algonkian DR
Owners: Russell, P Dean -Secondary
Manteo NC, 27954
Owner
Parcel: 016156000
7 S?— (0 S a^ y
Pin: 987119623304
Building Value: $273,000
Land Value: $324,200
Misc Value_ $16,000
Total Value: $613,200
C da
Tax District: Manteo Out
Subdivision: Beckonridge Estates
Lot BLK-Sec: Lot: 13,14 Blk: Sec:
Property Use: Residential
Building Type: Traditional
Year Built: 1980
AC , - nr
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 1
Name of Property Owner Applying for Permit:
`Try n�� l
Mailing Address: _
Ck.510
I certify that I have authorized (agent) u 1 �, Ma K 1 r) o IL to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ,
at (my property located at)
This certification is valid thru (date)
Property Owner
Date
J ` 6 - 9 ,< 1,7 Z.
J A-
23 $ I
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■ Complete items fj 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
3Grda"
� �A.q 124 cr nlc
I
A. Signature,/
j Agent
X ` (� Cr �B'RtTEIe'sse
B. R by (Panted Name) C. Date of Depven
D. Is delivery address different from item 1? 13 Yes
It YES, enter delivery address below: ❑ No
3. Service Type 0 Registered Mil'- ®
t ❑ Adutt Signature C Registered Mail*"'
"Ad" Signature Restricted Delivery ❑ Registered Mail ResMcted
9590 9402 6189 0220 6986 56 en fied Maile Delivery
G certified Mail Restricted Delivery u Signature ConfirmationT
❑ Collect on Delivery ❑ Signature confirmation
o nr+lrla Number (transfer from service tabeo C Collect on Delivery Restricted Delivery Restricted Delivery
0090 Cool -761:9 1,898 nMc" 50o
Merl Restricted Delivery
PS Form 3811, July 2020 PSN 7530-02-OOD-9053 Domestic Return Receipt
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: Ck_ kCtr �
D Ages _
HdressE
B. Received by (PriMWJ me) C. Dateiof Delivo
5,
D. Is delivery address d'rff@rent from item 1? El Yes`
If YES, enter delivery address below: Q,Pfo
3. Service Type ❑ Priority ?clad E® xpress
!l I IIIIiI IIiI !Ilill:l II(� �lil 111 ll ; Nill! �I I,i P Adult Signature Registered Mail
I I I d�CAdult Signature art fled Mai ®Restricted Delivery C DlveryRegistered Mail Restricted
9590 9402 6345 0296 2435 8 0 Coollect annDelail very ^tool Delivery C Signature confirmatioI-, Signature n
�n Delivery Restricted Delivery Restricted Delivery
ai
7020 0090 0001 7619 11881 1z�Restricted Delivery
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Ps Form 3811, July 2020 PSN 730.4244 903 a 2. .t ! i r.t�fg4not f

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