83919A_Anderson, John_20210824

>?,CAMA / DREDGE & FILL Na K3y 1 y i` `,' B "'C D V
~ Previous permit #
GENERAL PERMIT
)r Nevv Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �/
ules attached.
4pplicar��3me _ (��n._y� & A —N �_O .,,�•�Project Location: County_ GLL�%`L�----- - _--
4ddress 1���� ` � �Ifit/'�y�� ��xr Vu�►a�r Street Address/ State Road/ Lot #(s)�
-ity �-{U wtv�i�S�OWtn State P� ZIP �'d3NC yl y ✓��Slpt��----
'hone # (41T) &Z9 20:58 E-Mail j ?aA%Lw_flO5 (-' Subdivision ro
o �,
authorized Agent _1 City ( 6 ZIP—L—�--' �}— ---
effected CW )(EW )(PTA [ES PTS Phone # ("�) _ River Basin
OEA HHF IH USA N/A i ,_ ,� - - ,. •,
\EC(s): Adj. Wu•. Body_Al 1l�Y�i Ai ry at man_- unkn
PWS: _
�� Closest Maj. Wtr. Body Ma1-
3RW: yes !V PNA yes
Type of Project/ Activity N C3 1'i�► Ll t� i X i Le r "✓ n l Ev WL --
- -- --- - - (Scale: N 'rz-? )
Pier (dock) length
Fixed Platform(s)
it
Floating Platform(s)
Finger pier(s) I
Groin length _
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing _
Other
Shoreline Length_ —I J I t
SAV not sure yes no
Moratorium n a yes no
Photos: es no
Waiver Attached: yes no
t R` s See note on back regarding River Basin rules.
A building perms[ may be required by:
( Note Local planning)urisdietion) ��
Notes! Special Conditions
Applicant Printed Name
;ignaaire "" Please read compliance statement on back of permit
0Z.X-00 - -- - - - - 1039
kpplication Fee(s) Check #
Permit Officer's Printed Name
Signature ,
Issuing Date Expiration 044

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: -? 10 �V�T cal CA-,
PA
Phone Number: 7
Email Address: Pr'k
I certify that I have authorized Py-)IiGyt S ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I ou e-r doc +U
at my property located at Dl H
in D�� County. C'Gl �,n�n c�
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:
Gd, f -s cen
Print or Type Name
H0001Q, Clot nk-r-
Title
F / 1 / o l
Date
This certification is valid through 1 /.

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:-���'�C1 ►- C cCL�r S CV-)
Address of Property: IV 1 90,'� "r--Y,,Q i,
Mailing Address of Owner: 7 t o E 5, � Vcr i-u C htun► M4 1 S 1--ty,rN
716S
Owner's email: (�Jaendy-r ate. Cc UsSL, r�Owner's Phone#: 11 % q -ao
Agent's Name: Ate,, e,, EyA r Agent Phone#: oiS24S 7 —5-1V7
Agent's Email: CLIP —
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
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 they are proposing. A
description or drawing, with dimensions, must be provided with this letter.
�-- I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback 51<�,
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of AR
Mailing Address of ARPO:
L—
PO: ShOS-6.n R'C.hMcn Ck
) � 0 -� � �-k V ) 1U C--,
ARPO's email: ARPO's Phone#: t�9 0— O 7 7
Date: Z� — � L — -2-` "waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: �G�� ftn On
Address of Property: PD-S �o r V 2 �� K,°)� [�ea.;`� �} ,��k (-,g):�^
w
Mailing Address of Owner: % / 0 S 5 , i �T'o x t, tt Vw�,,y, t.j .� a P6 , 1 -703(;v
Owner's email:.,.alu�7�S�
Agent's Name: ELZ6nS
Owner's Phone#: �� — . aC1 as S
Agent Phone#: C��---ZI C,]Z — G; Z"
Agent's Email: ge.Vrv,S Cc,,-I'SG%[+;en FA�) ��A�t i', C a,--
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that 1 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 they are proposing. A
description or drawing, with dimensions, must be provided with this letter.
V I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: % / 0 -3 HAZ6W 2 V -x6�-'
ARPO's email: SIT-VEiv N DMCA & L GA 4E L "ARPO's Phone#:
Date:
*waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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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.
1905 Harbour View DR
Colington NC, 27948
Parcel: 020023000
Pin: 986420800569
Owners: Anderson, John Barry -
Primary Owner
Anderson, Janice L -Primary Owner
Building Value: $299,700
Land Value: $210,000
Misc Value: $19,900
Total Value: $529,600
'1
1
Tax District: Colington
Subdivision: Colington Harbour Sec O
Lot BLK-Sec: Lot: 33 Blk: Sec: O
Property Use: Residential
Building Type: Beach Contemporary
Year Built: 2000
t
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