83928A_Johnson, Daniel & Jennifer_20210830

v4CAMA / DREDGE & FILL NY 83928 OA: B C D
GENERAL P M 1 T Previous permit #
1-'New Modification nplete Reissue (-'Partial Reissue Date previous permit issued g
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 4
WIRMes attached.
Applicant Name_ Rni - 9- T +z A .1 i �±--kAf Project Location: County � c,�S s►�
Address r, fr3 % .—_ Street Address/ State Road/lot #(s)
City CT_State _Nt ZIP 2�2y3 JA 11 �_7 s' l►2. j -o_A�r-
Phone # (;204 3 L✓' 313 pE-Mail _ Subdivision i� i
Authorized Agent 4.r i t �j t -L _ City_��T�__ ZIP -7-:7 _1_
Affected L'C1N f vES nPTS Phone # (._ .-_)- ff River Basin t„ 4,6-n k—
GOEA ; 1 HHF LJ IH _itJBA UN/A Ad' Wtr. Body tM JWnkn
C7 PUNS:` S
��� /� Closest Maj. Wtr. Body -_- '"^� —
ORW: yes / no PNA yes K no
Type of Project/ Activity C w '1 ) f fv, c5t %:. c•'T (•• -'"�- w : i. (� 1'•'�J s e.•���
f Qc �;t iLd�: �� ;f�E' lv�R C�►� (Scale:
Pier (dock) length
Fixed Platforms)
Floating Platform(s)
t
Finger pier(s)
Groin length j _
number - -- IitfJT71116
Bulkhead/ Riprap length I j
avg distance offshore A I
max distance offshore".lr�Th�fl2�� /^
Basin, channel i PCs•
or�d J:
Ex� oli"Itkk, � C I/f�fwtic!
cubic yards
Boat ramp e
Boathous Boath(t
c VL t t
Beach Bulldozing I1 405, T'/AiG Ob*9V * oK
Other -- '
h_1 n
Shoreline Length /V• = r ; 1-----
-,-- _
I
SAV: not sure yes ono �. I C
� �I hq d
Moratorium: n/a) yes no 4-0
Photos:_..:_---__ --
�o F— L
Waiver Attached: yes no�
A building permit maybe required by: '���+ Z. `' `^'� ` See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction) (('
Notes/ Special Conditions A � �' 7 4 I a1. 4 1 "t ` _ >; k" I( �ii•{• o.rtisl r l d'z i"f.Z
r
-----
Agent or A plicant Printed Name
Si nawre '�Piease read cdnp ianee� nbatko(permites
Apfkatlon Fees) Check #
PermitOfflcer's Printed Name
CL
Si
Issuing Date
Expiration Date

r
LAMA / 1 DREDGE & FILL `j (.i '�i i 0 ,! CA) B C D
fPrevious #
ENERAL PERMIT p
ew Modification 'Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ' / 11 / Z b a
and the Coastal Resources Commission in an area of environmental concern pursuant to I M NCAC_ (�
pftules attache .
Applicant Name, �d./l t --I N- , Q<t ytt 1tnf fin Project Location: County T0-CR-
Address P Z:, , JJ. X (0 3 7
City 40 k`et' Z State ZIP
Phone # iWj ,),3b5- 03" E-Mail
Authorized Agent , "S1 41"1 'g,
Affected CW e -IOTA ES PT5
A
Affecte OEA HHF IH UBA i N/A
PW &
ORW: yes / no PNA yes to
Type of Project/ Activity
Pier (dock) length
ry r
Fixed Platiorrrys) -{ ey
Floating Platform(s)
Finger pier(s)
Groingength
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin. channel
cubic yards
Boat ran>/p <—
Boatltot,Boatcft t ox / for
Street Address/ State Road/ Lot #(s)
S7 0 2,1 [}K o 4 / fit`"` `l)r. _ ..
Subdivision Pa en` -r c .)1. jpo � rt "
City v �-�'eCaS ZIP �,7..-,
Phone # ( }' River Basin
Adj. Wtr. Body . (_w." C.,o___S?,nn d_ (nat /,an /unkn)
Closest Maj. Wtc Body raf
CSr- X 3 u 01, I i Ih r 11
(Scale:
pc. /in I t-
�S'flaG 111
4wLKPOP
C;C, FISH
c,c Ekt1 t km
STAri—)
J
rtwlsot'-,..� /4,1 fo
2' �><rs7nla P� t Lt6
Beach Bdldozing / '
Other
/ 1
q J
Shoreline Length 1 �• 5 L
SAV. not sure yes (.6)
\n
Moratorium: { n/a~} yes no dia�Y�cs 4 !
Photos yes no
Waiver Attached: yes ro'
A building permit may be required by: L)l, t c. C—S u t ��{ _ See note on back regarding River Basin rules.
ote Local Planning jurisdiction)
Not Special Conditions Ar ► r r 2 e� b o rx �'1 �� > < v e4�sSrt c_ ��r (n / i and
64 ?' (- tt f }" t C, C
r.,(;Ct y
of
Agent or A plicant Printed 'N�ame, Permit Officer's Printed Name
�0
Sgnauire "• Please read compliance statement on back of permit" SigOture ,
r � '
8 7 it % ?
ApplicationFee(s) Check# Issuing Date Expiration Date

AGENT AUTHORIZATION FORM FOR CAMA PERMIT APPLICATION
Name of Property Owner Applying for Permit:
Daniel C. Johnson
Mailing Address:
P.Q. Box 637
Hatteras, NC, 27943
Telephone Number:
252.305.6323
I certify that I have authorized Gary Price agent to act on my behalf,
for the purpose of applying and obtaining CAMA Permits necessary for the
proposed development of: Construct boat -lift including 6 pilings
My property is located at: 57021 Kohler Dr., Hatteras, NC, 27943
1 further certify that I am authorized to grant permission to the Division of Coastal
Management staff, the Local Permit Officer anf their agents to enter upon the
aforementioned lands in connection with evaluating information related to this
permit application.
This certification is valid through 06/30/21 .
(Property Owner Information)
Signature
JoS
Print or Type Name
Date
See Above
�Telephone Number
6/� V cd 01Id of
Email Address

U)
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U)
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Til A
DANIEL C. JOHNSON
57021 KOHLER DR.
w
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EXSITING BOARDWALK--
8' 6' �f
I
EXSITING
PILE (typ)-.0 o I
PROPOSEDP PROPOSED
PILE (typ) BOAT -LIFT
16'X 16' WITH w
fi,PILINGS °.
32' EXISTING ,
PAMLICO SOUND

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to -04/111GL L.-112MA(SOA1 is
(Name of Property Owner)
property located at -57101 104LG2 DR,
(Project Site: Address, Lot, Block, Road, etc.)
on P4ML1C'h JLWAIQ , in 4AT75RAS , N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #: 64Ay PRICE Mailing Address: 1 i'73 JT IAF,1Y6r1t SX
Agent's phone #: M- 65, 650 STU/1tZT. FRd, 3y999
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
..S&G REVc Ur- SIDE OF 71413 51JEET
If you have objections to whatls being proposed, you must notttytheDivlslon ofCoastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be malted to 1367 US
17 South, Elizabeth City, NC, 27909. DCM representatives can also be contactedat (252) 2W901. No
response is considered the same as no objection if you have been notified by Certltled Mall. _
(Property Owner Information)
Signature
MABEL e� -WWSUiV
Print or Type Name
Pb BOX G 37
Mailing Address
1.07TERM, Ali) '1?3 43
CitylStatemp
"262, 3y5, 63t 3
Telephone Numberl Email Address
Of, I& V
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Si nature*
1\ t7 G to 1;
Print or Type Name
20&i x 3q
Mailing Address
4A41-tm,1U6 7`
CitylStateop
AS-)- 3 cis'- y3 ya © �
Telephone Number/Email Address e, r4 A A P�Q !tl OR
r
Date*

UNITEDSTATES
Mid POST/][ SERvlcE
January 29, 2021
Dear gary price:
The following is in response to your request for proof of delivery on your item with the tracking number:
7019 2970 0001 7694 4727.
Status:
Status Date / Time:
Location:
Postal Product:
Extra Services:
Delivered to Agent for Final Delivery
January 26, 2021, 2:23 pm
MECHANICSVILLE, VA 23111
First -Class Mail"
Certified Mail TM
Return Receipt Electronic
1•
Iftecipient Si-gnature AW ~
Signature of Recipient: %
(Authorized Agent)m
Address of Recipient: lza
Note: Scanned image may reflect a different destination address due to Intended Recipient's delivery instructions on file.
Thank you for selecting the United States Postal Service's for your mailing needs. If you require additional
assistance, please contact your local Post Officer"" or a Postal representative at 1-800-222-1811.
Sincerely,
United States Postal Service"'
475 L'Enfant Plaza SW
Washington, Q.C. 20260-0004

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57021 Kohler Dr
Hatteras, NC 27943
4-0
Data
Tax
Tax
Land
c�heet
Bill
Cert.
Transfer
Property Summary
Parcel #: 029779000
PIN #:959517116839
Tax District: Hatteras
Subdivision: Pamlico Point
Lot BLK-Sec: Lot Parcel One Blk Sec
Property Use: Residential
Building Type: Traditional
Year Built: 1995
Property Ownership
Tax Owners: Johnson, Daniel C -Primary Owner
Johnson, Jennifer F -Primary Owner
Mailing Address: P O Box 637
Hatteras, NC 27943