83933A_Adamson, Robert_20210831

CAMA ! DREDGE � Ftt_t C? i {�L
83_� 3 B C D
GEtVERAL. PERMIT Previous permit#
Jew Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina. Department of Environmental Quality �f
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC I H • � L{.it
uks attached.
Applicant NameRcbe'* •� AA bo v\� Project Location: County
Address 4�"ii� ... _�, j�„ _ _ Street Address/ State Road/ Lot #(s) y
y,
city V�-i i'�+. ►tr -_ State �li: ZIP , � y if ��.>i ul— } tfi�_ ... 1 �"'H_ —7
Phone # (42IN 308-90�45 E-Mail VOID :_ctddl" Co�Subdivision
��-.�.��-k�
Authorized Agent .. Yhar'.14 4�1 3 t� City - _+ _ ZIP"
Affected
CW XEW V�TA ES PTS Phone # ( '"'�"" .. River Basin
OEA HHF IH USA NIA
AEC(s): Adj. Wtr. Body _ 46t G2yk4_ an unkn)
Pws
QRW: yes ! no PNA yes no
Closest Maj. Wtr. Body A}i -- '&.1f.t-YU
Type
,,,,o,,,,f��Project/ Activity r t X i
�1 !'n 4` F c�a► � {Scale: ' }
Pier (dock) length
�� Jam' � `� Platf
Finger ensi rmfsj CA `•1/� � � ! , � j� L.} �1G p 1iG�J � `�'[
Finger p,errs ('� `"Tf
Groin length
number
Bulkhead/ Riprap length IF "i � t A Okoy'7•,,,r+�
h tMT � � utcr.+p
avg distance offshore r % � �' � D ti e t X' l 0 E % l f+_. �v
,rax distance offshore /L t J �.? tWt�%w °t
LleO
Basin. channel
p
cubic yards
lali4tw4
Boat -amp ..*�-
$oathousel $oatlift � piit�s{h�F[QJ Ljj�
piev
Beach Bulldozing
Cher LJA- .-
1exi7 '
shyI boa+-�vY 5a.
ranted Cs/ W
Shorel,ne Length I b 4 � �
SAV not sure yes no3
Moratoriumn,a yes rto ) [Adam
viA
Photosyes 1 no ci
waiver Attached: yes } no
A building permit many a required by:
( Note Local Planning jurisdiction)
i
Notes/ Special Conditions
_r Applicant Printed Nam-- l /
yam ` �. ? to U
sigr,nature lease read compirance statement on back of permit
it 2
Appiication Fee( s l Check #
c-►.1
la �
Aw
L�
___ See note on back regarding River Basin rues.
Permitofficer's Printed N
�Nk_.
Signature
1 3 rZ.
Issuing Date Expi ation Date

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: A1�A, �
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Agent / Contractor
1r
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: � � G'rI, of
/7 -4
at my
7F�
perty located at�
r
in County.
I furthermore certify that 1 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.
P pe"n Owner Information:
4LC'�--
Signature
C� P - 1�q �K-�2�
Print or Type Name
Title
Date
This certification is valid through 1

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTiFIEC MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
+ &
Name of Property Owner,
Address of Property -7 T%j
Mailing Address of Owner
n 4
Owner s email pr A
nwns Pnone#
0 &&C-M- (k LAgerl P�,one#_2:5
Agent'sName
�4qert s Email lei V1q'JSL% A67
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom portion to be Completed - , the— A,,--- nt Property Owner.
I hereby certify that I own property adjacent to the above referenced. property. The individual applying for tNs
permit has described to me. as shown, on the attached drawing, the deveicipment they are proposing L�
_Ies . I I n or di, w, �wqh �imri ins. rovied with this �iet r
qZAO NOT have obtecrions to ins proposal ___ i DO nave objections :0 is proposal
jj-j6L7jj8—Ve - — — - ---nju" — -- — objections to what is being prop6j#d� you t 6jity the r4.C. Div�sioii of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin Sti, Ste. 300, Elizabeth City, NC, 27909, DCU 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 j-Qe,-Sta-n,' , that any croposed pier, dock. mooring pilings. boat ramp. breakwater. boathouse, 'Hit, ci
groin must be Set tack a irirzmurn d;stanl-e of 15'frorn my area of riparian access unless waived by me
(this doeS not apply to bulkheads or zrau revet�leris °; il If f,iu wish to wa*ve tne setback you must sign
the appropriate blank below,)
I DO Nish to waive somelall of the 15' setDIaCK
41acent Riparian Property Owner
I do not wish to waive tre 15' setback reouirement i tritt lai the tank
Signature of Adjacent Riparian Property Owner.
Typed!Printed name of ARPO: �011/'
Mailing Address of ARPO: �je '/-V
ARPO's email:
-J &W P 0, s P h on 0:
Date: Ci)/* *waiver is valid for up to one year from ARPO's Signature*
Re-vised.V4:iv 202 1
(or.f4ek

ru
cc
ti
Emanuelson & Dad, Inc.
PO Box 448
r--
Nags Head, NC 27959
a
Phone: [phone]
C3
C3
Fax: [phone]
C3
Email: emanuelson6705aoutiook.com
O
m
r-i
ra
06/14/2021
cc
John Risoldi,
3901 Ivy Lane,
Kitty Hawk, NC 27949
Re: Robert Adamson - 3847 Ivy Lane
MAIL � RECEIPT
DomesticCERTIFIED
For
Kist 'P'1L►(AL USE
Certified Melt Fee $3. fi0
f (954
$ ,
02
Extra Services & Fees (check bar. add tee )
Rettxn Recept (hartYoopll $l-
❑ Reium Receipt felechmic) $ ti f f CIA
Postmark
❑ CWW*d Mail Reatrkt id Davery It _11-1 QQ
Here
Adult Signature Repri3ed f
Adult Signature Restricted Delivery S
Postage 55
$
06/24!2021
Total Pwtags Fees
i . l7
sent T nn
.. . ..........�--------------- ---'
SYreer an t. o., ar F5d
Form 3800, A�2015 ps,, See Reverse for Instructions
We have been requested by the above property owner to do the following work:
1) Install 4 - 10" x 30' mooring piles
2) Extend pier 4'x8'.
In order for us to obtain the Cama permit for this project, Cama (Coastal Area Management) requires
each adjacent property owner to be notified. We would ask that you sign the attached form and return to
us as soon as you can. You may scan and email, fax or simply mail. We are also attaching a sketch of the
proposed project. If you have any questions, please do not hesitate to contact us. If you do have any
objections to the proposed work, you may contact Cama at 252-264-3901.
We thank you for your cooperation in this matter.
Sincerely,
i ■ Complete items 1, 2, and 3.
Jacqueline Lewis ■ Print your name and address on the reverse
Emanuelson & Dad Inc. so that we can return the card to you.
■ Attaothis card to the back of the mailpiece,
or on the front if space permits.
1. ArWe:Add to:
jam, G
K,
2-75
1111111 M111111111111 OF 1111 N I III
D. is delivery addr # u vas
tf YES, enter tI No
3. Service Type a P=11ylJfai }
❑ Adult ftrab" O 1ia -
Restricted Delivery ❑ MWf1wh .
Malt®
9590 9402 6133 02091059 23 ❑ c iMVa FIV&kAed tally � cra►
C1 Cuffed on Delivery
2. Article: Number (Transfer frrxn Se %*& .. _.. ❑Coped on Delivery Restricted DeSvery
.._ _ �..,�.._.i Mail
7 018 1130 0001 7767 1282 t Mail Restricted Delivery ReMicted Dejv"
PS Form`3811, July 2015 PSN'75W-02 000-M3 oomesttoReturn Recek,

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Emanuelson & Dad, Inc.
PO Box "8
Nags Head, NC 27959
Phone: [phone]
Fax: [phone]
Email: emanuelson6705 aaoutlook.com
06/14/2021
Dorothy Summerton trustee
3845 Ivy Lane,
Kitty Hawk, NC 27949
Re: Robert Adamson — 3847 Ivy Lane
iii I
Domestic
ile
r L u S E
Certified Mai] Fee zi . h Il
is 9 C5 4
(v
t�
$ 25
!y
Extra Services Fees l eck Dar. add tea �' J . i
❑ Rattan Receipt (tr®rdoovy) f !
a❑
Return Rece,pt i i s 10 t1i i
Po st rtark
0
❑CertilW MM PeeOkW Deavery s S. 4)A
here
0
0
QAd.h SVWa Re[pared % IIi to @(4
— �T'�
❑ ACLN Sort. Restricted DeW+ S
Q
Posta"
ill,
�
i Ib/2{%.`].(J2l
ees
ToTOWPostage and Firy�
�7
S
co
0
Sent Ti,d fo U M 1'L bn
Api -- UFO"No.---------------------------•---•-- --.
17-
f r fyrG 4'!J ,NC-J�7 4Lrl
We have been requested by the above property owner to do the following work:
1) Install 4 — 10' x 30' mooring piles
2) Extend pier 4'x8'.
In order for us to obtain the Cama permit for this project, Cama (Coastal Area Management) requires
each adjacent property owner to be notified. We would ask that you sign the attached form and return to
us as soon as you can. You may scan and email, fax or simply mail. We are also attaching a sketch of the
proposed project. If you have any questions, please do not hesitate to contact us If you do have any
objections to the proposed work; you may contact Cama at 252-264-3901.
We thank you for your cooperation in this matter.
Sincerely,
Jacqueline Lewis
Emanuelson & Dad Inc.

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIA . PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: p
E
Address of Property:- lCLt `1
(Lot or Street #. Street or Road. City & County) r
Agents Name Mai ing Address:
Agent's phone #:
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 have no objections to this proposal I have objections to this proposal.
it you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact infonnation for DCM offices is
available at http://Www.nccoastaimanagement.net, lweblcmistaff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
(�46P-CT
Print or Type Name
61%6 �- P, �-c
Mailing Address
cdrstate2ip 22
Telephone N mb rl Email Address
Date
(Riparian Property Owner Information)
Signature
T> V r-O ,--
Print or Type Name
Mailing Address t
Ciwstate/7lp
Z5 2.--2b1 ?5x©'!�)
Telephone Number/Email Address
i
Date
{Revised Aug. 20141

7
Robert Adamson
p
lz

t z 1
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.
3847 Ivy LN
Kitty Hawk NC, 27949
Parcel: 027619000
Pin: 986514348871
Owners: Adamson, Robert -Primary
Owner
Building Value: $194,400
Land Value: $187,400
Misc Value: $9,800
Total Value: $391,600
Tax District: Kitty Hawk
Subdivision: Kitty Hawk Landing Sec 4
Lot BLK-Sec: Lot: 5 Blk: Sec: 4
Property Use: Residential
Building Type: Salt Box
Year Built: 1986