83947A_Wilson, Whitney M._20210909

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NU 8394;' � B C D
GENERAL PERMIT Prevolo„sp,,"*III-`�
,riiit_w Modthcat,on Comps-tc Reissue Partial Rerssue Dam pr+ vww pernm tssuad
As authorized by the State of North Carolina. Drparvnrnt o! Eimronmental Quab y , ,
end the Coastal Resources Conrrtre
ssron a+ an area of enwontren> of concern pursuant to I SA NCAC_ r _
9,1RDles attadwd.
Applicant Name W h i �4 Ott �'(. hJ I • n Project Location: County —'rD ..
�/
Address .28'/ 1 S AL'.. /. C o j4v.- . Street Addrew' State Road/ Lot #(s)i:-
cty NqJ � 1 st�cel,.1L ZIP 7/"7y.�'Y y4Zs S/ Z/X
Phone # 0 2) Z S C.- 0 7 g'D F Mail WA i �nre7r Ltii �z�r.% I�At�r. Subdivision d Nc1;, j # a' &- '4
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Authon zed Agcnt - City /v n. 4 S ZIP L.�i 9-S p
Affected CW r LW ItTA *5 &TS Phone # ( — River Basin Ak .F •I1e.>.I.e
AFC(s) OEA HHF IN WA Adj. Wtr Body C c. -k r., � (unkn)
revs: _
ORW yes '.— PNA yes rto Closest h1al. Wtr, Body 7` a� n + k r— S a ,4 �.4
Type ciProject/ Activity ---/�r• kka-e.4 %cam �/r< <7 /a, e d%CK
t' %•• cat ..-. s.�� �x_n_1 � O i l i � L I mot'+!' � - J �s 1 / " t )
Pie, (dock) k Wh / O' IK t s (Scam —7 —mot T •w }
F,ssdrlt+t"s)
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W3,verAtc.he4 ""Wo
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A building prra ,nay ov q ued by-. �`- s �'� 1 Sce note on bick reg edtng PjKw Saw ruin.
(Note Local I'Llrlinp
Notet,/ Sprrial Conditions S IL k >— a. A t a -_ i,. d i D J- O
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App�� r«ts! C1xc i r
Per+nrt er i R•,nsc4 tlw.•,r
tsaung Date

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONM/AIVER FORM
CLRTIFIFn l�tral RFTIIRt� RECEIPT RCOUESTFD or II�,P1tJ t�FLIt1EHti'
(Top portion to be completed by Owner or their anent)
4 �
tiara! rd P(UNttj O,atu;r;i + •
ACdfcss of Propraty: `���7,_= .Q. ('` ► rr L ,-.J-�_
Uail:nq Addross of 011"r.
pantos email:'d� , , i lIlr, `Ir .l i- Ownef's Phone*- _O ti
1
AgenfS NO=: Agent Phone:'.__
Agents L" snail:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be cornoteted by the Adiacent Property Owner)
1 hereby ccrffy that 1 own prcpPr1y ad)aaenl to the nbovo referenced proper'y. The inCwidual applying for U-is
FYrm:t has Cuscribed to me, as shoran on Die attached diming, the developntPrit they arc Reposing A
dC:,cri ttibn ru drovane. with r;imen;ionc, mti z o%jdPcf with this letter
n0 NOT have objections to this proposal. 100 have ObjWtons to this props a1.
1f you have objections to what is being proposed, you must notify the N.G. Division of COaSt.31
Management (L)CM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to dOl S. Griffin St,, Ste. J00, ElizaW(h City, NC, 2790. DCAd representatives can also be
contacled at [phone]. No response is considered the same as rro objection i you have been
notified by CertMed Mail.
WAIVER SECTION
1 under tancl Mal any �opose0 pier, dock, m0o-V pilings, boat ramp, tm3ilNritCr, boathouse. IiR, or
than must be net back a minimum distance o1 15 `rOm my area of r0artan access urUC53 waived by me
(Otis dons not apply to bulkheOdg or ripnP revetrricnts). (If you wish to wnivo the Sctback.
tic appropriate blink below.) /� n you mu_ t s `ion
I DO vnsh to waive somehill of Uto 1 S setbaci 1h 1 �l/ i A P.
/1 /1 �
-OR. Slgnorurc of Adj-.re-1.R pariah Ar»pe TX Uwncr
I do not vtish to w-ovo the IT se10ack requirement (,6,ial the. hk-lrk
S«jnaturu of Adj. tccrd Rorian I'ropurly Ouner.
Typed/Printed name of ARPO: n e_
Mailing Address of ARPO:
ARPO's *mail: ARPO's Phones:
Date: / zi waiver is valid for up to one year from ARPO-2 Signature-
1"41viSed JuJy �1)27
C�r 041 •.ii4.l%

P)C:ja TAJO (� A.N-�J-)Y"D

Mail Fee s'
xtra Services & Fees (check box, add fee s'Iappr AF(ate)
❑ Return Receipt (hardcopy) $
❑ Return Receipt (electronic) $
Certified Mail Restricted Delivery $
Adult Signature Required $T`rr
0 Adult Signature Restricted Delivery $
Postage
fit
Postmark
µ ;� •-�1
-.. JjG Here ,
102027 vn
r 1.
4.
Sent To
Street---------- :, or P ox No.------------- ---- ----------------------------------
----------- ------------------------------ c ----- ------
t Z , +4�' 1 --------------------
C9-nnnnrl AAAf i rnmCrannnr

This map is prepared
from data used for the
Dimentory of the real
property for tax
%kk%N\
purposes primary
information sources such
x recorded deeds, plats,
wills, and other primary
public records should be
consulted for vesication
of the information
contained in this map.
s
4625 S Blue Marlin WAY
Owners: Wilson, Whitney M -Primary
Tax District Nags Head
Nags Head NC, 27959
Owner
Subdivision: Old Nags Head Cove Sec
Parcel: 006250000
Lot BLK-Sec: Lot 125 Blk: Sec: A
Pin: 989116945519
Building Value: $158,700
Property Use: Residential
Land Value: $170,000
Building Type: Beach Box
Misc Value: $9,500
Year Built 1975
Total Value: $338,200
006250-000 14989116-105 Ol/

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:
Address of Property:
Mailing Address of Owner.
Lu1�l�nec. { u..� t` so �. `Z "� � nn.Sr . cca ✓t'ti a
Owner's embil: Owner's Phone#: Q1Sa .&S 0 -O-TRO
Agent's Name:
Agent's Email:
Agent Phone#: --
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.
100 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.) J,
I DO wish to waive sometall of the 15' setback
Sigrnature 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: (0{{ U
Mailing Address of ARPO: A � V
ARPO's email: h 1J f7`('
Date: Cr. r% E 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021
9
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August 12, 2021 in MECHANICSVILLE, VA 23111.
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August 12, 2021, 3:08 pm
Delivered, Left with Individual
MECHANICSVILLE, VA 23111
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Your item was delivered to an individual at the address at 3:08 pm on August
12, 2021 in MECHANICSVILLE, VA 23111.
August 12, 2021, 10:37 am
Out for Delivery
MECHANICSVILLE, VA 23111
August 12, 2021, 10:26 am
Arrived at Post Office
MECHANICSVILLE, VA 23116
August 11, 2021, 4:58 pm
Departed USPS Regional Destination Facility
RICHMOND VA DISTRIBUTION CENTER
August 11, 2021, 1:11 pm
Arrived at USPS Regional Destination Facility
RICHMOND VA DISTRIBUTION CENTER
August 10, 2021, 8:53 pm
Departed USPS Regional Facility
RALEIGH NC DISTRIBUTION CENTER
August 10, 2021, 6:30 pm
Arrived at USPS Regional Origin Facility
RALEIGH NC DISTRIBUTION CENTER
August 10, 2021, 3:47 pm
Departed Post Office
NAGS HEAD, NC 27959
August 10, 2021, 9:05 am
USPS in possession of item
NAGS HEAD, NC 27959
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1. Article Addressed to:
t
31e( an
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(9122At l
II I IIIIII IIII I I I III II I I II I I II I II II I I I IIII III
9590 9402 5806 0034 1600 38
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X ❑ Agent
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7019 0160 0000 9652 4389 1 Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
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