86494A_Kirchoff, Jerrod & Erin_20220119

�)(LAMA DREDGE & FILL W 86494 B c D
GENERAL PERMIT Previous permit
;e J-__--_-
Date previous permit issued
WNew [l Modification ❑ Complete Reissue El Partial Reissue
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 Rules attached- General Permit Rules available at the following link: www,de� ne,ggy/C�MArule�
Applicant Name _..,L� .V_t� 4 idt tom, k.T r a f�... __ >G r s ✓. s v t E
Address-40?��A A* k-L _
Cityto NIC._.-----zip -'
Phone #
Email ?- --
Authorized Agent _ .......... " i f!�
Project Location (County):
Street Address/State RoadiLot #(s)
Subdivision
City .... ......
Affected �CWEW PTA ES JPTS Adi. Wtr. Body_. Ca�y,.�— (na an nk}
AEC(s): ❑ OEA 0 IHA 1 l UW SPIMA PWS Closest Mai, Wtr. Body _...-...A] �" Lim Q .__....__....._.....
ORW: ye9f?'n iA PNA; ye no
Type of Project/ Activity
Shoreline length _ _ F1 c)
Access length _.__.�— *•. f'
Pier dock Nength
Fixed Platform(s)
Floating Platforms)
Finger pier(s)
s y
Total Platform area
Groin i n th/#
Bulk iprap length
Aug distance offshore V. s
Breakwater/Sill
Max distance/ length .
Basin, channet
Cubic yards
Boat ramp
Boathouse/ Boatiift
Beach Bulldozing�/�*.�
other __. PiL
SAV observed: yes
Moratorium: n a yes no'�
Site Photos: no
Riparian Waiver Attached: yes no
A building permit/zoning perm. may be required by: � t
Permit Conditions
(Scale: Nj'' -,)
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�1��ix lgipt�.#�
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TAR/PAMINEUSEtBUFFER (circle one)
Sec: note on back regarding River Basin rules
........._...... KSee additiona otes/c ndibonsonback
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Brandon Mitchell.', �.
f ent o Applicant PRINTED Flame � Permit Officer", PRINTED N
Signature "Please read compliance statement on back of permit" Signature 1
Application Feels) ��� b0 Check 9/Money Order Issuing D to Exp r tion Sate
(*66"3ye(4415) t42-6

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jp"CY-0 l Lljc�ay
Mailing Address: H 429 1 V4 L n.
ICi }-y Rawk NC 2-1c
Phone Number. Uq 2-t2 15q q
Email Address:
34"rrL'4V J_,( "CL;r)00 . Cry
I certify that I have authorized O j 6 gU 1 K het�� S C NC..
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
N QVv 0Wk%')f-CkC1
` W I 1 tl C41-k-4 n
at my property located at H 2-9 l \A-1 �"JK N C. 2-7gt-{q
in 0Q&R_
County.
! furthermore certify that l 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:
�'W4 6rd aff
a ipnatgref
7erro arc o f
Print or Type Name
mr
Title
11/9/2021
Date
This certification is valid through
t
3

N,C. DIVISION OF COASTAL MANAGEMENT
ADJACENS RIPARIAN RECEIPT REQUESTED orHA
PROPERTY
OWNER QUoA'O�DELIVERY
FORM
CERSIFIED tv4A1L RETURN
liap portion to be completed by owner or their agent)
Name of Property Owner )-uxtdi Y-�"C& D 4l —
Address 01 Property `y N
Mailing Address of Owner.
owner s V�M.Curvi Owner's Phone#. 13t y Vaq— 15y 17
age~ts Name%l dt}� ► ,� Agent Phone# `7 0 Li L4 i a (o(v%
AgentsEmaOt`10.1����G-Qi},Corp
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the_Adiacent Property Owner
I hereby certify that I own property adjacent to the above referenced property The indwwdual applying for this
permit has described to me, as shown on the attached drawing the development they are proposing. A
�Jescri tion or draw rig with dimensions must be prov_tded with this letler.
'lr t DO NOT have objections to this proposal I DO have objections to this proposal
ARM t s CiFT-0AJ
!f you have objections to what is being proposed. you must notify the N.C. Division o 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
no
by Certified Mail.
WAIVER SECTION
1 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 trust sign
the appropriate blank below.)
I DO wish to waive somelat' of the 15setback ; -�
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 Owne
Typed/Printed name of ARPO: 1 _�w"Y_j(l _ M l
Mailing Address of ARPO:-40 2
ARPO's email: C Dy,JjA ({[(ems Phone#:�_,-� y
Dater �a`l �(o �2-waiiver is valid for up to one year from ARPO's Signature
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED 141AIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Marie ofProperty Owner Sew o ��
Address of Property p'L-e� NC 21q(40
Mailing Addtess of O\%;ner!
Owner s pnlaii JtXY
- � o -iv_P y4 4pM Owner's Phone# 3 d--4 2 $ sue- � q
Agent s Name [7i ph "i� l_ Agent Phone# -1 C y 441 % 'bto (o
Agents Email10i'W q6 cj �i, Ct1wt
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 oespfipyon or drawn with dm,ensions must be rovided with this letter
---titjy" -
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 (0CM) 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. dockmooring pilings. boat ramp, breakwater boathouse lit. or -
groir, must be set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to buikheads or rjprap revetments). (If you wish to waive the setback, you must sicin
I
he appropriate bank below }
1 DO wish to waive sometall of the 15' se?t' yck
-OR-
Signature of Adjacent Riparian Property Owner
! 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 ofARPO: '�,f _'�,7_�„
ARPO's email:
ARPO's Phone#: _ 34 ( _ y N qy
{waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

4-A

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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,
i
wills, and other primary
r�kll
public records should be
f f k�ti�ti�^~
consulted for verification
of the information
contained in this map.
0
4029 Ivy LN
Owners: Kirchoff, Jerrod Jon Otto -
Tax District: Kitty Hawk
Kitty Hawk NC, 27949
Primary Owner
Subdivision: Kitty Hawk Landing Sec 2
Parcel: 026154010
Kirchoff, Erin Michelle -Primary Owner
Lot BLK-Sec: Lot: 10 Blk: Sec: 2
Pin: 986510462379
Building Value: $238,800
Property Use: Residential
Land Value: $167,400
Building Type: Traditional
Misc Value: $18,500
Year Built: 1987
Total Value: $424,700

IL
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