86476A - Dow, Donald & Mary Louse

ff V/
Akomutll tr4rCAMA ❑DREDGE 8r F!L!. 1�NY -' A` B C o
GENERAL PERMIT Previous permit
¢ Date previous permit issued
-@%New []Modification []Complete Reissue ❑ 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:
tR
15A NCAC Rules attached. General Permit Rules available at the following link: wwmdeo.nc.govICAMAruies
Applicant Name '. ,C
Address
CiryLL state_[.
Phone #
Email ---amr&t2` 4-Cl VV•— % _
R ` ..r
Authorized Agent � Vatf_A rI
Project Location (County):__._ -----
Street Address/State Road/Lot #(s) l' L � {
Subdivision
City
Affected ❑ CW EW XPTA ❑ ES 7 PTS Adi. Wcr. Body
AEC(s): �f OEA ❑ INA ❑ UW t__! SPINIA ❑ PWS e►osest Mal. Wtr. Body _ A IllaeiA> 4xN L
ORW ye no . PNA: yes no
Type of
Shoreline Length ± 100f
Access Length
re (dock) length ) T x
Floating Platform(s) ......... _._
Finger pier is)
Total Platform area
Groin length/# _„�_•„�
Bulkheadf Riprap length_,_.__.
Avg distance offshore ..w...... _.........
.
Breakwater/Sill _
Max distance/ length ........
Basin, channel
Cubit yards
Boat ramp
Boathouse/ Boattift
Beach Bulldozing
Other �--t
SAV observed_ yes no
Moratorium: n a yes no ,+
Site Photos: 0
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: _
Permit Conditions _ _1 N C AC b-l- K
EM
a
�- )
r�Jt Cif Isfp't� i l
I
Daves
.p
❑ TARIPAM{NEUSE/BUFFER (circle one)
'et -it ❑see note on back regarding River Basin rules
"— -� ""' See additional notes/conditions on back
I A AWARE OF STATUTES, CRC RULES ANITCONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT, %Please Initial) .______.,....._.
drA Vmt b6 to Serra RC.
Age. Appli ant PR D Name Permit Officer's PRINT D Name
Sig to a ­Pleaseread complizince'statergent on back of permit'" Signature
Application Feels) Check #/Money Order Issuing Date Expiration Nate

Lyn Small Inc. Marine Construction
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Donald Dow
Mailing Address: 228 Outrigger Dr Kill Devil Hills, NC 27948
Phone Number: 843-270-1845
Email Address: [e-mail]
I certify that I have authorized Lyn Small Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Dock Replacement
at my property located at 226 Outrigger Dr, Kill Devil Hills
in Dare —County.
1 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:
Signature
Print or Type Name
Title
This certification it valid through 08 / 1 i 2021
Date
This certification is valid through _03 i 31 1 2022

• Complete jtWS 1. 2. and 3.
• Print Your name and address on the reverse
SO that We Can return the card to you.
11 Attach this card to the back of the mailpjace,
__qr on the front if space permits.
t. Art,-rj. Addressed to:
to.' — — — — — — —
Tj
Ta JS
x
D.
A
Agent
D. Is delivery----------J—LA - "
2ddress different from item 14 ff—yel
If YES, enter delivery address below: 0 No
1101 IN IF I IF 1111111111111111 fill III V
9590 9402 4977 9()63 5557 23
f-11 -Mk. lbj
7020 009[l 0001 42 2? 2781
PS Form 3811, JUiY 201 F, PSN 7,530-02-000-9063
.3. Service Type
El Adult Signature 0 PrlOrftY Mail Expresse
0 R6G!St0r8d MaJITV
10 Adult Signature Restricted Delivery I R
El Certified Mails L s� mail Restricted
0 Certified Mail Restricted Delivery Delivery
Coitect on Delivery 0 Retum Receipt for
2 C. Merchandise
N
— De very Restricted Deli 0 Signature CcnfirmatlonW
'ad Mail
'ad Mall Resymtgo Del, r- Signature Confinflation
sal Ivery Restricted Delivery
Domestic Return Receipt

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: Donald & Mary Dow
Address of Property: 228 Outrigger Drive, Kill Devil Hills
Mailing Address of Owner: 228 Outrigger Drive, Kill Devil Hills
Owner's email: douglasdow1 @gmail.com Owner's Phone#: [phone]
Agent's Name
Lyn Small Inc.
Agent's Email: [e-mail]
Agent Phone#: [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 forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
�!escriotion g, drawino, with dimensions, must he 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 15from 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-
,? r
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:ziq N,
Mailing Address of ARPO:
ARPO's email: CAnJJk +r 4 :%_ARPO's Phone#: -7 7 5-'? cG/
Date: , i ds — *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

This map is prepared
from data used fnr the
inventory of the real
�^ fJ
property for tax
purposes. Primary
information sources such
as recorded deeds, plats,
wills, and other primary
f,
public records should be
consulted for verification
of the information
contained in this map.
226 Outrigger DR
Colington NC, 27948
Parcel: 019701000
Pin: 987417010238
Owners: Dow, Donald W -Primary
Owner
Dow, Mary Louise -Primary Owner
Building Value: $247,700
Land Value: $166,300
Misc Value: $15,100
Total Value: $429,100
Tax District: Colington
Subdivision: Colington Harbour Sec L
Lot BLK-Sec: Lot 80 & 81 Blk: Sec: L
Property Use: Residential
Building Type: Salt Box
Year Built: 1987

vf�
a �rk+; �••`�y�s P.t�A. '� t t' t>.
I �
r
I'?:3klw
-
_
a
Z 1
1,
r
k w- gq
,
.1.
M '
e
_ R
y
s
r
i,