86477A - Haas, Kenneth & Elizabeth

�ACAMA DREDGE & FILL NO 86477 B C D
A,
A P, Previous permit
GENERAL PERMIT Dare previous permit issued
>4 New nModification 0 Complete Reissue LIPartial 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 tw
15ANCAC.--...*...TK-.,.-11,2--C-)-Q--,, Rules attached, F General Permit Rules available at the following link; wvny.Agq.nc.ggyLQ6MAruI%
Applicant Name[
1-�LkilyU Ali 4 EL -Labe Pli -HAA 5 Authorized Agent D A P-2
Address 2- —4 2 6 LL4-V i Q (W D Ir i W , Project Location (County):
City K-r) $14 , State�_ �-. --ZIP —21-q'4b Street Address/State Road/Lot #(s) 2j 2-
Phone # 4") 111--l-601 Li) J
Email Subdivision . .... . .... . - -
City zip
Affected El CW WW PTA ❑ Es Eim Adj. v*r. aptly C&�UA tu �XajA&4 --..(nat1Jqunk)
AEC(s): [] OEA EjIHA [J UW SPiMA F] PWS Closest Maj. Wtr Body
ORW,y.o PNA: yeso
Access Length
Pier (dock) length . . ....
Fixed Platform(s)
Floating Platform(s)
Groin length./#
Bulkhead/ Riprap length
Avg distance offshore
IA—
er�5,'iyiii
` \,t 13 --*
o6l oa$
v"A
-LIL&
<-- CAN A-L'W"
,A—
Breakwater/Sill I - , .. . . .
Max distance/ length
Basin, channel . ......... y1i 6hylq
Cubic yards . . ...... ... .......
Boat ramp . ...... .
W/
--ski D-ftd—, Ve I 0404� 1
7/
SAV observed: yes nY---A
Moratorium: .01, yes no 1
Site Photos: no
Ri
parian
ian Waiver Attached , no -Y
A building permit/zoning pe?4 ay be required by:
Permit Conditions
ex;6+ ivki
�W (Scale: W5)
6 Oak U -)r-
Aw+wUA 24',K41
ft V 9, ev t 121X12.(
TARIPAMNEUSEISUFFER (circle one)
See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I All
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.
(Please initial) -y
Brandon 1 1
..mi-tc-he.
E93051 Applicant PRINTED Name
Permit Vcer's PRINTED Na e
Si nature "Please read compliance statement on back of permit—
ov r �Vto
Signatu
go-2 2-
Z
Application Feels)
Check #/Money Order
to t5o �9`4,-W4-f 0
is"t il ne ale
Expi ation Date

Requesting Permit:
Req
Name of Property
Mailing Address: ------ - Nc—
Phone Number: aaS 0.0I COS
Email Address:
�nrlln�`
i Cenity that 1 have authorized
1 ~� Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permts
necessary for the following proposed development:
2 y doh ,
at my property located at Trz C)L4 qi �qtr i
in DaX'i. County.
I furthermore certifY that i am authorized to grant, and do in tact grant permission to
l permit Officer and their
on then of Coastal ned lands Management
conn,the et;tion with evaluating informationagents relatedoenter
to this
on the aforementioned !a
permit application.
Properly Owner Information:
Signature
Kenneth Maas
Prtnt or Type Name
U VQ In cr
Title
10/20/2021
'Thos certification is valid through _1_J
S/1/2o22

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top (p[o,,rtion to be completed by owner or their agent)
Name of Property Owner: r �00kA , •\at1S
Address of Property: 9-7 Z 0u+t % Mf_ r- Ox- c cl t �, n �►`G Z 7 �{ { ____
Mailing Address of Ownerye" �"�
Owner's email:nn_u``�tr�`n �Str �; 0,C; •'tcn'1 Owner's Phone#: (r) � �J,3 Li6og
Agent's Name: Agent Phone#: —7CL-A mkt o Q ltl,% -7
Agent's Email b(o_*- 93tom? 91*n.0 ; I Cr-cvl —
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
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 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.)
1 DO wish to waive some/all of the 15' setback
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 Owner: L! Z
Typed/Printed name of ARPO?aA'n i K Kral r
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date: I I - I2 - 2 I 'waiver 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
C E=PTIFIED kAAll. RETURN RE=rEIPT REQUESTED or NAIJD DELIVERY
(Top portion tto�.bee{completed by owner or their agent)
Name of Property Owner, f AA
Address at Property
MOD�Ic Q
Mailing J 91LIV
Ma � Address ol4vmer
Owner's email �+ y—)0 pE,ajr-p—q��ov ,nets Phonp-
�'v1!
Agents Namex(jTK AgentPhonaAt��/`"1 L� lfctp,
Agents Email LJYa,-a,%�t`li�-(j •Cp(�(1
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
dt sCriDl,yn or drew,rg vnfh dimensons. must tW provided with this letter.
--
t DO NOT have objections to this proposal 1 DO have objections to this proposal
ff you have Objections to what is being proposed, you must notify the N.C. Division Of Coastal
Management (OCM) 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 r,prap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
1 DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wash to waive the 15' setback requirement (Initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date: //- Z� 'waiver Is valid for up to one year from ARPO's Signature'
Revised July 2021

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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,
wills, and other primary
public records should be
consulted for verification
of the information
contained in this map.
272 Outrigger DR
Colington NC, 27948
Parcel: 019721000
Pin: 986420910177
FA
Owners: Haas, Kenneth R Jr -Primary
Owner
Haas, Elizabeth P -Primary Owner
Building Value: $339,200
Land Value: $222,600
Misc Value: $43,700
Total Value: $605,500
Tax District: Colington
Subdivision: Colington Harbour Sec L
Lot BLK-Sec: Lot: 101 & 102 Blk: Sec: L
Property Use: Residential
Building Type: Traditional
Year Built: 1986
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