86267A_Dawson, B.B. & Rascoe, Gina_20220311

QCAMA ❑ DREDGE & FILL n N� 86267 A ; B C D
�* .'GENERAL PERMIT Date Previous permit y
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:
I SA NCAC j j ' ❑ Rules attached. a General Permit Rules available at the following link: www.dgg.nc.gov/CAMArules
Applicant Name, ' Authorized Agent �.
f !� '� 1
Address i V. � � = n � � -= 1rJ o � <,1 S It �� e. dI L Project Location (County): G r-
City V-Y S o n State zip Q 83 Street Address/State Road/Lot #(s) ` o'f
Phone # ( ) 9 (g /A r ^�
Email T �. S c o �t O i /n 44-1% 1 "rn � • \ 5 . C ; 1 Subdivision a ! // �._cl > ' c. S c S/
City t N,- 4 zip 2 1 i -5-3
Affected ❑ CW EW ❑ PTA ES ❑ PTS Adj. Wtr. Body (nat/6;a nk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body a
ORW: yes/no PNA: yes/no
Type of Project/ Activity /K e
n ► (Scale: N Y
Shoreline Length
Access Length
i
Pier(dock)length
Fixed Platform(s)
Floating Platform(s) -
Finger pier(s)
Total Platform area
Gro01q gth/#
Bulkheaclf iprap length % S
Avg distance offshore -
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards Jf
ac--.
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
v
r
SAV observed: yes no ;
Moratorium: n/a yes no
Site Photos: 1yes no
Riparian Waiver Attached: ;yes no
A building permit/zoning permit n'&W be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Y /f t -
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

4, 3 (3/z-z
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DE41VERY
(Top portion to be completed by owner or their agent)
Name of Property Owner Braxton Bragg Dawson Rascoe and Gina Stone Rascoe
Address of Property 4710 Blue Marlin Way, Nags Head, NC
Mailing Address of Owner 2627 Indian Woods Rd. Wndsor, NC 27983
Owners email. drascoe(C-Dhampton(arms crvt pl,ners Phones 252-209-7800
Agent's Name Alan Evans
Agent s Email aeyansconstruction yahoo com
Agent Phones .252457-5787
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owntli
I hereby certify that I own property adjacent to the above referenced pmpeity 1 hn individual applyutg tot thl%
Permit has described to me, as shown on the attached drawing the development thoy are pioposing A
description or drawino with dlmensiont}, jM!._tl provided with )hip [111471
' I DO NOT have objections to this proposal I DO have oblections to this proposal
If you have obloctions to wh,rr is being proposed, you most notify the N.C. bivision of itoastal
Management (DCM) lie wrifing within 10 days of receipt of this r►aflce Coeres1wrnfenre shoilld be
mailed to 401 S. Griffin St, Srr. 300, Elizabeth City, NC, 27909 DCM representatives call also he
contacted at [phone] No rosponse is considered the some as no objection If you have been
notified by Certified Mail.
WAIVER BECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, If", or
groin must be set back a minimum distance of 15' from my area of nparian access unless waived by me
(this does not apply to bulkheads or riprsp revelments) fit you wish to waive the selbaoli, you must sin
the appropriate blank below)
I DO wish to waive somelall of the 15' selback -
-OR-
Signalum of A tirwnf 7ipan n Property Owner
I do not wish to waive the 15' setback requirement (Initial the blank)
signature of Adjacent Riparian Property Owner
TypedfPrMted name of ARPO: 6% rW- 3 f1, �► �• f •( 3.N t f
Mailing Address of ARPO: 4701 S • (Sl u c INar1,,.4 W�t Nork� 14r
ARPO's emajl: (,i%miAli%4fTtuy . Jc-I: ARPO's Phone#- Ns v % s,I i 1, i
Date: 3' ( 2 a 2-z 'waiver is valid for up to one year from ARPO'% Signature'
171jvts-1 July 2021

"X 3 �3 /z Z
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVER°
(Top portion to be completed by owner or their agent)
Name of Property Owner Braxton Bragg Dawson Rascoe and Gina Stone Rascoe
Address of Property_ 4710 Blue Marlin Way, Nags Head, NC
Mailing Address of Owner 2627 Indian Woods Rd. Windsor, NC 27983
Owners email: [e-mail]%mers Phone* 252-209-7800
Agents Name: Alan Evans
T, Agents Email: [e-mail]
4-
Agent Phone#: [phone]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTiFICATIOU
(Bottom portion to be completed by the Adiacent 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.
ir' I DO NOT have objections to this proposal. I DO have objections to this proposal.
/f 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). (it you wish to waive the setback, you must sign
the appropriate blank below.)
1 DO wish to waive sorneJall of the IS setback
I ys
Signature Adjacent Riparian Property Owner
-OR-
1 do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Prmted name of ARPO: _�/1i-� ncA--
Matting Address of ARPO: T % Mae/'�J * A "1
AC
ARPO's email:_,a-)n c�-SieaA„ .t_ a fiU ARPO's Phone;ik:-*V;2, �S72&y a71107
Date: *waiver Is valid for up to one year from ARPO's Signature`
Revised July 2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: I I" '4� �-
RECEIVED
Mailing Address: C z.7i :,._ l.✓'c��,
f�j�,,c, ✓^ . �'yC'_ 5'' FEB 2 5 2022
Phone Number: 2_ 2 �2_ Q -;V
..EC
Email Address: +T" ' f
I certify that I have authorizedlltt�_t�tr _S ,
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Zc--,J -
Ael'ofe,c--Aeol-7—
at my property located at
in S)f1xe 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
0(A_)1nt_
Title
Date
This certification is valid through t I

d
A
S-A
This map is prepared
from data used for the 4710 S Blue Marlin WAY Owners: Rascoe, Braxton Bragg Tax District Nags Head
D
inventory of the real Nags Head NC, 27959 Dawson -Primary Owner Subdivision: Old Nags Head Cove Sec D
p opaty for W` Parcel: 009093001 Rascoe, Gina Stone -Primary Owner Lot BLK-Sec: Lot: 55 Bllc Sec: D
purposes. Primary100
information sources such Pin: 989116937720 Building Value: $424,900 Property Use: Residential Vasworded des• ply Land Value: $180,000 Building Type: Beach Contemporary
wills, and other primary
public records should beMisc Value: $15,800 Year Built: 2015
nsultedfor verification Total Value: $620,700
of the information
contained in this map.
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Parcel Data Sheet
https:Htax.darecountync.gov/parcelcard.php?parcel=009093001
County of Dare, North Carolina
*Owner and Parcel information is based on current data on file and was last updated on February 28 2022
Primary (100%) Owner Information:
RASCOE, BRAXTON BRAGG DAWSON EUX
RASCOE, GINA STONE EUX
2627 INDIAN WOODS RD
WINDSOR NC 27983
Parcel Information:
Parcel: 009093001 PIN: 989116937720 !;
District: 14- NAGS HEAD
Subdivision: OLD NAGS HEAD COVE SEC D
LotBlkSect: LOT: 55 BLK: SEC: D
Multiple Lots: -
PlatCabSlide: PL: 5 SL: 7 Units: 1
Deed Date: 03/19/2018
BkPg: � 2225 0843 090 00
Parcel Status: ACTIVE
Property Use: RESIDENTIAL
BUILDING USE & FEATURES Tax Year Bldg Value: $424,900
Building Use: BEACH CONTEMPORARY
Exterior Walls: MODERN FRAME
Full Baths: 3 Half Baths: 1
Bedrooms: 4
Heat -Fuel: 3 - ELECTRIC
Heat -Type: 2 - FORCED AIR
Air Conditioning: 4 -CENTRAL W/AC
MISCELLANEOUS USE Tax Year Misc Value: $15,800
Misc Bldg a: (WD1) WOOD DECK OR RAMP Year Built: 2011 sqft: 450
Misc Bldg b: (BK1) BULKHEAD Year Built: 2005 sqft: 75
LAND USE Tax Year Land Value: $180,000
Land Description : 14-Canal Front
TOTAL LAND AREA: 9000.00 square feet
Tax Year Total Value: $620,700
*Values shown are on file as of February 28 2022
4710 S BLUE MARLIN WAY
Next Year Bldg Value: $424,900
Actual Year Built: 2015
Finished sqft for building 1: 2488
Total Finished SgFt for all bldgs: 2488
Next Year Misc Value: $15,800
Next Year Land Value: $180,000
Next Year Total Value: $620,700
1 of 1 3/3/2022, 10:11 AM

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CONSTRUCTION
ENGINEERING
SERVICE'S, INC.
it-14 P.U. Box 665, Manteo, NC 27954
[phone]
FAX [phone]
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