86213A - High, Gary & Anne

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moh. t<CAMA "ADREDGE & FILL ' ' _ r`�(i � .-N B C D
Previous permit PERMIT _.........
Date previous permit issued
j New L 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
1 SA NCAC .1 _ S rS., Rules attached. General Permit Rules available at the following link: www.den.nc. oy CAMAYuIes
Applicant Name_ (1- y
Address
City Y-411 ` NI H,105 State &5....---- IP z L{
Phone # (&Z 2-6 (a 4-
t�
i
Authorized Agent ! ' `' �4" �l C L V1 ai, !
Project Location (County):
Street Address/Scare Road/Lot #(s)
Subdivision _ EJCi 4.1 r1r r ii's a,t &V to G
City___ L k G x F,i 115, ZIP
Affected [-]CW J*W N.PTA XXS TS Adj. Wtr Body -(i,Un(L7-1 .LC (na ma unk)
AEC(s): iJ OEA 0— IHA uW � 5FlMA �j PWS Closest Maj. Wtr. Body _ F - Ll(� {` j, �`
OAW: ye no PNA: yest�
Type of Project/ Activity
Shoreline-
Access Length
Pier (dock) length
Fixed Platform(s) ,__.^.__..
Floating Platform(s) _
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead Riprap length
Avg distanceAvg distance offs on *
Breakwater/Sill __�_'*�-�"
ax disian`c
Basin, channel _
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
P,
.0�
M
Y
SAV observed: yes
Moratorium:[ yes no
Site Photos: no
Riparian Waiver Attached yes now
A building permit/zoning permit may be required by -
Permit Conditions
I AM AWARE OF
"Please read
CRC RULES AND CONDITIONS THAT APPLY TO THIS
statement on bacRof permit- -
Applicatian Fee(s) Chmck #/Money Order
(Scale: K7'c-?)
TARMAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
COMPLIANCE STATEMENT. (Please initial)
r ! , , f
Permit Officer`. PRINTED Name
Signature } Z
Issuing DAte Expiration Date &�

AftffI AUTHORIZATION FOR _CAMA PEWIT APPLXATIQN
Name & Property Ov%ner Requesting remit:
Maihng Address.
Pt y,ie Number:
Email Address: izj a
1 cv-tity that lhave authori7ed
AW-1 I Contractor
to act or my beha1, for the purpose of applying for and obtaining all LAMA permits
necessary for the io Ilowing proposed development .1
at my prowny located at S D Lc et'l E-1 t(u i
in -----county-
i fuAermory cartffy that I am euthcrized to grant and do in fact grant perm-issecn tc
DivkSiOn of Coastal Management staff. the Local P&7n# Ofter and heir agents to enter
on eie &`drometftned lands in connecrPin with evaluating information related to this
application
Property Omer Info! Maticn:
S"h"
-Iftil or 4ype Nam
V60
DIM
This certification is valid through_._, 'j
Revised afar: 2016

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:
Ll I kUI
Owner's email: Owner's Phone!# �.5�� 0��"
Agent's Name: NE. fy—) e nC_ Agent Phone#:_
Agent's Email. r } L� t C Co- n c Y'Y'1 at— I n f' ccn sf.. C ram}
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 ust be proviVed with this letter.
bra CYV�e—
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objerctions 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. Grim 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 Mprap revetments). (if you wish to waive the setback, you must sign
the appropriate blank below.)MI-1 t—
I DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property
FEB 2 3 NZZ
Typed/Printed name of ARPO: lA A,,, r1 P 14 5 r'-TfcR r h A,, w,
(�sS c .R�st �tnt
Mailing Address of ARPO: � o B�'X � ��i � k t�(-{- , N L -i- 05 S St - �--
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ARPO's email: H SL ATf iX l Do a S4 ` ARPO's Phone#: ol 5 Cf J 53 '
Date: 6 ) l a *waiver is valid for up to one year from ARPO's Signature*
S Q , s i 3Ct r oc TN+{ - !3 9H r A - t Pv—
Revised May 2021
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■ Complete items 1, 2, and 3.
■ Prrcrt your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
N C-
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lililll�il�l111111(1111 Illllil1118�111lf lllil
9590 9402 6361 0296 8692 35
X 0 Agent
0Addressee
B. Received by (Ainted Afe r C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES. eater delivery address
below. 0 No
3, Service Type
❑ AdultSfpnffitw
Q Men EKPrG-O
M
R Slikited Delivery
❑ red Mail Restricted
❑ Cartiffed Mail Ae*k ad Ddvory
Q Signature Corriinnatimim
13 Collect on Del>Very
Q swaturs Confkrre"m
O Collect on t>aWary Restricted Delivery
Restricted Delivery
_ 7020 3160 0001 2522 1,347 0 D r
g PS Form 3811, July 2020 PSN 7530-02-0oo-9os3 Domestic Return Receipt
• Compile items 1--2. and 3.
■ Print your name and'address on the reverse
so that we can return the card to you.
• Attach this card to the back of the mailpiece,
or on the front if sMce per_.
1. Article Addressed to:
©CV't J aW6
11111111111111 ill 111111111111111HIM 111
9590 9402 6361 0296 8692 28
2 AdidabWtnt�ar_tin+cwswc m,.,,.,,:�••r..e.ts+,..n
?020 3160 0001 2522 135
Ps Form 38+ 11, dulY 2020 PSN 753D-02-000-9M
p Agent
Addressee
B.moved by drrGed Nam) Date of Delivery
D. Is delivery address different from tem 1? [3 Yes
If YES, enter delivery addre ow: Cl No
3. Service Type n Mal"
Q• Adult t D""WSkInIftill p mail Reshicted
DOWNY
R.W.Eed Dellvety Q sign ium G-Vit aacn,r,
❑ Colied on Dd VWY O Stgrredee CoMkrriat<on
C Cmaet nn D~f Dd M Restricted Delivery
4 NAail Restricted Deliver!
Da�sticReturn Receipt
F �B 2 3 2022
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Northeaster;, Mnrisia Cflnctruction II F � LETTER
up U.S. p TA E PAID
P. ©. Box 42 ''"'� �CI949 HAWK, NC
Kitty ! Iuwko N bF 27949 �� ��,/ f1lu�Uui�IT02 21
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be co
Name of Property Owner.
Address of Property: _
Mailing Address of Owner:
Owner's email:
Agent's Name: 9� 1 i GLY—(e-er
Agent's Email: `L(, et� n-emakr�
Ieted by owner or their agent)
11 Dex i 1 E---, l �s
Owner's Phone#: � _5 a - Q C - 1
Agent Phone#:_Q 1 _3 "
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
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
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 must sign
the appropriate blank below.)
1 DO wish to waive somelall of the 15' setback
=-a
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Own@r
Date: / / / // / / *waiver is valid for up to one year from ARPO's Signature* Revised May 2021

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,
A"`
wills, and other primary
public records should be
consulted for verification
of the information
contained in this man.
0
172 Ocean Bay BLVD
Owners: High, Gary Lee -Primary
z
Tax District: Kill Devil H�41�� s4ut
e
Kill Devil Hills NC, 27948
Owner
Subdivision: Baum Bay Harb-cs 1-4cr
Parcel: 004134000
High, Anne B -Primary Owner
Lot BLK-Sec: Lot: 69-72 BIk4 1
Pin: 988309177433
Building Value: $531,700
Property Use: ResidentiaL
Land Value: $280,100
Building Type. Traditior`a�l
Misc Value: $101,500
Year Built: 2015
Total Value: $913,300
M11111,:

Tois map is prepared
from (Iata used for the
j
iTentory of the real
�j
property for tax
purposes. Primary
ro
information sources such
a� recorded
deeds, plats,
Ails, Ind
other primary
_
f ,�eLk
p6bli4
consulted
records should be
for verification
0 th�
information
c ntalned
in this map.
172 Ocean Bay BLVD
Kill Devil Hills NC, 27948
Parcel: 004134000
Pin: 988309177433
Owners: High, Gary Lee -Primary
Owner
High, Anne B -Primary Owner
Building Value: $531,700
Land Value: $280,100
Misc Value: $101,500
Total Value: $913,300
pp' I '
,
t
Tax District: Kill Devil Hills Out I�
Subdivision: Baum Bay Harbor Secs 1-4
Lot BLK-Sec: Lot: 69-72 Blk: Sec: 1
Property Use: Residential
Building Type: Traditional t4
Year Built: 2015

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