86247A_Coats, Michael_20220211

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Q.'aNl_GENERAL PERMIT
RJ New C Modification ❑ Complete Reissue ❑ Partial Reissue
;1;v Ous permj; v
Date previous permit {slued
As both riled by the State of Nord+ C of a, Deparmrent of f rtvlrp—1 Qwl'ny and the CMM' Resources Commission in an area of -mroomemai concern pursuant te:
I SA WAC W ROO _. — fades attached. ® General Pm+tit RL4s ava,lable at die foporvNtE ink: Ww�.d.9 nc4ov/CM1Mrlu
Authorised
l Addres00 6 rep. 09—'Prot Location (CouY): e
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state N C zip e% 7 ibd9 Street AddrovlStata Road1Lot I!(.) _ lG{_# I a:3 t2 frMwrie # G3Y Z -- o—S x�a 12�}a�. W� —
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Type Of Project) Asti` �s _ r K k
Scale: i'`
Shoreline Length
Access Length t ^ P�4 ..AA....ry
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Pbr (dock) Ie.Vh ' A(p J ... �, - �,.r�°e �'{ ..:�Y 71
x
Fixed Pradorm(s) • z • k 1t wT 4 /�
Floating Platiorm(s) I Lv"
--- - --
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FatterP*rls;
TOW Platform area 55*!K
G d^ lengthit< ..........
kAncadi Riprapiengeh —•• t`'`' "' I .- I hT,ea -....
AvE distance offshore-
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Mae 6stance/ length.. _... - __ _... .. _.. _....... _.... .
Bann. channel
Cubic yards
LkBoat ramp
Beach
ad
SAL! observed'
Morawrium: yes no l aa�eeea�
RiW,4A ver AnaChad: I Q tr f' I CeA Qro$' ¢( yyiP �G. �t tlwsi P
A buwdr* permrtftc nmg permR may he required by: —.... .. .
i� ,u_ ❑ TAWAMrNEUSE;BUFFEN(circlaorte)
Permit Conditions —�U Cr! £ }usn T�+i _.... �. gyp„ _.�
6 rCt7 ar f . ( See who on back regarding River Basin rWas
�: fLT See additional notes conditions on back
I AM AWARE OF STATtlTE,CRC AULES ANG COND1TiryNS THAT APPLY TO TNIS PIIOIECT AND REVrE WFD CPMPLIANCf STATEMENT. (Vlease ktitial)
Agent or Applicant PRINTED t re Pmnut Othc r RINYCD Name y�..
9gnature "Please read corr� anu st.tameta on bock of purnnt•' Sigrw uru
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Atw{ication Fee(S) Chick MlMuiw:v Order Isuine Data fxMrntinn nate

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: MI (W 03 C/ OO,+S
Mailing Address: 9 tic 0 Cr V e
- C"I e t S.iv C_ 7 (e o
Phone Number: _ 9 � '� � - O ;S y �
Email Address: —1vt I ch C' e t •^ c c a.. 3 9 rvt o.4. l c o v✓�
I certify that I have authorized D-\k
Agent /—Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at 16c W - \2,0!Ac(- I W CL9 M-" Ir
Q 2A957
in "� e, Counry.
l 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:
'2'7
Signature
Print or Type Name
Title
1 ! L-I / 2. 1
Date
This certification is valid through /__ j

f aye k •� � -R� Q i �'
k ■ Complete items 1 2, and 3.
■ Print your name and addres to he reverse
so that we can return the cardyou.
.
■ Attach this card to the back of the mallplece,
or on the front if space perm
Article AtltlreSsetl to:
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,�,e.rrytl��l Nc,2�G5�
f lPJ C' I�IU�IIf�O!I IIIIIIII III ICIII IIII III
Qs90 9402 6011 0069 6529 63
111
A. Signature
B. Received by (Printed /Varrtp) ! �,
D. Is delivery address different from ;teat 1 ?
If YES, enter delivery address below:
4
Agent
Addressee
ate of Delivery
Yes
No
3. Service Type
❑ Pricrity Mail Expresse
❑ Adult Signature
n Registered MailTIA
❑ Adult Signature Restricted Delivery
C Reg=em4d Mail Restricted
❑ Certified Mail®
Delivery
❑ Certified Mail Restricted Delivery
❑ Retum Receipt for
❑ Collect on Delivery
twercnancise
❑ Collect on Delivery Restricted Delivery
n Signature ConfrmationTM
n insured Mail
❑ Signature Confirmation
�3 2 ? l $ b 6 g ail Restricted Delivery Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt .i

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CEZRT•F`EO IMAIL RE T URN RECEIPT REQUESTED or HAND Li[= '/E ;'i
!Top poflior, to be completed by owner or their ay(:nt) �
Acaress of Pfc:;e-ty PNOL 1 W1t ty Oil I NC,21g'57
F. ,.V QdC•ec5�j'::rner LA900_ C,rt,al �jeo�do sc- ._RQ�►1-e �(1 iVC, Z-?bOq
tl�'i ck,ie a 1 R C 8 CO- S toy-; I. C-AT-% 9
- - - - --- _ - - -- -. C'::ner s Phonev C11G1 2-) 2. 0342.
= �iY acid 0n Al- t'P-1
- �-C�1(1'C � �
_ �-ye"t Pnr.;ne# � oy �•••i l $ 8l0
b - a8u3 @ �maa 1 co{Y� 0 $ P�U1K 1r7e ue1S IN L
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
:.Bottom portion to be completed by the Adiacent Property Owner,
r ':2rHGY ::efi i{ ti'a: ; G`;;r1 p: overly ad►acent to the above referenced property The rndiv•d,aai ar,0;v-nq ff" ;tr
perm It has cescr,bed to rie as shovm on the attached dravring. the development they are propcs,r:;f ; mensivris must be�rovided v�i;h ,his fE'fer.
%CT have OC'ec'.io^s to this Gropf:Sel — 100 have objections !p
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 he
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
tna- ary proposed per dock. mooring pilings. boat ramp. breaKwater boathouse if, ar
c�c -• st be set cask a m,rirnurn distance of 15' from my area of riparian access unless ;rave, w r:e
s does nm apo;y to bu*heaos or riprap revetments). (If you wish to �.Jawe the setbacK. you must Sign
'"e a�^rcpr:ate t.;ar•K oe:'O:v
:, sr to :v-4ve some -'a of tie 15' se--ack 4SI
Signature c Arran Property 0►.ner
_rcZ_
do not vrish to ;ra.ve the ' S' setback requitement (initial the blank) ___
S,C^att a of Aa-pce,r. Rioa-an P►overly Owner
Typed/Printed name of ARPO: ��a��eJ� �✓
Mailing Address of ARPO:
ARPO's email:
ARPO's Phone#:
Date: l • I y •2 I 'waiver is valid for up to one year from ARPO's Signature -
Revised July 2421

rye. K.-.- -
This certifies that there are no delinquent ad valorem real estate taxes, which the BeTbe
County Tax Collector is charged with collecting that are a lien on plN*. 6882-29-0755,
Bertie County office of Land Records. This is not a Certification that the PIN # matches
the deed description.
SqpT, --) - \
Tax Coiled& Date
PREPARED BY JONATHAN E. HUDDLESTON, PRITCHE-TT & BURCH, PLLC, POST OFFICE
DRAWER 100, WINDSOR, NORTH CAROLINA 27983
MAIL AFTER RECORDING TO:
Excise Tax- $360.00
STATE OF NORTH CAROLINA
COUNTY OF BERTIE
Mr. and Mrs. Michael R. Coats
4900 Great Meadows Court
Raleigh, NC 27609
THIS DEED, made this the day of October, 2021, by and between
Riall Corporation, a North Carolina corporation organized by law and with a mailing
address of 105 Scotch Hall Court, Merry Hill, NC 27957, party of the first part, to

Subject to those minimum building setbacks and other conditions as shown on
map recorded in Book 13, page 953.
TO HAVE AND TO HOLD the aforesaid lands with all rights and privileges
thereunto belonging or in anywise appertaining unto the said parties of the second part
and their heirs and assigns, in fee simple forever.
And the said party of the first part for itself, its successors and assigns covenants
to and with the said parties of the second part and their heirs and assigns, that it is
seized of said lands in fee simple and has a good right to convey the same in fee
simple; that the said lands are free and clear of all encumbrances, SAVE AND
EXCEPTING rights of ways for highways and public utilities and ad valorem taxes for the
year 2021 and subsequent years, and that it will forever warrant and defend the title to
the same against the lawful claims of all persons whomsoever,
IN WITNESS WHEREOF, Rial Corporation has caused these presents to be
executed in its name by its President, all by due authority of its Board of Directors
heretofore duly given, this the day and year first above written.
Rial Corporation
113

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• Complete 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 space permits.
T. Article Addressed to:
N I \ \/(Ijx - �-
C e�)c5 Q.,-
(nc k k i S-1i
A. Sighature
X ���
B. Received by (Printed Name)
❑ Agent
0 Addressee
C. Date of Delivery
�( I :i 1 k. z. 4-1(z�.1/-\ I I11 1 1-e'_.
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: O No
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3. Service Type O Priority Mail Express®
I ! � O Adult Signature 9 O Registered MaiITM
O Adult Signature Restricted Delivery ❑ Registered Mail Restricte
Ili 1141 O Certified Mail® Delivery
9590 9402 6011 0069 6612 31 O Cartined Mail Restricted Delivery O Return Receipt for
0 Uollect on Delivery Merchandise
2• Art--- "'"^^~^" rrrzncfar from service label) 0 Collect on Delivery Restricted Delivery O Signature ConfirmationTm
70.20 316 D0001
El Signature Confirmation
81, 5 7 ricted Delivery Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt11111111
t..
■ Complete 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 space permits.
1. Article Addressed to:
-�+aIf°' � ?.`,`i,r ;ft;i,1�.;-•7 �-`' o pv 1x
A. Signature
X
Agent
L
la Addressee
B. Received by (Printed Name)
C.
ate of Delivery
r I n prio(A
1y�! 4�-Z-
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below:
Q No
3. Service Type O Priority Mail Expre
sso Registered MaiIT"
O Adult Signature Restricted Delivery
Registered Mail Restricts
D Certified Mail® Delivery
9590 9402 6011 0069 6612 24 0 Certified Mail Restricted Delivery O Return Receipt for
0 Collect on Delivery Merchandise
2• Arti 7020
O2D 31 rC D - O Collect on Delivery Restricted Delivery 0 Signature ConfirmationT"
O01 5279 9697 O Signature Confirmation
Ieted Delivery Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
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