86564A - Tomlinson, Jonathan & Judith

At0�ru CAMA k'DREDGE & FILL N( 8(5
z Previous permit
f(GENERAL
PERMIT Date previous permit issued
VNew []Modification []Complete Reissue []Partial Reissue
As authorized by the State
North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC Rules attached.6Eneral Permit Rules available at the follovring link: www.deq.nc.gov/CAMArules
t
Applicant Name CT0 5q._ A I-- t`7 t a . r 5'1 Authorized Agent
Address r' S S�v_r�F__�y,k d _— Project Location (County): ct(
City _State f,i ZIP 9 -1 9 7 Street Address/State Road/Lot #(s) /� 1 `C� �l
Phone #c`
Email _ Subdivision Ip ozC r i ti ---- — - —
city _Al ��{� -- —ZIP
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Affected eW �W pT5' Adj. Wtr. Body (na an% nk)
AEC(s): OEA IHA UW SPIMA PWS Closest Maj. Wtr. Body f' �n `� Q _Sw
ORW- yes PNA: ye no
Type of Project/ Activity
Shoreline Length S
Access Length
Pier (dock) length _-
Fixed Platform(s)
Floating Platform(s) -_ -_
Finger pier(s)
Z> / //i
Total Platform area 32, S
Groin length/ii
ulkhead Riprap length I 3 O
Avg distance offshore
Breakwater/Sill--
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift .-_ Pa'
Beach Bulldozing.—________
other ----- ---- ---
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: no'
A building permit/zoning permit may be required by: J
Permit Conditions (A.0 [ 0,1A J 3-f ' f ' t^ t
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AWARE OF
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AND
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(Scale: N 5 )
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Alta lEXISTI�Ii Cit4t KF/EO i
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6 /n, L/ A/ S b rJ I
P� OG
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
-• r � ''_�� t ��o� See additional note sl conditions on back
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APPLY TO THIS
A ent or Applicant PRINTED Name
S u e "Please read compliance staten nt on back of permit"
Applic lion Fee(s) Check II/Money Order
tD REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Yv � �J�- Co-ru"r
Permit Officer's PRINTED Name
N
tr--- ------
Sign u
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Issuing Date Expiration Date

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-PROPERTY IS LOCATED IN A F.I.R.M. M1q,P0210 +/�
ZONE AE(4') (Suacer To d1Amm CY r.E.M.A)
-AREA-21,260sq.R.(COORD.) 1 ll
DR
COVERED AREA-4,555sq.ft. LAGOON S C WARf/A
SITE n
-MIN. BUILDING LINES PER CURRENT F
ZONING _
-DARE CO. PIN/ 0709(05) 06 3785(26A) PIER
EAC
M10w yICINITY MAP
0709(05) 08 2753 7 BULK N
NTS
PIM-- --� �.ar`� PL
67 _ — 5021129W 129.w -- 5' /
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fao ea (14.4808¢k.)
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R/W R1011T OF WAY
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HIS NCT TO SCALE
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PL PROPEM LINE
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ID
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240
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MBL Momum SGIDMC LINE
o(30
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Op11C�1F/PAVER
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Dd CRIIA FENCE
P=ML m 3 i.^ 5/K roEIF / 1.4' FROM PL
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260.00—130.00':• N027*48*00 E
♦'ROIRRD t71F Oro ' .. .. �•;>>,!`;. ,;'':. .•P.... .. ...
aY ABOVE FD 1'CA ~ c I U
to ASPHALT ROADWAY
o I NA1l RR Cl O
in 1 w e a' r L. CUL-DE-SAC
NORTH SHORE ROAD RIP RAP— �� - MCE
1 (60' R/W)
--- , — S02.48WW 00 130.00'
m r- IPF
F
se•Fcns 50 SOMME PARCEL a o
PERRYFa S
(6,790sq.TL) V,
G 795)
N 13219'
(DB 1138, P_—
FOP RAP N11 •31 S I RYAN—K000N
—•••� aSHORE LINE
\ume
� (DB 1147, PG 571),
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ROANOKE SOUND SHORE
LINE

AGENT AUTHORIZATION FOR CANA PERMIT APPLICATION
Name of Property owner Requesting Permit .,C.nc 11Ct1.1! �nI I I �-.5Ct I
Mailing Address:IN ncje-'
1t CA
Phone Number:
Email Address:
I certify that 1 have authorized 1 �� Ci:i ► 17 ' ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: C_ o'i ;i'. \ ! O l.;
at my property located at
in ���'>::' . County.
I 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:
it Signatrue
tam hfAl
Print or Type Name
<7& Cy —
Title
Date
Revised Mar. 2016
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MAY 1 0 2022

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. �� _(�Y�`1"r ' - i1 ��' �� J h -
1 k q V`1 c� C Y�' �,� C(C� S
Address of Property: ,
Mailing Address of Owner: t 0 1
Owner's email:
Agent's Name: cry r 1 1i e
Agent's Email: ,� l� �� ��' Yl P mC -
Owner's Phone#:
Agent Phone#: Sk5 , p(4, 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
descri tion or drawing, with dimensions must be Provided with this I tter.II
I DO NOT ha' e objections to this propos�. 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
Y
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
l 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.)
I 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 Pro'perty/ /Owner
A
Typed/Printed name of ARPO: /4/(/� �' - / ly Z �� Y /
Mailing Address of ARPO:
ARPO's email: _�) P &ye yL 1`'41P_ 4'1�2 L �ARPO's Phone#: 7-57._ 417Z - �G131i
Date:lPjZ��Z *waiver is valid for up to one year from ARPO's Signature'
Revised May 2021
�y�

RECEIVED
■ Complete items 1, 2, and 3.
A. Signature
■ Print your name and address on the reverse
$o that we can return the
Ag
card to you.
■ Attach this card to the back of the mailpiece,
or on the front ifs ace
B. Receiv �d
Y (Printed C. Date o t
P permits.Iry
1. Artlds Addressed to:
---
Pe
D. Is delivery address different from item 1?
If YES, enter delivery address
❑ Yes
n-r t./
x
below:
C�Vo
boa ��-
a33 �
II�'III'I
I'll I'1 IIIII II IIIII' IIIII'
Service Type
❑ Adult Signature
O
9590 9402 6361 0296
II
III II III,
❑ Adult Signature Restricted Delivery
rCerti Z Mail®
Registered Mail-
❑ Re9lstered Mail Restricted
De
8692 66
2 � N� ��rl) SB/VtCe %BGC�I _
Certified Mail Restricted Delivery
10 Cotlect °f1 Delivery
O CWect on Delivery Restricted Delivery
very
❑ Signature Confirmation-
❑ Signature Confirmation
7020 3160 0001 2519 0896
1MalRestrictedDelivery
Restricted Delivery
PS corm 3811, JW202o PSN Two-U-0oo eoes
Domestic Return Receipt
MAY 2 3 2022
CM -EC
r

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: ` T t )11a l Vrnl
Address of Property: 1
Mailing Address of Owner: k
Owner's email:
1v,
V J S hCxr-
Agent's Name:
Owner's Phone#: a-5-a�
Agent Phone#: Q 5 'A .
Agent's Email: ` Ll-->
C- C-Df`—)�
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
etter.
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.)
I 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: (�rI MAC 0
Typed/Printed name of ARPO: �v�fli�I 1" �% A t� 0 C Cl- I)
Mailing Address of ARPO: l 3 S W2S� J��06�IS G Ot C ���ff
ARPO'semail: l�APn tGtrti� lr,L,a?.r�rnARPO'sPhone#: 3Z 7 3' 3�50
Date: ' 5 ' 2-0 22 ''waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

Ins
map is prepared 117 S West Shore RD
from data used for the
inventory of the real Nags Head NC, 27959
property for aParcel: 007866000
purposes sours Pin: 070905083785
t ary
information re,cred sources such
ecorded deeds plats,
w lls, and other primary
pubr<record, should be
Y , consulted for verification
of the information
contained m this map.
Owners: Tomlinson, Jonathan W
-Primary Owner
Tomlinson, Judith C -Primary Owner
Building Value: $684,800
Land Value: $286,000
Misc Value: $30,600
Total Value: $1,001,400
Tax District Nags Head
Subdivision: Pond Island Marina
Lot BLK-Sec: Lot: 26a Blk: Sec: 1
Property Use: Residential
Building Type: Beach Contemporary
Year Built: 2000
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