GP86452_Robert Pedersen & Jenny Hawk_20211229

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Previous permit
ENERAL PERMIT Date previous permit issued
4,New [ .. ]Modification []Complete Reissue []Partial Reissue
As authorized by 0 ate of North Carolina, Department of Environniental Quality and the Coastal Resources Commission in an area ofenvironmernall concern pursuant to:
J, ' / 2' '�- -" A%. n ISA Rules attached. 11,�Nencral Permit Rules available at the following link: wvvw.deKI-­cgoy CAMArulo
Applicant Name - e -0 bo-e tfb,�4, Authorized Agent '-A IKA!:f�4S
Address 0 46 Project Location (County): 'P
City State zip Street AddressIState Road/Lot #(s) -A—IJI -3 ------
Phone #
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City zip Z- -5­3
Affected [- IS n"n-1-1--n P"/' an/unk)
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AEC(s). 11 OEA �`IHA UW SPI MA PWS Closest Maj. Wtr. Body
ORW: yesCo) PNA; VeIC)
Type of Project/
.2 Ll �4-9 4-9 r-,o, (scaie: T-s
Shoreline Length 4 2- ID
Access Length *V, A/
Pier (dock) length _
Fixed Platform(s) e "j"
Floating Platform(s) 0
Finger pierls)
Total Platform area
IJ
Groin length/0 <4 t
f"I
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length "Irb
Basin, channel
Cubic yards
(Buallhouse Rc2t,
V
Beach Bulldozing
Other
11 -V
0
SAV observed- yes 1-
Moratorium.�/a Qrlo* 14P.0
�L A f L —)-336
Site holes: (�� no. 6MV-4- T*4 ac�(-
Riparian Waiver Attached: yes (�D bc;+
A building permit/toning permit may be required by: -Zb-na- TAWPAM/NEUSEIBUFFER (circle one)
PeriyiitCondidons,-,-,--
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See note on back regarding River Basin rules A Ll
1:1 See additional notes/conditions on back
L?� AWARE Of STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.,M (Please Initial)
Brandon Mitchell
V n nQ C,.-Cv -.r—
A,enl or Applicant PRINTED Name
12/29/2021
Permit Officer's PRINTED Name
5igqpture *"Please read compliance statement on back of permit*
A2- ........ .....
Sigau
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Application Feels)
Check h/Monvy Order
Issuing Date
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Expiration Date

T IZAT N F R MA Mt P TI
Name of property ()wnor Requesting Permit:
Mailing Address: R-
max,Np 0 NL
25' Z
Phone Number:
Email Address:
I certify that I have authorized Agent! �tTactar
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
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necessary for the following proposed development: 0
. 'Coo-� q ma;�rves
at my property located at
in --()0_f*C.Counly.
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 ©tenter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Properiy Owner infOrm8li0n:
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— — — — — — —Sig—nature
Robert Pedersen
--p—rint or TypeName
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1012212021
Date
This certification is valid through

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Tracking Number: 70203160000152798010 Remove X
Your item was delivered to an individual at the address at 1:24 pm on November 20, 2021 in
MANNS HARBOR, NC 27953.
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November 20, 2021 at 1:24 pm
MANNS HARBOR, NC 27953 -nM
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November 20, 2021, 1:24 pm
Delivered, Left with Individual
MANNS HARBOR, NC 27953
Your item was delivered to an individual at the address at 1:24 pm on November 20, 2021 in MANNS
HARBOR, NC 27953,
November 20, 2021, 4:59 am
Departed USPS Regional Facility
ROCKY MOUNT NC DISTRIBUTION CENTER
November 19, 2021, 11 :16 am,
Arrived at USPS Regional Facility
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Tracking Number: 9590940260110069653441 Remove X
Your item departed our USPS facility in ROCKY MOUNT NC DISTRIBUTION CENTER on
November 23, 2021 at 5:02 am. The item is currently in transit to the destination.
I I I I I 1 Vwpiqii��111
November 23, 2021 at 5:02 am
ROCKY MOUNT NC DISTRIBUTION CENTER
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November 23, 2021, 5:02 am
Departed USPS Regional Facility
ROCKY MOUNT NC DISTRIBUTION CENTER
Your item departed our USPS facility in ROCKY MOUNT NC DISTRIBUTION CENTER on November 23,
2021 at 5:02 am. The item is currently in transit to the destination.
N ovem ber 21, 2021, 11:29 am
Arrived at USPS Regional Facility
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1 of 2 12/22/202 1, 11: 00 AM

A0UNILED STATES
POSTAL SERVICE,
KILL DEVIL HILLS
302 S CROATAN HWY
KILL DEVIL HILLS, NC 27948-9998
[phone]
11/18/2021
----------- ---------------------------------
12:30 PM
Product QTV Unit
Price
Price
-------------------------
-----
First -Class Mai16 1 -----
---------
$0,58
Letter
Manns Harbor, NC 27953
Weight: 0 lb 0.60 o2
Estimated Delivery Date
Mon 11122.12021
Certified Mail@
$3.75
Tracking 4;
70203160000152798010
Return Receipt
$3.05
Tracking #:
9590 9402 6011 0069 6534
41
Total
$7,38
Grand Total: $7,38
---------------- - ------ - --- ----------------
Debii Card Remitted $7.38
Card Name: VISA
Account #: XXXXXXXXXXXX5243
Approval #: 070946
Transaction 0: 915
Receipt 4: 032793
Debit Card Purchase: $7.38
AID: AOOCO000980840 ChTp
AL: 05 DEBIT
PIN: Verified
--------------------------- --------------
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5679 Mashoes RD
Mashoes NC, 27953
Parcel: 017460001
Pim 984106482014
Owners: Pedersen, Robert C -Primary
Owner
Hawk, Jenny R -Primary Owner
Budding Value: $0
Land Value: $205,400
Misc Value: $20,600
Total Value: $226,000
Tax District: Mashoes
Subdivision: Subdivision - None
Lot BLK-Sec: Lot: Blk: Sec:
Property Use: Secondary Improvement
Building Type:
Year Built: