86390A - Yang, Ju & An, Da

DREDGE & FILL
CAMA Previous pernut
I GENERAL PERMIT Date previous Pernn'"Ssuied
Complete Reissue Partial Reissue
Modification m an area of C—er" 1"U"'t to
As Awt,�,Ied b* tt�, Stare of N-th Ca,ohQ. Depatin-nt f F.rIvIro­,ta1 Q11ality and line Coastal R&�rces Co��%""n
, win
I SA 14CAC H., tk
75 AgetA
Applicant Nance , L- V�� P-lectLocAocra(C-10.-ey)
_...—_-
Address Street Address/State litoaWlLot #is)
City ot-r-h' StAte ,6iJ, t 71P a5, 9­41.
S u b d i v m e 0 n 14 N 1. k
C'ty
Es PTS Adl, wit" Body
Affected jcw P.
i ISPIMA UPWS Closest Mar W"' Body
AECis) Ll OEA F.J 1HA E] Uw
ORW Vest) PNA
Type of Project/ Activity— (scale: 1�'MS
Sho,ebne Length (4,5! . ....
Access Length.............
Pier Idock) length-- t3 0,4l, k4l�
Fixed Platformis)
Floating PlatfOrn'll(s), r—
Finger pier(s)
Total Platform area
Groin length/#-—, f
Bulkhead/ Riprap length IL L�--i& y—
Avg distance offshore_.. —
Basin, channel
Breakwater/Sitl
Max distance/ length
TX I
Cubic yards T
Boat ramp
Beach Bulldozing
Other
SAV observed. ye
yes no Plcry.
L 1no 4 1
Moratorium! t C­(
Site Photos: no I
Riparian Waiver Attached: e
A building permit/zoning permit may F1 required by 7ra—Z 1­42[— TARJPAl-VNEUSE/BUFFFR (circle one)
Permit Conditions See note on back regarding River Basin ru
See additional notes/conditions on back
IA"A AREOF5TATUTESCRC-R—ULESAND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) THAT APPLY "PL'
—IzAeL� AA, Sc?be4 Cot,&: +-f-
D N P Officer's PRINTED Name
Name
Agent 0 11cant P 7E;w�
compliance Signature
Sign ure el Vad complianc,,Ilat,ment on back of permit"
Application Feels) Check M/Money Order issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLlCATtfl�l
Name of Property Owner Requesting Permit:
Mailing Address: I
Phone Numbers .� i ~r -� ` ` 7
Email Address:
l certify that l have authorized 1 ��:>�,�"f � jo
Agent contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following Proposed development , t'
at my property located at _ a t-t (
ini�
_County.
1 furthermore certify that i am authorized to grant, and do in fact grant permissior, to
Division of Coastal Management staff, the Local Permit O,fcer and their agents to enter
on the aforementioned lands in connection, with evaluating information related to this
permit application_
Property Omer Information:
f,
Signature
Print or Type PIame
Title
/IVfZ(4 1 26) 2'L--
Date
This Certi °ication is valid through _- ___.... 1 1

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 N-./
Address of Property: t\;A --�C,2
Mailing Address of Owner: ' ' ' t
Owner's email: ,, Af tf'4-Aj 4Y 7
Agent's Name: Agent Rhone#:
11 re?-
i
Agent's Email: f`� - ►, 7 J:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(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, .is shown on the attached drawing, the development they are proposing. A
description orrlrawinn with
I DO NOT have dbjections to this proposal. 1 DO F-, we objections to this proposal.
r' sV -' i LUn -C
If you havb objections to what is eing propose , you must n tify the N.C- Division of Coastal
Management (DCMi) 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, goat 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 yo is to waive the setback, you must sign
the appropriate blank below.)
.1
I DO wish to waive somelall of the 15' setback
Sigrfa�re Adj cenrRT ei " Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)__
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: L Rtr.l r _w_.11
tJAMc.-�C _
Mailing Address of ARPO: I S14--*11 `Pr" _ kJ �( {C 4L t`? ( _
ARPO's email:
Date: LA - Zc , . 2 Z
ARPO's Phone#:
*waiver is valid for up to one year from ARPO's Signature*
,Revised July 2021

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:..) L4
Address of Property: �_ ti,t �, I� i �j c- k:_ C_ -2r7c-, yc�
Mailing Address of Owner ' '
/ t
Owner's email ,,2i.1
Agent's Name: 1-�b i27D C_t2 ( A4 I1) �-(_- / Agent Phone#: 2 " 2 -2
Agent's Email: 1; Is
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
i hereby certify that i own prop.irty adjacent to the above referenced property. The individual applying for this
permit has described to me, ;.s shown on the attached drawing, the development they are proposing. A
CIACCrinlinn,Ar r1rou i­ .,i++..1:..........:...,...--
Y I DO NOT have objections to this proposal. _� I DO trive objections to this proposal.
l�es3 D C4 0A T L-\ r' F ©1U�. SL (t 7 l�t � I i� t b ill k .'l tC; �? 7' f
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, btiat 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 sometall of the 15' setback , f
l,/ l
-OR-
Signature of A iacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) L L
Signature of Adjacent Riparian Property Owner: '± wyj A C241
Typed/Printed name of ARPO: t � lC (t2 ��", i�j C o
Mailing Address of ARPO: .;ate (;�,
ARPO's email: a%�7 (ca.,,,�`'% ��C� yy,��, ARPO's Phone#:
Date: �(� ,�� I7 N *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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This map is prepared
from data used for the
1" ()�,
inventory of the real
��
,�, . �J
property for tax
purposes. Primary
��y. "
information sources such
as recorded deeds, plats,
wills, and other primary
(� _
public records should be
�'�'/f! t .1501
consulted for verification
of the information
�
8
111 Nash RD
Owners: Yang, Ju -Primary Owner
Tax District: Duck
Duck NC, 27949
An, Da -Primary Owner
Subdivision: West Winds Sub.
Parcel: 026476006
Building Value: $1,109,200
Lot BLK-Sec: Lot: 6 Blk: Sec:
Pin: 985920818940
Land Value: $332,600
Property Use: Residential
Misc Value: $55,000
Building Type: Beach Contemporary
Total Value: $1,496,800
Year Built: 2015

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