86673A_Girardi, Dorothy_20220822

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`r'�tCAMA DREDGE & FILL N(� 86613 O B C D
kNPrevious permit ... ..... ....... _..
GENERAL PERMIT Date previous permit issued
Y New j J Modification Complete Reissue Partial Reissue
As authorized by the State to�f Northh��Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC __.___ � - i � f_..__--- _...._..._._.__._........... )Rules attached. � General Permit Rules available at the following link: www;d�q.nc,goy[CAMArul�s
Applicant Name
I Address _ __(
City _ ... DA.......... . ZIP
Phone # (9_4
�y 1111t 231
ii .Si 8 —
Emai111��_`_��_...... ....._..
Authorized Agent ........... _U__T_ rJ Z_...__.___....._._..._..­
project Location (County):. yt,/--------- .....LL.........____...........
Street AddreWState Road/Lot #(s) ? �{ "7t(/ id �� ��
Subdivision 6L�.. P oy,
gr
City ___kn ,__DeA i 1 �^f.I` �i � . '..._..—.Z1P __!+ Z...-3—.6
-— Ad"Body
Affected I]CW XEW PTA ES �PTS Y Wu: a
AEC(s): F_�OEA IHA 5PIMA PWS�Uw� Closest Maj, Wtr. Body -- _-�4A C
ORW ye no PNA: ye no
Type of Project/ Activity rpVi "ityu Ck- ti
Pier ock ength (, i� �• �-
Fixed Platforms) l
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/q ... __..........
_
ulkhea Riprap length
InvV
Breakwater/Sill . ..................
Max distance/ length _.
Basin, channel
Cubic yards
Boat ramp
Boathous oatGft ......._.. __ I
Beach Bulldozing
_10"440VA4_
SAV observed: yes no
Moratorium: it yes no
Site Photos: e `
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by::
Permit Conditions .._.�...15-A.-
> /0:04 '�p
t,
TARtPAM/NEUSEIBUFFER (circle one)
See note on back regarding River Basin rules
l �!% `- � y `� E See additional notes/conditions on back
LAM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEME L Please Initial)
Brandon Mitchell (,V Q,' v(� ; ' _
en r Applicant PRINTED Name IV VI Permit Offic 's PRINTED Name
..... .... . ......._ _ . _. ...
Sig ature "Please read compliaMe -state. rrient on back of permit— Signat r
f
Application Feels) Check s/Money Girder issuing Jae Expiration Date
(carp ap s-86G14d 'fe"?6)

Statement of Compliance and Consistency
This permit is subject to compliance with tw, application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may Cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance, The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer With appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program,
River Basin Rules Applicable To Your Project:
Tar Pamlico River Basin (suffer Rules _ Neuse River Basin Buffer Rules
L.
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources, If you have any questions, please contact. the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215),
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Manaeemerit Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252 808-2808/ 1-888-4RCCIAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
Washington District
943 Washington Square Mail Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
401 S. Griffin St, Ste, 300 127 Cardinal Drive Ext. Wilmington, NC 2840S 3845
Elizabeth City, NC 27909 910-796.7215
252-264-3901 Fax:[phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http-//portal.ncdenr.or webJcm/dcm-home Revised6/011202]

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: l y S(ll C�dui! {Zc�
cw W da
4,Dq _ Nc- 3-1cmg __ _- --
Phone Number- qy1 T71 o 'Pi23 I
Email Address: ���� GQ—
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
r
necessary for the following proposed development:
D bcy are CAD -k'lkv2s sn
at my
property located at �_� U_ � t I -4
in V d`� - —
county-/
furthermore certify that l 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.
Properly Owner information:
V arAl Girard i
Signature
Dorothy Girardi
Print of Type Name
T.N�
SUN 1 4 2p22
V ' " -ec

4 - 3
if Complete items 1, 2, and 3.
IN Print your name and address on the reverse
so that we can return the card to you.
9 Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to;
ccs, kzcl
KO 2--79
9590,9402 75392098 8051 97
Kft 1-1-ne 1'7-nqnqfAr from �prvice label)
?222 0410 0001 0563 ?389
PS Form 38111 July 2020 PSN- 7530-02-000-9053
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ntf
A. Signpatwf65
Agent
Addressee
B. Receiv t me) C. Date of Delivery
D. Iddelivery address different from item 1? Yes
If YES, enter delivery address below: No
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C t'll
3. Service Type 0 Priority Mail Express®
0 Adult Signature 0 Registered MaIlTm
0 Adult Signature Restricted Delivery El Registered Mail Restricted
0 Certified Mail© Delivery
1:1 Certified Mail Restricted Delivery 0 Signature Confirmatiortlm
F1 Collect on Delivery 0 Signature Confirmation
11 Collect on Delivery Restricted Delivery Restricted Delivery
cured Mail
cured Mail Restricted Delivery
ver $500)
Domestic Return Receipt

RECEIVED
N.C. DIVISION OF COASTAL MANAGEMENT JUL 5 ZRZ
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiONIWAIVER FORM
CERT►VIED l+>!5AIL Rt UkN R CEIP-f REQUESTED a' HANU . v ACM -EC
(Top portion to be completed by owner or their agent)
Name of rter
Address
ivt�+latcy Ackkrss of (h►n^c "'---------- --- --- --- --- — - --- _,. . _ .. _ _ . -- -- . - - -_ _ _ _
Y/flPf s PhoirI Ll •5-716'C3W'-_
acic.�Cs mama aN� %A-gklk"L Agent phottc:#: �-f _i.$ swe-7
r /far: Its Email'. - VT O� i���{3 gYYGli I •coNi
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom ttortion to bra SgMpkrtect bW the Adiacent ProOOKIY pw080
I h(neby certify that F ruin prnperty adjaceiri io titre above referenced property. i he WvbVM'Lv-at applying tnti itHs
permit has do%cribrd to rite. as shown on the attached ctrawirtg. the devetoprrent they are proposing. A
*�1 ciescn riian or drawing Stith dintensions. must be provigej( ynth this letter.
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 orthis notice. Correspondence should be
mailed to 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909. DCAf representatives can also be
contacted at [phone]. No response is considered the some as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I rn,deistarri that any proposed pier. clock. mooring pilings, boat ramp. breakwatf:t. boathouse. tilt or
groin must be set back a minirnunr distance of 15' from my area of riparian access unless waived by mr:
(this does not apply to bulkheads or riprap revetments). (if you wish to waive the setback, you must sight
the appropriate blank belovi.)
100 ti,ish to waive surnelahi of the, 15' %ltback ,,,,
oft
-OR. Signatu►e of Adjacent Riparian Property Owner -
104
i do not wish to waive the 15' setback imMiement (itUtial the Dian*)
:xgnature cri Ad1ace►tt Riparian Properly Otivn _ "° i ou-v,4�r
TypedlPrinted nanm of ARPO:
Mailing Address of ARPO:
ARPO's omail;
ARPO's Phone*:
Date. - 'waiver Is valid for up to one year from ARPO's Slgnatuw
Revised July 2021

N Complete items 1, 2, and 3.
N Print your name and address on the reverse
so that we can return the card to you.
X Attach this card to the back of the mailpiece,
or on the front if space permits.
I. Article Addressed to:
s.
�j c ;Y7 qq
C9
2. Article Number (Transfer from service label)
7022 0410 0001 0563 7396
.0
PS Form 3811, July 2020 PSN 7530" 2-Ooo-9053
A. bvialwf
x Ci Agent
E3 Addressee
B. Recel"d b ri t me G.,pate of Delivery
7
D. Is delivery address differe t from item 1? 0 Yes
If YES, enter delivery address below: 0 No
3. Service Type
11 Adult Signature
0 Adult Signature Restricted Delivery
C1 Certified Mail(D
n Certified Mail Restricted Delivery
11 Collect on Delivery
El Collect on Delivery Restricted Delivery
11 Insured Mail
ired Mail Restricted Delivery
or $5001
• Priority Mail ExpressO
• Registered MaIlTm
• Registered Mail Restrictet
Delivery
• Signature ConfirmationT`4
• Signature Confirmation
Restricted Delivery

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This map is prepared
from data used for the
S1 �� Off•
inventory of the real
.�
property for tax
.1.'
ah
purposes. Primary
information sources such
as recorded deeds, plats,
wills, and other primary
i,
public records should be
consulted for verification
of the information
contained in this map.
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•� `� a Ct.
114 St Clair RD
Owners: Girardi, Dorothy J -Primary
Kill Devil Hills NC, 27948
Owner
Parcel: 004167000
Pin: 988305185600
Building Value: $202,300
Land Value: $180,700
Misc Value: $9,400
Total Value: $392,400
�
1
Tax District: Kill Devil Hills Out
Subdivision: Baum Bay Harbor Secs 1-4
Lot BLK-Sec: Lot: 1 Blk: Sec: 4
Property Use: Residential
Building Type: Traditional
Year Built: 1989

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