86616A_Everett, Thomas_20220714

CAMA ❑DREDGE &FILL �N9 86616 B C D
Previous permit
GENERAL PERMIT Date previous permit issued
WNew ❑ Modification ❑ Complete Reissue []Partial Reissue
As authorized by the St at oLf North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
,
15A NCAC t / �--3 ❑ Rules attached. General Permit Rules available at the following link: www dea nc.goy/CAMArules
Applicant Name 11
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Authorized Agent
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AEC(s): 1-1OEA
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❑ SPIMA ❑ PWS
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of Project/ Activity
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Shoreline Length iJ
Access Length (�
Pier (dock) length
Fixe Platform(s)
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Total Platform area
Groin length/#
Bulkhead/ Riprap length --
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards �-
Boat ramp
Boathouse eoatlift . �7C A. �
Beach Bulldoz
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SAV observed: yes �o
Moratorium: n/a es no t
Site Photos: y; no A-
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Riparian Waiver Attached: yes no
building permit/zoning permit may be required by:
Permit Conditions —AR R S �r, Ci Q S r- -'^mot � rQ-�a. i r�
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(Scale:
❑ TARIPAM/NEUSEBUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
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Age t or Appl ant P e Permit Officer's PRINTED
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Si nature `•P o liance st ck of permit• Si ure
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Application F (,) &Ak M/Money Order Issuing Date Expiration Date
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0
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Thomas Everett
Mailing Address: 9105 South Old Oregon Inlet Road
Nags Head N.C. 27959
Phone Number: 434-996-5334
Email Address: [e-mail]
i certify that 1 have authorized Millstone Marine Construrtinn inr,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
3°
Install a 5' x 3� dock on land, a 4' x 20' finger pier and install a boat lift s
at my property located at 345 Mother Vineyard Road
in Dare 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:
Signature
Thomas Everett
Print or Type Name
Owner
Title
Date
This certification is valid through __$_L 31 1 2022
Revised Mar. 2016

New Dock and Boat Litt for
15' riparian Tommy Everett 345 Mother Vineyard Road
corridor
$""(" sti

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
! hereby certify that I own property adjacent to Thomas Everett
's
Property located at 345 Mother Vineyard Road ;Name of Property Owner)
�04hb (Address, Lot, Block, Road, etc.)
on -�Sound ill Manteo
(Waterbody) (City/Town and/or County) N.C.
Agent's Name #: Millstone Marine Construction Mailing Address: 201-A Etheridge Road
Agent's phone #: [phone] — Manteo N.C. 27954
He/She has described to me as shown below the development he/she is proposing at that location,
anc; I have no objections to the proposal.
-------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
;Individual proposing development must fill in description below or attach a site drawing)
install a 5' x 34' dock on land, a 4' x 20' finger pier and install a boat lift If you have objections to what is being proposed, you must notify tite Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.net/contact dcm.lhtm or by calling 1-888-4P,CQA�T. No
response is considgreci the same as no objection if you have been notified by Certified Mail. _
_ _..
(Property Owrier,information)
Signature —�
Thomas Everett
Print or Type Name
9105 South Old Oregon inlet Road
Marling Address
Nags Head N.C.27959
C11y/Stale21p
Telephone Number
Date
/(Riparian Property Qwner Information)
U signature
Charles Gaddy
Print or Type Name
349 Mother Vineyard Road
Mailing Address
Manteo N.C. 27954
City/Stateop
Telephone Number
� ~ .26;, 22
dare

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to Thomas Everett Is
(Name of Property Owner)
property located at 345 Mother Vineyard Road
(Address, Lot, Block, Road, etc.)
on Afbeff6ade Sound in Manteo N.C.
(Waterbody) (CitylTown and/or County)
Agents Name #: Millstone Marine Construction Mailing Address. 201-A Etheridge Road
Agent's phone #: [phone] Manteo N.C. 27954
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fillindescription below or attach a site drawing)
Install a 5' x 30' dock on land, a 4' x 20' finger pier and install a boat lift
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for OCM offices is
available at www.nccoastaimangementneticontact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if 17ou have been notified by Certified Mail
(Property Owner Information)
Signatwe
Thomas Everett
Print or Type Name
9105 South Old Oregon Inlet Road
Mailing Address
Nags Head N.C. 27959
CitylState/Zip -
Telephone Number
Date
(Ripaarian- Property
Owner Information)
Signature Q
Connie Grav
Print or Type Name
341 Mother Vineyard Road
Mailing Address
Manteo N.C. 27954
Citwstataop
Telephone Nuntbw
Date

0