86826A - Williams

Acomy"r ❑CAMA ❑ DREDGE & FILL N° 86826 A B C D�
a GENERAL PERMIT Previous permit
Date previous permit issued
F71New [_]Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deQ.nc.Rov/CAMAnulas
Applicant Name _
Address
City
Phone # ( )
Email
State
ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no' PNA: yes/no
Type of Project/ Activity
Shoreline Length.
Access Length
Pier (dock) length
Fixed Platform(s),
Floating Platform(s)
Finger
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore_
Breakwater/Sill
Max distance/ length _
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no.
A building permit/zoning permit may be required by:
Permit Conditions
THAT
Agent or Applicant PRINTED Name ! _
Signature -*Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
(Scale: )
❑ TARIPAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Application Feels)
Check#/Money Order Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Lee_
Mailing Address: I 0 1 rnc� �gw k I'Lq
Phone Number:
Email Address: le�Gr��e �•1`'�1rG (�1(� 7 9r/lG �,(-Or"
I certify that I have authorized __PkGU i l �,
Agent % C ntractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: CU r, S I Qy (—
at my property located at 104) m o hr,U Ct 12 Q I ,
in Q1 oWcJ ,-, 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
Lee Ar, S Li l l C, mS
Print or Type Name
Title
�l aC) I
Date
This certification is valid through /
03—W l
ROZ t i 0 3 A
Al 1.
�P3.

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
1T ,Pn e W t�/Mo
Name of Adjacent Riparian Property Qwner
l C,�1k 2ti.1
A�dres�Q ^+
City, State Zip
To Whom It May Concern:
�'
F�g2�ti�'l3
GWt® I-,
Date
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
c 0r-\s4a 0 - -i I S+
on my property at I UMo 6,cw
in Ck� ) 4,--, County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
/.r A�
Property Owner's Name
Address
City
r�sD- L,S3-��
Telephone Number
State
JL l have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature
Print or Type Name
Date
- 287 . -2 90
Telephone Number
Zip
Address City State Zip
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Date
Name of� anan Property Owner
1nti' -D ocv !�� FEB 2 4 1�23
Address
�U o A fan / (C Z�g3 Z
City, State Zip
To Whom It May Concern:
This correspondence is to notify youas a riparian property owner that 1 am applying for a CAMA Minor permit to
Qro,�S+2U L A 6o,,+ L �4-
on my property at 1 0 I V�o4,c s 1 k Tec l
in QJ-1' o vJ c, Y-. County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property Owners Name Telephone Number
Address City State Zip
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
it
,;L Iao),�3
A Jacent Riparian Signature ' Date
W(l P) IAI�eru W I lnly l ` 757 - 96Q -� -9)
Print or Type Name Telephone Number
Address City State Zip
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT AIVER FORM
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIW IVER FORM
crFh MAIL RETURN RECEIPT RE g GT o or �,-� --
(Top portion to be completed by owner or their agent)
y/..�� S � -A \ tiw.
NamecrPropeny Owner. �'-"`n'''--'---'I— % r. Ai
Address of Property:
Mailing Address of Owner.
owner's email: �.Sk-a2. t r�tt < -< 1S1 Owners PtronaM:t`���q
,p %mn; t. Cam Agent Phonefl:,_,.__._..---- a e,
Agent's Name o. i
Agent's Email: •�
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(settom nordon to ba eompleted by the Adlacant ProuerlY Owner)
I hereby certify that 1 own properly adjacent to the above referenced properly. The Individual applying for this
paned has described to me, as shown on the attached drawing, the development they are proposing. A
��. •�n or drewind with dimel3filons. mug be nividded with this letter.
V I DO NOT have objections to this proposal. _ I DO have objections to this Proposal.
ff you have oviecaons m wear ra .A..,a r,�.^q�-• :__ ...__..- ,
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
malted to 401 S. Grflhn St, Ste, 300, Elizabeth City, NC, 27W9. DCM representatives can afro be
contacted at [phone]. No response Is considered the same as no objection if you have been
notified by CerUfled Mail.
WAIVER SECTION (Choose only omit
I understand that any proposed per. dock, mooring pilings, boat ramp, breakwater, boathouse, lit, or
groin must be set back a minimum distance of 15' from my eras of riparian access unless waived by me
(this does not aoo)v to bulkheads ar dor42 reve..i_nrents). (If you wish to waive the setback, you must Stan
the appropriate blank below.) /
I DO wish to waive someiali 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,
Typed/Printed name of ARPO:
Mailing Address of ARPO:
t <. i^rtt Gbtst(,sjt:jA, r`
ARPO's email:. i1r�: n ., , t Ai„, ARPO's PhoneN; �` , / � I `J"te
Date: d „2 ] ��„7_-'walver Is valid for up to one year from ARPO's Signature,
,a......_......_...., .,ten.,
FRI 2 7 2023

Filed: 0810312017 , 2:06:44 PM
Lynn C. Gilliard, Register of Deeds
Chowan County, NC
Revenue Tax: $0.00
Land Transfer Tax: $0.00
Book 497II PAGE 531 (3)
410721 �I IIIII�II��I�II�II 111
FEB 2 7 2023
DCP0-Ec;
WARRANTY DEED
Excise tax: None Tax Parcel No.(oq-100`ISF2=i, ` ; I
Prepared without title examination or opinion by and return to:
R. Edward Railey, III
Railey and Railey, P.C.
Post Office Box 40
Courtland, VA 23837
NORTH CAROLINA
CHOWAN COUNTY
THIS DEED, made and entered into this �� day of April, 2017, by and between
GILBERT H. STORY and wife, PHYLLIS KEETER STORY, whose address is: 101 Mohawk
Trail, Edenton, NC 27932, hereinafter GRANTORS; and LEEANN STORY ALEXANDER,
whose current mailing address is 22094 Main Street, Courtland, VA 23837, hereinafter
GRANTEE.
W ITNESSETH
THAT GRANTORS, for adequate valuable consideration, have given and granted and by
these presents do hereby give, grant and convey unto the GRANTEE, and her heirs and assigns,
an undivided one-third (1/3) interest in and to the following described property (the "Property")
to -wit:
"Lot Number 149, Section B, of Arrowhead Beach as shown on the map of same,
said map being prepared from survey by S. Elmo Williams, Registered Surveyor,
No. L-609, which map is registered in Plat Book No. 4, page 18, Office of the
Register of Deeds of Chowan County, North Carolina; being the same property
conveyed by American Central Corporation to Harry C. Russ, Jr. and wife, Mildred
1 7v 5 7

Book 497
Page 532
E. Russ by deed recorded in Book 103 at page 690 of the aforesaid Registry,
reference to which said map and deed is hereby made for further description and
chain of title.
SUBJECT to the restrictions, conditions and covenants of record registered in Book
19, page 78, Office of Register of Deeds, Chowan County, North Carolina."
It further being the same property conveyed to Gilbert H. Story and Phyllis Keeter Story,
by Harry C. Russ, Jr. and Mildred E. Russ, individually and as husband wife, by deed, dated
January 15, 1976, and recorded in the office of the Register of Deeds of Chowan County, North
Carolina on January 15, 1976, in Book 108, at page
This conveyance is made together with and subject to legally enforceable easements,
restrictions, rights of way and conditions, of record or apparent on -site.
FEB 2 1 2023
TO HAVE AND TO iIOLD the aforesaid tract or parcel of land, tr;tr rn all
privileges and appurtenances thereunto belonging, to GRANTEE and her heirs and assigns, as
joint tenants, with the right of survivorship as at common law.
The GRANTORS covenant with the GRANTEE, that GRANTORS are seized of the
described premises in fee simple, have the right to convey the same in fee simple, that title is
marketable and free and clear of all liens and encumbrances and that said GRANTORS will
forever warrant and defend the title to the same against the lawful claims of all persons
whomsoever, except for the exceptions and restrictions hereinafter stated. Title to the property is
subject to the following exceptions:
Ad valorem taxes for the current year, not yet due and payable.
2. Legally enforceable restrictions, conditions, rights of way and easements of
record or apparent on -site.
IN WITNESS WHEREOF, GRANTORS have hereunto set their hands and seals, the day
and year first above written.

Book 497
Page 533
(SEAL)
Gilbert H. Story
eLA:ae J%cc _r.. (SEAL)
Phyllis Keeter Story
G .
' /1 F
__1EB 2 1 2023
STATE OF V la1��c
J ®CMWEC
COUNTY OF to
1, ate —P�.-WCt;% , a Notary Public of the County and State
aforesaid, certify that Gilbert H.9tory and Phyllis Keeter Story, personally came before me this
day and acknowledged the due execution of the foregoipg instrument.
Witness my hand and official seal, this the Ztl -- day of April 2017.
Notary Public
(please sign exactly as name appears on seal)
My Commission Expires: 3i $ (NOTARIAL SEAL/STAMP)
NOTARY
PUBLIC
* • REG. #170270 •:
o MY COMMISSION Q
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