87152A - Geurtsen, Andrew and Lauren

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°mow I�'CAMA IVFDREDGE $ FILL W 87152 CA� o C D
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GENERAL PER Date provious permrtlaamd.
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Riparian Waiver Altacbed a no
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TANPAWNEUSUBUFFER (circle inn)
See note on back regarding Aner Bain rule
IJ See addmonal hales/<omiitlom on hack
I AM AWARE Of STATVTfS,CAC RUILS ANDCONDIfI0N5 TNAT APPIY TO TNIS DROIECT ANo REVIEWED COMPLIANCL STATEMENT. (pleaseI laly, ul.T
Aden orA iT aolj'RINIF a Permd Olhce,'a IT WWII Name
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1.CAMA EDGE & FILL N9 87152 OA1 B C D
GENERAL PERMIT Previous permit
� Date previous permit issued
@Ff4ew ❑ Modification []Complete Reissue ❑ Partial Reissue
As authorized by the
(State [off North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC Q/ I t (1 ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwdeq nc gov/CAMArules
Applicant Name 4A A rr —.3 1�pt-
Address js %�. s-Gt. �_I rC
City % aA A % State P'h A- ZIP 6 2?9
Phone # cc4) Ta % — I Zi(o?
Email
Authorized
0 b
Project Location (County): `1/G(W r-
-
O Street Address/State Road/Lot #(s) EE
449 2 L2 Mo s CQAC 1
Subdivision LLP % 4's C, a-S K I �o f S�
City B(.t_X ,n ZIP % %--6
Affected ❑CW 't6FW Y;fTA PIES'— �S Adj. Wtr. Body C-y-/1 CIL- / (n ma nk)
AEC(s): �❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ I
PWS Closest Maj. Wtr. Body �GM t CA L
s s,6
OWN: ye<- \ PNA:ye no
�/ Type of
r`Proiect/Activity
J t +.
C- d tom/ i�iiecc. (Scale:
Shoreline Length `' �'2 / rV r ✓
Access Length
Pier (dock) length �'�� Ott M l`SN Y
Fixed Platform(s)
Floating Platform(s) J 7j t3- Finger pier(s)}} Fpp
Total Platform area
Groin length/q� �• XN/1 �— (�
ulkhead Riprap length
Av nce offshore
p� O • U
Breakwater/Sill
Max distance/ length
Basin, channel 11-`
Cubic yards
Boat ramp -
Boathouse/ Boatlift )
Beach Bulldozing — (1
Other
SAV observed yes no
Moratorium: n/a
Site Photos: yes qp C
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by: cJ GS\sL CX. k�n -jk
TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
See note on back regarding River Basin rules
ElSee additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please lnitialA
}� yy��/k Cs�✓ems
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
LZ
Sign lease lease read compliance statement on back of permit**/ i Sig re
UUII lI07--�&2/-, CP�i�/2Y
Application Feels) Check JJ/Money Order Issuing Da3� Expiration Date

❑DREDGE & FILL No 87152 " A') B C D
ao Previous permit
G E N E RAL PERMIT Date previous permit issued
phew ❑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:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deg.nc.gov/CAMArules
Applicant Name
Address
City
Phone #
Email
f c:
State ✓k, ZIP ,y -%jS Q-
'7 a (,^
Authorized Agents%
Project Location (County), (�-
Street Address/State Road/Lot #(s)
Subdivision
City Z-`,' ZIP
Affected ❑ CW ❑ EW ❑ PTA Q ES 0 PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW D SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:/,J/ )
Access Length
-
,.
-
-
Pier (dock) length
I
\
i
Fixed Platform(s)
L
)
l
-
'�-'
-
Floating Platform(s)
Imo'
;1-
-
Finger pier(s)
_c.
._�__
Total Platform area
Groin length/It
Bulkhead/ Riprap length--
f
Avg distance offshore
1
Breakwater/Sill
Max distance/length
i
i
i
i
-
Basin, channel -
-
-4-
s
-
i
Cubic yards
Boat ramp
-
Boathouse/Boatlift-21
Beach Bulldozing
-
+
j
Other
SAV observed: yes no '�..-
_j
-
--
Moratorium: n/a i yes no
-
-
t
}--
SitePhotos: yes no
------
_.__.
)-
-----
Riparian Waiver Attached: yes no .,_
A building permit/zoning permit may be required by: C>,
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (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) �.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Sign '
ure "Please read compliance statement on back of permit" Signature
17
Application Feels) Check tt/Money Order Issuing Date Expiration Date

• AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Properly Owner Requesting Permit Q(,Aa)
Mailing Address \ `J Qy� cx
Phone Number: 'Soil Rpm ^12b�
Email Address:
I cerfity that I have authorized Lid d- Ar\q,&t S ,kk l Toe 00N
I---() Agent/Cony dot I Wr�5,V (v1LPJ-i
to act on my behalf. for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development. rnZ'lg1\_ _^
at myProperly located at �1 D IO rn. S t in.. n
(
• r �?c`n- _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
Lauren Geurtsen
Print or Typo Name
Title
9 / 13 / 2023
Date
This certification is valid through

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL R T RN RECEIPT REOUEsTFn or HAND DELIVER
IVER
(Top portion to be completed by owner or their agent)
Name of Property Owner. Q�Ndflj;� X l C. � htt n�--4)-�_
Address of Property: _ _�-{� I� v l_fGKJL�r•S try
Melling Address of Owner r%-t d (Z.Y n21�0
Owner's email: �� Owner's Phoneik5vl�^C,
AA enl's Name: C4- CalL)�" Agent Phonst .2 5i r'1d1
saEmail
�% '{1,,,tYicA1c1 CA, M- @ 4. CAL tiro C,'A
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Aottom Donlon to be completed by the Adjacent 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, as shown on the attached drawing, the development they are proposing A
I DO NOT have objections to this proposal.. I DO have objections to this proposal
it you nave 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, Sto. 300, Elizabeth City, NC, 27909. DCM representatives can also bo
contacted at [phone]. No response /s considered the same as no objection If you have been
notified by Certif►ed Mail,
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat 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 wisp to waive the setback you must sign
the appropriate blank below.) �
I DO wish to waive some/all of the 15' set6a-/
-OR-
Signature of Ad)aeenf Riperfan Oroperty caner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Printed name of ARPO:
Meiling Address of ARPO:
ARPO's email:
ARPO's Phone#:
Date: 'waiver Is valid for up to one year from ARPO's Signature,
Revised July 2021

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7OP2 100 0002 1100 7127
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1ST NOTICE
2ND NOTICE
RETURN
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�p BK 2532 PG 373 - 374 (2) DOC# 700103538
x-\This Document eRecorded: 08/04/2021 01:21:34 PM
Fee: $26.00 Excise Tax: $40.00
�gare County, North Carolina Transfer Tax: $200.00
Cheryl L. House, REGISTER OF DEEDS
Dare County Land YpAnsfer No.: 4039-21 Land Transfer Tax: 200.00 1985 Sessions Law Chapter 670 (HB 215)
be mailed to the preparer, David R. Dixon, at Post Office Box 750, Avon, NC 27915
Y Parcel 0169100 Brief Index Description: Dock Easement in Buxton
CAROLINA DEED OF EASEMENT
THIS DEED OF EASEMENT is made this 4 day of August, 2021, by and between:
G
`�5 Preston Ross Barley, unmarried O
0ost Office Box 113
Buxton, NC 27920
1<1'
(hereinafter referred to in the neuter singll_ aF as "the Grantor") and
Andrew�M. Geurtsen
and wife, Lauren S-�eurtsen
15 Red cC e
Taunton, ryryry �1} 02780
(hereinafter referred to in the neuter singular as "the ltee")
WITNESSETH, that the Grantor, for a valuable considellllllr��v��vat�ro t paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does hereby give, grant, and sell unto the Grantee and any future owners of
the property described here as the dominant estate, an exclusive, perpetual, and appurtenant easement over and on
the property described below, being a part of the servient estate Os also described below.
The purpose of the easement shall be for the use of boat dockage196d for allowing access, ingress, egress and
regress to and from that property owned by the Grantee, described heir `Flts` the dominant estate, and from Gaskins
Lane, to access the waters of the Pamlico Sound, allow for boat dockage,'@M other general maritime uses. Any and
all maintenance, improvements and utilities supplied to the easement shall be at the sole cost and obligation of
the Grantee, the Grantor having no obligation for the same in any manner. -
The Easement is more particularly described as beginning at the point marking th Northwestem comer of the
lands of the Grantor, as described in that deed recorded in Deed Book 1798 at P*d 284, proceeding thence
along the lands of the Grantor North 85 Degrees 41 Minutes 01 Seconds East 18. et to a point, thence
cornering, and proceeding South 4 Degrees 27 minutes 00 Seconds East 24 feet, th South 85 Degrees 41
Minutes 01 Seconds West to the margin or right of way of Gaskins Lane, thence alon askins Lane North 04
Degrees 27 Minutes 00 Seconds West to the point or place of beginning.
The servient estate is that parcel of land described in that deed recorded in Deed Book 179Ot Page 284,
described as a deed of correction and conveying the parcel to the Grantor herein.
submitted electronically by "Dixon & Dixon raw offices"
in compliance with North carolna statutes governing recordable documents
and the terms of the submi tter agreement with the Dare county Register of Deeds.

BK 2532 PG 374 DOC# 700103538
O
The dinant estate is that lot or parcel owned by the Grantee, who acquired the property by deed recorded in Book
2520 at )'age 224 in the Public Registry of Dare County.
IN WITNE"EREOF, the Grantor has hereunto set her,d and seal.
O
� (SEAL)
{j ��''Preston Ross Barley
NORTH CAROLINA, DA14OUNTY
I, allotary Public of the County and State aforesaid, certify that Preston Ross Barley, Grantor personally a'p/yegred before me this day
and acknowledged the execution of the Po&going instrument. Witness my hand and official stamp or seal, this'f — dayuf August,2021.
�O
My Commission Expires:
Y�
Notary Public
Dare
1county
Notary Public

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Carver, Yvonne
From: Carver, Yvonne
Sent: Tuesday, February 13, 2024 4:27 PM
To: Top $
Subject: Geurtsen GP87152
Attachments: GEURTSEN GP87152-RECEIPT-02132024162153.pdf
Um
A copy of general permit (GP) number 87152 authorizing the bulkhead project at the
Geurtsen property at 47176 Gaskins Lane, Buxton is attached for your review and
signature. A copy of the receipt for the permit fees is included in the pdf attachment.
To validate this permit, please address the following:
1. The authorized agent must print and sign the permit on the bottom left-hand corner
below their printed name,
2. initial where indicated on the bottom right of the permit, and
3. scan and send a signed copy of the GP back to me.
If you have any questions regarding this correspondence, please don't hesitate to contact
me.
Thank you.
lua�vne
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-621-6453
401 S. Griffin St., Suite 300
Elizabeth City, NC 27909
1