5-24 PERQ - Moore, John and Donna

Perguimans County 5.24 PERO
Local Government Permit Number
CAMA p`pF COASTA[
a
MINOR DEVELOPMENT z
PERMIT
as authorized by the State of North Carolina, Department of Environmental Quality and the
Coastal Resources Commission for development in an Area of Environmental Concern
pursuant to the Coastal Area Management Act, Section 113A-118 of the General Statutes.
Issued to John & Donna Moore, authorizing development in the Estuarine Shoreline (AEC) at 138 Discovery Trail In
Holiday Island Subdivision, in Hertford, as requested in the permittee's application, dated July 17, 2024, received on July
17, 2024 and received complete on August 19, 2024. This permit, issued on August 19, 2024, is subject to compliance
with the application and site drawing (where consistent with the permit), all applicable regulations and special conditions
and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment or civil action, or
may cause the permit to be null and void.
This permit authorizes: Construction of Single Family Residence.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on August 16, 2023. [GS 113A-120]
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations. [GS 113A-120]
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit. [GS 113A-120]
(4) A copy of this permit shall be posted or available on site. Contact this office at 252-264-3901 for a final inspection at
completion of work. [GS 113A-120)
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for
compliance. Any maintenance work or project modification not covered under
this permit, requirefurther written permit approval. All work must cease when this
permit expires on: DECEMBER31,2027
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal
Management.
Check #4881. in the amount of $100, was received on 8/19/2024 for the
permit fee.
Cynthia Rountree
Field Representative
401 South Griffin -St.. Star
PERMITTEE
required if conditions above apply to permit)

APPLICATION:_ I IOO7e I 366% Q'bOrY1y LOCALITY: ��/`6 i L40naAs PERMIT ISSUED USING
C STATIC LINE EXCEPTION?
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AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address:
Telephone Number:
I certify that 1 have authorized &-' L I'v 104-k (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of
at my property located at
This certification is valid through ,7 Zav a/-/ (date).
(Property Owner Information)
Signature
Print or Type Name
Title, co. owner or trtisfee for property
i
Telephone Number
Email Address
RECEIVED
JUL 17 2024
®CM -EC

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
G— 1 2
RECEIVED Date
JUL 17 2024
DCM-EC
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor pemtit to
on my property at
in�>CC'�Nk:%McltNS County, whict
drawing is attached/enclosed for your review.
is adjacent to your property. A copy of the application and project
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: NC
Division of Coastal Management (DCM) at 401 S. Griffin St., Ste 300, Elizabeth City, NC 27909.
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact DCM staff at 252-264-3901.
Sincerely,
Property Owner's Name
Address
City
259- 5.3 „-cal3
Telephone Number
State
✓I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
'"Ile I,
r'(1VA�
_ 0& 10612624-
Adjacent Riparian t nature Date
Brio W. C-Lo 2 -7 57- 4/6 - 18
Print or Type Name Telephone Number
Zip
)062. OQPNDOfl >S NOcfi— l vA 239ar
Address City State Zip
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
Name of Adjacent Riparian Property O V r
1,414, Z�tr�`'tig"
Ad Tess
1�rec c� OC 37I44
City, State Zip
To Whom It May Concern:
RECEIVED
JUL 17 2024
DCM-EC
Date
This correspondence is to notify you ns a riparian property owner that I am applying for a CAMA Minor permit to
Lk a (Lc X 3�s �lDfCIP
on my property at "elf U I
in `?,E! cq Li %mcl o'c' County, whicl
drawing is attached/enclosed for your review,
is adjacent to your property. A copy of the application and project
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: NC
Division of Coastal Management (DCM) at 401 S. Griffin St., Ste 300, Elizabeth City, NC 27909.
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact DCM staff at 252-264-390L
Sincerely,
Property Owner's Name
25'J-53Gr' oy/_3
Telephone Number
Address/ City State
- I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
/) .
Adjacent Riparian Signature
G-/e'.,, ;). Sort, .,Tk
Print or Type Name
2y
Date
-2S"S7
Telephone Number
Zip
Address City State Zip
e, �e y T,L >_. j cza �.,zi� s` C- � 3q
Revised July 2021

This Document eRecorded: v 05/13/2024 02:03:43 PM
Fee: $26.00 DocType: AFFT Tax: $0.00
Recorded By: DONNA H. PHELPS
Perquimans County, North Carolina
Jacqueline S. Frierson, Register of Deeds
STATE OF NORTH CAROLINA
COUNTY OF PERQUIMANS
RECEIVED
IUN24224
[)CM -EC
Prepared by and return to:
THOMPSOy & PUREZA, PA
101 West Main Street
Elizabeth City, NC 27909
AFFIDAVIT OF COMBINATION
DONNA L. MOORE and husband, JOHNNY R. MOORE, do hereby certify and declare
as follows:
Donna L. Moore and husband, Johnny R. Moore, are the owners of the certain adjacent
parcels of real property located in Perquimans County, North Carolina, and more particularly
described as follows:
Lots 62 and 63, Section J, as shown on map or plat entitled "HOLIDAY
ISLAND, SECT. "J"", dated May 27, 1971, prepared by S. Elmo Williams,
Registered Surveyor, recorded Plat Book 4, Pages 261 and 263 of the
Perquimans County Public Registry.
Said property being described in those certain deeds recorded in Book 525,
Page 467, and Book 525, Page 469, Perquimans County Public Registry. Lot
62 is presently identified as Parcel Number 2-D082-J062-HI, and Lot 63 is
presently identified as Parcel Number 2-DO82-JO63-HI in the Office of the
Perquimans County Tax Assessor.
1. It is the desire of the Affiants that the Perquimans County Tax Assessor combine
all of Parcel Number 2-DO82-JO62-HI and Parcel Number 2-DO82-JO63-HI into one (1) unitary
parcel.
2. The Affiants intend to use the previously described property as a single parcel in
regards to any future convenances.
3. It is the intent of the Affiants/Owners that the property described hereinabove will
hereafter be listed, assessed and taxed as one real property tax parcel number for ad valorem taxes
in the above County in which the real property is listed.
submitted electronically by "Thompson & Pureza PA"
In compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Perquimans County Register of Deeds.

LAX JJU r V V'YV ✓V Vtt `iJG JJU
Affiants/Owners covenant that this Affidavit may be relied upon by lenders, purchasers,
attorneys certifying title to said property, title insurance companies insuring the same and other
dealings with the said Affiants/Owners, their heirs, successors and assigns, to treat this property
as one tract unless and until a new division of the property may be created as permitted or required
under the subdivision laws of Perquimans County, North Carolina.
IN WITNESS WHEREOF, the undersigned has set their hands and seals, this the _ day
of April, 2024.
D M ORE (SEAL) R CEIUE F
(SEAL) IUN 2 4�
1T.OHNN?' R. MOORE
pCM-EC
State of North Carolina County of
I, the undersigned Notary Public of the County or City of � % and State
aforesaid, certify that DONNA L. MOORE and husband, JOHNNY GORE, personally
appeared before me this day and acknowledged the due execution of the foregoing instrument for
the purposes therein expressed. rd
Witness my hand and Notarial stamp or seal this day of April, 2024.
��hhMP4'dy
;i, �����G ;•'= z Notary Public <
MyC'"' s:

LEGEND
HOLIDAY ISLAND RD
DISCOVERY
DISCOVERY
VICINITY MAP n.t.s.
LOT AREA:
26516.9 SF/0.61 AC.
LOT AREA WITHIN 75' A.E.C.
18151.5 SF/0.42 AC
PROPOSED LOT COVERAGE
WITHIN 75' A.E.C.
3641 SF/0.08 AC=20.069
LINE
BEARING
DISTANCE
L1
S 8S28 00 W
17.78
1-2
S 18'04 27 E
14.80
L3
S 13' 12 39 E
24.65
L4
S 03'29 39 E
27.21
L5
S 14'09 42 W
23.74
L6
S 17'08 01 W
21.23
L7
N 89'54 25 W
8.68
L8
S 81'38 15 W
28.55
L9
S 67'56 37 W
15.72
1-10
N 88'29 25 W
22.36
11-11
S 79'03 51 111144.4
CANAL
L7 L8 L9
FOUND MONUMENTARON
SET MONUMENTATION O
DITCH -_-.._.._..-.._.._..-.._..-
RIGHT-OF-war----------
PROPERTY LINE
ADJOINING PROPERTY LINES - - - - - - -
UnDTY POLE
HYDRANT SEN
BENCHMARKK
P-K NAIL
TREE STUMP
ZECOVED N
4'
AUG 16 2024
Q'
®CM -EC
L10 L11
L6
1
I
ZONE AE 4.0
I
n
-
I 2
L5 45.3'
30' CAMA BUFFER
--T
GLENN SMITH
/
TO CODE
PATRICIA SMITH
STEPS
2-D082J061-HI I
i
PROPOSED
wo i
DB. 543, P 318 L4
DWELLING
w
ZONE: 10.2%
5t.6
Z
o DAVID CLOER
I
L3 STEPS/
+
j o 2-DO82JO64-HI
1 TO CODE
DB. $49, P. 606
IZONE., X
I
g
BULKHEAD L1-
r 1
1
I
I u,
POSSIBLE
- j
0 IW
I
WETLANDS Ln
(NOT BEEN DELINEATED)
PROPOSED
o !TT--
g
DRIVEWAY
lo0 0 l PROPOSED /v o
AREA
m III \ DITCHEPTIC
JIB
all l
S.I�L----------��- -
- - - - - - - -
-- -
10' UTILITY EASEMENT
(08_63, P. 485) _
i20' SETBACK-.
i•• S 83'00'00" W 1/2"'
N 83'00'00" E
150.00"
N 83'00'00" E 3
PIPE PIPE
69.75'
PIPE 150.00' REBAR
(BENT)
\
EX. DRIVEWAe
CULVERT
EX. DRIVEWAY
CULVERT
REF:
DISCOVERY TRAIL 60'
OB. 525, P. 467
DB, 525, P. 469
AFFIDAVIT OF RECOMBINATION
DB. 558, P. 639
REVISED: 07/17/2024
REVISED: 06 1 2024
0 40 80
DATE.06 03 20241
FILE AI24070P
PLACEMENT SURVEY
TM 2-DO82-JO63-HI
DOWNEASRE) MES
TAX MAP
�., r��Tl n,I
1"(O I11C/`/•1/COV TOII
..� , ..i in CT

LEGEND
RD
L
B LNG
TAN
L1
S 83'2800 W
17.78
L2
S 18'04 27 E
14.80
L3
S 13' 12 39 E
24.65
L4
S OS29 39 E
27.21
L5
S 14'09 42 W
23.74
16
S 1TOB 01 W
21.23
L7
N 89'S425 W
8.68
L8
S 81'3810 W
28.55
L9
S 67'56 37 W
15.72
L10
L11
N 8829 25 W
S 790151 W
22.36
44.47
FOI/ND MONUMENTARLW
SET YDNUMDVTA HT O
RIMT-- _.._._
PROPERLY UNE
ADJO'NINO PROPERtt LLNE$-------
ORE H POLE
SDI. �KNT
P-K MAX
MEE SNMP
VICMITY MAP n. L.
m
N
LL'
LOT AREA:
`F
26516.9 SF/O.61 AC.
al
LOT AREA WITHIN 75' A.E.C.
4
18151.5 SF/0.42 AC
CANAL
PROPOSED LOT COVERAGE
WITHIN 75' A.E.C.
3641 SF/0.08 AC=20.O6R,"
' —
L9 LIO Lll
L7 L8
10 26516.9 Sq. Feet
v
-----
R
CEIVED
I
0.61 Acres
ZONE: AE 4.0
L
I
"
v A8A
BUFFER
JUN 2 4 2024
GLENN SMITH
CAMA
PATRICIA SMITH I
/D
I
TO CODE
STEPS
2-DO824061-HI I
i'
PROPOSED l�
r
D9. 543, P. 318
/I
DWELLING �0{,,
I
^n/��CC
C
1) U •A y
I
2
V'
ZONE: I0.2X 1
54,
1
1 _
0 DAVID CLOER
I STEPS/
��+
_
_ _
_
c, 2-DO81.1064-HI
w 1 TO CODE
DB. 649, P. 606
�1 ZONE: X
0
tJ1
I
I
�
BULKHEAD L1
ip
POSSIBLE—
IF
m
WETLANDS1
(NOT BELW DEUNEIt ED) 0 1 1 /
Y I 1
®
V
PROPOSED
Z
o \
€
o
DRIVEWAY
NI I{ EPTIC AREA
I$ o1i PROPOSED
h
JCILL
10' UTILITY EASEMENT—"
ASEMENT a 90 SETBACK
1• S 83'00'00" W 1/2" N 83'00'00" E 150.00, PIPE N 83'00'00" E
69.75'
PIPE 150.00' REBAR -
(BENT)
\
EX. DRIVEWAY/
CULVERT EX. DRIVEWAY
CULVERT
REF: DISCOVERY TRAIL 60'
DS. 525, P. 467
DO.. 525, A 469
AFFIDAVIT OF RECOMBINATION
DB. 558, P. 639
0 40 80
SCALE: 1 IN - 40 FT
7RM.✓ 3720786800 K �12 21/2018 PB. 4, P. 261 BETHEL TOWNSHIP
PEROUIMANS COUNTY, NORTH CAROLINA
IS OFPAHIL FXAS1 NG PNIC0. OF�IAIW) MD WT IDOES NDT
1 sS PNEN L. CAROWELL. PD LSO CERTIFY MAY MIS , . 5 j,. CARD PLLC SURVEYI.I�T(�
PLAT WAS DRAWN FROM AN ACTUAL SURVEY MADE -+
UNDER AIY ORDER IN D TWIT THE DEED DESCRI3 �I IAI\
RON 6 E RIIMIEO IN DEED N 0 : I PAGE 639 I -
MMAtTIS ME RATIO R PRECISION 9 1: WCE WITH
TWIT
THIS PLAT WAS PREPARED IN ACCORDANCE WITH
NCGS 47-30(Y), AS AMENDED. WRNESS MY ORIGINAL
SIGNATURE, LICENSE NUMgER, AND SEAL THIS
Is DAr NE, zo a! 106 MARLA'S WAY
CAMDEN. NC 27921
SMPHEN+ CARDIWLI, PLS 252.336.5827

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