Lee, Denton

AMA EJ'DRIE,DQE & FILL
A B C 1).
NERAL. PERMIT
Previous permit,#
Modification El C= evy El plete Reissue []Partial Reissue Date previous rmit issued
7Coastal
riz
As auth rized by the State of North Carolina Department of Environment and Natural Resources
and the, Resources Commiss on in an area of environmental concern pursuant to 15A NCAC
ED Pules
Applica' n e
attached.
Project Location: County
Add-1 'A
r I I "
Street Address/ State Road/ 1,ot #(s)
City
State ZIP
Phone #ail
j
14
Subdivision
Authorized Agent
City, ZIP
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Affected PTA ❑ ES D PTS
Ph #
one River Basin
1:1 OEA ❑ HHF H El UBA El N/A
AEC(s):
Adj. Wtr. Body Y gnat /man /unkn
P:
1 "01WS
.
ORW: ((yes /)no lPNAr yes /�no
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Closest Maj. Wtr. Body
Type of Projecit/ Activity
O
(Scale:
Pier (dock) length
Fixed Plat
Floating Platform(s�'—..
Finger pier(s)
Groin length
numbeY—
Bulkhead/ Riprap, length
avg distance offshore
max distance offshore
Basin, cha nn el--�
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Beach Bulldozing
Other.',, k.
MEMENEEMENO
Shoreline Length
SAV. not sure yes �no,,
Moratorium: n/a yes k9,
Photos: Xes
Waiver Attached:
tuilding permit may . y be'requir . ed by:
Note LocalPlanning Juriscli c!,ion),,
Notes/ S pedI Conditicins
Ageriog .4.
Sijriatdrq
d compliance statement backoirper `it*
em m
ate:
r
Expiration Date
7
�1? 7" W',

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific 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 or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
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. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.net/
Revised 08/27/ 14

LAMA / ❑ DREDGE & FILL
f
' EN ERAL PERMIT
Previous Permit # A B c
ew. . ❑Modification ❑Complete Reissue
❑Partial Reissue Date previous ermit issued
4s aufh ' rized-by the State of North Carolina, Department oY Environment and'Natural Resources
and the Coastal Reso Commission in an of I SA NCACi
rc�s area environmental
concern pursuant to
�~
\pplicant , me , : ;fix / Lij '
•,, pPules attached.
Project Location: County ik,' :
ity 1. V�, U V, Il State �t ZIP r—
Street Address/ S a e Road/ Lot #(s)
/ y` i t �J ? -'^ .1
F Mail
W
- /
Subdivision -Y
\ ,thorized Agent
Ci ZIP r-
`cW W PTA ❑ ES ElPTS
Phone # O River B�sin'..-
\ffected f
❑OEA ❑HHF ❑UBA El N/A
1EC(s):
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PWS�
)RW: Yf es /F no PNA yes / no fj
H _�(nat;
Closest •.Body'a I t i
Maj. Wtr.
Type of Project/Activity
� l
(Scale:
..Pier (dock) length
All
{
Fixed Platform(s) 1
�I
,Floating Platforms) l --^�_ffTl I I I I
I I I � ill I I I L rd
Finger pier(s)
Groin
1.
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ��- g�O h.%
Mailing Address: 4;;�� �& --e—c 16
Phone Number:
Email Address: %90L , Cow
w
I certify that I have authorized L- )—e(� ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Z
J7-
at my property located at A
in `-County.
I furthermore certify that I am authorized to grant, and do in fact grantpermission 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.
Print or Type Name
L%
Title
03 1 o � i c;?-O/ 7
Date
This certification is valid through I 1
MAR 13 2017

ADJAM N.T RIPARti M PROPERTY.{ HV{aIER TATEMENT
hereby GE rt 1, that I'oiv' i. proper,iy adja.-en 9J �-7j �:.'s
t.to � ,. • •V=
[2!fplp?Y Qin►ner�
property la'4ted ek � ' ' -
(A dtlr.'ess, L61, BIC d J.,d; eiic..)•
om
iri : A��7 . �
{IN �te�rbot! Y _ ._ -- _ 1aCfa�rn an�lora��n1y
TOO appiiditnt has 6.6d to ine',..as-.sl7own below, th6.deveJopmont proposed.a the Above,
!�. I' hG.vQ rna'olujeCtion to rthi >-prpoosal:
11ai v . ohj ei ons -to lhjs I
DESGR[PTIH�.}f Q['jNIQ; ORPSD:DEVE.OPMi:.IV�:
�Itidiv ctual ,prrip .m..:.
Pndcnjisdafifowor wing)
,-
�. M 1
' b� set oin: i Ost 1•.ideraii 9 fiat:.K�rF cicick,..tnoo�i°1lintz:fieEkvti:3r,::boethoitse; tl or g�
lsaick=a MIA rt3u x� r is ice o `� ` f or i=ii fy,:, a flfi.ri na i:aocess antes:, walved by ie. �pf you
w$h to vvai� + ttze :ak; yoit nrIJst: iris oaf the _ro ria l:e blantE bE;low.)
'
..RECEIVE®
- '. -1 Flo v �sta,t� ��aanie the �15� � et#a�c � ` uiremf ant~ ' • • � . -- -; f
MAR 11 2017 �
. 1 +;10-FI6A wtsll to w81V8 t18 16' Setback regU1-'ot1.6bt.
t ►wi per 11'i . r dohj.:` (Adjirit Pra�ietty OwnSr lI`if� n ot� t:
Sagnclure
or 1 -Name Prini;are
fitiG - Ai1d . ��ss IirfaJltr �ess
vo
T oiie P' rm.he Te>+w rWheelfamber
1,`7 Wc('�
Tydte Dare �-
(Revlm `6 laft i2) s

�IDdACEN.T RtPAR1AtV t?ROPERTY O ..`kR$iATEMENT
:.
; ..
I hereby certify that i own. property adjacerit.t :. ,(f— 's
��j NO Properly t]uvne
of. -. .
_ property lacatetl at !`T:U at fjj
on tl �N Address Bloc ';;ftoa 10.
46. FNC
(INat od (City/Town an ::or County)_ .. ..
• The applicant has describetl to me,: as shown below, the.development proposed at the above,
z
loca ion .:
no obieciron to this prgposal. '
I have ob}ecffons to Phis proposal..:::
DESGRIPTIE?t� ANDIOR WNING OF �RpPQSEtY:DVELOPMIENT:
Indiyiclual ro osan dvelo mint rirust flit rnescriiitt'arl' below or aitaetr •a•ste drawing)
I�
:.
WAIVER 8 tTIU•N .. .
I' understand.:that; a �erx dovk, rrioorm ilrr� s; . reakuvater :boathouse, fift; or groin: be set ...
" gpn b ,.
:.
.-
back a m�nimu (distance b - V f'om my,area of npanan:access unless waived by me. (If you
:.�.
.
vrnsh to' waN . e setback; you.must initiat the. appraprtate blanl�.below.j
�
.,..
[ do wish to wave the 15' setbaok requirement'
1 do not wish fo waive the 16'setback'requirerwt.
r ert Owner Ifif4i anion) _ : (Adjacent Property Owner Information)
griature Sign ure .
:FFE e,°
S
rmt or7ype Name Print:or . y,Y �•• a Na�►e IV
:. f.
Ma�7rng Lb
Addressgddr s �s
MAR 13 2017
.:....
yf$ ate i-- CityfState%Zi-
9.�OEJ
.� IVI 1� C.I'Y
TO)epho e N berelepFione Nu ber .
,
i
Date . Date
(Revised 6118120f2)