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GE & FILL 6647 A B CC D
GE
NERAL PERMIT Previous permit #
ElComplete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Corpmissiln in an a ea of environmental concern pursuant to 15A NCAC 1H
ules attached.
Applicant Name 11 - P o! Project Location: County -
Address Street Address/ State Road/ Lot #
ell,
Zip
City, State
Phone # E7Mail Subdivision
Authorized Agent City ZIP 4��
E -1 Cw VV ZAAEPTS Phone # River Basin I
Affected 7
AEC(s): EI OEA El HHF 0 1H 0 UBA El N/A Adj. Wtr. Body Z
in—a't4man /unkn)
0 PWS:
Closest Maj. Wtr. Body-
ORW: 14;S'^11A no PNA yesJ nQ
Type of Project/ Activity
4
Pier (dock) length f 'K I —!
Fixed Platform(0 RL-1 -I-
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore —
max distance offshore
Basin, channel
. . ..
..... ... ...
cubic yards
Vat ramp
Boahouse/ Boatfift '
o
hi x
Beach Bulldozing
I.
Other
Shoreline Length
SAV. not sure yes �0'i
Moratorium: n/a yes jn�0
— ""'
Photos: yes (n
.-- -- - I--- -I-- - T-- -1:
i.
Waiver Attached: yes " ri�
A building permit may be required by:
IN
t
Note Local Planning jurisdiction) 6 -
Notes/ Special Conditions
I
Agent or Applicant infedt1lame
El See note on back
r
Nam!
(Scale:
'00wT
GJ
River Basin rules.
A
ce statement on back of permit Signatur **Pl6se read compliance Signature
App6cation ,e(s) Check# IssuiniDath
iration'Date ,
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:
0 Tar - Pamlico River Basin Buffer Rules 0 Other:
M 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 how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: 252-247-3330
(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: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http-//www.nccoastaimanagement.net/
Revised 08/27/ 14
AMA / ❑ DREDGE & FILL'
$ 66477
CsEA B
NERAL PERMIT
Previous permit #
,lifflkew ❑Modification ❑Complete Reissue El Partial. Reissue Date previous permit issued
As authorized,by the State of North Carolina, Department of Environment and Natural Resources 'A6
and the Coastal Resources Co mi i n in an a ea o envi onmental concern
'pursuant to 15A NCAC
Wes attached. a
APPlicant Name Project Location: Count
y r
Address
t j Street Address/ State Road/ Lot #(s)
City . 1f r �15 v � i i � State ZlP �15 47 CA JA A, �✓ 4
Phone-Eri��
ail Subdivision
Authorized Agent -' City ZIP
CW Phone # TA ❑ PTS River Basin !'
Affected ' O O
❑
❑ IDEA ❑ HHP ❑ IH ❑ UBA ❑ N/A f
AEC
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Closest Maj. WinBody W�
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Permit _
�P�
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
�I.,I,► W�kV-e,,,
Mailing Address:
Na q&
I certify that I have authorized (agent) -- ` -ber 61A � f0j i o lv&to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) i�7a (Y-ai ►aA bT- IC: le.
Gfi
RECEIVED
This certification is valid thru (date) I tCJUV►' 1 ` i� �� DEC 2 9 2015
Property Owner Signature Date
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: I t1; Q to k I I C-,
Address of Property: /� -LyC! God l
s- (Lot or Street #, Street or Road, City & County) /J /
Agent's Name #: !J, y (Jl(�� tj Mailing Address: f,) D boy
Agent's phone #: d5� "3 J c-9 9`�� 1�1,41,erol ,l
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 description or drawing with dimensions must be provided with this letter.
JI have no objections to this proposal. I have objections to this proposal.
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 DCM offices is
available athtta://www.nccoastalmanaaement.net/web/cm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish L
tow the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(PrOiDerty Own r formatio) (Ri riar(Property Owner Information)
Signature JFature E C E I V E D
ph't fe--0 9vot ri %o? DEC 2 9 2015
Print or Typb Name Print or Type Name
67 NG q6 W K C &OV 00Ni (` AUt DCM- MHD CITY
Mailing Address Mailin Address
Ile lUG �75�� �w►���I�SI� n-�
City/St /Zip City/State/Zrp
fAi
q1C
Telephone Number E ail Address Telephone Number/ Email Address
Date
C'1 It 35
Date
(Revised Aug. 2014)
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER N OTIIFICATIONMAIVER FORM
PhName of Property Owner: 4 t /
P W A i -11e -
Address of Property: [� / Q� 6,egt -oa Ar
(Lot or Street #, Street or Road, City & County)
Agent's Name #: 0-14 tl Z�/r �C16�(, 15 Mailing Address: ✓" a /�0/ / 5u 4" C�
Agent's phone #: q� a- �`l d -1,V 7 /' yM ��2"� Gt .�- S 1 c IQ6 �� � /
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 description or drawing, with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
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 DCM offices is
available athtto.11www.nccoastalmanaaement.net/web/cm/staff-listina orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop rty Owner I mation
tgnature
PA,h�
1I�
Punt or Typb Name
Mailing Address
Y dun u (lamp
City/Sta ip
19 -351 �h; l l,pi, ", e® t)e . c(. 60
Telephone NumberE ail Address
Date
(Riparian Property Owner I form ion)
t lvA"J�„
Signature '
Print or Type Name
t0g0.& CANS RECEIVED
Mailing Address
e•✓t;r�D �� ` F � � DEC 2 9 2015
5tyistateizip nf' nn M H D C IT
-6116
Telephone Number/Email ddress
l7�illlZvlS
Date
(Revised Aug. 2014)
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252-W4987