Harrell, Walter

IPA
-� ❑ CAMA / ❑ DREDGE & FILL N2 72085 A B C D
GENERAL PERMIT Previous permit #
❑New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
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.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State
Phone # ( ) E-Mail —
Authorized Agent
Affected ❑ CW ❑ EW D PTA El ES ElPTS
❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
ORW: yes / no PNA yes / no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)x ,
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel ,/
cubic yards
Boat ramp
Boathouse%Boatlifi f ,17
s
Beach Bulldozing
Other } i;
Shoreline Length
SAV: not sure yes Ono
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction) ,
Notes/ Special Conditions Al
� t
Agent or Applicant Printed Name
ZIP
Subdivision
City ZIP
Phone # ( ) River Basin _
Adj. Wtr. Body (nat '/man /unkn)
Closest Maj. Wtr. Body
i
(Scale: Aj )
f" ,` -
Ol) ❑See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signature ** Please read compliance statement on backof permit" Signatyre
Application Fee(s) Check # Issuing Date E piration 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, certify that 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 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: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
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://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

LtRTIFIED MAIL - RETURN RECEIPTREQUESTED
rvrasn
I hereby certify that I own property adjacent for S. ,�_jrrt✓ ,s
I ((� n A (Name of Property Owner)
Propertylocated at I `r �: �n _
(Address, Lot,
onrr�w C �'�---_ in _
(Waterbody)
Agent's Name #:
Agent's phone #:
(City/Town and/or County)
Mailing Address:
N.C.
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
-------------------
---------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED -DEVELOPMENT r
(Individual proposing develo rent
A must rill in d scription b w or attach a site dra in )
x (2 pec . oW N a 0, Dob Lb . j � _ / -�
It you have objections to what is being proposed, ou 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 athttn://www.nccoastalmanapement net/web/cm/staff listing orbycalling 1-8884RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail
Si ature
�7e
Print or Type Name
N1 . ng Address
City/State/Zip
U.2�5(,LIIO
Telephone Number Email Address
2 i2 i�
Date
( Property Own r Information)
ignature
Pnnt or Type Name
Mailing Addres
2s/
W-1—L—r-1011
City/StatelZip q, "I — U 9 _773
Te ephone NumberlEmail Addressl
v�
_l l g Date
(Revised: Aug. 2014)

LERTIFIED MAIL - RETURN RECEIPT -REQUESTED rvravi
I hereby certify that I own property adjacent to
property located at (Name of P perty Owner)
AloP r S C't`e-e- (Address, Lot, Block, Ro d, etc.)
on
in
N.C.
(Waterbody)
(City/Town and/or County)
Agent's Name #:
Mailing Address:
Agent's phone #:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
-----------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
----------
(Individual proposing development must fill in description below or attach a pi drawing)
r)) 5} c,,J A) -t 6 o ,4 2x I St / vi.+o
e,
' .14
if you have objections to what is being
(DCM) in writing within 10 days of receipt of this onotice. Contact information foru must no ' the Division oftal DCMa offices is
availableathttp://www.nccoastaimanaaement net/web/cm/staff lis-* orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information)
r
Si nature
i/
A( as
Pnnt or Tye Name
Telephone Number
//Email Address
Dat
(Aillf-Pon Property Owner Information)
Signature
Print or Type Na e
Jaffing-�A21dress�r���
N�=o
Aafe/Zip
Telephone Number/Email Address
2 ZV �
Date
(Revised: Aug. 2014)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Y 51,`�-i L4,1-d j
p
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
&ii`IN 01,1 i�ll�i�i
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: L TM m ® iE(- GIa
at my property located at
in 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
kfd 0- r' m
Print or Type Name
OW r er _
Title
2/ `-/
Date
This certification is valid through - l,/ 2, / -1

CAMA / ❑ DREDGE & FILL N272085 A B C D
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
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 ,�r _ 1 •C �' 1
les attached.
Applicant Name j''? L 'L I Project Location: County i z� T
Address 1 1 i t-)' , 'f� L i:° r Street Address/ State Road/ Lot #(s) �!
r' 7 /
City i -t i State Lf. ZIP_' f f
Phone # (. d`) �t'ia ' F_Mail Subdivision
Authorized Agent
❑ CW D EW ❑;PTA
Affected
AEC(s):
❑ OEA ❑ HHF ❑ IH
❑ PWS:
ORW:
yes /, no PNA yes / no
City ZIP _
❑ ES ❑ PTS Phone # ( ) River Basinr Q-
❑ UBA ❑ N/A Adj. Wtr. Body .f # na •.man unkn
Closest Maj. Wtr. Body
i
MEN
MEN
ME MEN
MEN MENOMEMEMEMNE
EMEEMEMMEMEMEEMEN
M.
MINE NEON mom
MENNEN
� i3
Agent or, Appli nted a \i
Si ref
I read compliance statement on back of permit
�-- 71
Awlication Fee(s) Check #
Permit Officer's Panted Name , f_ 1,44
Signat re
Issuing Date E niratinn Data