Lowe, Jayne

171 C, AMA ❑/ FL-1 DREDGE & FILL v/ N272040 A B C D
GENERAL PERMIT Previous permit #
E'New LJMoclification ElComplete 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 concem Pursuant to 15A NCAC
Lj Rules attached.
Applicant Name Project Location: County
Address
City-- State zip
Phone # E-Mail
Authorized Agent
El CW El EW A I S L1 PTS
Affected
AEC(s): F- OEA Ll HHF /EE] A06113A [I N/A
_j Pws:
ORW: ves / no PNA yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City -
—
Phone # River Basin
Adj. Wtr. Body---- ____(_n41t /--an /uPkn)
Closest Maj. Wtr. Body— ------------
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or Applicant Printed t
Sig Please readcompliancestatement on back of permit
Application Fee(s) Check #
Permit Officer's Printed Name
Signature
rt
Issuing Date Expkation 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/ 1-888-4RCOAST
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)
http://portal.ncdenr.org/web/cm/dcm-home
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)
Revised 7/06/ 17

IV
CT,!
I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I,hereby certify that I own property adjacent to ` _ ' �' L LJ s
( e of roperty Owner)
property located at ILA S' L.!� .��_.%� 7
(Address, Lot, Bock, Road, etc.)
on in w �- N.C.
(Waterbody) ( ity/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatiet�
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Wividui / proposing development must fill in description below or attach a site drawing?)
.L���-tom w�,I ( 3 )ram ky)-PL\) O� VUA:-<-'
ObO c)uJcx1.�
2
WAIVER SECTION
I understand that a 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. (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.
(Property Owner Information)
i
Print or Tvbe Name
Telephone Number! email address
Date
(Adjacent Property Owner Information)
-7
S rfytrrcJ `�>
Print otTy�e l�ememe
`t : f ,
Ma' i Address
' A c rVtJ`��
City/Sta
C,x,-'0 Teleph nne Number email address q td¢.vl^ � t
/ , rI '
`Valid for one calendar year after signature'
(Revised Aug. 2014)
RECEIVED
NOV 032017
DCM- MHD CITY

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ,,\Qc nc, C . Low e-
Mailing Address: N LewL- 14 .
Phone Number:
Email Address:
I certify that I have authorized
pal Ric "win, MT, I -awl, ff I
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at may property located at I,'�
in CCa j±2a P+ County.
r)C)
l furthermore ce-tify 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:
V
Signature
u (\ C-, Lowe -
Print or Type Name
Title
10 / Ic / aOI
Date
This certification is valid through I I NOV 0 3 2017
DCM- MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
T
f d--
I hereby certify that I own property adjacent to 73Cl (2• s
i (Name of Property Owner)
[
property located at l �J a S : �.eLo I� S "-
(Address, Lot, Block, Road etc.)
on , in NecvEJprt IVY , N.C.
(Waterbody) 1 (City/Town and/or County)
The appli ant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
proposing development must fill in description below or attach a site drawing)
19b O c� c� u� v� •�
L>spc)oY W<--)
2�
WAIVER SECTION
understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.) RECEIVED
QJ I do wish to waive the 15' setback requirement. NOV 0 3 2017
1 do not wish to waive the 15' setback requirement.
TY
(Property Owner Information) (Adjacent Property Owner In n �'�
'CUAN 0 0 LLW—
Signature Siknat re*
Sid Q
Print or Type Name Print or Type Name
Mailing Address at iM 1 n Addre
N� �onr� NC tiv .�A";k ZF 7
Ci tate ip City/State ip
)o."CY) i- 10c, a?)57D
Telephone Number / email address Telephone Numb e / email address
33(9- `7A -Mb one n+bo �a Qn .1 .
Date 10 - ICI - I Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
T
I hereby certify that I own property adjacent toT0LU(-\P-C-- L��e 's
• I Name of Property Owner)
property located at 0 S L2 u� i,3 \'--
(Address, Lot, Block, Road, etc.)
on , in Ale -Dorf- NC, ,N.C.
(Waterbody) (Cityrrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
I
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
proposing development must Fill in description below or attach a site drawing)
w�-, I l 3" 1 M 44L,\ a ��
tom.. l o
060nt�0.3Qc7--3 c:0,
E50
u cs t ) a.....
20
sir
' WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. r �._
I do not wish to waive the 15' setback requirement. N r ! V C 7� � 0 j o
(Property Owner Information) (Adjacent Property Owner Inf n), ;,
Si"a �i si�egtu l cy o
U Yl l P_ Lo W {- UAA
Mailing Address
Print ype Narne !
55 (� e
Mailing Address
CO/State/Zip Cif�tatelZjg G
Telephon Number/email address Telephone Number/email address
33(v -7Lt3 - 8'9q (p 33.', L,me�� .. q i `t - 9 2 ©- 3 (' 3
Date I o - Iq - I-) �— C,c? M Date; [
*Valid for one calendar year after signature*
(Revised Aug. 2014)
`C ATE,

C�-CAIVIA /,EJ DREDGE & FILL
A B D
,GENERAL PERMIT Previous permit #
11 New ElModification E]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 are4 of environmental concPr rsuant to 15A NCAC
X:Aulii hed.
Applicant
Name, Project Location: County
- f^t r)
f
Street Address/,State Address. Roao/ Lot #(s)
City State
i I
Subdivision Phone # all on,
L
�Ci k rip
Authorized Agent
<1 [I Cw *E�W TA D PTS Phone # I ID ��i`7 River Basin
Affected 01 �Xs r-1 L
Ll OEA 0 HHF El UBA 0 N/A
AEC(s): Adj. Wtr. Body A t"', (nat Irrian Junkn)
Ll Pws:
ORW: yes / no PNA yes Closest Maj. Wtr. Body,,.,
� roject/ Activity nAd c-1
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)_
Groin length
Bulkhead/, raplengi:Kr X
avg distance offshore—L.
max distance offshore E7�
Basin, channel
cubic yards_
Boat ramp _
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction) N
Nrotes/ Special Conditions
Agent or Applicant Prfntid
Signzqktur Please —re—aa*compliance statement on back of permit *!kl
Application Fee(s) Check #
(Scale:
El See note on baAtjn L IrBasin rules.
A,
In
I
Date