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[I CAMA DREDGE & FILL N270949 A B C D
E I
GNERAL PERMIT Previous permit #
ONew -''Modification ElComplete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality i
and the Coastal Resources Commission in an area of environmental -concern pursuant to I SA NCAC El Rules attached.
D t Location• County
Applicant Name
Address
City
State ZIP
Phone #
-Mail
Authorized Agent
D Cw
F -1 ES Ll PTS
I EW f] PTA F
Affected D OEA
El HHF ❑ 1H El UBA El N/A
AEC(s):
El Pws:
r%ow. ' I
lPNA ves / no
I Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp "I
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length L U'
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes
Waiver Attached: yes
A building permit may be required by:
(Note Local Planning Juriscliction)\
Notes/ Special Conditions
1 wje
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone# I -Aiver Basin
Adj. Wtr. Body --------g9-a—t—/m—a—n—lu—n-k—n)
Closest Maj. Wtr. Body
Y_ r'i' .� I I f 7 —
(Scale:
See, note on back regarding River Basin rules.
V I\ -------- 7—
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Printed Name
Signatu e
Is�ing ate Expiration 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/ I-888-4RCOAST
Fax: 252-247-3330
(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:252-264-3723
(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: 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: 9 10-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
Revised 7/06/ 17
AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: ��. �.4 Ke ✓'
Mailing address: g' S 6c —f-4 � --
o N G. ? F.F 7
Telephone Number:
I certify that I have authorized (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 / 6' 1 5 - ejt4l'-� W"IR 4—
This certification is valid through (date)
(Property Owner Information)
Signature
Print or Type Name
Title, co. owner or trustee for property
�— Date
Telephone Number
Email Address
ECENE0
FEB 21 2018
j)CM- MHJ) CITY
MAIL -
1 hereby certify that I own property adjacent to i;*
(Name of Property Owner)
property located at t �' I 5. is+��-�s.►..4t a..*,
(Address, Lot, Block, Road, etc.)
on %N—nck C&CJC in L�ftft! Cori— ALJ G N.C.
(Waterbody) (Ctty/Town and/or County) n
Agent's Name #: - Mailing Address: 16'a �I - L��l N -
7
Agent's phone # �I} �G—� 1 ' fil h L- p� �
PLl-
He/She has described to me Abs shown below the development he/she is proposing at that location, I I L
and I have no objections to the laroposal.��a-�_�w-���
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
{Indiv(dual proposing development must fill in description below or attach a site drawing)
If you have objections to what Is being proposed, you must notify the Dh4slon of Coastal Management
(DC" in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at httQJlwww.nccoastaimanagement netlweblcm/staff-listing or by calling I-888.4RCOAST
No response is considered the same as no objection if you have been notit%d by Certified Mall.
(Property Owner information)
* � k 0-4- A --
Signature
1�r t�as� � t�J,A �.r•�.Y'
Print or Type Name
Mailing Address
AAP-cypt&r ( h 4:c:- 7-,FS7 0
City/5ta a0p
7.0 z- 157Z j
Telephone Number/Email Ad4ress
(Ri ran Property ner Info ati j
' � � � t"vTl�
-
SignahNxl
ture
J �,I
Print or Type Name
-)3 L
Afalf/pif Address
City/5tateop
Ie • hon% Num r/Email Address
h7 I
Dare, f) iWi
FEB 21 Z018 (Revised: Aug. 2014)
�y„r Fie.. II
1%ArtilAme
—3
,o
.0
1,0
_0
FEB 21 Z018
CM— MHD CITY
€A V i.' 1UN Ur trUA.-b I AL IVIANAt r-MCIV I
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to..ti° 's
(Name of Property Owner)
property located at I V 1 5 - GK+4'b,' .. 14+^-a---
rr ii (Address, Lot, Block, Road, etc.)
on 11 no—a,� �C , in N)e-4yw�F IV . , , 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 site drawing)
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 at hg2.11wwwr.nccoastalmanagement.netlweblcmistaff-listing 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)
Signature
SZ l LJ7A��re..�'
Print or Type Name
Mailing Address
Rlparlan Property Ow Information)
c `,
Signature
T
Print or Type Name
Mailing Address
City/State/Zip City/StatelZip
Telephone Number/ Email Address Tele_ hone Nu er Email Address
Date Date
�-
RECEIVED
(Revised: Aug. 2014)
FEB 21 2018
DCM- MHD CITY
sJIVEStUM Ur +ErL3AZIAL t1F1AS AIf *=t ip
'nFIE3 MAIL a RETURN RECEIPT REQUESTED
t hereby cerfify t ►at ovm prop" ac#acerti to � ty'y- 's
z ..tee & Proper..,; ®car)
oro ert'yloca�ted et -OP I �5 - +64^w,a Ie♦.�.e
!Address, Lot, Block Road, etc,)
City:7ow an or Cow)
-Agerrrs die #: " asitn A c9ct :
Agentt's phone *:
He1Sh8 haS descry to me as shovvn cellokq tlhe development helsbe is proposes at that tccatio;,
and 1 have rro objections tD the pmpcs .
DESCRIPTION AMOR DRAVVING OF PROPOSED DEVELOPMENT
AhcM ►ua! proposing development must Hit In dmatpgbn bakw ar aftch a -czft € ,gig)
s _I
FE8 21201`3
Np p�T� V
18
ffYOU ftaye Objeeftmio t1s b"-VprqP , you wust;;;;i `MeB9F0"r F e6MBarra
tpC . In wfifinq wfthin 10 daY of receW of thIs as fce. Contact t c Qn for DQW cites hs,
avaftble ai orb-,- =g ;=88 RCOASi,
NO mponse iS con-sidered the same as no qkttgcn if you have been rgt.ffed W Cw-07-ed Mai{
(Properly Stec lna 3 n\111parlan. Pmperty owner
Srgxratura S&17afure
Print or Type Afame Pnnt or Type N&ne
,ding Odd: ss trailing Addmss
Telephone NUfterlEmad Ad4ress t Tafi honaNumberfEmeffAddress
%X
Dafe
0.2eviw& Aug. 14)
R,Cev ry
� Eg 212p18
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V
OCAMA / [:]:DREDGE & FILL
N270949 A B rr
i
GENERAL PERMIT Previous permit # .GENERAL
ElModification 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 concern pursuant to I SA NCAC
E] Rules attached..
Applicant Name iik I Project Location: County
Address—,
Street Add ress/ State Road/ Lot #(s)
City
State _�,L'Zlp c-'-, I'11A
71-0
Phone # 1 7 ail Subdivision
UUA _x, -�7,t
Authorized Agent �)A - city---,- 0, ZIP
0 Cw LNI EW PTA 0 ES 0 PTS Phone # ver Basin
Affected
El OEA El HHF El lH 0 USA 0 N/A C, I
AEC(s): El PWS: Adj. Wtr. Body(nat / man /unlin)
/
-,
ORW: yes/ no PNA yes / no Closest Maj. Wtr. Body \A
Type of Project/ Activity
Pier
Fixei
Floall
Fing4
Groi
Bulk
Basil
_4
Boat
Boat
Beac
Oth4
Sho
SAV-
Mor Phot�
Waiv
Ll'�; V_
_00r200 WINE
•
0■K
ram
MENOMONEE
.. - .
■■EM�7■■■LIMOlI■■■■■■■■■■■■■■■■■■■■■■■■■■
NIB
ILI-MIS
MOOMMEMEM
ubic yards
ramp
iouse/ Boatlift .....
OMEN
Bulldozing
i
r
MEW".
line Length
not sure yes
rium: n/a yes no
Elm
EMMEMEM
•
yes
■It
r Attached; yes n 0,
A building permit may be required by:
Note Local Planning Juni Jurisdiction)
Notes[ Special Conditions
n,�
Agent or Appirid, ame
Signature piI;ase read compliance statement on back of permit"
C�-
Application Fee(s) Check#
i
61-5
Issuing
See,note on back regarding River Basin rules.
V