71477_Elton & Judy Sawyer_20180418

CAMA / ❑ DREDGE & FILL 0 71477 KCA) B C D
ENERAL PERMIT Previous permit #
affl;sNew ❑Modification ❑Complete Reissue ❑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 (ZUo
Rules attached.
Applicant Name abAJ JL 5AVA)P-e.
Address 2[aJ PiEEi4 1p=f� -IA&l/�
City S t- I LOH State ZIP
Phone # ( 3��j—ZSSE-Mail
Authorized Agent J eL6rv+4-A) by, f) 0i
Affected ❑ Cw ,CEW krPTA ❑ ES ❑ PTS
AEC(s): ❑ oEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
.i 6/► at�'14n L y
Agent or Applies Printed Nam
Application
Please read complifnce statement on back of permit **
Check #
Project Location: County CXMI76To
Street Address/ State Road/ Lot #(s) j' 1(?j
2�� P5 G �zrf �� Drz(
Subdivision
City -5tb Lctf ZIP
Phone # ( 1K?i6-ZSZS River Basin
Adj. Wtr. Body (7,LSt�tCol�yy))�� (tea /man /unkn)
Clncact Mai Wtr Rnriv(—
Ll; tKJ i.f A-14 /%7Fl f
Permkofficer's Printed e�
Signature _
I 1b, 7v1 S elf � /�, ZZ78
Issuing Datef Expiration Date

No 71477 B c D
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / ! L L 7- V
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC � /
Rules attached.
Applicant Name p ( 1;; J4fi /1Ws rk2 Project Location: County CA M�7LI�j
Address IL �r1FE lir[�v�
City jI�ILLf StateAC ZIPS
Phone #
Authorized Agent �, � ; I�.,F,, Lv} 0) t)j
T r
Affected ❑ CWW [PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW: yes / tio PNA yes /
�]CAMA / DREDGE & FILL
' GENERAL PERMIT
CI New ❑Modification El Complete Reissue El Partial Reissue
Street Address/ State Road/ Lot #(s)
Subdivision
City 51gI tz N ZIP Z-7>7
Phone # ( 2}z,1�ti- 2S ZS River Basin l / n/�
Adj. Wtr. Body (71564 u,C lA/tlle 4CaVlman /unkn)
Closest Maj. Wtr. Body
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gAhr-„ L tiydiov
Agent o Applicant Printed Name / f
y
Signature7i�Please read complia ce statement on back of permit
�
Application Fee(I Check #
LI�,lu /i //,Y /-7* r _
Permit Officer's Printed Name
r-Q
._ 1Z-7�
Signature V
Issuing Date Expiration Date

NC Division of Coastal Mgt, Habitat impact Computer Sheet
Applicant: PP ��zyJ j rf�� S'/�-Gli� �2 Permit #:
y r/
Date: /
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
"Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
ternimpacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp im acts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 n 1-8884RCOAST
revisal: 02/03/'1'D

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ELTON E SAWYER
Mailing Address: 200 B BEECHTREE DR
CAMDEN,NC
Phone Number: 252 336 2525
Email Address:
I certify that I have authorized LAYDEN MARINE, INC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
12FT X 30FT BOATHOUSE WITH LIFT
at my property located at 200 B BEECHTREE DR
in CAMDEN
County.
/ furthermore certify that / 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
ELTON SAWYER
Print or Type Name
Title
04 / 09 / 2018
Date
This certification is valid through 06 / 06 / 2018

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 0 f �o n Sa wY er 's
(Name of Property, Owner)
property located at Dr
R
L(Aridness, Lot, Block; Roadetc.)
on GtSgGdEGc/►!t iSker in_ L'Qyr�dCrl N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at- the above
location.
I have no objection to this proposal_
- L I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
�M P neat n l a bel ow Orasech a
To n.si�c>L!! a X 3d f R OO-F. (g) PC,,,.,
alt sY5 erg
.s4:s I�' --�� p �
u►k �,�' as
9.
R�
Beadt4fte Or.
�d u. ptn Prof $47
P WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwbter, boathouse- lift, or groin
must be set back a minimum distance of 15' from my area of riparian access uafess waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below-)
I do wish to waive the 16 setback requirement.
(I do notWsh to waive the 15' setback requirement.
(Py Owner InfbnvwAw) (Adjacent Property Owner Information)
Signature Signature
Pnnt or Type Name Print or Type Name
r
Mailing Address _ SA141i .N Mailing Address
/V C
C 64wate/zp 2-7!?7Y City/State2ip
Telephone Number/email address
Telephone Number/email address
Dote
pl ee,Se -�' a Date
• - -�- w A Tit G. (Revised Aug. 2014)

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AN PROPERTY OWNER STATEMENT
N
o Scent to ELTON SAWYER s
(Name of Property Owner)
3 BEECH TREE
\ddress, Lot, Block, Road, etc.)
in CAMDEN N.C.
(City/Town and/or County)
s shown below, the development proposed at the above
is proposal.
proposal.
0
o IRAWING OF PROPOSED DEVELOPMENT
o trust fill in description below or attach a site drawing)
M
Z
a
o _ATFORM FROM EXISTING PIER TO EXISTING BOATHOUSE.
N
T
7
T
co
CO
LL
a
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) (Adjacent Property Owner Information)
ELTON SAWYER
S, � at e
il% ,�QGlJG� Gt �G �GC
Print or Type Name �?rre Name
200 B BEECH TERR C LCL h
Mailing Address Mail g Ad(lr ss / �}
CAMDEN NC � �� L l�
City/State/Zipp ityl& e/Zip
252 336 2525 (1rg0_re- f-IttL jI G `rytsh . LtiYI
Telephone Number/email address Tel hMe Number/email address
06/10/2018 -7 1 e
Date -F Date
I ea�c roc: (o
Lc i q/en fV 1-q'-j ' e' T^ c- (Revised Aug. 2014)
p-o-box II)IS
'gj:2, c:4&l n c a 21Ob

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
on PASQUOTANK RIVER
(Waterbody)
200 B BEECH TREE
ELTON SAWYER
(Name of Property Owner)
(Address, Lot, Block, Road, etc.)
. in CAMDEN
(City/Town and/or County)
I
. N.C.
The applicant has described to me. as shown below, the development proposed at the above
location_
I have no objection to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
TO CONSTRUCT 8FT X 8FT PLATFORM FROM EXISTING PIER TO EXISTING BOATHOUSE.
DRAVMNG ATTACTED
WAIVER SECTION
I understand that a pier, dock, mooring pilings boat ramp, breakwater, boathouse. lift. or groin
must be set back a mff=um citstance 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) (Adjacent Property Owner Information)
ELTON SAWYER
Punt or Type Name
200 B BEECH TERR
Mailing Address
CAMDEN NC
City/state/Zip
252 3362525
Telephone Number / email address
06/10/2018
Dare
ie„ ryl ��tr►e� 3�
*Foxure
Print or Type Name
Ala— g Address
Gi<rswe/zip
Telephwne Number / ernad address
(Limed Aug. 2014)
« U-W1(('e Capi 'i

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June 20, 2018, 12:10 pm
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ELIZABETH CITY, NC 27909
June 20, 2018, 8:14 am
Arrived at Unit
ELIZABETH CITY, NC 27909
n
June 20, 2018, 2:16 am
Departed USPS Regional Facility

ROCKY MOUNT NC DISTRIBUTION CENTER
June 19, 2018, 11:48 am
Arrived at USPS Regional Facility
ROCKY MOUNT NC DISTRIBUTION CENTER
June 19, 2018, 2:44 am
Departed USPS Regional Facility
RALEIGH NC DISTRIBUTION CENTER
June 18, 2018, 10:07 pm
Arrived at USPS Regional Facility
RALEIGH NC DISTRIBUTION CENTER
June 18, 2018, 4:30 pm
Departed Post Office
CAMDEN, NC 27921
June 18, 2018, 2:07 pm
USPS in possession of item
CAMDEN, NC 27921
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