Rink, David

-� [�,CAMA / ❑ DREDGE & FILL N2 71323 A B C D
G,IEN ERAL PERMIT Previous permit #
?New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resourcpes' ommission in area of nvironmental concern pursuant to 15A NCAC V �•./
/ les attached.
Applicant Name 1fJ t+'f r 114 r Project Location: County e,
Address ass i j Street Address/ State Road/,,Lot #(s)
City: State ZIP
^ ' i (i4'``� • �•-
Phone # (' ) =v i >' �iD _Mail Subdivision
Authorized Agent
Affected ❑ CW ❑'EW ❑ PTA
AEC(s): OEA ❑ HHF ❑ IH
PWS:
ORW: yes / no PNA yes /,
Type of Project/ Activity
Pier (dock) length=
Fixed Platform(s) to
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/ Boatlift
Beach
Other
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes r o} T
Photos: yes
Waiver Attached: yes to
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
. V
❑'ES ❑ PTS
❑ UBA ❑ N/A
>f
R
4'X6' irk
Please read compliance statement on back of permit"
City ✓'' rol+ f " r ZIP =-
Phone # ( ) River Basin
Adj. Wtr. Body' " Oman unkn
Closest Maj. Wtr. Body '
/ "-I (Scale: j l
❑ See note on back regarding River Basin rules.
Signature . - `°"
4W „So oil
Issuing Date Expi tion 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 (252-946-648 1 ) 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: [phone] 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)
(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

� a-T 16 (::�cv-� L
RECEIVED
MAY 2 3 2018
DCM-MHD CITY
(ZSZ)a�i�
SO V r
0

RECEIVED
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
MAY 2 3 2018
DIVISION OF COASTAL MANAGEMENT
DCM-MHD rff4ACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner: D i� olo M
Address of Property: ,
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
K f('{'
CA(�
l' I
T 6 N(_e
Agent's phone #:
1
vc 6
Mailing Address: b e.,C—, �lelak�.:
SC� 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. e p`rovrdect.wrthryfhrslefter.
A// --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. Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808-
2808. 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, 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.)
1
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Inform tion)
r
Signature
Print or Type Name
Mailing Address l 7 ACIA
l�
City/State/Zip
asp a -o
lepho e N tuber
Date
t Property Owner
Print or Type
l/ 7 �JUL4
Mailing Address
a- Ee44 /) SG/z V(' -7ckSIY
City/State/Zip
( 2 L3,5 q -�,�io
tephohe Number
1,
Date
Revised 611812012

EC fVF
. MAY 3 2018 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT 2 S� Od;�07
OCM-"014"ify that I own property adjacent to _ Dl�li t '�/, �l s
property located at b '� 0 8 S Cv '. (Name of Property Owner)
(Address, Lo Block, Roa , etc.)
on �ci UA � .L ��'� in tuyei� Lis N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locati
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
d // I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Ow er Information
\ignat ref `;
Print or Typ Name
�.0, 0Cx 5��3
Mailing Address
City/State2i
pC,-5���i
Telephone N bter
Gt � � o
Date
(Adjacent Property Owner Information)
Sign re
; 0','/
Print or Type Name
/t'0S' r-,G'ye
Mai Address _
102
City/Statelz
Telephone Number
Date
(Revised 611812012)