72184_Platform and single mooring_20180626

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LAMA / ❑ DREDGE & FILL 0
.>' `GENERAL: PERMIT gn Previous „l A
lew ❑Modification -]Complete Reissue ❑Partial Reissue Date previous permit issued' tit / A
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 0-7 1-1. G') N 22 cZ�c7 -
Rules'attached.
Applicant Name-ji-A. i���C�N T Project Location: County
Address R ed Street Address/ State Road/ Lot #(s) Z:>I✓ r SR- 1 I 1 0 a'
City G 'iZ i ,_?' State �1 �_ ZIP -7- 43 S 3 O
`Phone # (IL 2 Z i - 99 5 7E-Mail
Authorized Agent
Affected ElCVN %� .PTA ❑ ES ElPTS
' '.'.AEC(s): ❑ OF O HHF ❑ 1H ❑ UBA ❑ N/A
❑ PWS:
G OTZ-r 'ago , ,1 -r
Subdivision "i
City -l3t .Dv JT Gf� ZIP Z —t ► '9--
Phone # ( ) River Basin'Aiz" PA"LI r,r�
Adj. Wtr. Body 'FA mn , % [ o ((na�t /man /unkn)
(-lnsast Mai_ Wtr Rnrlv_1?A 1-)),/ n 172t1,iP--t_
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OWN al�aiim:.q..-Iclw MEN NEENNERE
number
max distance offshore
n, channel
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MENOMMOM
ch Bulldozing
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MOMMOROM
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Agent or Applicant Printed Name
Signature, Please reader Please read compliance statement on back of permit"
statement on back of permit"
r✓A I(_ A 4a 0
Application Fee(s) Check#
�7mitefc er's Printed Name
,
Signature '� ~ •- _/ '
Zcp'�
Issuing Date - Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
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:
--m- i /- V
Sign9tire
rint or Type Name
Title
Date
This certification is valid through I I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
t (Address,
on k % in .
(Waterbody)
1%.. s
(N me of Property Owner)
Block, Road, e c
N.C.
(City/To ;andlor County)
The applicant has described to me, as shown below, the development proposed at the above
location
I have no objection to this proposal.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
{/ndnifdual proposing-:develo `_ it'ent must fill `in descriptio►i beloii� or;aftactiaaite::clrawiiq)
®S(
OM h7 �
tt 15't�u
9� 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.)
<� d I do wish to waive the 15' setback requirement.
r
I do not wish to waive the 15' setback requirement.
M M'V_/Uc' Z2;!�30
OF City/Ste ip
Telephone tuber/ ail address
� 'A4_ r
Date
(Adjacent Property
Print
Information)
City/State/Zip�
Telephone Numbe /email ddre�s
Date*
(Revised Aug. 2094)
"Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property; adjacent to P--, aL-T 's
(N me of Property Owner)
property located at T
(Address, Lot,'Block, Road, e
onf?•n��,iC a \�� V , in , N.C.
(Waterbody) (City/To and/or County)
The applicant has described -to me, as shown below, the development proposed at the above
location
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)
Q yv�09AA3S o37-
<j
v�
Der —
OS
9
I -
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 ish to waive the setback, you must initial the appropriate blank below.)
=-a I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
wr ,y uu, s
�N 1vC, Z2;S 0
/STV-,
ip, ✓49,S /
Telephone 11 mber./ ail address
Date
P
Information)
ature *
�tinntt %Type Name
owelfgifng Add
it /'s- ip53 B - 6 6
T61eohorfe Number/email address
Date*
*Valid for one calendar year after signature*
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
(Address, Lot,
on a� fVN�(t' AdL�,,A ....,- , in
(Waterbody)
9 7 's
Narn6 of 7,19011
perty Owner)
4"')
;k, Roa etc.)
► •' " . N.G.
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.,,,-"'
Ls- I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Indivic/ual proposing development must.fill in des cription,below or attach a site -drawing)
.t' - 4, '! dp,��
-1
SIB
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be setback 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 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner
Print
Maili jJEC"
City/StatelZip ,
Telephone Nu ber/ mail 0a dress
Date
(Adjacent Property Owner Information)-
r 72,
s4; e i
TPrint or Type Name
Mailing Addre
IJ le,.1 7 +s C l`r
City/St te2ip
�4-11?`�j
Telephone'Number/email address
2 9 x4 -179
Date`
"Valid for one calendar year after signature*
(Re-vised Aug. 2014�

Coasfatftnqgement
EN. 461446N 1L Q ALrrY
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
ROY COOPER
Governor
MICHAEL S. RFGAN.
Secret l
BRAXTON DAVIS
. iff�-
A riparian buffer authorization is required for pier and docking facilities access ways through the Tartamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 012B.0233 & .0259. The
Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer Authorization
provided.the project is constructed in a manner that continues to meet all of the conditions listed below: Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation.
i. Crossing is Perpendicular: Pier and docking,facility access way must cross the 50 ft. riparian buffer
perpendicularly, (which is.defined as between 75 and 105 degrees) unless otherwise approved by DCM. The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall betaken to ensure the access way is made of pervious
materials like open -slatted wood or -composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project'Drawing: The drawing on the CAMA General Permit is considered the.project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This .
drawing will be used to aid in compliance and monitoring efforts.
• Pre -project site conditions:
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
that all information provided is complete and accurate.
460 C�
Agent or Applicant Printed Name ffleWrSigpAture
Agent or Applicant Signature Issue Date
CAMA GENERAL PERMIT #:_']2t 16 L4- �
state of North Carolina I RivrconmenWQuality lCoastal Management
Washington office 1943 Washington Square Mall Washington.NC2788912s2-946-64&
Wilmington office 1 121 Cardinal Drive Ext. Wilmington, NC 284os-384s I %0-796-72i5
Morehead city Office 1400 Commerce Avenue Morehead City NC 28557 1 252-808-2808

Applicant �� o'i'�-1 y � 121 L, a. r--
Date:
General Permit A -1 .Zt ea % f 3
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet -
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
Habitat Name
DISTURB TYPE
Choose One
Disturbance total
includes any
disturbance.
Excludes any
Disturbance
total includes
disturbance.
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp im ads
amount)
Au..o --D
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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 ❑