70631_Pier, T-Head and uncovered boatlift_20171128

./•4CAMA/ : ..•ry, t o 06-34 A B C 'D`~E'N'ERAL PERMIT. ' S �� Previous ermit•#h11A
P
New ❑Modification El Complete Reissue: ❑ Partial- Reissue Date previous permit issued 14 1 _Pk_
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 15A NCAC (7-) ?_J
(Rules -attached., ;
Applicant Name -Asc,0 3oTz Project Location: County
Address ) $1 % - 6C>T?_S t C. A
City JAIA S4� I Q�,,) State J.G. ZIP 2-74881f
'Phone # -Z494- E-Mail
Authorized Agent >J-] ,4
Affected ❑ CW ❑ EW, F PTA ;d ES El P.TS
AEC(s): ElOEA ❑ HHF ElIH ❑ UBA ❑ N/A
❑ PWS:-
ORW: yes /(:D PNA yes / no
Street Address/ State Road/ Lot #(s) p'r'•F
Subdivision P;:.
City1�A--7-) ZIP -2-7 -19 ,D '�5
Phone # ( -rr` River Basin-r A-g-- 69AAAL) G 6
Adj. Wtr. Body i'3d y C),_/-2 � wiz fnat /mT nkn) '
Closest Maj. Wtr. Body;2KIL4LI Zr--I IF-), A-� '
IF 111
MOM
M.
■■■�r■■!!I���■■I��R1l'!S7■■■■■■■■■■■■■■■■
■■■■■■■■a■■■riia■■■■�a��!■■■■■■■■®■■■■■■■
■a■■■■■■■■i■�■■■■■■■mow■■■■■■■■■■■®■■■■■■■
-■■■■■■■■■■I■tl■■■■■■■■■■■■■■■■■■■■■■■■■■■
•■■■■■■■■■■!■I■■■■■■■■■■■■■■■■■■■■®■■■■■■■
■■■■EN2li■iitir/■■iiliii`li��■!9■�1�■■■Ca■�a�■�■■■■
��!l1��1�■■■�1�■�■�■`�■'�■■■■■�■■■■■■■�+►■■■ill■■■
- • ■■■■e■■■■■t■t■■■■■asp■Q�■■■■■■■■■■■■■®■■■■
1a
� Tas6h Ed Vk,1
Agent or �Alicant Printed Name
Signat a ** Please read compliance statement on back of permit
ctilL, .2
'Application Fee(s)
Check #
%-
PermltOff c is rimed Name
Signature
Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
( ame of Property Owner)
property located at �,� h;1, u/a tleee --i%U'VAS!err Lo -
1 (Address, apt, Block, Road, etc.
on-aoYd r P1C in LiouFar�'Gouct;jy,,�')ri N.C.
(Waterbody) (C41Town adddlor County) .
The applicant has described to me, as shown below, the development proposed at the above
locat_ ior�.
t have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED -DEVELOPMENT
(I/adividual proposing development must till 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 16 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 wlsh to waive the 15' setback requirement.
I do not wish to waive the 16 setback requirement. _
(Property Owner Information) (Adjacent
Sty tin a Si rare
Trion ��nrs-r _ o
Print or Type Name j/ Ptin�f�or Typp
Mailing Addre s� PMf ng Adc
GtylStatemp CitylStatea
7s� - �s�ay�9s�
Telephone Number Telephone
1-5-
Dare lrats'
J)erty owner information) S
v
Week.
r7�e
rber-
I-!W-? -
(Revised 6/1812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to JeLSey? Cbeyr I
property located at i-eeNili!! 2Ula 6(0-eir 5abdjy,, m L.ot"'r f
(Address, t, Bloc c, R ad, etc.) LL
on _ A.yJ ��,�& k , in �T� N.C.
(Waterbody) (City/Town an.tUor County)
The applicant 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
(Individual proposing development must fill in description below or attach a site drawing)
b
Y `
}
Lo�
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, yo must initial the appropriate blank below.)
� OM l�-z$-r�
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pro erty Owner Information) Y1 (Adjacent Property Owner information)
'Ad.'7s
Afnature T �^% .Signatures
Utz&ell G t7�1'Y�1
Print or T�Pe Name Print Type Namg,,
l �Y1 Cully 3 tGi1 I(�i / � / 5� .1
Mailing Ad�dres Mailingg Addr s e
CitylState2: Citylstatelz-
75z-� lK729 9�f I-41? "Y��t
Telephone Number Telephone Numb r
!�/<- r7
Date Date
(Revised 611812012)

NCDENR
North Carolina Department of EhVironment and Natural Resources
Division of Coastal Management
10at McCrory Donald R. van der Vaart
Governor Secretary
SUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar -Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 02B.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
as long as 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 &the party (contractor) performing the
construction &/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation.
1. 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 be taken 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.
.. 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: w
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.
Agent or Applicant Printed Name Pe it OlYiceres Signa
X Zau� Pe'P'V�
Ag& ft or AppfiGL6ht Signature
CAMA GENERAL PERMIT 0: 0 L-, i —
a
4:�, IL1.
Issue Date
Washington Office Morehead City Office Wilmington Office
943 Washington Square Mall 400 Commerce Avenue 127 Cardinal Drive Ext
Washington, NC 27889 Morehead City, NC 28557 Wilmington, NC 28405 3845
Phone [phone] Phone [phone] Phone [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

Fait.-SJfu ��.+•1S i Y:."_,..`,r��b�io- M•o'-
Applicant __S_. spermitt -7a G3 i —�
Date: -2_4� -122 vaj gt� � 1--
Descnbe belowthe HABITAT disturbances for the application_. Ail 'valu' s should match the name, and emits of measurement
found in your Habitat code sheet
TOTAL 5q_ FL
FINAL Sq_ Ft
TOTAL Feet
FINAL Feet
(Applied for-
Vn6ripated final
(App(iad fork
(Anticipated Urraf
Hal,ifaf blame
, DISTUR&TYPE
Oisuurbance total
disturbance.
Dlstdi•bance
disturbance.
Chabse One
includes any
Exdydes any
total includes '
Excludes any
anticipated
reitaratfarr
any andcclpated
restarafian andlor
restoration ar,
andlar temp
restoration or
temp fmpac
temp fmpacis)
im'aat amount)
temp impacts)
amaud
I-,1A- r4E-jZ,
Dredge Q FU-Q Bath. Q Mar
(0(05
loS F'r�
Dredge Q , Fill Q 'Boat Q Other,7a,
"Dredge-Q• Fig Q eath Q Other Q
Dredge Q Fit€ [j Bath Q Other [{
Oredge Q Fig Q.. Both Q Other Q
Onadge.0 rt Q Bath Q Other Er
I
+Oredga R t_ bath 0Other
I
r
�.:
Madge �.riff Q Elath f , Ocher
0[E�gB Q Q. Gatti Q - O'her t✓t_
l
(-
"Br¢h
Oreage t Tit Q Q Other. i✓
`—'tesige k i'i[i Q •Darn Q' Other Q' •�._
f
I
. '
�i-edge �zI' ' � ...: •:,u"ief ._
�-
t '
Oresd' ga Q fyll Q Sath•Q' Other Q,
`
dredge 0 _ Fill 0 Sdt(1 Q 'Other 'C