71165_Bo & Peggy Clayton_20181003

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❑DREDGE &FILL NQ 71165
GENERAL PERMIT Previous permit # CA!7By C °
P -5
❑New ❑Modification +Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality _?�L,
%
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC � / Z C-- ----
'Rules attached.
Applicant Name kJa 6Z clC /G Project Location: County 2:) o. (-
Address �� �r �X 3 $ Street Address/ State Road/ Lot #(s) L t>+JJJ
/ 2
City _:57 �.. e C o, n State M /ZIP 13 Y kS a v 1..1. A ) 6 o, c 4,C--
Phone # ($d`) 7 f 3 L%31 E-Mail3,%Q �/�y 1�►' �� ubdivision a %d N ac, S /-� e.�_cr! C.1 ✓ k S Q z
Authorized Agent L M << < l 50 A Q `l City o IS f{ c,e� ZIP 27 9S
❑ cw
fHi4v
p�zTA ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no
PNA
yes / no
Phone # ( ) River Basin QS
Adj. Wtr. Body C- u n o, nat man unkn
Closest Maj. Wtr. Body
Type of Project/ Activity } s T — "X fj ��a 'f -� c
y
46 (Scale: I r = Zo )
Pier
Fixed
Floati
Finge
Groir
BulkF
Basin
Boat
Boatl
Bead
Othe
Shore
SAV:
Mora
Phot,
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■■■■■■■iiil■^■■■■■��■�■■■111■■■■■®1�1■■■■■■
■■■
MEMO
■■Cmom
■■mom
■■
1
M■■■■
IF■■■■■■
■■■i
■■■■■®�I�■■■■■■
_■■■■■�i�r■�■r�r�®■�■■�■■■1!
Bulldozing
■■■■■■■■■■■■■1%■■■■■■■■11■■■■■®1'I�■■■■■
Mom
--7r--11MM1
-line Length _5'3
not sure
■■■
■■■■■■■■■[J■■1■■■�!!%/�■■�■■1■■■■■■
■■c�.l����:�:::o::©:::��i■■■■■■■■■
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yes
lorium: �9 yes no
■■
Aii�li■■ii�ir�iii�i�i�■■%i■r�.��n�■■■■■■■■
A building permit may be required by: G
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ""Please read compliance statement on back of permit
4-9 70 ? 7
❑ See note on back regarding River Basin rules.
%(/`ten 4 7 C_6-tV
PerrAtOfficer's Printed Name
g
Application Fee(s) . Check# Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �6 o 4 (�� __ _
6.11
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
601
"e f(aro, A . a 3 $ �) S
t 9�04 ) C-14 3 ' &73 f
17
�ahnrnoLn rsc�n
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA(p_er_mits
necessary for the following proposed development: CJ'j.`����� ,1'Y
at my property located at O��a f�GCCO✓L ov /a ICE N $ Kj Co Ve-
in �`�' Nt'�� . County.
1 furthermore certify that l 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:`
0
Signatu
Noj6Z'6."-(. Crt'1'�) �
Print or Type Mame
9AIV.& OUlt-I A
. Title
Date
This certification is valid through _0 1___/0 1 !S

►N`u / ❑ DREDGE & FILL
PENERAL PERMIT
New i]Modifit 40D Complete Reissue ❑Partial Reissue
f 1
�2.:
Previous permit #�
Date previous permit issued
s ,otcmd by the State of North Carolina, Department of Environmental Quality 7 , ,{ , j � � C
-id -die Coastal Resources Commission in an area of environrnenta) concern pursuant to I SA NCAC K
11, ri Project Location: County
pplicant Name
Street Address/State Road! Lot #(s)
,ddress .q Sxate�ZlP 2 S` -
G bdivision � yU cA.
'hone ( )� i'-Cs� 3 f E-Mail iJ ZIP_
kuthorized Agent � �
�.ffected ❑vV C
16WA O ES ❑ PTS Phone # (=) —River $earn
❑ QEA 12 HHF 01H ❑ URA O N/A Adj. Mr_ Body, �-� rt � net matt unkn
4BC(s):
❑ PWS: Closest Mal. Wtr. Body
ORW y6s � 0 PNA yes /WPJ
Type of Project/ Activity , S ' • �' '��
(Scale: f !�
n
Pier (dock) length i I
Foced Piatforrn(s)
Fkabng Piatfornt(s) —
Hnger pler(s)
Groin length
number
_nAkheadl Ripraplength
aV& distance diffshore
max distance offshore Y
13asin> channel
cubic Yards
Scat ramp
r
Boathous oa6d, I
Reach Bulldozing_
Other
Shoreline Length
SAY_ not sure Y— trj
iviomt)rium: 01 "o
Phobos- cm
wales Amadted: Yes og
A buliding parmk may be required by
( Note Lacai Planning jurisdiction)
Notes) Special CondRiQnis
Agent or
L+ v
1q 1v Al
s wre � Please read comps --lance statern M on back of permit
.+
� Check#
0 See noft on back regarding River Basin rules.
P Loifi s Printed Name
S' pure f
Issuing Date Expiration Date

s on Page 2 of 2 2018 04-18 13:52:49 (GMT) 18882140710 From: Paxton Contractors Corp
Ap�;-16-20113 093t4 FroM:.00ASTPL M"GSENT
�523�ic9�1
ra;-31t 62218i P.r
DtVOON OF COASTAL MANAG RT
ADJACENT RIPARIAN PROPERTY OWNISR Ni�VF1CATIOWIWANER iFORM
1ac^j t q=n nr,14-ANn nFLPJFRED
lyw 8
of property gnat '^^� J � Ci C= �• -
.� •.7'y' _-..- � .
Adc#resS of Pro¢erly: 00 � � D Q C �1f^�r �� ,,,1 �' t � '`V, L
tud or-S met #, Sheet or Roo, City & Co 1
Agint's Name #: Mailing Address'
Agenft phone M _ --- �--�
hereby ow* thIl 1 Own ProPO.rr adjacent to the atove re€erenc>-_d prop"_
indMduel
applying for this.permR has deScribed to rrle as shown on the adached dt in tha devel"trit
ow we proposing. A' on=Odraw'"
I b4ve Tv objcctions to this p£nposal. t have ob.jectious ui this proposal_
ttyou have of ons to wM,tIs:being �, You met me oiYia ore+ra id be � M d to 401 t
f�c�a� ;� , Ta a+ of rsaw of this rt0600. Gormponds»ca ah�u�d be mtfted to �f S
of"A st, Ste 300, lukabem ,. mc, 2me. 4C#r0plaaenta6M CW afto be corrt, at{752)204-
aRn r 11<f t►�81:ti¢Jf hi}vN 6@Ci7 /iOtii9d t p1 Nf�AW,
WAIVER SECTION
I unders3sftd that aier,.d, rnpair>g prr►gs, boat ramp, breakwater, boathouse, eft, or groin
must:be. set back a rniNrrwm diStance,rea bf 1 T ftm MY aof rIParigtr ac as:unie ytraivadi . t
Me. Of you w#sh tovaive the SetbEcfc.'/au iMMIIM the appropriate bihnk below.)
i do_ wish to wi0ve the 1 b` seilbs& requiremmt.
t do not wish tc waive the 1 & sethack requirements
(Fropeny Qwrner Infonnation)
ice.-��`'

""R-16-2012 09;14 From;COASTAL MANAGEMENT 2523312951
To;91BO48612183 P.F
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFiCATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of property Own
Address of Property:
A A' 114s
(Lot or Street #, Street or Road, City & County)
Agent's Name #7 Mailing Address:
Agent's phone #-.
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 drev_elapment
they are proposing. A'c�esciatittoti or. draw�na: with rnens�ons: must 5e rdvided with this letter.
_,� I have no objections to this proposal. I have obiections 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 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264.
3901. No response is considered the same as no ob�action if you have been notified by CeiVried Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set Ock a minimum distance of 15' from my area of riparian access unless waived by
me. (If u sh to the setback, you must start 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 Information)
Signature
w
B0
Print or Type Nam
P o, /3Ox ,3,'8
Mailing Address
City/State/Zip
Telephone Number 1 Email Address
Date
'Valid for one calendar year after signature'
Information)
Print or Type Name
/157tl Fk ko-,) 4W,
Mailing Address
441)
City/State/zip
relephone Number/Email Address f�Lur,c��ny
Dare*
Revised 2017

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