71223A_Manuel & Karyn DeLeon_20180924

MCAMA / ❑ DREDGE & FILL
GENERAL PERMIT
New ❑Modification ❑Complete Reissue [-]Partial Reissue
No 71223 (D B C D
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / `Z
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC kl Z T
ules attached.
Applicant Name m0.n%x1L I - — kc r ti�D4 L 't
Address 72°7 LAIC, -�-r a , L)r
City Statee_ ZIP 2� 031
Project Location: County
Street Address/ State Road/ Lot #(s)
4i/ 3 tom• 5... d z dQ Qc!
Phone # -/737 E-Mail ['t-. -Subdivision
Authorized Agent G e r i
Affected ❑ CW U�EV tj�UA DES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes fno> PNA yes no
Type of Project/ Activity Can S -Y`r ec
City N S' ff !eZIP
Phone # ( ) River Basin OoQS q t^A-4f_�
Adj. Wtr. Body 50,n %, k` S�. \^�-J nat /man /unkn)
Closest Maj. Wtr. Body /6-. o. e, -a fie- --5 -�- ` , n_­�
Q tyls0
3 i
2 ,c %i �- eGd n.1-�3C,.- (Scale: � � C
Platform(s) /:2 "K
-
Finger pier(s)
■■■■■■■■■■!i■■■■■■■■�%■■■■■■■Y■■■■■■�i'n
■■■.■■■■■■■■■■■■■■■■■■■■■`■�■■sue■■e■■■
■7Fixed
■l�M
■■■�■■■=■■■rill■
Groin length
number
Bulkhead/ Riprap length
distance offshore
max distance offshore
Basin, channel
rl/
LIE■��■■■■■■■
■!NlIRl7/1/�ilir`iwl■
f�■■�1■■1�■r■e�:ll�Sl.�■■■■■■..SO■■avg
■L�7lL7�iiN1�lI1■■■'•!!•■■■■■■■�Jii,■■■■■■■■■■■■■■
�n�r�,■■■��■i�■■■�■■■■■■■■■■■■■■■■■■■
ME■EM
No
■mill■■a■■■■■■■
MEN
cubic yards
Boat ramp
■■■■■■■■■■■r■����■■■■■■■■■■■■■■■■■�■■■■
■■■■r,■■■■`��►■■■■■■■■■■■■■■■■■■■■■■■■
Boathouse/ Boatlift
■■■■■1�■■■■■■■L�■.�■■■■■■■■■■I■■■■■■■■■■■■
■■■■NBeach
■■■■■■i���■■■■■�■■■■1�■■■■■■■■■■■■
Bulldozing
Other 40
■■■►■■■■t���■■■■■■■■■■■■■■■■■■■■■
Shoreline Length
�7■►�■l�:�L�■■■■■■■■■■■■■■■ice■1■■■■■■■■■
1� yes no
Photos:
.. _ .... ..
■■D,■■i■■■■■■■■■■i■rfi'iiiS=WICK:
i■S■■■■
UL
■EM■\iill■■■■■■�■■■■■■■■■■■■■�!
;L■■!Y■■■■
■_
■■■■■■■■ENIPI-Ar
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ONE
RV_0H■■■■
■■■■■u■■■■■■�■■■■■■�■■■■■■u�■
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A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
AJ a q S e p. ❑ See note on back regarding River Basin rules.
i f
Agent or Applicant r' 1 0 Name
Signature" "Please read compliance statement on back of/permiit�"
Application Fee(s) Check #
r ✓ten /1 Q Cu c'v i r
Per it Officer's Printed Name
Si /1Z Y L // 2
Issuing Date Expiration Date

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Manuel & Karyn DeLeon
Date: 09/24/18
Permit #: 71223A
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
temp im acts
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 impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Open Water
Dredge ElFill ElBoth ElOther ®
568
568
High ground
Dredge ❑ Fill ❑ Both ❑ Other ®
60
60
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 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10

http://gis.darecountync.gov/report.html?parid=006767000&lat=35.94874756897931 &ing=-75.631187455... 9/24/2018

Locality Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Tmst Shoreline Other
(Fa)•official use onftq
GENERALIti�
LAND OWNER - MAILING ADDRESS
Name_0o- ye¢RI)N leoteo"'i
Address 7ao7 ei{� t2fe a2,v�
n
city & fT4t[ S+4 t DI+% SL
State L�— ZmaL03 /9 Phane 2e>2 - A10 Q-
f f� 3 /
Email► aaaicue teo,+i /100) 5CA.A& . Cc6
-
AUTHORiZED AGENT
Name_ A
Address O
�p n �-
City -"� A w V State zit t C Once
Email R Od WNU hAh A.? t C-(2 . illt
C
LOCATI N OF PROJECT. (Address, street name and/or directions to site; name of the adjacent walerbody, i
—
- /ll_4.c�;P
A0Q3,^.
///05� 1r�N�cP/s�cP{`^)t
--b A .y`� .� r�l I �r w w �i / /uY� 7 `C ��
,Nk
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) P' `R [Awk
0a2('1', A l 2 es st .. -,, AAe,-
SIZE OF LOT/PAR('EL: , Warefeet , bS acres
PROPOSED LiSE: Residential ❑ (Single-family ❑ Multi -family Q 1 Commercial/industrial ❑ Other
C'ODIPLETE EITHER (1) OR (2) BELOW (Conurcl Pour Local Perridt Officer If you are not sure which AEC applies
to yomr prop"):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AEC%: SiZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: _3 square feet (includes the area of the foundation of all buildings, driveways covered decks,
concrete or masonry patios, etc, that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORAIMATER MANAGEMENT PERMIT- is the project located in an area subject to a State
Stormwater Man ent Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR 1?
YES_ NOT
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square :eet.
(1)
(2i
(3)
(4)
OTHER PERMITS !14AY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit. including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system). Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FiA
Certification, Sand Dune, Sediment Control, Subdivision Approval. Mobile Home Park Approval, Highway Cmnection, and fta*'
others. Check with your Local Permit Officer for more information
STATEMENT OF OWNERSHIP:
I. the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in at AEC or a
person authorized to act as an agent for purposes ol'applying for a CAMA minor development pemrit, ccrlily tlut the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as (check one)
—tan owner or record title
Title is tested in namsie )f A) L- 2�
see Deed Rook-• page- y-�- in the ;j)LR to E County Registry of Deeds.
an owner by %irtue of inheritance Applicant is an heir to the estate of
prolate was in _ County
_if alter interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACENT RIPARIAN PROPERTY OWNERS:
I filydwrmore certify that the following persons are owners of i rope ties adjoining this pmperty. 1 affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
"J.-
4 Addresz)
�1LAn►74r►Nc days
w.s y
1 C1-
ACKNOWi.EDGEMEN"fS:
1, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. i acknowledge that the Local Permit Officer has explained to me tie particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerningslabiliza-
tion and flrndproofing techniques.
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.
r This the _ der of u _o
Laado+vne or person nut rized to act as hislher agent for of fill g a LAMA permit application
This application includes: general nrforin mon (thisform). a site drmrvag as described on the boct, (if this applicaion, the
ownership statcnhenl. the Ocean Hazard •4F•C' Notice where necessary, a check far r100.00 made prrvtoble to the Jolt ;and
anv in as may be provided oralJv by the applicant. The details of die application as described by these sco rres are
inc orparated without reference in tot y permit which maybe issued. Ueviatunr from these de•talls will constitute a mn,lation of
an pernrir Ant, person developing in an AF.0 without permit is subletl to civil, criminal and admoustrrlivt action

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: 41 () ? /Z,T/Oz/ 6
FA
(Lot or Street #, Street or Road, City & County) /U6tq /*P&.
Agent's Name #: lac y I ct ,�S f4--1
Agent's phone #: �` -� a 5g- a I o o
Mailing Address: �Do�2cx -2-�
1) /✓A :-d l�
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. A description or drawing. with dimensions must be provided with this letter.
1 have no objections to this proposal. 1 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. Contact information for DCM offices is
available at http://www.nccoastaimanaaement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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.
(Prop ner Informatio_2�
)
Signature'
1�/ l
l U n3 u, e /• Cc Y N D(CGr,�
Print or Type Name
-7 a 0'7
Mailing Address
.Sf4%(O 1 VA �2&?q
City/State/Zip
Telephone Number/Email Address
Ag,,,S t / 7 --� o/ �?
Date
(F
K
r) J 14da A �A/J
Print or Type Name
Mailing Address
MAA)2�a. tJ
City/State/Zi
�52 '73 - 3 . 2
Telephone Number / Email Address
P — ') bl 2�—
Date ti
(Revised Aug. 2014)

CA' AG P
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CONMTE
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APPARENT {D-B. U, pG
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LINE AS PER \ `
�— • -8- U. PG. ?7i
D.B. 2013, PG. 616
��pzA5©s o� h
�rrao+�1�J a � / � � •J7O� N��1`a''T

,rye ,
Mme of Property Owner RetgWft Pem dt: /' �AIJatl- � �2�� j
tMaIkV Address: _7.107
Phone
Nu nbw. Q D ;( 7 9 7
Email Address: ° e i e•oy •�Q,%. co�j
1 oerft that 1 have auttWI=d _ CYAO.M^)LZ "TAN �t2
Ap M 1 CotM adw
to act on my behalf, for the purpose of spoft for and obWnbV all CAM permits
necessary for the fofi raft proposed deveioperront: 1�`/ESP_ 99( DOC,k' �L
at my prop" located atY103 LJ. Sou-j&.-d-e /Va-, j-leW4J tic
lnA2E county.
I AmPor rwre cGf* drat I am audwind to grar4 and db In fact grant pomdssban to
Dlvisian of CosaW AIanasw► enf staff go Loco/ PwvX Ofter and the k age o to enter
on the oibrornerrdrarred lanais In oonnec don with ew tie ft 6Awmadon m kdod to this
P 7r* +WIcation.
Propuly OWW
/t
Pft ON
or type
0~
69 Tft
'!S" t.
D"
Tht oertMc ation is valid Rough 1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �4atJ�� 4-1/4 >� e 1zon� S
/O L/1 , / f=1 (Name of Property wner)
property located at 1 j! ? i s ou+ir� 5 /CQf o
(Address, L t, Block Road, etc.) _
on dOArJOVe S o u;� r� in QQv %� . A& 779.5 ? 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.
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)
S�C
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
e. (If vou wish to waive the setback, you must initial the appropriate blank below.)
Y
I do wish to waive the 15' setback requirement.
to waive the 15' setback requirement.
In
Sigz�??at re /
/ 17 Qona�r l 'D , td -7) P J, rj
Print or Type Name
:1Ant'.Iy_Q�AYP7-GEE- Z'-�iyf_
M fling Address L p 'f Q
citylstatelzip 3
Telephone Number/email add ss
�+�_�. 2c
Date
`Valid for one calendar year after signature*
(Adj ent Prope
wner Information)
Si nat re
m,(71ell to mer':ty
Print or Type Name
Mailing Address
0.���s lac �`'
s3C a2 YS`Y
Ciry/sta ezzip
C,
Tele hone Number / email address
�t��
/C , )61,8
Date*
(Revised Aug. 2014)

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2018-09-24
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2018-09-24 m 2018-09-24