71237A_Leonard B. Alphin_20191010

CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
YNew El Modification ❑Complete Reissue El Partial Reissue
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
Applicant Name Lt, v-\c i a a . Al d1 h;e)
Address It
City W1,-\c1S„r State VA ZIP yy j
Phone # ('I s 1) 5 u H -1 till E-Mail
Authorized Agent < < 1.. _ 1 k 1'..' J S
❑ CW/
3EW [) PTA [ a ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / 6o;?
PNA yes / fLioT�
N271237 e:q B C D
Previous permit #
Date previous permit issued
14 H.1(0 ]
[,}'Rules attached.
Project Location: County r v , , � _ , IL
Street Address/ State Road/ Lot #(s)
Subdivision
City K�Jtts TS)ic.-'J ZIP J-4tiSa
Phone # ( ) River Basin
Adj. Wtr. BodyIAnan /unkn)
Closest Maj. Wtr. Body t`
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Agent or Ap icant Pri e
Signsure 'Please rea compliance statement on back of permit"
Application Fee(s)
1gri
Check #
i
Permk n N
Signature
Issuing Date Expiration Date

NC 'Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: A1V9 t,n ) ltolnG/cJ
Date: 101 J / i K
Permit#:��-�
Describe belo',iq 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 impacts)
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)
Dredge ❑ Fill Vy Both ❑ Other ❑
y C)
0
Dredge ❑ Fill ❑ Both ❑ Other to
fLi Do
L-A
5�'1N t 1 -
Dredge ❑ Fill Both ❑ Other ❑
v
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.necoastalmanagement.net revised:02/03/10

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Cyr P�,n
Mailing Address:
(6 /ems `f8 7
Phone Number: ' 2 5 -7 - y y - /Y 3?
Email Address: ��v� �� �p�ti� ® Svnr-iiI • cotn
I certify that I have authorized / J-&4 c ti
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: e2itrnov4 + Tvr461t
at my property located at i bT;- A 1 ev 1-?d
in t 'Ud'1i4c� County.
/ 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:
gnature
Cep
(� Print or Typ Name
� ' l(�t1�l.Q✓
Title
Date
This certification is valid through /?- / ':3,/ //V

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i t
I hereby certify that I own property adjacent to L �' 1 �' �1t rj is
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on C� Vyz-jj Uc"C SOUVA0 in t-AO 4S icAry , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: ZSZ 207-14'9��Mailing Address: 10 to f affl� Cane elf -
Ei..dv tic- a-t-?9 39
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
E�saele4"tt
1
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
,gym '��'.
gV1c �6vk
CJO
�e
(Information for Property Owner Applying
for Permit)
Mailing Address
i.17-"So'r 0 A Z.3 4(8?
City/State/Zip
Tele e N ber
Signature Date
(Riparian Property Owner Information)
KI c
Signature
Print or Type Name
7Z--Z32--35'3</
/o-i—za r
Telephone Number
Date

Renaldi, Ronald
From:
Tab Winborne <[e-mail]>
Sent:
Wednesday, August 29, 2018 1:39 PM
To:
[e-mail]
Cc:
Renaldi, Ronald; len alphin
Subject:
[External] 185 Brumley road
CAUTION: External email. Do not click links or open attachments unless verified. Send all suspicious email as an
attachment to Report Spam.<mailto:[e-mail]>
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT co
I herL+y certify dmd I own pnVerry adjomt 10 1pVi 4 � ? W -j
(Name of rroprrt� ("urr)
property kxmw a, (2c �i t'WA*'4 FA -
ii
(LK Klock. Road, etc)
N.C.
(Tavin and*ut ( oun(% I
Appikant's phone 9: IC)(- P-I.
lie has descnbad ID me, as shown below, the &-velopment he is pfijxwmg at Chat locaton, and. I
have no ck*lwm to his proposal.
10" k\,I) ok Ilk \\! 1%i, A it pt % 1 1 4)11%1F 11
(To be fiur4 in by proprM, aw"T peww"Ag deveApr6wai)
PO
jinformotioafar Property 0weerApptyin (RIP*ri*$PmWrtYo"*Orlmkcmsti")
for Pervado
Mailme
tma see `pis z34t? 49 -7m,
Pvwor'lyff Nvrse
lute

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203. G 5 . 113A - 103( 5 0'y )
Applicant Name j oG Phone Number
Address ,`,.` Vr�-.���� ►�t.,�t
City State V A, Zip �kI4 1�
Project Location (County, State Road, Water Body, etc.) It.S' Nfvr+.le
Cvt,r vLK- C Jniy _ n ni t2 %�oitg L%IcnC4 chanAi I
Type and Dimensions of Project 1.04' c4 i_�Otki.k s rt t, 4 3y` + + 0e x' c + n� & h o„mkD
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
&.5.I%;,- Jol(V)( b)(s)
SKETCH
F11F
I
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t I
E _ _
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
t d_(3
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
k
r—
Issuing date
! !I} I -�.C,
(SCALE: �;- O' )
I
t ,
1
to
Expiratior'tdate
Attachment: 15 North Carolina AdministrativeCode7K .0203