62991_Propose to install 12 x 13 open Boatlift_20180730

;s'°f" - -ter„�%�,:xx�ppx.s�,-artix�•,��ra�,r - Y�.,�7^�.0�::.r�,.:;.•,za .:y, . - ,-- �aF
IYCAMA / ❑„DREDGE &' FILL. 0
GENERAL .PERMIT.' '
(New ❑Modification ` OComplete Reissue ❑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
.N2.72196 . c b,
Previous permit #,/r%/ ..,
Date previouspermOissued
Applicant Name- - �I z' l' C— Project Location: Countyi1f�' r l L
Address ' ; S '� .��?r / Street Address/ State Road/ Lot #(s)�
City State /l/� ZI
.,Phone'#''(,�Z�,?'ra55/ E-Mail' Subdivision
Authoriza�nt = G P - IG City ZIP
Affected ❑ Cw ' ❑ EW I -PTA ES ❑ PTS
❑ OEA. ❑ HHF ❑ IH ❑ UBA ❑ N/A
-,AEC(* ,
❑ PWS:
Agent or --A ppli6k Printed Narfie _
Signatures **-Please read'compliance statement on back of permit"
/ k
Aj plication Fee(s)-r Check#
Phone # River/Basin
Adj. Wtr. Body % ��/�� !`� na,man unkn
ell-
Permit/of, r PH heed,, ame
Signature
n
Issuing Date Expiration Date

Coastal Managements
6iAAR6NMENTAI. dbkLFTY
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
ROY COOPER
Governor
MICHAEL S. REGAN'
secretary
BRAXTON DAVIS
Director
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
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
alignrlient'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.
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 condition isted above and verify
that all information provided is complete and accurate.
�G�II %1G
Age t r Applicant % inted Name Permit Officer's Signature
Age or Applicant Sig re Issue Date
CAMA GENERAL PERMIT#:� !�(�
State of North,CaroRna I Environmental Quality [ Coastal.Management
Washington Office 1943 Washington Square Mail Washington. NC27889 i252-946-6481
Wilmington Office 1 127 Cardinal Drive Ext. Wilmington, NC 28405-38451 910-796-726
Morehead City Office 1400 Commerce Avenue Morehead City, NC 28557 1 252-808-2808

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to J avy,, s 9- 'Mar go,r cT 1& y 1`tr—'s
I I VA
of Property Owner)
property located at 6,3 -Fa- < LaYnAj°'� V A
(Address, Lot, Block, Road, etc.)
on�rj-�+T Cf -C, in C2-r—A k i 1 &10 , 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.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndiv dual proposing development mus f fll in description below or attach a site drawing)
,o d�N
es
�19'57
' 7C '�r�H�� WAIVER SECTION ®�-� p-
I understand that 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.)
I do wish to waive the 15' setback requirement.
�� �(�s� slgn
I do not wish to waive the 15 setback requirement. �A Ce r C- 4.
(Property Owner Information)
l
V,
Signature
An'nt or Type Nam
Mailing.. Address o
Uhl o-en � 979 l Q
City/State/Zip
5y c0 230 -2-6 S (o
Telephone Number/email'address
7 Z, —/ c2
Date
(Adjacent Property Owner Information)
�� ✓ • P51�ao�,Uri/Y�
Signatur
�
Print or Type Name
JVC-
Mailing U+ �6
CityCity St tt ip
Telephone Number/email address
Date*
'p -T -e—
(Revised Aug. 2014) a5 0l -
*Valid for one calendar year after signature* c� 43--'c? 0
T�Al1� ISSCO-S�/&(VA/i y

.y
l _ _ _ i . �' ) �. r
I hereby certify that I own property adjacent to
propedy iiicate at
tC
INVAne
II (Address, Lot, Wdccty d, etc.)
on . h r e i✓ L in ca star � . N.C.
fIWFWWbIq=9body)- - (CIWTown andforCounty)
The applicant has described #o m% as shown below, the development proposed at The above
kxmftL
I have no objection to this proposal.
DESCRIPTION AND/OR DRAWi_NG OF PROPOSED_ DEVELOPMENT
uuwwffssw��wwww IIII- - -
a� la 1 VV�lIVV1I -�
• + 'k e r
WAIVER SECTION
I understand that a per. ,loot, mooft pigs, boat ramp, breakwater.boaitmm, lift or grm
mast 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 most i'WdW fhe'appropriate blank below.)
I do wish to waive the 4N setback requirement
I do not wish to waive the 1F setback requirement.
(Property Owner I anon)
�e
Print or Type Name
a6-?, 7-� lCl-rIFZd
' e��P CSC-
TehWhone NumberlematT
7—,—/ —/V
Date
*Valid for one calendar year after signature=
(Adjacent Property Owner Ucforrnation)
- LO r-e n-e %c\ 00 r r-r
Print or Type Name
MaffngAddmw
tfty)Wate/r
25-2 — 6e / Z
Tdophone Numberl emas? addrem
7—I;k Is- —i,K
Date*
(iWsedAug 2014)

AGENT AUTHORIZATION FOR CAMA PERMrr APPLICATION
Nam of Property Owner Requesimg Permit
Mailing Address:
Phone Number:
Ernail Address:
I car* that I have authorized
>Lr -RbNNC-
to act on my behalf,, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed develo menu
/� 00_4 L ,
at my property, too2
located at 6
in na,! 0rCountjt_
1 furMemore certify that I am authorized to granny and do in fact grant permission to
Division of Coastal Managernertt stag the Local PemW Oiiioer and their agetft to enter
on the afarer mftmW rands in_connecWn mCi evaluang infommfto rdlated to this
permit appricafion.
o m" hafannation:
Sdgee M
�S '6 r I Y f� I0/--
PtattorType ttf m
-71--Z 1 lV
We
This certification. is valid through Za-1—

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: cs'�loz--s 4,
Date:3 D Ja)y�;
General Permit #:��9�
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)
Q
Dredge ❑ Fill ❑ Both ❑ Other
7
eE
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 :: 1-888-4RCOAS'T :: www.nccoastaimanaaement.net revised:02/03/10