63139_pier.T-head platform_20180925

MCAMA EYDREDGEA FILL -
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GENERAL PERMIT.permi t #
4New,. .- ElModificatibn Reissue OPartiAl Reissue Date previous permit issdecle///Y,'
As authorized by -the State of North Carolina, Department of Environmental Quality
and the Coastal Resources,C mission in anarea of environmental concern pursuant to 15A NCAC
Ms aue I tta h d.
Applicant Name-, 'S/%q Z— Z-V,�21-) Project Location: County &�
Address Street Address/ State Road/ Lot #(s)
City State 1K zip 0,��
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Phone # a r- M a i I Subdivision -/?" �r 4:-�
Authorized, Agent
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City kle%G ZIP'
Phone# River Basin
Adj. Wtr. Body Ad/-09 (hat I(=
Closest Maj. Wtr. Body
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-Agent or Applicant Printed Name,
gig-hat-u-re *X1P ease rg;f� 5'Rpliance statement on back of permit
Fee Check#
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Issuing Date V 'Expiration Date/

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Nod th Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Da%As John E. Slcvaria, III
Governor Direotor Secretary
BUFFER AUTHORIZAnON 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 Quality (DWQ) regulations 15A NCAC 026.0233 & .0259. The
Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water
Quality (DWQ) 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 (LAMA) 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 Vor land clearing to a civil penalty by DWQ 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
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 oponsslatted 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
property indicating the relative location of the
drawing will be used to old in compliance an
e Pre -project site
General Permit Is considered the project drawing of your
pier or docking facility and any requested access way. This
d, monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the conditions Ilste above and verify
-that all information provided is complete and accurate. /1) M
_—"&ncT -
nt Ageor�A piieant Pri ted Name
CAMA GENERAL PERMIT
WNhlnston Office
Morehead City Afficu
Wilnn Office
943 WMAn8ton Squm Mall
400 Commerce Avenue
127 Cadinal Drive Ext,
Washington, NC 27889
Morehead City, NC 28557
Witmhoon, NC 28405.3845
Phone [phone]
Phone [phone]
Phone [phone]

S. F. Warren & Sons, Inc.
180 Taylor Farm Road, Belhaven NC 27810
Office [phone] Fax [phone]
Forrest cell [phone] Freddy cell [phone]
NC General Contractor License #72600
www.nepiers.com
Authorized Agent Consent Agreement
To: State of North Carolina Department or Local Government Department
from whom this permit is being applied for.
I, the undersigned property owner, do hereby authorize B.F. Warren & Sons INC. to act on my behalf in
obtaining the necessary permit/s for the below listed projects. I have contracted there services to perform
the work permitted. This agreement is limited only to the specific activity of obtaining permits for the
below specified projects.
Projects:
Corc�A k,1)OCAL
Project location/ address:
500 �1
� t� NC
Body of Water:
Property Owner Mailing Address:
Property Owner's Signature: Lr ¢1-h Date:
Authorized Agent Signature: Date:

Adjacent Riparian Properly Owner Statement
Pnepawd by
B. E Warren & Sons, Inc.
180 Taylor Farm Road, Belhaven NC-27810
Office [phone] Fax [phone]
Freddy,Mobile [phone] Forrest Mobile.[phone]
NC General Contractor License# 72600
www.nepiers.com
September 5, 2018
I, the undersigned property owner, do hereby certify that I own property adjacent to Kathryn
Lyon's property located-at:500 Lyon Drive on Pungo River (body.of water-), in Belhaven, NC.
The applicant has described -to me, as shown below, the development proposed at the above
location. I understand that any construction, excluding bulkheads, -must be set back a minimum
distance of fifteen feet (15'-) from my area of riparian access unless waived -by' me.
Please initial the appropriate blank, sign and date below.
I have no_objection to the project as proposed but do not wish to waive the fifteen foot
(15') setback.
" I have no objection to the project as proposed but do wish to waive the fifteen foot (15')
setback.
I object -to the,project prop(o's�ed..
Property owner signature
Printed name mb,('acf -I
Address _ I 1
Telephone number
Date AD Ao
Description and / or Drawing of Proposed Development
Installation of a 5x70 Concrete Dock with a 10xl7 Platform

Adjacent Riparian Properly Owner Statement
Prepared by
A E Warren & Sons, Inc.
180 Taylor Farm Road, Belhaven NC 27810
Office [phone] Fax [phone]
Freddy Mobile [phone] Forrest Mobile [phone]
NC General Contractor License# 72600
www.ncplers.com
September S, 2018
I, the undersigned property owner, do hereby certify that I own properly adjacent to Kathryn
Lyon's property located at 500 Lyon Drive on Pungo River (body of water), in Belhaven, NC.
The applicant has described to me, as shown below, the development proposed at the above
location. I understand that any construction, excluding bulkheads, must be set back a minimum
distance of fifteen feet (15') from my area of riparian access unless waived by me.
Please initial the appropriate blank, sign and date below.
I have no objection to the project as proposed but do not wish to waive the fifteen foot
(15') set back.
✓ I have no objection to the project as proposed but do wish to waive the fifteen foot (15')
setback.
I object to the project proposed.
Property owner signature %;,��z�-9 _
Printed name V�! Q e. [.l e Y5
Address 0 r " e
Telephone number ( a 'a ) `� 3 - (p 1 °)
Date
Description and / or Drawing of Proposed Development
Installation of a 5x70 Concrete Dock with a 10x17 Platform

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
Date:
General Permit #:
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 impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
nt)
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 ❑ 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10