Flynn, Joseph

11 CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification El Complete 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 NCAC_
� I
y
No 71379 A
Previous permit #
Date previous permit issued
QRules attached.
B C D
Applicant Name
._
Project Location: County u
Address
Street Address/ State Road/ Lot #(s)
City
_
i
State J ZIP k� 707
_
Phone # O
E-Mail
Subdivision ;
Authorized Agent,,
(` t-?
77�_C,
City ._ , s.h f r ZIP
Affected ❑ Cw
❑ EW _111 PTA
❑ ES ❑ PTS
Phone # ( ) Riv Basin
ElOEA
AEC(s):
❑ HHF ❑ IH
❑ UBA ❑ N/A
i°
Adj. Wtr. Body (nat %man /unkn)
❑ PWS:
Closest Maj. Wtr. Body
ORW: yes / no
PNA yes /
no
Type of Project/ Activity if"i i V e >4- , V1 f 1�71/)
/r 1.a, ^ j
(Scale: ��=
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) +'
Groin length /
number
Bulkhead/ Riprap length /
avg distance offshore
max distance offshore /
Basin, channel
cubic yards`% y
Boat ramp %
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length f
If J i
SAV: not sure
yes no ;
/
Moratorium: n/a
yes no
Photos:
yes no
Waiver Attached:
yes no
!,. pt .t y [See note on back regarding River Basin rules. A building permit may be required by:
( Note Local Planning jurisdiction) j / t i
Notes/ Special Conditions .7' 7� ri` r f�3 it�• •
i
Agent or Applicant Printed Name/ /
Signature Please read compliance statement on back of permit
-- '­3 \ 1b
Application Fee(s) Check #
Permit Officer's Printed Name
r
Signat re
�-v.4
Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
Other:
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888ARCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

V
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: __Jl
Mailing Address: }—
Phone Number:
Email Address:
I certify that I have authorized
f�U c)_( ') �T r
3o
f)l at
PaL i
Agent /
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in County.
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.
Property OwDer Information:
Signature
or Type Name
_".�Z / I /�
Date
F EIVED
This certification is valid through l _I ZU 11, JUL 13 2018
DCM-MHD CITY

I hereby certify that I own property adjacent to flu=�-f�-✓
's
(Name of Property Owner)
property located at �i o d s— C 4 -S ro WVt- \7/ k^ '�/ 47 z2/ _ (') / j ,a
01I bJ, N.C.
iM%ierifniit/► I/iiyii/'nw.► .�N�in� /�n..r.i.�
The applicant has >described to me, as shown below, the development proposed at the above
Location.
`/ I have no objection to this proposal.
(individual proposing development must lyll in description below or attach a site drawing)
RIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or -grain
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 w &� try wave ' * 15'
d do nat wish to waive the 15! setta.ck req Arement.
Owner I
rgt or y e e
M ng Address 1 3 i y t) O
City1s e/Zip G
°t«-t/r9&�
Telep ne Number/email address
Gd
(Adjacent Property Owner Information)
Sig e
O,t_o Rtr lQ r CtCS
Print qr Type Na
Gyo � m Ssou../iF-y
MalingAddress
/Vc JAI Q C1Q Al /t�' -� 0
Cit tateMp
Telepho ee Nymber/ email a dress
op
FeuRE13HVED
*Valid far one calendar year after signature*
(Revis coup fflt
DCM-MHD CITY

I hereby certify that I own property adjacent to
property located at 600
(Name of
I
i 1:66-,(Address�ot, Block, /R�oad, etc.)
on i , in �Ar(-Cv �C�2r/I r' % � e1� iN.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)
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
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.
(ProperK Owner Information)
Address
Tele hone umber/email address
20rd
Dar
*Valid for one calendar year after signature*
Property Owner Information)
Si r�ture
I() T "�M i
Pn',gt or Tye N
00 e
S
Mailing Address
City/State/Zi
�o2 22 - 7odi-
TelephQn$�cj� ber/email address
!V // // J RECEIVED
Date*
(Revised,ii�10&4 018
DCM-MHD CITY

RECEIVED
JUL 13 Zola
DCM-MHD CITY

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