72525A_Stephen Brawley_20190129

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ICAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New :Modification Complete Reissue ❑Partial Reissue
No 72525
a B C D
Previous permit # -4 1 1-4 $ A
Date previous permit issued q /%% I ao Ig
As authorized by the State of North Carolina, Department of Environmental Quality _rL.101
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC N,Pe, t
Rules attached.
Applicant Name - 4a p kA ,r. D. 13iC. w 1 r J Project Location: County
Address 111-1 Sho rc 1Jr Street Address/ State Road/ Lot #(s) 114 Sharc Dr ✓<
City State u L ZIP D 15 4 1 I.a i :w 1� SQ # ll '�- 6
Phone #(90k1)byy-bi$ lS E-Mail drLi Subdivision NO4Ai,- R,v, Sho�c S
Authorized Agent
Affected ❑ CW 'APTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW: yes / ,no PNA yes
City Sc r +OD ZIP l,4 9 `I 1
Phone # ( ) River Basin P.", ".. - ,,, K
Adj. Wtr. Body t," i k , N.,i i 1, 12, yr A / 11ijj�/man /unkn)
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Type of Project/ Activity 'buy + F&L A,�,I 1w o (So, 1 ! , ? t a
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A building permit may be required by: It Ca✓, y ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions (f) 1 12t r o E.Q. , c� S n, +, »i c t 1,. n r� kur rvw 1. 2trJ SI , j2 S
(JPt/ is i,t Cxn�"(cj a,. 12x jjl tiv
Agent or
Signature ** Please read compliance statipoent on back of permit **
Application Fee(s) Check #
v� r,a1C,
PermitOffic ame —
nature
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IssuinDate Expiration Date

CAMA / DREDGE &FILL ' w, 2 71175
g C D
GENERAL PERMIT Previous permit #
�ew Modification --Complete Reissue EiPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality G
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC —4
T Rules attached.
Applicant Name �34 e js},A r-1 6. 9,rcwle tf ___ Project Location: County_ �, ,�„ c l(
Address Ii 6A Shutt IrA r
City r r r __ State W C ZIP 11 ct 41 l
Phone # ( Cat - (aX" E-Mail
Street Address/ State Road/ Lot #(s) 11 y Shore #fir y r
Subdivision Shoe?
Authorized Agent
City -1 G r o r 0 n'JV'
ZIP :1 C, 4
O CW )TW
PTA ❑ ES ❑ PTS
Phone # ( )
River Basin
Affected OEA O HHF
AEC(s):
r_ IH 0 USA El N/A
Adj. Wtr. Body
11
ith QI or na /man /unkn)
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A building permit may be required by: t v r r , ., c i e`'o..., ❑ See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions I ,�( { r,y. r t �o r i 00 ma rc Ina.^ -;rwo �v�.*� it �� fit• o` '
Agent or licant P inted Name Permit Officer'
Signature Please read compliance statement on back of permit'"' Sign re
Application Fee(s) Check# Issu nl g aD to Expiration Date.

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner:
Address of Property: I/ / Slyr-e— )i ue—
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
Mailing Address:
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.
` I have no objections to this proposal. I 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. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. 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, 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.
'(J 1 do not wish to waive the 15' setback requirement.
(Pr ner In tion (Ad'ac nt Property Owner Information)
Sign tune Signature
Print or Type Name Print or Type Name
Ma, i g Address Mailing Address
c
City/st9telzip _ City/State/Zip
�( :Z PC--) &---o �
Telephone Number/Email Address Telephone Number/ Email Address
9 -� - iLq
Date Date
*Valid for one calendar year after signature* Revised Jan. 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner:
Address of Property:
Agent's Name #:
Agent's phone #:
(Lot or Street #, Street or Road, City & County)
Mailing Address:
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 re proposing. A description or drawing imensions must be provided with this letter.
have no objections to this proposal. I 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. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. 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, 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.
(Pro Owner Inform on
(Afcnt Prop Owner Information)
Signatu �e-d
Si tut
IC`_''
Print or Type Name y Sftp� (`,'u e-- Print or Ty e Name
Mailin Address c./ ✓ N— Mailing Address
pry
City/State/Zip Cty/State/Zip
e ephone Number/Email Address Telephone Number/Email Address
C
Date Date
`Valid for one calendar year after signature' Revised Jan. 2017