64533_Stetson Mann_20190723

77'.M1iir,{�y}'H{{tt.//':.�s J',��1J"ric`�4'' : .5 'S.• _ - in�'.q._. {!clr
•
• •moo CAIVIA O'DREDGEA,FILL .�3 , No. -73097 A '
[_ . G,E�NERAL� ,:PERMIT . . . 62 : L � �.,y .
t,:;. , • Previous permit# ' t�//q
.'_ `>( New ❑Modification .00omplete•Reissue El Partial Reissue. ' Date previous permit•idued A//�} ." ,,,t,*
r
As authorized by the State'ofNorth.Carolina,Department of Environmental Quality -
and.the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 6 7 I.) r)266
❑Rules attached. , -
Applicant Name•-.5 T3Or f1A,i A Project Location: County YEA IA(d1Z1 (obi p)`/-
Address 1113 ; POE C Ali S !' -R 1 ! Street Address/,State Road/Lot#(s) )Il 3 - P frJCc(2( sr . , •
City 13A114 / State -IA. ZIP 7908 OZD or(' 7.35 .
Phone#,'( ) 3L/j' /o I G . E-Mail ' ,. Subdivision po(,i(Z F ST
Authorized "l
Agent TJ/ A(2.WE S City FAT)1 • ZIP i 75;16 g • -
- ❑CW 1 Ew - - ❑ES ' ❑PTS Phone# ( ) - River Basin .f � ' • -
Affected El •
OEA ❑HHF 2, TA'
IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body PAIltrc0 RI LICIZ natl/man /unkn)
❑PWS:•
ORW: yes / no' PNA yes no - Closest Maj.Wtr. Body 17AM CICG fZ I()Cif .
_.. 'Type of Project/Activity 41A-11.10 Q I?CO I‘ixl6 / •VI A77 c M d— /0017 6 ' I'/LR.
' (Scale: ) N.1 v 1 )
Pier(dock)length 1 bo'st ' _
Fixed Platform(s) /6 t Y fr,/
jiii
' Floating Platform(s) --...
Finger pier(s) �r u C 6 •e (Al) 15 1 it P.Groin length r E` f ��� • i X' /
number j i 17/A fh1tT'
Bulkhead/Riprap length ' . _
avg distance offshore , f •
max distance offshore . I j •
Basin,channel f '•
• i
. ', cubic yards i - -
' Boat ramp .
Boathouse/Boatlift
.Beachnr B"ulldozing 1// i
Othe 1 ' •
, •
I i •
Shoreline Length 135
SAV: , not sure yes no
Moratorium: n/a yes 41150 -
Photos: , yes no
Waiver Attached: 17.0 no
A building permit may be required by: LTA I)(6,0 CO VtirJ H See note on back regarding River Basin rules. •
(Note Local Planning Jurisdiction) _2
Notes/.Special Conditions ( o I4. j7_�, AU`fl4orll2G0 2�"GrT S1 or At t ow02 -gaoE/
IA) 011 /U v Sfnt6 tr. S7M ar2A(2C -71(0c")(T z.
o � h.rI . Kcv„� IA A f .eno \t/ts
or Applican P inted Name Permit Officers Printed Nam ,
Signature/* Please read compliance statement on back of permit*!, Signature
`71 Zoo, pc) - _ ii ll-. 2 . ,)4 t y 20 11 23 �oJ .Z0i9 .
Application Fee(s) Check# Issuing Date Expiration Date'

Authorized Agent Comae tA:x. ee. eau(5-
1 au1 M herby authorize Tobin JayTetterton of
(Property Owner(s))
TJ's Marine Construction,LLC to act o d rt,y behalf in obtaining LAMA per sI It its for
the location listed below.
PRI PERTY AD I RESS:
/1/3 *I'd& elest
,e .? ' r
•
PROPERTY OWNER'S MAILING ADDRESS:
(5Q fri e--
Phone 3 dit-- 6/
PROPERTY OWNER'S SIGNATURE: �
C
AUTHORIZED AGENT SIGNATURE:
TOBIN'TETTER ON
DATE: r17
2 c
•
- 1
W/Authorized Agent Consent Agree.
1

I
a µV
I
ADJACENT RIM- AN PR*PER1Y O NNER STATE TENT
I hereby certify that I own property adj nt to C 7 C)N �J 4 it 's
15-'
Jame of,?.*',arty 0 er)
property located at /, f �!1 e irec37"
(Address L ;loc ;Road 4tc.)'on , in ( eG/iY , N.C.
('.°3 aterbody) (CitylTowm 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.
DISC,- IPTION AND/OR®RAINING OF PROPOSED DEVELOPMENT NT
(in f Vv duai proposing davelopffnann mast li in description below or Each a site drawing
Re c 0 1 4 f`r 0)4./Pkj
/Oa'
/4X/.
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.)
r
( ./'. I do wish to waive the 15'setback requirement. '
I do not wish to waive the 15'setback requirement.
(Property e=A r,er Ingo ton)
(A+ddacent Pro rty Owner Information)
'6,- , l'1--� „It.
Uri' 1 1 13oL
03, 11 cri4 -
St tur �/J Si atur *}
e.isoh �'�'l q %!m + �W i 1AJ;i 1taV� \
Print or Tyggqq Name P 'nt or Typ Name r
1i 3l li freerC 5 r p ,s sr
Myyl g Address C- c92 - Mailin� )I _ 7 rw
��jj � ,;i � Y?r At_ r� �[Y'
G p' 3 W--044 O 1.6 �l fir ?? e tl ,';itutmef'uotiK,vlutf ;
Telephone Number/email address Telephone Number/email address
7 71 —IP 51�q/, ©1y
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

, i
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
's
I hereby certify that I own property ad'acent to I�aeree of Pro .r)
�e/ie© ....te's7` 2
property located at fly ,
(Addre n�;-ot Q1-,A e 41 �,5.,,4,N.C. `
on \. pity/Town andlor County) ,
(��ter���y)
The appli -has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
•.ESC , PTION AND/OR D '- 9NG OF PROPOSED DEVELOPMENT
(individual proposing Owego must till in •{ ..crlpttof below or attach a site drawing)
/?, 'er ffr1
fo
I /4 g
3
1
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.
(Property Owner hW'rmation) (Adjacent Property Owner Information)
SiamatureSi tore* -- S l�k�rz -
P-}v eS fJ01(+19-Icy
r e N� ` Print or rys ame
'. Q d s Mail16 .1 , a2trOk Ong Address / a7rde
city tat City/State/Zip 5712v - `clS
Telephone .Number/email address Telephone um��erriail address
7 -/9 y jq
Dat Date
e
(Revised Aug.2014)
'Valid for one calendar year after s4gnature*

Applicant: .>
6a f��,✓
Date: ) Jbl c`( 2019
-General Permit#: 73097,Q
Describe below the HABITAT disturbances for the application. All values should match the name,and units of measurement
found in your Habitat code sheet
TOTAL Sq.Ft FINAL Sq.Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
dpE MCA/ Dredge 0 Fill 0 Both ❑ Other pi is57F% es-i r j 2
Dredge 0 Fill 0 Both 0 Other ❑
Dredge 0 Fill 0 Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill 0 Both 0 Other ❑
Dredge❑ Fill❑ Both ❑ Other 0
• Dredge❑ Fill 0 Both 0 Other 0
Dredge❑ Fill❑ Both 0 Other 0
Dredge❑ Fill❑ Both 0 Other ❑
Dredge❑ Fill❑ Both 0 Other 0
Dredge 0 Fill 0 Both ❑ Other 0
Dredge 0 Fill 0 Both 0 Other ❑
Dredge 0 Fill 0 Both ❑ Other ❑
Dredge❑ Fill❑ Both 0 Other 0