73814A_Smith, Joseph & Donna_20190813

CAMA / _Y DREDGE & FILL
ENE
RAL PERMIT
New El Modification ❑Complete Reissue ❑Partial Reissue
No. 73814
6V B C D
Previous permit #
Date previous permit issued
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 �+ . 1 1 uU
Rules attached.
Applicant Name 3ok nl-.
Address l o l
CityState Nc ZIP 1-+g.)r-
Phone#E-Mail
Authorized Agent LC' I (fit c
El CW
)4EW ,PTA #ES ❑ PTS
Affected
AEC(s): El OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /L�io,>
PNA yes /-ro?
Project Location: County C'.. r r • V, c le -
Street Address/ State Road/ Lot #(s)
Lot N )It . Si2*1 13ci S
Subdivision Stile I s1 c
City C"";1"tk ZIP 93Cr
Phone # ( ) River Basin Posq voi,,� t1C
Adj. Wtr. Body & 4� (nat / a /unkn)
Closest Maj. Wtr. Body K So..✓'r<
�l1�0//�J■■■■■■■■■■■■■q■■Eli%1M
M■■
■®■■■■■■■■■�■■■!■■w■■■®�■■�■■■■■■■■■
■w ■■■■■■■■wE■w■©�■■■
w ■■■■■■■■
■EM�
ME= MEMO■■■■
EPEE■■ME■■Ew=■ClII�E'!©�l�w■ME■■EE■E■■
■
ESE■■E■E■■Mw
■■�sw��Q■�■■EwEM■■E■
■®■■■■■■E■■EOM■■a■■■E�®■E■■■■E■M■E
■■■■■■■c■■■��11�■E■c�nc■►�wwwM■1■■EM■■
YYrYY
__
�YY/ ��Y'i Y•YYYYYY7YYN�� �YY� YY■,■■. ��
■M
iEMEMOMMO■ME
ME :.. ■�■■■■■E■■M�■■■■E■■E■w■E■EMS■■■■c■MM
MEMM■MMMO■MIMMMEM
■■
■�iE■■■�MM■■■■ice■■®M■■■iii■■■�����w
u
M■E■E!I■■EME
E■w:R11300 ..I 1■■■O
(Akq ae C
Agent or Applicant Printed Name
Signature ''* Please read compliance statement on back of permit
,tLr U0 a-) p � ao. �►�
Application Fee(s) Check #
Permit Officer's Printed NW4he
Si
'e,11 3 /aol'i 1af13/dv�5
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 1) 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 Other:
Neuse River Basin Buffer Rules
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/ 1-888-411COAST 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

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
Date:
Permit#: —f 3�) `11
Describe belo'-,� 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
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)
5
Dredge ❑ Fill Both ❑ Other ❑
C-�—OC7
Dredge ❑ Fill pJ Both ❑ Other ❑
G2 .
Dredge ❑ Fill ❑ Both ❑ Other i
0
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.nccoastalmanaaement.net revised:02/03/10

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: S
Mailing Address: io I 1 yo-( iQ r C l
Phone Number:cj
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: (3o �Vt ead
at my property located at L
in (AxIfI' -0c�V County.
Q X4a9
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 Owner Information:
Signature
��`` '' \\ Print or Type Name
�e-c
Title
l
Date
This certification is valid through

�t- .
� � r ... i.
:r

-
I hereby certify that I own property ij, iceril to in -e r)
(~_,__ PropertYproperty located at
proposal,
�
L]
\\ \�*��l caA
'Tiv' \���
�. ~^
�������
�~ v / /
WAIVER SECTION
| understand that pier, dock, mooring pi|inBs, boat ramp, breakwater, boathouse, |Ut, or groin
must be set back a minimum distance of15'from my area cfriparian access unless waived by
me. (If you wish to waive the sntback, you must initial the appropriate blank below.)
|dowish towaive the 15/setback requirement.
|donot wish Vowaive the 15'setb8ckrequirement.
(Property Owner Inform ? ation) (Adjacent PropertyOwnerinfor7ation)
4
��l C�A
`.
CltylStatelZip
ail address
Duie
-
*Valid for one Calendar year after signature* (Revised Aug.
��

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to yO P)nj 5 [D t;9 t^ 's
tame of Property Owner)
property located at � ©1 ✓' e`') Ic'' { / � � �
!
(Address, Lot, Block, Road, etc.)
on C'in , 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.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
�U1t�heC,�
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 erty Owner Information)
i ture
Prin or Typ Name
Mai ' g Address'��
Cit /State ip
252-24)2-2905
Telepho e N tmber/e ail dd
Crares
GC 122.5�P�
Date
(Adjacent Property Owner Information)
Signature *
Print or Type Name -
Mailing Address
City/State/Zip
Telephone Number/email address
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

.r
1
14
Or
I
gtl,^'N
ii

pow-
14 0,
.09