73684A_Cohoon, Robin_20190725

1/
.. )CAMA / —_ DREDGE & FILL No. 73684 ® B C D
GENERAL PERMIT Previous permit#
IlINew--]Modification ❑Complete Reissue El Partial Reissue 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 i i , �� l �U
Rules attached.
Applicant Name �J n (� o ��� n Project Location: County 011 �. k,, C k
Address 113
City k-�, T%toV.c1 State Nc- ZIP a1q� )
Phone # (_) E-Mail
Authorized Agent ke ►h \
Affected ❑ CW C*W 'i PTA X'ES IaI PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes 1,6) PNA yes /`15
Street Address/ State Road/ Lot #(s) a I'} 1 <, i ,,,,, R a
1 ti
Subdivision Cc , u vo
City L'o"v 1\cg
ZIP old.
Phone # ( ) River Basin Pa k
Adj. Wtr. Body (),til `fo ll o" T1. (�• V (natnat � /unkn)
Closest Maj. Wtr. Body C„v - c k So� ^ C4
Type of Project/ Activity jAcA \ ,,A,( y, c vN LA_ Il{ t cj !QA M4 r - +y.• Lk c, U I
(Scale: = LIJ )
Pier (o k I n h
Fixes
Flom
Fingi
Groi
Bulk
Bas4
Boat
Boat
Beac
Oth(
Shor
SAV
Mor.
Phot
Wain
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ing Platform(s)
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Room
A building permit may be required by: C,,,,r r .kV c ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions A S 4,v " cl 4 1 V — N kL • I S MG �
If" fra1AA nt461 o,n lord,..CJ[I �.Lc r1L- l,`11Ch�G�/ crrct Juw in�1L r.t wilt ./�
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b ✓y-jo �— K,� r-�
Name X I / it Permit
Signature) "Please read compliance statement on back of permit" tgf d�u_,1e-_ - L---
Application Fee(s) -+36g3k Check # 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 ❑ 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/ 1-888-41RCOAST 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
i
Applicant: [ �,j���n PC, r�
Date:
Permit #: 7 3 b X --I A
Describe belo',�t 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)
Dredge Fill ❑ Both ❑ Other ❑
o
,4 . �.
Dredge ❑ Fill 1� Both ❑ Other ❑
OOV
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

-• •r' 100 ft ;;

HCDEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue; Governor James H. Gregson, Director Dee Freeman, Secretary
llate —7— I -� - ( C-)
Name of Property Owner Applying for Permit:
�?o 1--� ( n ( 0 k 0 t
Mailing Address:
YLA a-r'1
n F-3
I certify that I have authorized (agent 1 Lr;—: s gQ. to act on m
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) �U C4
at (my property located at) �� ( S 6- 1)'Yl e ---C
This cS##Wjcation is valid thru (date) -� ' / .
Owner Signature
-)-/ 7>/
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www,nccoastaimanagement.net
An Equal Opportunity 1 AtfirmaNve Action Employer — 50% Reoy)ed 110% Post Consumer Paper

■ Complete items 1, 2, ar03.'"-- ,,
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addresgd tel
o:
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,=a-1C,
A.
X ❑ Agent
_ ❑ Addresse,
B. Received 6y (Printed Name) C. Date of.Deliver,
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Expresso
❑ Adult Signature
❑ Registered Mailr^
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❑Registered Mail Restrict
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❑ Certified Mail©
Delivery
9590 9402 3394 7227 5391 89
Certified Mail Restricted Delivery
❑ Return Receipt for
O Collect on Delivery
Merchandise
9 Grtirlc ni ti . rr * --- __ _.. _ _ . . •,
^ Collect on Delivery Restricted Delivery
0 Signature ConfirmationT
I015 1660 0000 7 5 2 2 1175
Insured Mail
Insured Mail Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
-
I (over $"0)
3S Form 3811. Juty 217115 PSN 7530-02-Dnn-9053
Domestic Return Receio!

LISPS TRACKING # 111111
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 3394 7227 5391 89
United States
Postal Service
• Sender: Please print your name, address, and ZIP+4�1 in this box*
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AL MANAGEMENT
REQUESTED or HAND DELIVERED
adjacent to U b i n&o h o L 's
(Name of Property Owner)
Ee:
Address, Lot, Block, Road, etc.)
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N.C_DODO " in C,Ya JCSL[[225/Sl
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(Waveiva�..y, 5'C0L (City/Town and/or � County)
Agent's Name #: �t�� �) / h a l-3c3r) Mailing n Bok'36-7
Agent's phone #: o�Sa S --I J 0 q(, C,�W L)
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
o u-t -S I I 10
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 notirtedby Certified Mail
(Pro e'rttyry Owner Information)
.7
Signature
'7R6 6 i �pO �A n n
Print or Type Name
(Adjacent Property Owner Information)
Signature" l - _
ck---t-� (ay-s,
Print or Type Name
Maijling Address Mailin Address n 0 �S 1 I-SI A
Cifiy/State, Zip City/State/Zip
Telephone Number/Email Address
Date
Telephone Number / Email Address
(.-o.ta-r0Y
Date*
*Valid for one calendar year after signature* Revised Jan.2017

i -
Certified
■ A receipt (this P.
■ A unique identiti

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to,
Jose h �
iUS rnoAvi° -
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❑ Agent
D. Is delivery address different from it ? Y .,
If YES, enter delivery address below: 0 No
3. Service Type
❑ Priority Mall Express®
❑ Adult Signature
0 Registered MilTM
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❑ AdultSignature Restricted Delivery
❑ RegIstered Mail Restrict
❑ Certified Mail®
Delivery
9590 9402 3394 7227 5391 96
O Certified Mall Restricted Delivery
❑ Return Receipt for
O Collect on Delivery
Merchandise
_
2. Article Numhwr frm—fn- E— -- •
Collect on Delivery Restricted Delivery
❑ Signature Confirmation'
' 015 1660 0 7522 118 2
Insured Mail
u Insured Mail Restricted Delivery
El Signature Confirmation
Restricted Delivery
(over $500)
PS Fnrm RR11 .irrly 9n1r, P.OM 7san-no-nnn-onaa

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to�601�
ii (Name of Properly Owner)
property located at � l � � �� (7YI c r>� �„�
on
(Project Site: &dr7s, Lot, Block, Road, etc.
in 0. CQ ,( (i V ct N.C.
(Waterbody)
Agent's Name A
Agent's phone#: -,)-- Sa -q5 o
(City/Town and/or County)
Mailing Address-.:�- 1y-,?--> 0
c"af O J L N c, J--tg a-1
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
-----------------------------------------
der c14 e.. C0.4-1 Q,�-r S q
�CK+- bocce-�
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
(Property Owner information)
Si nature
�6
Print or Type Name
113���
Maili Adder
(
City/State/Zip
Telephone Number/Email Address
bA/6 l�
Date
(Adjacent Properly Owner Information)
Signature*
Jb4Tpe Print ame
0 j UYY1S
Mailinq Address
City/StatelZip
Telephone Number/Email Address
Date`
*Valid for one calendar year after signature*
Revised Jan. 2017

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