63934_Elizabeth S. Dawson_20190312

_1CAMA / :DREDGE & FILL GENERAL PERMIT 1-D#1031 3(4 No. 72992
Previous permit#
T New _;Modification ''Complete Reissue -Partial Reissue Date previous permit issued
/B) C D
As authorized by the State of North Carolina,Department of Environmental Quality P [/ //C;('
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC `/
�- _ 121R9 att3iched.
Applicant Name E/2�4C , �i cnj, ) Project Location: County /y,��/� i
Address O`DS-- . .d Y /t/eV 19/ i U4 Street Address/State Road/Lot#(s) f] ,�ie
City ?//r .f%
C- -1 State /l/C ZIP 6)-; �j �� f) /ti l .�'. 1 �� /�/z,C�
Phone# ) )7�'"7f&`E-Mail Subdivision / 1��e-
Authorized Agent City_ / WI", ZIP �2`o�G
CW �$TA (tS 2TS Phone # ( ) River Basin /l//
Affected 0EA O HHF ._IH -UBA ❑N/A 7
AEC(s): Adj.Wtr. Body l /7 /l/ (/ f AP A . unkn
= PWS:
^''� Closest Maj.Wtr. Body : f^
ORW: yes /trio / PNA yes /;'no
Type of Project/Activity ✓ / /; 7-'1 C-`1*7-C•-
i --•--)
(Scale: /fit /O '
. )
Pier(dock)length ,
I
Fixed Platform(s) f j I 4 '
Floating Platform(s) �., ) -* • f
p� ,
Finger pier(s) �" i � � � I !' _ .�-4.---
Groin length — I `
J
L
number -_ !f I /2/.6
T `—
Bulkhead/Riprap length 6- /
avg distance offshore ___ j j ( i'
max distance offshore c� / y� I ) , '
Basin,channel
cubic yards
l I
Boat ramp l , 1
Boathouse/Boatlift to- s"- ' 4 '
Beach Bulldozing ,/V � 7t =' e---."`�-
Other
Shoreline Length )/ • f !
, ,.., , . _
SAV: not sure yes no f t+1---."-- - f T
Moratorium: n/a yes no - :. A•] r
Photos: yes no r ! I C 1 /
Waiver Attached: yes no _-- /4' r 4- L.
i. 1
A building permit may be required by: �� p/L /.>4 CI See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) �?
Notes/Special Conditions .�-'' �7 ' ' r /2-i• - r/f,. V / G 7�/ .
A C 1 /
'7 4 e
Agent or Applicant Printed N t Permit Officer's-Printed Na
-0 (AAA'I
_<--ic:(2' --rz'-- / ' ,
Signature p lease read m .` ce statement on.back of permit** Signat
65
. / 4 . ,
..
/5) . a -
Appf t .on Fee(s) Check# Issuing Date Expiratio ate

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(910-796-72 15)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/ I-888-4RCOAST 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

Authorized Agent Consent Agreement
t, CG.4Z4 / 6' al41 (2 , herby authorize Tobin Jay Tetterton of
(Property Owner(s))
TJ's Marine Construction,LLC to act on my behalf in obtaining CAMA permits for
the location listed below.
PROPERTY ADDRESS:
86 t3 k_lcsr a4„,0 14e-w 4
/ 7 ', A/C z1&oe
PROPERTY OWNER'S MAILING ADDRESS:
4105 5 ---,2#•dOD a
%if4s).; A/C Zie9s'
Phone No. 252-237- 816 2
PROPERTY OWNER'S SIGNATURE: r h �) tL <)L�
AUTHORIZED AGENT SIGNATURE: �''G,�, Zt"t7-75----
TOBIN TETTERTON
DATE& // 21/
71
W/Authorized Agent Consent Agree.

ADJACENT RiPARKAN PROPERTY OWNER STATEMENT
I hereby certify y that I own property adjacent to '1_124/S7y S; Dig pus d N 's
properly located at 9t? a .Z'SLQva I/! 4°f Propwt
, Owner),
on Av/Gtv�✓G�.. (Address, Lot, E3loc Road, etc.)
i1al erb®ei ' in 17�4?�/ , N.C.
y) (CityiTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatior.
Adjacent I have no objection to this
E Prap y proposal.
GGrare I have objections to this proposal.
DESCR
IPTION AND/OR OF(Individual proposing development DRAWING
��ly in description b®oworatt attach DEVELOPMENT
to drawing)
AAiGrI✓ �%N`/GLl��G7�0
I understand that a ier, dock, INTER SECTION
°''° "=� p 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.)
t''"t VJ /
r I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement
(Proper Owner Information) (Ad'acent Property Owner Information)
fiJI /fJ
Signor e Lv n T
eza4e,Gry 5 Digo /gssiw Sia a
Print or 7 e Name a urn LJ o r
-4- os sx,gkiodo a Pigtgoi f Iro,ecafe,
Run
Mailing Add ss Mailing
�v/�d'd�/i �C �2?SSGi [sonddress /V z7�9�
City/Sia -f' City/State/Zi a n�,ltsy bu-r o r f�
' 2S2- 237 �¢G 2 2 52-2 . ?-g(o 4.9 '
ail
o�' �"Telephone Nuneeer/v all address Telep one rer/email address
Date L /' r z 9
Dar *
Valid for one calendar year after signature= (Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that i own property adjacent to 62-/Z/62r# 5- J244-450,') 's
property located at /9V3 Thc4 (//v,r
.(Name of Property Owner)
(Address, Lot,clock, Load#, etc..)
on 4 j,w ,t/04- , in ape , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
lacatiop.
Adisco,t ✓ I have no objection to this proposal.
Prorratty
c„ 1 have objections to this proposal.
Cr. one
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fi in description below or attach a site drawing)
Nee) l yL VUZNG?o
•
WAIVER SECTION
pro ;u 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
r- -r below.)
v� tJ/ I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement
(Property Owner information)iota) (Adjacent Property Owner lnfor zrnation)
JLQLJJ ' Lae ) v� . 1,
Siva a Sim
./24rt4-flr S. 9,9&'ci'J V ri'
/ a c. Ern,e.5
Print r T e Name Print or Type/0f s1/aw �'s1 /-a /e/epY.
Mahn Address Mgr Address
lJ/Gso,t , lC 27�i 6dma Ne_ a 7d 3 /
City/State2p ( Vl baffles 59 &9 mair-C.oM
2 5 L 2.37-64 6 Z S3 (4, aSS - .
Telephone N tuber/email address Telephone Number/email address
///2Fes!/e3 La Ala
Date Date*
(Revised Aug- 2014)
`Valid for one calendar year after signature= - "

NC Division of Coa a! Mgt. Habitat impact Computer Sheet
L'l2
Applicant: F 47(e-c6"
6'
Date: /� ,Q t 1 "1-'2Of 7
General Permit#: 7 2 9
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. I 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 1 restoration or temp impact
temp impa impact amount) temp impacts) amount)
StiCic-4 Dredge ❑ Fill Both ❑ Other ❑ i -/4/102,17
Dredge/6 Fili Both ❑ Other ❑
Dredge❑ Fill❑ Both 0 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 ❑
•
252-808-2308 I-88x_4R''0,1 _.- -- 2.`,3. 1_