64441_Jason Raper_20190624

4111 22 N
CAMA / DREDGE & FILL 4 v r --....)e- o. 74 19 A B.- C D
GENERAL PERMIT ' f Previous permit# r i
�� - New ❑Modification l iComplete Reissue ❑Partial Reissue Date previous permit issued /--► I -
j 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 ISA NCAC c z r v `�
Mules attached.
Applicant Name :�,., ; j_?A , �--c_ Project Location: County 1jZ--1-1-1-,i Z1- l c� , •
Address , 7 {\.-7 v ,-- ',A.) T cl . Street Address/State Road/Lot#(s) .,>,, sZ /-, . (e,
City r 'V-f---L\ State +--)C__ZIP -7 c / a = 1 ) 2;4 //.?",)
Phone# (__ )\.f / :/ - -7::7; I E-Mail Subdivision d/} L> u,A.:;-1,--,--)
Authorized Agent r 1 1 City '_L.j/N Y --1- ZIP —2 •' `'
Affected Cvv W /2:PTA ❑ 7-.Z ES ❑PTS Phone# ( ) ��j River Basin� - O 11!.-'Ni L - (
AEC(s): -OEA El ❑IH ❑UBA ❑N/A Adj.Wtr. Body % C. - % /-II
PWS: - �-)Nclnathnan /unkn)
. Closest Maj.Wtr. Body �(l N1 t '( `J - " ram'
ORW: yes / no PNA yes /"not)
Type of Project/Activity 7,-) x .6 2 C-h /'_ / ) L -/ /„-2
(Scale: / ;1 d )
Pier(dock)length 70 . , ,-;
I
Fixed Platform(s) /Z X / � ° t I • i s
Floating Platform(s)
Finger pier(s) n ti 1 L.. I O
Groin length I l i
number
Bulkhead/Riprap length / �-
avg distance offshore 1_j ..
max distance offshore i
Basin,channel
-EicL.71 .--------.1) L
1
cubic yards /
_
lY , ) .
Boat ramp i ' T 7rz, l•f
�
Boathouse/Boatlift - - -• - - 1 I
Beach Bulldozing I - - 4 i
Other 4
I '
i
I r 9 I
r I i
Shoreline Length_ - `i c) _ _ I
SAV: not sure yes no 1 —.
I l
Moratorium: n/a yes t I iI i1', !' I , --T
� •
) i I 6 s t #-'_Photos: yes Ai-1 Pahl;v • 1 _ 1 i ►)
Waiver Attached: no ! ),,a,-1 4 ;7� ;: I YJ 1L. I 1
A building permit ray be required by: /2C4*-i��y7 -r �'u . g See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions ,p'T l ' "•-7 )T 4-,,a-c y? L./-L-t--- 4/ , li'. . ,; /-21L c-) :"_>> 3
t )6 Lc< ` - ' O % Jam/A-rcox- .
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a sC*` AI /— • �a 4.L ���G /
Agent tinted N e PertnA er' tinted Name
- Signature' )ease read compliance sta me ..on back of permit** Signature
•
`k-E- L ,'A , L. Y7 /Ni. i f J,, A-1: 2, 1 1- -20 �L- ' • -_c)/ I
Application Fee(s) 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/ I-888-4RCOAST 252-946-6481
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 9I0-796-7215
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to .e/L s
���me of P ope Owni C a ���
property located at j c-/ /) 5' g ,c,a4f,
(Address, Lot, Block, Roa eetc.)
on fl in 3,riltet. , 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
1
L
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 . 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 Information) (Adjacent Property Owner Information)
i<J2,.(1._( .4., 0,U,,,,,,..
gn ture Signature,* i_—
gfen 49 p e,.- \A.I I 1-. -5vr,
Prin or Type Name Print or,Type arpe
4A;,_ t, 3o� g 1, ( ' `1 inc..c� QIo.
• -s Mailin ddress
11 / A/c D, i jPg
C. /S ate/Zip, 1
7 A�/ City/State/Zip
ill Y : ---) -- sI61
Telephone Number/email address Telephone N rnber/ mall address
Date J �J6` l -> I h(,1 u 1 J
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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•
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
S ( ame of Pro•e Owner)
located at /, i
property �! it,t.CQ,W r�"
� s` �-1 .��' ..-- � �.( �7 ,gag
r (dress, Lot, Block, -oad etc.)
on prCl a,t,s0 ✓u"LAQrt , in E , 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
I- -
I
I
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// I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Qwner Information)
/7._.,..,
/1,2/2-r___
• : ture *
S t�re ,/
Udsoh �afv�a— _��f, : � l 7
Print or Tye Name Print or T e Narne S // I
Mailing 34$ s� Pr«<sC' Rill Cl�,t,.-c1, I .
ailing .dress Mailing Address ,
Arr
City/State�p City/State/Zip 1
L / - ') qj1 �, / c -s - J 1l
Telephone Number/email address Telephone Number/email address
`
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

N.. •

Applicant rt S d rl A'P&-<-
Date: 2 cf �'�, , . 2a I q
General Permit#. .-7 4.p 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 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)
Pe7V 2 2
Dredge❑ Fill❑ Both 0 Other 0 e
Dredge❑ Fill❑ Both 0 Other 0
Dredge 0 Fill 0 Both ❑ Other 0
Dredge❑ Fill❑ Both 0 Other 0
Dredge❑ Fill 0 Both ❑ Other 0
Dredge 0 Fill❑ Both 0 Other 0
Dredge❑ Fill 0 Both 0 Other ❑
Dredge❑ Fill 0 Both 0 Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge 0 Fill❑ Both ❑ Other 0
Dredge 0 Fill 0 Both 0 Other 0
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both 0 Other 0
Dredge❑ Fill❑ Both 0 Other 0