73858A_Jordan, Steve E._20190829

ICAMA / -1 DREDGE & FILL
GENERAL PERMIT
C;�NeW Modification El Complete Reissue ❑Partial Reissue
No. 73858 Q "A-. 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 I SA NCAC
15'Rules attached.
Applicant Name ey e Project Location: County ?,*z r S
Address / / 3 N C //w 1 3 N 3 Sa -�'� Street Address/ State Road/ Lot #(s)
City ,<.4 / a�, State N`_ ZI P Z 7 `j ? l f/ (, V e y +,, r,,- L o n
Phone # (,?S�) !G / i - I rr` E-Mail
Authorized Agent
Affected ❑ CW >4,€W e0PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes f no�
Subdivision
City /-1 e ZIP Y
Phone # ( ) _ River Basin G S
Adj. Wtr. Body C n G (nat Qa
\V�unkn)
Closest Maj. Wtr. Body A r• VT S a, 4
Type of Project/ Activity / 2
i
(Scale:
Pier (dock) length
Fixec
Float
Finge
Groh
Bulkl
Basin
Boat
Boatl
Bead
Othe
Shore
SAV:
Mora
Phov
Waiv
■■„�■■■■■■■�■■�■■■■■■■■■■■■A1��
■
i length
I■U■■■E■■■■
_
11mmMEMMM■■■■■■■■■■■■■�
■�NUMMMMMMENE
MMM■MEIM■■■■■■■■■■■■■■
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Ii1l[�■■I■N��■���
number
iz■■■�■■■■■■■■
w■■■■■■■r��■w�■■■■■■■■
■■■1■■■■
■■■■
�r�■■■■■LaiifYr■■■■■■■■
avg distance offshore
1■®�■I�i■■■■■■■■■■■
■■■■■■■■■■■■!:�■i■■■■■
max distance offshore
1�■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
1■■■■■■■■■■■■■■■■■■■■■■�1■■�■■■■■■■■■■■
1■��■■■■■■■■■■■■■R■/��fC3�■M■■■1����■■■�■■■■■
cubic yards
1■L�!■■■■■■■■■■■
■�i!1!�.1►1ii�■i11�ISi�lYlillr■�■■■
■■■■■
ramp
1■!i■■■■■■■■■■■■■■Ili■■■■�1■■■■■■■■■■■■�■■■■
■��■■■■■■■■■■■■■■�1■■■■��■■■■■■■■■■■■■
■
MM■■■■■�■■■
■
■■■
Bulldozing
■■ly■i�C!1
NEEMMMW
ENE
ENE
■®■■■■■■■■
■■■err■�il�rnil■fir■■■■■rr■■■
.line Length
not sure yes
■■■■■■■■■■■
�■■�1■■■■■■■■■I■■■■■i■■■■■r■-■
torium: yes no
■■■■■■■■■■no
■
■■■■■■■■■■■■I■■■■�w_
■tom■■■
--r Attached: Kes\ no
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MEE
■
■■■■■■■■■■ENE■■■■■■■■■
tri
A building permit may be required by: 12 h n'• . A Sg ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) I
Notes/ Special Conditions r e<} m o S44 Q �y
J I c V c ru �• �.Jv r-�a �
!{gent or Applicant Printed Name
J
Signature Please read compli ce statement on back of permit
Application Fee(s) C eck #
Officer's Printed Name
Signs e
�,/2-�5%I 7 /2�i/�
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 complywith 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/ 1-888ARCOAST 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to S-rn1no E r(7&x / I
(Name of Property Applicant)
property located at � � 6U211�iti ��� (_�
(Applicant's Address, Lot, Block, Road, etc.)
on �� v. �� �) , in ge r'T=Q e-1-I' , N.C.
(Adjacent 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.
You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909
If you have any questions you can call: 252-264-3901
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
i O & cwtJ—r Tr-,t,�
e Tk&ee- Nv%e- —"
j /cCr 1 i ✓+ � V� � � ��"
Gam, K X 1 L
P,of,-;7� -�? 1 FoPr y 2-1 IT 5`L�a�y Ln •
WAIVER SECTION
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. (MUST INITIAL)
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature MIX- l F Z _ aAQAAJ
Print or Type Name
Zling Address
r'1 rvL 2'79Yy
City/State/Zip
2j L/ /4.r.Try liray19aoi.-C64K
Telephone Nu��JJber / email ad ss
S7ho i e
Date
(Adjacent Property Owner Information)
0 a
Signature*
�— 4--:� P—v 11,/k1 0 . F-,
Print or Type Name
Mailing Address
City/ tate/Zip
Telephone Number/email address
Date*
(Revised Feb 2017)
"Valid for one calendar year after signature"

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to STc V16 N E -TO aJ)tAhJ s
(Name of Property Applicant)
property located at LoyiyTi tu,re, 1-;, He,.t-P,,4 N4 - 2--71 s/y,
on 6//�� (Applicant's Address Lot, Block, Road, etc.)
,A h t, I , in rycr•-r� -.ci , N.C.
(Adjacent Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc
I have no objection to this proposal.
I have objections to this proposal.
You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909
If you have any questions you can call: 252-264-3901
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
J l lY VeiZu rc, � ✓l • C ad 1 CA G-2 hT 1 iDDe, / / " r .? ykiwy
(Property O*ner Information) (Adjacent Property Owner Information)
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f
Signature —mob• �I
� �� r la ..� Signature * 2
Print or Type Name Print r Type ame
11a�7�11 � ;r;
Mailing Address Mailing Address
tJ� ?fd �r f\C 2-t'i y y ,�n.� /Vt—
City/S_ tate/Zip City/State/Zip
ZJ _L G, / 17 "Jogg Qom/, (vd1% � / �12Kr) k4at) l L
Telephone Number / email address Telephone Nu ber / email addres akma; L . LAM
Date J� 11, °7y 1 q / Z�v (-!f T�/�—
Date
(Revised Feb 2017) "Form is valid for one calendar year after signature"

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ' ' c1�'-N E-TO R.DAK I s
(Name of Property Applicant)
property located at Ca Ve✓►Mtre, Lh iIe-r-"-P'op.( NL 2-26 5/Y'
(Applicant's Address Lot, Block, Road, etc.)
on h L � � , in Nc�t, N.C.
(Adjacent Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
�1( I have no objection to this proposal.
I have objections to this proposal.
You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909
If you have any questions you can call: 252-264-3901
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
re, � v-� .
(Property Owner Information)
�- a�a, - -
Signature
S9.,b If- !i►--�t-
5k0 -;e-' IhI-
ad ; a el.e h-T ),-ope
(Adjacent Property Owner Information)
Signature
VA _ RA r/© L' <
Print or Type Name Print or Type Name
I Le Ve- 0 —1, re Ln .
Mailing Address Mailing Address
1-4,-,-r-(o cl , ryc- 2:1"y y U fZ", r,)C- T 17;z
City/State/Zip City/State/Zip
Telephone Number /email address Telephone Number / email address
Date C, D t j Date * /011(
(Revised Feb 2017) *Form is valid for one calendar year after signature*

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