72427_Daniel Rascoe_20190814

• CAMA/ DREDGE & FILL
(Dy(DX No. 72427 A B C D
GENERAL PERMIT Previous permit#
�� = NNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued_AI/f
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 5A NCAC O70. 1100 .
-I E Rules attached.
Applicant Name L A/' 1 EL PA$CO j Project Location: County Pig!'(t CO 61 ti rV
Address JO id/ f AU rN) le pc ie j Jz'. Street Address/State Road/Lot#(s) 4 D.YACEN r CV '?
City FA) Ei{Jf State tsk- ZIP ;7 Iy .SDuvL�ti,l- Pi)
Phone#(9A ) 8 t17 '3DB,5 E-Mail Subdivision 5014 Alb S)D k
Authorized Agent City [.Ol j4 M k 1 A ZIP 2 75'2 r
Affected __cw PTA As 1 rrs Phone# ( )/n/ River Basin P/15 Q f,o TAN/L
AEC(s): OEA HHF -IH ❑UBA ❑N/A Adj.Wtr. Body /1 C it.Nl'g I I SG(AND ( a)man /unkn)
Pws: ^ i 4 g t L o.^N 0
ORW: yes I no, PNA yes / no Closest Maj.Wtr. Body AC04
7
Type of Project/Activity 0 la ' FIA L 1C !FA!)
(Scale: //i / )
Pier(dock)length `- ' 30
Fixed Platform(s) - I A
I !
Floating Platform(s)
Finger pier(s)
Groin length . I -
Bulkhepraplength_
- avg distance offshore t ' 4
max distance offshore ,S j C�1t �0 �1.)`1
Basin,channel ,` j - L
�j
. - `F
cubic yards —
J Boat ramp I
i 1
Boathouse/Boatlift .
Beach Bulldozing T
Other f
d 'I .a• • :
Shoreline Lengt _?O III
/ gt.iti h
SAV: not sure yes no � 1 b 1 ,/
//,� Ras Co PAPt i `
Moratorium. n/a yes �a�
Photos: yes ® i -
Waiver Attached: yes no
•
A building permit may be required by: -TreI (.L C 0..N T/ . ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 5 f I 070.i100 C o/V r; /-l0N>. /1 I r6j/t1M J.v r P 412 KL.V c}/////1
1?y J:i7/
A„ 4 %< A 5(o r ) v,,J /lMRi
plicant Printed Name Permit Officer's?rinted Name
0(1)/16_I j0_, _ -
Signature **Please read compliance statement on back of permit** Signature
-(0). oa )V ALf6 Zolg IV U1( z0/7
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 (252-946-648I) 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 Mal!
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

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: n A „J t✓L 4 _ /'� f}sc,0c
l `
Address of Property: I-OG4.IW OOkIc jt E 141- OLvr,41314 .N C_
(Lot or Street#, Street or Road, City & County)
Agent's Name #: Mailing Address:
Agent's phone #:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
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 943 Washington Square
Mall, Washington, NC, 27889. DCM representatives can also be contacted at(252) 946-6481. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
(Property Owner Information) (Adjacent Pro Owner In rmation)
Signature Signatu e
.Z
Print or Type Name Print or Type Name /
q J
Mailing Address Mailing Address
674_,9 FAQ i�- .
City/State/Zip City/State/Zip
oZ g � e(6
Telephone Number Telephone Number
6 - 3
Date Date
Revi /18/2012

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Applicant: MI C t`A S C G,E
Date: J(1 41.4C, ZO/
General Permit#: Z LiZ 7-n
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) ipact amount) temp impacts) amount)
f5 No 2 Cc(NE Dredge❑ Fill 0 Both ❑ Other ❑ l a F 7
- 1`I I(,N G4110 Dredge❑ Fill Both ❑ Other tor II -
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge 0 Fill 0 Both ❑ Other ❑
Dredge❑ Fill 0 Both ❑ Other 0
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge 0 Fill 0 Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill 0 Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑