73820A_Humphrey, Daniel_20190919

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-. JCAMA / , V Rw DREDGE & FILL No. 73820 V g C D
GENERAL PERMIT Previous permit#
New El Modification ❑Complete Reissue ❑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 N . 1100
❑ Rules attached.
Applicant Name bco%tk Iry u2hee
Address KL NtL44 of'.. K.Vtr Q c,
CityV,.�ti tom, h State VA ZIP �3LIS�
Phone # (—) E-Mail —
Authorized Agent _&C ►3„ It IV-, cl S
Affected ❑ CW [YE PTA XES APTS
AEC(s): ElOEA ❑ HHF ❑ IH ElUBA ElN/A
❑ PWS:
ORW: yes / PNA yes
Project Location: County ., r . A � c k
Street Address/ State Road/ Lot #(s) 4 t7 j 5,,o je c4
Lu4 q-i s,_J. to
Subdivision Corovc i3tcc r.�
City imt 0 1\4 _ ZIP ?-4'i Z'}
Phone # ( ) River Basin cs it k
Adj. Wtr. Body C.. nc 1 4,? K fv1 tS T% t1c,l (nat /unkn)
Closest Maj. Wtr. Body l r �c k !Sx�)"e CA
Type of Project/ Activity Ntw ►311KA-L& 1 a,. UC ,ee&r,.cd cIrr,11 SAp/cIIM 8 124-4""r �
(Scale: �' = AU
Pier (
Fixe<
Float
Fingr
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Basir
Boat
Boat
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Phot
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avg distance offshore ;1,
max distance offshore -
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A building permit may be required by: k ❑ See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions ('12 D A�,, A TaAdl-L rr, b,sLe/ bi.,LA /rn , i-c r' -40 "aO j cr1c,k,c i� u�
A
or
Signature ** Please read compliance statement on back of permit'"
Application Fee(s) Check #
Pe ' Officer's Printed Names --
Signature
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 1) 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/ 1-888ARCOAST 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

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: N J,ti.�il/ t�� n, t I Permit #: 3 R,4,0 A
Date— 19. 11
Describe belo'N 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)
.5
Dredge ❑ Fill Both ❑ Other ❑
5ha r
Dredge ❑ Fill [A Both ❑ Other ❑
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too
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Dredge ❑ Fill ❑ Both ❑ Other
Wo
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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: j Y
Mailing Address: hgei Tyr �d
1-11
Phone Number: %�5�- 4- .3 _ /22-7
Email Address: I/r:4; e �/1412WS RA C"2 C26-7
I certify that I have authorized f�ti C�
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
t :-�-
'41 24xZ 4 /J�z�f -�� -se-
at my property located at Z/6<-:;-
in L91714DCL County.
I furthermore certify that I am authorized to grant, and do in tact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
d l�L_I ► �l _
Date
This certification is valid through //l I> / / /,/

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ocA Y11� 1 �Y(� �1 °��j 's
(Name of Property Owner)
property located at _ _ 14O S 5 t oA *y �-P d
(Lot, Block, Road, etc.)
on C0i' --4u A-- 50 uv\e , in (orr o N.C.
(Waterbody) (Town and/or County) t
Applicant's phone #:75-2 7)
ZP—(6ZI- Mailing Address: 166 4'ir?a e-o,iv Ct
( & j roc 27%757
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
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U kv was" S �-�et Ywtchime t i`�a✓k�✓
----------------- ------------- ----__--___________-------------------------------------
(Information for Property Owner Applying (Riparian Pr perry Owner Information)
for Permit)
` 4.
Mailing Address Signature
0-ty n(c fB4r ch 014
Citytate/Zip Print or Type Name
7,S�7 - `t 3y - 2C)it
Tel one Number Telephone Number
Signature Date Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to V11-0- s
(Name of Property Owner)
property located at q o S .5 c,34 * v l? a .
(Lot, Block, Road, etc.)
on Cir, Au CV SU ur�1 /
, in (ov .:) 1 I Ct. , N.C.
(Waterbody)
(Town and/or County)
Applicant's phone #: 7�;-2 -7,S7-V17- c Mailing Address: xx A0-e`w.1C d -
d-Q- i 4 ,I( ;t-i53 -5r
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
a
y &1 Sc
(Information for Property Owner Applying
for Permit)
W.
Mailing Address
CY�nic 4C-4h 014 a3%S-7
City tate/Zip
Tel one Number
Signature Date
4e3 5�
�•l Cht�sz � • f ��'kc✓
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
- 57 9- o 63S
Date

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