73043_Archi "corkey" Pentz_20190518

erCAMA /X DREDGE & FILL .D V lob 33Y No. 73043 / �a
GENERAL PERMIT Previous permit#/(/` c °
)C,XNew ...]Modification C Complete Reissue D Partial Reissue Date previous permit'issued
• As authorized by the State of North Carolina,Department of Environmental Quality u `
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC //• /r • ' .
;, Rules ttached.
Applicant Name it"n /e / / /���� Project Location: County //-. �C.
Address ! ' n• // k //�. Street Addres /State Road/Lot#(s) J . U�(^)
City r! re--71 ,/r c' State/Si( ZIP /( ( )
Phone#OQ)* % 4_Mail i Subdivision / 4
Authorized Agent <:_'. ,,// \26X', re>9.--) City ( (C-1/(X'P ZIP ,/ �d&/(.
)
Affected a CW 4EW *PTA ,r P S TS Phone# ( ) ...--__ / River Basin
AEC(s): OEA ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body 74�1 nat1/eft an /unkn)
PWS:
ORW: yes / PNA yes /moo / Closest Maj.Wtr. Body
)�I� 1p a i���
Type of Project/Activity ;/fI r, fl #C� 4,/ G7:3, / f1 / !1!'///4`ham'!
(Scale: ' -:S 7 )
Pier(dock)length
Fixed Platform(s) r •
Floating Platform(s)
Finger pier(s) /
Groin length I i
.......
number _/ C .y ,/^,
Bulkhead/Riprap length 04.� / �" "_" I I
avg distance offshore-4/� i
max distance offshore 9 v I I t Nt..,7,._ hi ' )
Basin,channel -, --
--. I —
cubic yards 1-
Boat ramp_
i
Boathouse/Boatlift
l-
Beach Bulldozing- G
Other ., t-� i
it.
— . Aoti,.. 160.?4f
Shoreline Length- -0 p��
SAV: not sure yes n j - ,�//� l �11�"/Y"� j GtUseeri Vp
G ---- I
._T.._._ I .41> Af-3/ I i
Moratorium: n/a ye no �J i _ ; -
Waiver Attached: y no ' 1 i t I I ( '
Photos: �esi� � i ;
— �-
yesI I
A building permit may be required by: (/1.)G ap e note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) / // ). -,-_J
//Notes/Special Conditions � - ,))`may (e, -)j�, 7.� 2f
7- (1.- .-'/' /j
Agent o t Printe• Name ...... _ ..„.
x VIM. Perm ffi is Pri Nam
iii
„.. , ,i,
Signature PI a r-... mpliance statement on ba •f permit ° Signa ure
Ap ication 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 Headquarter_s 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 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
P P
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(10dividual-Prflp+isi g teE elopmet** fit I m desciWei belour train a site drawing)
'tc" 1 T`
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 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr erty Owner I on) r ( •'a•0 t Prope Owner Information)
Si n to eV-Cl4 I i Z . Si_'�a freecm:5.6 G.6
„pis- Name , Print or T Name
kqf
�ooc c LA)
Maigqg � Mailingro5�� �I
City/State/Zip City/ tate/Zip
Tele ho a Number/e ail dress Telephone.. Number/email add
p �- a - ©I ✓ v 5/ 3
Date Date* /, Z 1� 8
(`j (Revised Aug. 2014)
*Valid for one calendar year after signature*

A

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to # t'E r 's
(Nape of Prope Owner)
property located at 464- 7 DO 7c�:(�n�L f 7
Address, Lot, Bt k, Road, etc.)
on 1` fivr?L-iG0 �� U � , in K� , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
V I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
infe
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 do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner I t.. - 'on) (Adjacent Property Ow r Information)
.�-�!7O9;77J
Sit-1V-e H l� c7P 1 i Sys l cmtncJ
PI 1 �Ty a Name Prin 5 pe the
`'1' o x I l(o f" '
Mai Ag ddr j CC O� a �c� Mailing Address 2 7/ —?
City/State/ZipCit($ e/Zipt
a5 - 9�-� 9o54 9 -B 1-4,11 31@7 •cam
Telephone Numbej/rri address Telephone Number/email address
Date Date*
(Revised Aug. 2014)
*1/nliil fnr nnea cinnob,re,*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to fire-c i� PL1117-2-- 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on , in , 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 diV kM1 rnpos r devel o
P _ opment rrausf fill in b(escriptoit-below or attacli�a site drawing)
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 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)
Signature Signature*
Print or Type Name Print or Type Name
Mailing Address Mailing Address
City/State/Zip City/State/Zip
Telephone Number/email address Telephone Number/email address
Date Date*
(Revised Aug. 2014)
*\ fnr nno nolonrlor,,nor ofFor cinnof,,ro*

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NC Division of Coastal Mgt, Habitat Impact Computer Sheet
Applicant: /gr ..4 N (o•/ - '', {
Date: /5 acR /
General Permit#: 930 V3
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 restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
Dredge❑ Fill❑ Both ❑ Other ❑ - -
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
• Dredge 0 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 0 Both 0 Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
• Dredge❑ Fill❑ Both ❑ Other 0
•
252-808-2308 1-888-4RCDAS.r unrar:oc::la5tairr,arac3amer^;.n : 024)3,'10