75641A_NCWRC_20191022

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7,CAMA / ;4 DREDGE & FILL NO. 75641
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GENERAL PERMIT Previous permit #
[XNew ]Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
0
70 150
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
71 Rules attached.
Applicant Name W e VV R '(r - Project Location: County Cho. JQ n
Address (` / d 0 0(, . ( S('Y" x 2. Cefi.1f' - Street Address/ State Road/ Lot #(s)
City__" (,e , q i State N e ZIP Encl r`r /ntJW4LN 7r
Phone # ( i�) 10 `l - prrS U E-Mail J9t r,. oQ r DI rinr @new, fc! i ,' Subdivision
Authorized Agent (,Ij � a C inn City is c;E n IJ n ZIP 2-6
3 Z.
Affected ❑ CW NEW ® PTA ❑ ES ❑ PTs Phone # ( — ) _ __ River Basin 1 If,
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AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body III Vic rr G r (-e S"ADJ "an
/unkn)
❑ PWS:
CC __
Closest Maj. Wtr. Body A( yr�CAr (f ��si4kd
ORW: yes / no PNA yes k no
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WVEWEIIIIEIIWMEM ow■ 11�1�!■
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Agent or Applicant Printed Name ,
zi i'oy /�
Signatur ' ** Please read compliance statement on back of permit
Application Fee(s) Check #
�\ rJ t� t G
Permit0 er's printed Name /?
L/'! d U f
Signature
w/N�/19 �2 z�1 _
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/ 1-888-4RCOAST 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: NCV%I IR C Permit #:
Date:
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
Habitat Name DISTURB
TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
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
tem imacts
im act amount
tempim acts
amount
SIt� 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 n
Both n
Other M
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.nccoastalmanagement.net revised: 02/03/10

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: ^LI)'A Lae-
IVC�i`Jt,%cc�
Mailing address: YQ").�
Telephone Number: Z-)- D 1 S
I certify that I have authorized V `) C (agent/contractor),
to act on my behalf, for the purpose of applying andobtainingall CAMA permits
necessary for the proposed development of c-\ (�'S Sn' Axzc.JS t .,Ij
at my property located at
This certification is valid through Ohs' L f a (date).
(Pr party caner Information)
Signature
P nt or Type Name
c,n¢n.� •ram 4�k� •�
Title, co. owner dr1rustee for property
�)Ja\) Ig
Date
q 15-- "1 o1SO
Telephone Number
soroew Q i(1 C c �• 1 cX
Address

DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTfFIED MAiL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to as•$ tt*�,.� Wti-Je-- 's
(Name of Property Owner)
property located at
(Project Site: Address, Lot, Block, Road, etc.)
on inN.C-
(Waterbody) (City/Town andlor County)
Agent's Name #: 1 t!Cyv L t .� e_ _ Mailing Address: Y.O. �-,6-Laan
Agent's phone #: Q- 49D, tbrtt E&n'ba— 1V3Ic- -XI qz �-
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
---------------------------- ----------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual propdsfng development must fiffin description below.or attach a site drawing)
if you have objections to what is being proposed, you must notify the Division ofCoastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 1367 US
17 South, Elizabeth City, NC, 27909. DCM representatives can also be contacted at [phone]. No
response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information) (Adjacent r terty�Owne�ln;,
t�ftn� UC .
Srgnat Sign ure'
/� t1f-6 a
U-) Q . C. - (�r''�� +1r`� _ � e) � . Ch4IC t &rJQ 161G C...Ql+ hvl L V
Print or Type Name Fri t or Type Name
%'I a p tC �\ Se,T %C,. Ce.-key
Mailing Address
1e 's-, N-C-
CitylStatelzip
�-6116 - 44s'c�
Telephone Number l Email Address
lb/a) I / a
Date
"Valid for one calendar year after signature'
N L masi pt: 90"
Mailing Address
C4 rs N C Z �j'JZ
Citylstate7Zi
Z5Z-348-36�P0
Telephone Numberl Email Address
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Da

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to -Fl.,e -R. o Q M-,d�t C.%
(Name of Property Owner)
property located at T1Ne.. �Svcc�- 4-c.. P fie. :54 .Ir;.�.•.w.�
(Project Site: Address, Lot, Block, Road, etc.)
on---Psl�oc vn. \t in c r,�w� % Che�.,e..� N.C.
(Waterbody) (Clty/Town and/or County)
Agent's Name #: terry Mailing Address; P.C. 8c,4 a31
Agent's phone #: 9-c - L123-.�- IAO' Xk Ede. fix- aig3 2,
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
-------------------------------------------------------------------------------------------------- ------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fNf in description below or attach a site drawing)
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 1367 US
17 South, Elizabeth City, NC, 27909. DCM representatives can also be contactedat [phone]. No
raqponse Is considered the same as no objection /f you have been notified by Certified Mail
(Property Owner Information)
h4--
Signature -
�. R. C.
Print or Type Name
Mailing Address
CitylState) if p
aSZ-('r0-yysC
Telephone Number/Email Address
Date
'Valid for one calendar year after signature"
(Adjacent Prop Owner Information)
S' n t
Print or Type Name TL` UI
Mailing Address
�ls�`1c�ce NL 2gz\yy
city/state/Zip
-ZSZ--9$Z--7588/bjayr►'yC'��baA./.cdo�>�. �,,•7
Telephone Number/Email Address
jai zt I I G
Date*

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that 1 own property adjacent to -e_ th,;"
(N !me of Property Owner)
property located at `�'�� ��t �C tip CL� m%A W" &kolt-
7 / - — ,-- ,
(Project Site: Address, Lot, Block, Road, etc.)
on A&eMi-41 1:!Sav41,L in f'a�^1W n`l f Cho w , N.C.
(Waterbody) (City/Town and/or Co nt
Agent's Name #: ` bae �.r,;,,�-t Mailing Address: P.
Agent's phone #:—,,So1_ 4,g�r ^►O'11 _ ��t+bgw� "�. C. �'143'L _ ,v
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He/She has described tome as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
W1v1duW4vqpoaft dawe/opment must ffil'ln dssc*tb >! below -or °?.thcb a xNe drawlnW
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(OCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 1367 US
17 South, Elizabeth City, NC, 27909. DCM representatives can also be contactedat [phone]. No
response is considered the same as no objection if you have been notified by Certified Mail
(Property Owner Information)
r kJ6
Signatur
1. Co,— L %47-r-t- Q�)
Print or Type Name
Malting Address
jQ . C. Vl(04q- ►-12U
City/State& p
%CC - -lon - 615y
Telephone Number/Email Address
/opli gal
Date
`Valid for one calendar year after signature'
(Adjacent Property Owner Information)
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Print or Type Name
Mailing Address
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Legend

iEINT
AMA / is (DREDGE & FILL r- " - -' '- (DB C D
NERAL PERMIT Previous permit# jModification ElComplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
les attached.
Applicant Name Nt'yj"'
Address j`?Z-L) Ab, It 10 #° L f f1 [ L
City�� :j t State_a,} ZIP
Phone# (It;i) Ljt: -- q q S -E-Mail
Authorized Agent
Affected ❑ Cw XEW O(PTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS:
ORW: yes / no
PNA yes /, no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Project Location: County_ t. - -� i ,
Street Address/ State Road/ Lot #(s)
Subdivision A
City �..t,t'.i ZIP_ -Z_
Phone # ( ) River Basin HA ,4'r_ s
Adj. Wtr. Body & tif-.� r1 ty43' r -� � "; /m�_an /unkn)
Closest Maj. Wtr. Body , , i
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building p.. ,L. —
( Note Local Planning Jurisdiction�-­N----,
-Notes/ Special Conditions
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit*
AnnlirationFee/cl
+ ti' i�Ef�
Permit Officer's Printed Nam
Signature