75633A_Hewitt, Carlton_20191030

-i DREDGE &FILL
VCAMA /
GENERAL PERMIT
New Modification -Complete Reissue
No. 75633 B C D
Previous permit # �SGI
❑Partial Reissue Date previous permit issued IC- GI -
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
E2Rules attached.
Applicant Name ��'
a f ) -iT"^ or%,' I
Address it Q0 TQ I I )C, r P LN
CItty , -i .-f — ' l Ol c S Stated ZIP_
Phone # ( ) S , -or.) Ci E-Mail aJ 6'J V.;s�c.�L
Authorized Agent `7; n, kgr� ( cn5�4i4cL, UV
ElCw
❑ EW 6d'PTA ❑ ES rAPTS
Affected
A
ElOEA
❑ HHF ❑ IH El URA El N/A
Affecte
❑ PWS:
ORW: yes / no)
PNA yes I�L�
Type of Project/ Activity Ai-( 7 S x ly
W,(dock) length X �$
Fixed Platform(s)
Floating Platform(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshon
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bul
Other
Project Location: County )If e
Street Address/ State Road/ Lot #(s)
Subdivision
City ---I ShU' C's ZIP a-7Jg9
Phone # ('—) — River Basin PQqx" 4a. %
16
Adj. Wtr. Body �,.r 1 {, , &(, C 1EAL (natnat /�)
Closest Maj. Wtr. Body Cr-' 1 LX k (�d--
Shoreline Length t Z
SAV: not sure yes no -
Moratorium: n/a yes no
Photos: yei no
Waiver Attached: yes no
A building permit may be required by: �{ '� lt;�fr` S�.C? f P S
( Note Local Planning jurisdiction)
Notes/ Special Conditions
/ `.y) d-th V ) -e P S
Agent or Ap#cant Printed Dame
i
�\
Signature "Please read compliance statement on back of permit"
� c ex"
Application Fee(s) Check #
KC)
(Scale: j I i- 3 G
❑ See note on back regarding River Basin rules.
Pr,rmit Of icer's rinted,Nam
nature
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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: j "-Aj-tm
Mailing Address:
Phone Number: (-),5r� S )-D o b I c)
Email Address:
I certify that I have authori
Agent /
to act on my behalf, for the purpose of applying for and //obtaining all CAMA permits
necessary for the following proposed development: W
/1\ A
at my property located at
in " County.
1 furthermore certify that 1 am authorized to grant, and do in fact 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:
Signature
Print or Type Name
Title
Date
This certification is valid through I I
C L-C

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER ON/WAIVER FORM
Name of Property Owner_
Address of Property:
(Lot or Street #, Street
Agent's Name #.
Agent's phone #: �6 D 4-(0 3 12 (-1 3
Road, City & County)
Mailing Address: •
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.
/J
✓ 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, Contact information for DCM offices is
available athttp;i/www.nccoastalmanapement nethveb/cm/staff listinv orby calling 1-888,4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Marl
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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)
Signature
K%ZL # Wi%/
Pnnt or Type Name
_/2-0 1�1rl R,1VE /A-vC
Mailing Address
SUu-fI4vN xx Z% /
City/State2ip
0 -- o c, 10 rh)L
lit fiSi( �s .cv�
Telephone Number/Email Address
Date
(R- rian PrOP01V Ow In ation) w
Si ature
Joe( R It:,, dO Ie
Print or Type Name
170 L 4.,,, e
Mailing Address ,
So r«latrh .5� 4Po e 5 Z7�1%
City/State/Lip
703--94Y-7637 j i�t`il,��•lertr� �
Telephone Number/Email dress / / ° na
Date
(Revised Aug. 2014)

01�I Mql� ' 'ET�R
CE T iriCu i� TtIRLIESTED
CTw
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street
Agent's Name #-,
Agent's phone #:
City & County)
Mailing Address: I ?
1M � Y�r
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 roposing. A description or drawing with dimensions must be arovid ' h thisletter.
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. Contact information for DCM offices is
available athttp.lAvww.nccoastaimanaaement net(web/cm/staff listinv or by calling 1-888-4RCOAST. No response Is considered the same as no objection /f you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 InMal 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)
Signature
(_�r�✓�L 1� -w; rr
Print or Type Name
_I ZO r_41 i P) A/C L4 AAE—
Mailing Address
S kirltr72N _,f,,2Es /VC
City/State/Zip
75 l 5l0 0(p /o CA)P— Cc d64 S iows
Telephone Number/ Email Address
Date
(Riparian Property Owner Informatiod)
PaturePrint r Type Name
9
93 Clew,,ne-n't 14t/e_
Mailing Address
Wes1t �3Q��/� i
City/State/Zip
cv.,.5/G �32 �✓ne.,r-a � 70Jhca.c
�vn
Telephone Mum ber/Email Address
/ `9Ap
Date
(Revised Aug. 2014)

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Page 1 o
ire County Parcel Data
This map is prepared
from data used for the
© D3re inventory of the real
property for tax
purposes Primary
information sources such
corded deeds, plats
wills and other primary
public records should be
consulted for—ficanon
of the information
contained in this map
99 S UI
Southern SI
Parcel:
Pin: 98
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fd TRL Owners. Hewitt, Carlton Primary Tax District: Southern Shores
NC, 27949 rltvne Sub& eson: So/sh 114-117 126,127 200-
0 202
66371 Building Value: $0 Lot BLK-Sec: Lot: 7 Blk: 115 Sec:
Land Value: $145,400 Property Use: Vacant Land (Private)
Misc Value: SO'
Type:
Total Value: $145,400 Year Built
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ps://maps.darecountync.gov/ie-users/ 10/9/20

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This map is prepared
99 S Dogwood T
from data used for the
•� �' { )�, inventory of the real
Southern Shores NC,
�j property for tax
�� 7r Primary
Parcel: 0222960
purposes.
Pin: 9867102663
information sources such
as recorded deeds, plats,
�^ wills, and other primary
-� public records should be
consulted for verification
of the information
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RL Owners: Hewitt, Carlton D -Primary Tax District: Southern Shores •
27949 Owner Subdivision: So/sh 114-117 126,127 200
00 202' _
71 Building Value: $0 Lot BLK-Sec: Lot: 7 Blk: 115 Sec:
Land Value: $145,400 Property Use: Vacant Land (Private)
Misc Value: $0 Building Type: » t
Total Value: $145,400 Year Built:

NC Division of Coastal Mgt- Habitat impact Computer Sheet
Applicant: 1- "cam i Permit #: S 6 � 3
Date: to / 3 ' /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.
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
ternimpacts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
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