73854A_NCDOT_20191121

r
uCAMA / Lf DREDGE & FILL NO. 73854 A B C D
GENERAL PERMIT Previous permit #
S(New JModification ❑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 I SA NCAC
71 Rules attached.
Applicant Name �J C C Orr
Address ) )3
A)f—P''QT 9,)
. SyiT1 100
City �CF'�'S
State NL ZIP 0)7017k
Phone # E-Mail
ma c„' P n��.� . qt'I
Authorized Agent
Affected ❑ CW
❑ EW R"A
❑ ES OTS
AEC(s): ❑ OEA
LHHF ❑ IH
❑ UBA ❑ N/A
C PWS:
ORW: yes / r PNA yes / no
Project Location: County f .417f7%.
Street Address/ State Road/ Lot #(s)
'f v�l►�F,�S �p .
Subdivision
City ZIP e
pp p�
Phone # ( ) —" River Basin Tf ."T1 ti
Adj. Wtr. Bod N <. T14t, C&, at man nkn
Closest Maj. Wtr. Body
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MENOMINEE
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STf J f- TQi,V,/F L
Agent App' ant PH Name
Sig ature Please read compliance statement on back of permit **
w? s� 1. 119411
Application Fee(s) Check #
Permit Officer's Printed Name
Signature
" (, 11 7b, O
Issui g Date Exp tion Date
. 7..

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/ 1-888ARCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth Ciq 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: NC Department of Transportation Permit #: 73854
Date: 12/20/2019
Project: Shoreline stabilization
SR 1232 (Poyners Rd.)
Moyock, Currituck Co.
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
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
Shoreline
Dredge ❑ Fill ® Both ❑ Other ❑
—impact
210
210
Shallow Bottom
Dredge ❑ Fill ® Both ❑ Other ❑
1,491
1,491
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST c: wwvv.nccoa ta#manp_q ri,,,net revised.02/03/10

AMEMORANDUM
TO: Jessica Gibson, Business Officer, Morehead City
FROM: Greg Daisey, DOT Project Field Representative, Elizabeth City
DATE: 12/20/2019
SUBJECT: Debit to NCDOT's Account for a CAMA Permit
Please debit DOT's account in the amount of 400 for the following CAMA
permit request:
Project: Shoreline stabilization on SR 1232 (Poyners Rd.) in Moyock.
County: Currituck
Transportation Improvement Project (TIP) No.: N/A
WBS Element No.: 1.102711
General Permit No.: 73854
Major Permit: N/A
Fee Division
DCM: (100%)
DWQ: (0%)
Please contact our office if you need further information.
Thank you.
Cc: Ella Godfrey

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
November 11, 2019
Greg Daisy
NC Division of Coastal Management
401 S. Griffin St., Ste. 300
Elizabeth City, NC 27909
Received
NU12410
DMEC
JAMES H. TRomom III
SECRETARY
Subject: Request for a CAMA General Permit for riprap stabilization along SR 1232 Poyners
Road adjacent a man made canal off Tull Creek near Moyok in Currituck County. WBS #
1.202711.
Dear Mr. Daisey,
The North Carolina Department of Transportation is requesting the issuance of a GP
.1100 permit for the repair and stabilization of the road shoulder along SR 1232 Poyners Road
adjacent a man made canal off Tull Creek near Moyok in Currituck County. Approximately 210'
of road shoulder will be stabilized with class B riprap. I am available to meet with you to stake
the alignment per the attached drawing and obtain the necessary CAMA/Dredge and Fill General
permit.
Included with this letter are the location map, permit drawings, MP -I and MP-2 forms
and adjacent landowner notice cards/statements. If you have questions, please contact Steve
Trowell at [e-mail] or [phone]. The permit fee can be charged to WBS #
1.102711.
Mading Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION ONE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932
Sincerely,
Jerry Jennings, P.E.
Division One Engi r
Steve Trowell
Division One Environmental Specialist II
Telephone: [phone]
Fox. [phone]
Customer Service: 1-977-3684968
Website: www.ncdot.gov
Location:
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932

Road Shoulder Repair and Stabilization on SR 1232
Poyners Road
Currituck County Quad Name Currituck
0.5
eveived
nrm_rr

Gem MP-1 Nov 1) 4
APPLICATION for
major nevolopment Permit
(last revised 12127iO6)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
N.C. Department Of Transportation
Project Name (if applicable)
SR 1232 - Shoreline Stabilization
Applicant 1: First Name
Stevel
MI
J
Last Name
Trowell
Applicant 2: First Name
Mt
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
113 Airport Raod
PO Box
City
Edenton
State
NC
ZIP
27932
Country
USA
Phone No.
252 - 482 -1861 ext.
FAX No.
252 - 482 - 8722
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
2. AgentlContractor Information
Business Name
Agent/ Contractor 1: First Name
MI
Last Name
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
-
ext.
Phone No. 2
- ext.
FAX No.
Contractor #
Street Address (if different from above)
Cfty
State
ZIP
Email
<Form continues on back>
252-808-2808 :. 1-888-4RCOAST :- www.nccoastalmanagement.net

Form DCM MP-1 (Page 2 of 5)
APPLICATION for
Major Development Permit
I Project Location
County (can be multiple)
Street Address
State Rd. #
Currituck
SR 1232 Poyners Road
NG-et5
Subdivision Name
city
State
Zip
Moyock
NC
27958 -
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - ext.
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Pasquotank
Tull Creek
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
®Natural ❑Manmade ❑Unknown
Currituck Sound
f. If applicable, list the planning jurisdiction or city limit the proposed
e. Is proposed work within city limits or planning jurisdiction?
®Yes ❑No
work falls within.
Currituck County
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
500"
10,000 ft2
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level)
(if many lot sizes, please attach additional page with a list)
2.5 ❑NHW or ®NWL
e. Vegetation on tract
Various roadside grasses on a maintained shoulder.
f. Man-made features and uses now on tract
SR 1232 and man made borrow canal.
g. Identity and describe the existing land uses adiacent to the proposed project site.
Mackay Island National Wildlife Refuge, conservation
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
Institutional/Conservation
(Attach zoning compliance certificate, if applicable)
❑Yes ❑No ®NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes ®No
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes ONo ❑NA
If yes, by whom?
I. Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes ®No ❑NA
National Register listed or eligible property?
<Form continues on next page>
m. i re there wetlands on the site? —DYWS ®No
(ii) Are there coastal wetlands on the site? []Yes ®No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? []Yes ®No
(Attach documentation, if available)
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Form DCM MP-1 (Page 3 of 5) APPLICATION for
'Received Major Development Permit
n. Describe existing wastewater treatment facilities.
None �,JV 12 tilj9
o. Describe existing drinking water supply source.
None
p. Describe existing storm water management or treatment systems.
None
5. Activities and Impacts
a. WIII the project be for commercial, public, or private use? ❑Commercial ®PubliGGovernment
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The purpose of this project is to repair and stabilize the road shoulder to improve saftey to the traveling public.
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
Stabilize the eroding road shoulder along SR 1232 using class II granite to construct a riprap revement while maintaining a
minimum 4' wide grassed shoulder. An excavator, dump trucks, rubber tire back hoe or track loader will be utilized.
d. List all development activities you propose.
Proposed to stabilize eroding road shoulder by constructing a ripa rap revetment.
e. Are the proposed activities maintenance of an existing project, new work, or both? Both
f. What is the approximate total disturbed land area resulting from the proposed project? 1,500 ft2 ®Sq.Ft or []Acres
g. Will the proposed project encroach on any public easement, public accessway or other area []Yes ®No ❑NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
Surface runoff from SR 1232,
i. Will wastewater or stormwater be discharged into a wetland? ❑Yes ®No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes []No ®NA
j. Is there any mitigation proposed? ❑Yes ®No ❑NA
If yes, attach a mitigation proposal,
<Form continues on back>
6. Additional Information
In addition to this completed application form, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (t) are always applicable to any major development application. Please consult the application
instruction booklet on how to property prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A she or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
252-808-2808 . I.888-4RCOAS1 .. www.necoastaimanagement.net

Form DCM MP-1 (Page 4 of 5)
APPLICATION for
Major Development Permit
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
—CA list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name Ben Stikeleather, Currituck County Manager
Phone No. [phone]
Address 153 Courthouse Road, Suite 204, Currituck, North Carolina 27929
Name NC WRC c/o William Ridgeway
Phone No. [phone]
Address 1133 Don Juan Road, Hertford, NC 27944
Name
Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
I. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
- _..... _ ....
statement of compliance with the N.C. Environmental Policy Act (N C G—.S. 113A 1-10), if necessary. If the project involves _--__exp.-.endit__-_._--ure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
Gertification and Permission to Enter on Land _...__ _ _ .1_ —�
I understand that any permit issued in response to this application will allow only the development
The project will be subject to the conditions and restrictions contained in the permit,
in the application.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date 11 November 2019 Print Name ev low , Di ision Environm tit Specialist
Signature
Please indicate application attachments pertaining to your proposed project.
®DCM MP-2 Excavation and Fill Information ❑DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information
252-808-2808 .- 1-888-4RCOAST .. www.nccoastalmanagement.net

Form DCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet
Access
Other
Channel
(NLW or
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
(excluding
Breakwater
shoreline
NWL)
stabilization
Length
Width
Avg. Existing
Depth
NA
NA
Final Project
_
�_
._ _
.. — . ........
Depth
NA
NA
I t
EXCAVATION
®This section not applicable
a.
Amount of material to be excavated from below NHW or NWL in
b. Type of material to be excavated. —
cubic yards.
c.
d. High -ground excavation in cubic yards.
(i) Does the area to be excavated include coastal wedandshnarsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
2.
DISPOSAL OF EXCAVATED MATERIAL
®This section not applicable
a.
Location of disposal area.
b. Dimensions of disposal area.
c.
(1) Do you claim title to disposal area?
d. (i) Will a disposal area be available for future maintenance?
❑Yes ❑No ❑NA
❑Yes []No ❑NA
(ii) If no, attach a letter granting permission from the owner.
(ii) If yes, where?
e.
(i) Does the disposal area include any coastal wetlands/marsh
f. (i) Does the disposal include any area in the water?
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
❑Yes ❑No ❑NA
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
(h) If yes, how much water area is affected?
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of disposal in these areas.
252-808-2808 1-888-4RCOAST „: www.nccoas#alman�t net revised: 12/26/06

Form DCM MP-1 (Page 5 of 5)
APPLICATION for
Major Development Permit
Received
l:5V 12 2019
DMEC
252-848-2808 .. 1-888-4RCOAST :. www.nccoastaimanagement.net

Form DCM MP-2 (Excavation and Fill, Page 2 of 2)
3. SHORELINE STABILIZATION ❑This section not applicable
(if development is a wood groin, use MP-4 - Structures)
a. Type of shoreline stabilization: b. Length: 210"
LJBulkhead WRiprap ❑BreakwaterlSill []Other:
Width: 6'-10'
c. Average distance waterward of NHW or NWL: 9' d. Maximum distance waterward of NHW or NWL. 10'
e. Type of stabilization material: f. (i) Has there been shoreline erosion during preceding 12
Class 11 rip rap months?
®Yes []No ❑NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
Unknown
g. Number of square feet of fill to be placed below water level. h. Type of fill material. Wana h lip
Bulkhead backfill 478 ft= Riprap 1,013�ft' Granite Class II rip rap
Breakwater/Sill Other (; V 12 LI
i. Source of fill material. quarry
D r V M-E'
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a, (i) Will fill material be brought to the site? ❑Yes ®No []NA b. (i) Will fill material be placed in coastal vretiantiRrmarct, ir•un
It yes,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
submerged aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL []None
(ii) Describe the purpose of the fill in these areas:
L 5. GENERAL
a. How will excavated or fill material be kept on site and erosion b. eorf construction
equipment
men
controlled? twill be used (e.g., dragllne,
ackhce
Using NCDOT Best Management Practices for soil and erosion tracked excavator, backhoe, track loader and dump truck
control.
C. (1) Will navigational aids be required as a result of the project? d. (i) Will wetlands be crossed in transporting equipment to project
❑Yes ®No ❑NA site? ❑Yes ®No ❑NA
(ii) 1f yes, explain what type and how they will be implemented. (ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
11 November 2019
Date plicant
SR 1232 - Shoreline Stabilization
plicant Signature
Project Name
Steve Trowell, Environmental Specialist
252-808-2808 :: 1-888-4RCOAST :: ynMW4Wc9ss_.laltnanaaement nst nw 1

J
TO HWY 168
EXISTING RIP RAP\
NORMAL WATER LEVEL
Received
20' 20' 0'20'
GRAPHIC SCALE
EXI T R/W
SR 1232 POYNERS RD
BANK STABILIZATION
OURRITUCK COUNTY
P.O. BOX 9
CURRITUCK.NC 27929
DB 1157 PG 467
SR 1232 (POYNERS RD 19' ASPHALT)
PROPOSED FILL MATERIAL
PROPOSED CLASS B STONE
TOTAL 210 LINEAR FEET -
CANAL
JEFFREY M.& KATHRYN G.GREZLIN
365 POYNERS RD
MOYOCK.NC 27956
DB 1156 PG 7
LAT: 36.468012'
LONG:-76.076320'
SURFACE WATER IMPACT: 1267 SQ. FT.
RIP RAP AREA: 1013 SQ. FT.
FILL AREA: 478 SQ. FT.
I I DETAIL NOT TO SCALE
EDGE OF PAVEMENT
TO SR 1222
(TULLS CREEK RD)
TOP OF BANK EDGE OF PAVEMENT
NORMAL WATER LEVEL`
JIMMIE AKOCH & )
DARLENE K.MCGINNIS
3810 ATLANTIC AVE •705
VIRGIBIA BEACH, VA 23451 NC DEPT. OF TRANSPORTATION
OB 1476 PG 494
FILL GEOTEX TILE FABRIC
CLASS B STONE COUNTY.
QUAD:
NORMAL WATER LEVEL BASIN:
PROJECT.•
WBS #:
17
SCALE:
DATE:
DRAWN BY:
CURRITUCK
CURRITUCK
PASQUOTANK
BANK STABILIZATION
1.202711
P, = 20'
&RA2019
B.K. BROWN

Received
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Nov 12 iil:y
I hereby certify that I own property adjacent to SR 1232 Poyners Road "-EC
(Name of Property Owner) �Yf
property located at 458 Poyners Road
on man made canal off Tull Creek
(Waterbody)
(Address, Lot, Block, Road, etc.)
in Currituck County near Moyock N.C.
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatiory
�_ I have no objection to this proposal_
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
Repair and stabilize 220' of road shoulder with granite riprap on the east side of SR 1232 Poyners Road
between the bridge and WRC boat ramp
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" I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
(Adjacent Pr perty Owner Information)
llZt <�� .iti�zi
Signature
Signature
Steve Trowell agent for NC Dept. of Transportation
William Ridgeway agent for NC Wildlife Resource
Print or Type Name
Print or Typ�e., Name
'(/on
113 Airport Drive Suite 100
%/� ���►�a�
Mailing Address
Main g Ad�1r{ ass h
Edenton, North Carolina 27932
p
CitWState2ip
City/State2ip
[phone]
2-.5-Z 1 S
Telephone Number
Telephone Number
13 August 2019
Date
Date
(Revised 61182012)

Received
NOV 12 iul'q
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
CM -EC
I hereby certify that I own property adjacent to -SR 1232 Poyners Road g
property located at 458 Poyners Road (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on man made canal off Tull Creek , in Currituck County near Moyock 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
(individual proposing development must fill in description below or attach a site drawing)
Repair and stabilize 220' of road shoulder with granite riprap on the east side of SR 1232 Poyners Road
between the bridge and WRC boat ramp
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.)
6-� 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prope wner Information)
.Sig►utturc
Steve Trowell agent for NC Dept. of Transportation
Print or Type Name
113 Airport Drive Suite 100
Mailing Address
Edenton, North Carolina 27932
City%State/Zip
[phone]
Telephone Number
13 August 2019
Date
(Adjacent Property Owner Information)
,Signallme
Ren Stikelea h .r C'urrihjrk County Manager
Print or Type Name
153 Courthouse Road Suite 204
Mailing Address
Currituck North Carolina 27929
City/State/Zip
[phone]
Telephone Number
13 August 2019
Date —
(Revised 611812012)