75700A_Newing, Steven & Jinni_20191220

/CAMA / [ DREDGE & FILL NO. 75700 WL Lbt c�
.-. <A� D
GENERAL PERMIT Previous permit# B C
New `Modification ❑Complete Reissue El 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
ORules attached.
Applicant Name ); it,; I). i�rj IY 9 z"le Project Location: County f
Address Y95 :7- kjcc ;,+e LA/
City Vi I , ,a I )P rC _ State VA ZIP 1 _ y SS
Phone # ( )
E-Mail _---
Authorized Agent ! i - ,'V"p (
Affected ❑ Cw dEW ❑ PTA RtS ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A
❑ PWS:
ORW: yes /�2? , PNA yes /ono
Agent o}jr�.A/jppli/i�
can
t
Pri ted Name
/^/
4 /// l N,
SignaturePlease read compliance statement on back of permit"
Application Fee(s) Check #
Street Address/ State Road/ Lot #(s) I -7,g ���� 1 L N
Subdivision
Cityk�ff- ZIP �-q']/6
Phone # ( ) River Basin 9,
Adj. Wtr. Body Ct-1 i Jc r k- 't-o4 6 (nat /man /unkn)
Closest Maj. Wtr. Body C ,f;_-,r k
Pe 'Off er's nted Namg_> f _
r
Signature '
12-Qo_I�
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
Neuse River Basin Buffer Rules
Other:
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 complywith 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/ I-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

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date { ^ / l
Name of Property Owner Applying for Permit
Mailing Address:
I certifv that I have authorized (agent) �'h; �-�-1 {-, , (1'lC ��,% to act on my
oehalf. for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) a " / � i) "q,4 ,
at (my property located at) 1 7 Y UnLL�� !�r
This certification is valid thru (date)
Property Owner Signature Date

L
r- T Q li
W
G

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner'
Address of Property:
Agent's Name #:
Agent's phone #
(Lot or Street #, Street or Road
ity & 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.
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. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
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 15from 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
Print or Type Name
L_ i (-- LtJ
Mailing Address
VA A:A(H VA
City/State/Zip
� ` Ll 3 Ll - l..I I
eiephone Number/Email Add ss
iZ1 C1
Date -
'Valid for one calendar year after signature`
(Adjacent Property Owner Information)
Signature *
s� 0 1 � t C',-,-1fl M te-
P Type Name
t (o O IJ EAR. L IAof t
Mailing Address
L E- rr- oy <_ z 79
City/St te&ip
z52 4s,�. (,Yn2
Telephone Number/Email Address
-1
Date
Revised Jan. 2017

.4 t 'VI
47
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Al
. iv

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: ALI, �tla� / ? adI
Address of Property:
To v Nil ,
(Lot or Street #, Street or Road, City & County)
Agent's Name #: t; 14 n, 0. ►AA e d<? t
Agent's phone #: — LI S -" yci
Mailing Address: P -0 . Ra Qw !c,*
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.
'-,� 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. Correspondence should be mailed to 401 S.
Grim St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
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.
(Proper Owner Information)
Signature
Print or Type Name
-Po )K (l -7
Mailing Address
AgAltit-Nc �-7qr
City/S ate/Zip
Telephone Number/Email Address
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature *
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/Email Address
Date*
Revised Jan. 2017

11/ 1 b/1U 19
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