71551A_Carr, William & Helen_20190605

['LAMA / 71 DREDGE & FILL
r. GENERAL PERMIT
i� New Modification -]Complete Reissue ❑Partial Reissue
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IA ) B C _ D
Previous permit #
Date previous permit issued
Na 71551
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
W Rules attached.
1
Applicant Name bJ, ttiA
Address 220 A/C
City IkT-f_ <r) State_Alf— ZIP77? y}
Phone # (245) FW- GSA , E-Mail
Authorized Agent
Affected ❑ Cw JtW )41TA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS:
❑ ES ❑ PTS
❑ UBA ❑ N/A
(>.a/!.6 1,+ in T . C
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
App 'on Fee(s) Check #
Project Location: County i 1 44 A A.' C
Street Address/ State Road/ Lot #(s)d'1_5 re
2 U., S Ou&v u w &ke 6 L-4 U e,
Subdivision N
City ZIP
Phone # ( ) �5AH6: River Basin
Adj. Wtr. Body 67 ANA L (matt /unkn)
rin ct Mni Wtr Rnrly AL Ai5i_4 1` -5_1i/A_J1-)
L -�N v M,4;�-/5
Permit Officer's Printed Name
Signature �—
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 1) 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 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: �� fi � Permit #: /71SSA
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.
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
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
dfi&AJ
Wv -�y/L
Dredge [I Fill ❑ Both [I Other
�� 9s�
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

�. SL G6Y )Yor
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L O , A :N T. G A 's
(Name of Property Owner)
property located at '"0 S0U#J4bWA" 1.
(Address, Lot, Block, Road, etc.)
on GJ40j Ac.. , in H64J�o¢� N.C. Z74'4
(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)
y �c7 h U L i 1. 7
Q
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) (Ac#jac nt Pr rty O ner Information)
,'
Signature Signature*
Print or Type Name Print or Type Name
ZZy sou PA W [A"
Mailing Address Mailing Address
HgCr FUR." � NAG , '3.�i 5t y rT n �C
City/State/Zip G#Vbe.561W10A06. coy it / tate/Zip
Telephone Number/email address Telephone Number/email address
s/z81zo19 - n? �- — a 0 J
Date Date
(Revised Aug. 2014)
*Valid for one calendar year after signature`

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
t,.,,LL,Aift rT CYil,IL-
(Name of Property Owner)
property located at ZZc S o`'vDLvAI'A Lb%
(Address, Lot, Block Road, etc.)
on G Ww AL` —,in a eATPos� u c% N.C. z�� Sdy
(Waterbody) (City/Town and/or County)
's
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)
A
v
LZu%, ►z 6666 4;&-? 1 7 "
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 t 5' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
�Z O G a o'u' D
Mailingg Address
City/State2ip Q>AI—SFj0r(& fAOL.w:A
Z 1� Z'o ec' b�
Telephone Number/email address
t-/z e->i 70i 9
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner intormaiion)
Si natctre
Print or Type Name
I a Wi 0 J12
Mails ddress
City/strytf/
Telephone Number/email address
Date*
(Revised Aug. 2014)
.1