75510A_Waldron, Dewey_20191231

NCAMA / -DREDGE & FILL r
GENERAL PERMIT
I7New -'Modification -'Complete Reissue ❑Partial Reissue
No. 75510 ef-
A',, B C D
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality n _
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /
QMules attached.
Applicant Name 1 e " ny W c, I J — Project Location: County �n _!'� C-­!' s
�l0 7/1
Address oeiy4t vo
City <'.'� � - S '� r �@ i d State ZIP 23 3 9
Phone # ("0` ) y` 9 30- E-Mail r
Authorized Agent G r-&^4i 1
Affected ❑ Cw 14W to PTA ,B*S ITS
AEC(s): ElOEA ElHHF ElIH ❑ UBA ElN/A
❑ PWs:
ORW: yes /(no) PNA ye � noD
Street Address/ State Road/ Lot #(s) Z j) Z
Subdivision
City t` v o ZIP / z -7 �S
Phone # (_) River Basin S�`1 a^ K
Adj. Wtr. Body C "` ^ (nat fi_r;1'/unkn)
Closest Maj. Wtr. Body
MEN! ■■■M■■■■o■■■M■■■■■■■■■■■■r■
■®■■■■■■r
1�/I■Liii■■■Oi■;�Ci�iIEJ■■■■Gi■■■■■■■
MEMEMEMEMENEMENME
M.
MEN
9=ZZU&MEEMEMEMEN
■■■
■�I
w■■
ii
il■■
■■EN:::
MEN
MENEM
�.:pie■■■■■■�■■■■■■■■■■■■■■■n■■■■■■�:�■
�
-J
Agent or Applica
Signa ure **Please read comp lance statement on back of permit
�7D l�y�
Application Fee(s) Check #
v -=' /I /I e a.f--"/ ,(
Permi fficer's Printed Name r�• �
Signat
3 ,3 a t�
Issuing Date piration 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 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/ 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

I hereby certify that I own property adjacent to N�
property located at
0
I:40
ER STATEMENT
f0Jk-/
ie of Pr perty Owner)
I
r� (Address, Lot, Block, Road, etc.
on It ' M. L% Co in A LIoX J ,(/t'� ,4/t c N. C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
eQZ 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)
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 do wish to waive the 15' setback requirement.
e;P—I do not wish to waive the 15' setback requirement.
(Property O er I formation)
Si nature _
rX
te%� +i
rint or Tthe Name
i
si
c,tryr,�)� 0 L'I L �D [ I X6
Telephone Number
Date
(Adjacent Property Owner Information)
C'DdaziL Q C' �
Signature _ S
Print or Te Name
toyp
jC l 112 AUo►V , Yx— A l416
Mailing Address
Npiu, 1S
City/State/Zip
psi - Wq 9
Tele hone Number
mom� -go, -�-o IC1
Dare
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �1_l t°c-'4 I � V C �60t-b I
(Name of Property Owner)
property located at 3 �0S
N
(Address; Lo Bloc'k, (Road, etc.)
on �/ ��t co in,0, N.C.
(Waterbody) (City/Town and/or County)
The applica as 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)
e"'n � vr,,/
Ne, I T�' do et
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 do wjsh to waive the 15' setback requirement.
I'o not wish to waive the 15' setback requirement.
(P perty Ow er Information) (Adjacent Pro erty Owner Information)
S' ature Sign re
Print or Type� e Print o Type Name
I � ? r � a 4L L4 /0. ,1 bua,v C1 r
M li Addres Mailing Address
P46M46t _ AA 6 z I z z
Cit / ate/Z' ` f / r� Cit / tat /Zi
Telephone Number Telephone Number
2- 5�� — /.? !i-I`�
D to Date
(Revised 611812012)

,�.. ..< ,_.M.. F .4 rya ,.... �, ....,. [ _..... Y ..,.,_ _. ... ... .: .... . - ... .. ..
{
r
r

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date / Z — / S —/
Name of Property Owner Applying for Permit:
Mailing Address:
l & 7 / ( �f crt
e/r) ii741 -27 �? "::6
I certify that I have authorized (agent) 6to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) J 9 v<i d-24-oekW /—AY
.�vav� IVc 2 ?� t-5-
This certification is valid thru (date) Z-cj . vS ZO
Property Owner Signature
Date

t
9L—•80-6LOZ 9L-80— �•
r
f '
yy
�. i Aai
�•
.4N.'
s�LA-80s�o ..: 9L—so—s�osc-80-6Loz
• E
1
call
yy ' At
i ,

s �'i'� �.
I Wol"-
ji

L-6 VOZ
6LOZ
All
,01

1 i.71 %
This map is prepared
from data used for the
inventory of the real
tir �J
property for tax
•
purposes. Primary
information sources such
as recorded deeds, plats,
wills, and other primary
public records should be
consulted for verification
of the information
contained in this map.
i
r
I jl1.
1�)•43jx
�
to �
cn
10
y .
it
•
8 7
' 22.2
C
,
39080 Tarpon LN Owners: Waldron, Dewey C Jr Trustees Tax District: Avon
Avon NC, 27915 - Primary Owner Subdivision: Hatteras Colony Sec 10
Parcel: 013955000 Waldron, Marion A - Primary Owner Lot BLK-Sec: Lot: 2 Blk: Sec: 10
Pin: 064010269330 Building Value: $0 Property Use: Vacant Land (Private)
Land Value: $108,400 Building Type:
Misc Value: $0 Year Built:
Total Value: $108,400