75433_Rosemond Tipton_20200130

ar ,_:CAMA/, ''DREDGE & FILL Tr,* �503to �5 No. 75433
GENERAL PERMIT Previous permit# A =B) C D
Y� KNew (Modification -]Complete Reissue .Partial Reissue Date previous permit issued Jv %9
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 5A NCAC 4)-7 j-/ • / i oD
,k]Rules attached.
Applicant Name ? r^'7o^--1,-, T P 7tn) Project Location: County igt A ej Fvss-?'
Address :-7-i/ .k) I G L I Ai")f3 Lf 2 4 VIZ- • Street Address/State Road/Lot#(s) pp--F- 572 i-7 y 4, A.
City4; E--1.1 v/ 4-C State Al G ZIP 7 '4'6---6 �� r/v3 :6 n v,c---' r-.,,ate
Phone#( 2) j/g, - 2,043 E-Mail Subdivision a.#i y v is 4.3_
Authorized Agent -w/e 3 i n-N9 City _6 A- TN ZIP 2 v 0 a
Affected Cw iW ciaTA DES JPTS Phone# ( ) River Basin -'4 .-PA',IL--ie o
OEA ❑HHF ❑IH ❑UBA ❑N/A �
AEC(s): Adj.Wtr. Body P.i M L../C v 'R,✓� cif/man /unkn)
^' PWS:
ORW: yes /,'no PNA yes no Closest Maj.Wtr. Body 2�"i i-' •e
,
)
: T of Project/Activi / re
-
YPe 1 tY > �L g i.f - .1-Z-A 79 72, :^' \o it CX ,7-7 z/.4, ,4-,l0
_AP /0 L.,,A--ram-2 t t ',* y) 7 r/ae7-^-,(-1- 4.,....11-1' 2 (Scale: 1 ":=�c) )
Pier(dock)length _ 1-t-ell e�_
Fixed Platform(s) % '
Floating Platform(s)
Finger pier(s) ! l
Groin length
MG-/F i -s
�'-- •rn � l I/h•'')"t ,_...1...-. j
number I- I _ I — --: —
gu[\1(1/Riprap le h 3 ^"— 1 • *f
avg distance offshore /0' I i +Y
max distance offshore /J
Basin,channel
I
cubic yards --)
Boat ramp , . , _ ?
Boathouse/Boatlift rn11017V/ ^
II�c '
Beach Bulldozing 1 if) ORS' G'"041-a-+/' 4t./}'�G
Other IJIr A/ /�J'G
Shoreline Length �7 3 ' r^ (/ 1
i_ r1
SAV: not sure yes n�
Moratorium: n/a yes no%T 4. e�jF
t O _ _.
Photos: yes T I t P-rr` _ ti
Waiver Attached: no-.Ij
A building permit may be required by: •,E(4..c-1-Fv,71 Zc . . •]See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions /5 /t^P.2 r-49"Pr,rfr Ln"t7? ) •
1/V/ - / IY) . 0 . -L/4-0 E_ /4G z-,/ - lie 7
Agen or Applicant Printed a Permit Off_icer s Printed Name
).................,....s..._
\; ,. „.. ,, --J- \ ,,...„.-
Signature Please read compliance statement on back of permit ignature
1 4 i,
Qd 6 4 1 .0 a� 4/q 7 -- - 5c� 70,7_4, /'--1 -2.J2 t_
Application Fee(s) Check# ssuing 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 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves: Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden, Chowan, Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: Pfl.5 e //I0 D.C/
Mailing address: cO! Id;`!J S 10 u-2-6 VI
ee , 1),e AiC
Telephone Number: za >� g�
I certify that I have authorized L/G)C 7// Z74 (agent/contractor),
to act on my behalf,for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of A i.1 l-l G /S/4-f)
at my property located at o( / (/ EAy A)/61;
gerx---10
This certification is valid through /2719120F , 5 C�, (date).
(Property Owner Information)
Signature
(:)se mom el NI ---rtAD-brr-
Print or Type Name
Title, co. owner or trustee for property
L
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent toKD6-Z4/D/C7O 77P7-DA/ 's
(Name of Property Owner)
property located at o)9/ fi/1yP/ Iei /2 0413,
(Lot, Block,Road, etc.)
on P/9)11.>co /0 ,in Ce ./9/01-7'/27- ,N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below,the development he is proposing at that location,
and,I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
1� I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
/- ,aSJf fepe/GS /9/,cl/9-y nvio C 4- 9/2 & iD /3 UL.2h'�f�LD
D12) V 2a5S 77 3 6--/2Dy /93ou7-
iL /=7 , cRo55 1J/J�2 oG22 �trL1G� s
7=/L7a)2.. C/ 9727' /9-c12D,5S
TG/l21`1 �SO/L /}/V/D A/L(.- 7 ' /?/VlsL. S,ioA or=1J/91L 0,4 '/3
�E, -2AR /ZbciG5 777 •e11,492.s/z9S ' 2
- c 29P -77 co/7/4 aQ. )peak
ter_ ii1
Signature
3090='i+ M S1R.Aui
Print or Type Name
252 - 823 -- L23�
Telephone Number
Date: 1/2.$l Zo Z a

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to R05 /7J9t10 1P727 I/ 's
(Name of Property Owner)
property located at J /3)9 y!/)4r J
(Lot, Block, Road, etc.)
on P/91792.1 CO Ri lffs/L ,in /Si9- / C��f91/F'02 T, ,N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below,the development he is proposing at that location,
and,I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
r,a s// R.OcIe5 /3,f/G /9-)i/0 c 04 u i-lei 479P
2- l7R1 vb.51 Rid/L, ci?P55 77 $ Z V GRev..N.o 136 Dc/T , - --
n mass 77 IRa24-27y. A
3- P ., c Go r / /3 cuss 40 'S
I F wf3LL ,
i4 E N le x/ c_Co/L '%O A4 J 1/�' ...sil Iv= L #9 wo s Lc4 L7
,4 - uRA✓ R 4cKs ( /P #P)9 F', j D Ri Y4/e Gm LL
P I,/ / /j X /2 - --- ----Signature
IN/LLinnj D. E Li9L
Print or Type Name
,a,5";/ l&-- 7 37
Telephone Number
Date: 1/�S��OjtT�

NC Division of Coastal Mgt Habitat Impact Computer Sheet
Applicant e"i ,rTh _rt 4=,-7-cnN
Date: O -A� Zoe a
General Permit#: S"
Describe below the HABITAT disturbances for the application. All values should match he name,and units of measurement
found in your Habitat code sheet
TOTAL Sq. Ft FINAL Sq, Ft. TOTAL Feet FINAL Feet .
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance Disturbance disturbance.
Habitat Name Choose One includes any Excludes.any total includes Excludes any •
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amoucitZ temp impacts) amount)
Dredge❑ Fill❑ Both ❑ Other ❑ — _ •
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both Cl Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
• Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
•