Darmo, Louis

❑ DREDGE & FILL NO. 75756
-.. „ A B 'C D
®ta NERAL PERMIT Previous permit #
Q ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality '^`�`./
and the Coastal Resources C mmission in an area ofe vvonmentalconcern pursuant to I SA NCAC
4Rules ttached.
Applicant Name L� ✓ /I �' Project Location: County C ✓1 J �J t/
Address r o U �T l 7 Street Address/ State joad/ Loot )#(s) .
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AEC(s): ❑oFA HHF IH ❑UBA ❑N/A Adj. Wtr. Body
❑ PWS
ORW: yes //nno Y PNA yes /f� Closest Mal. Wtr. Body
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Agent or Applicant Printed Name -- Permit Officer's
Signatwe *"Please read compliance statement on back of permit" Signature
--
QplfcationFeels) Check# Issuing
E oiratio 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 RulesApplicable 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/1-888-4RCOAST
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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(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-hoine
Revised 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: L o u is <l',4M E s 6 /+R rn-o
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
�)_�S 0
'D t` 0
a5a ��_'f i z H/'
/1 iA AA — 1
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: "100 C_k
at my property located at ;k iS W ATE2 S 1W FC r_
in 0n sc.ocl County.
1 furthermore certify that I am authorized to grant and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
' J ignature
Leis S- 4mes 1>Igemt'
Print or Type Name
�c,Jr1G/L
Title
D$ 1 3U I r
Date
This certification is valid through
RECEIVED
SEP 2 5 2019
DCM_MHp CITY

1�
?F WAX;
i or
W w A'an Oq i'j't".
solo (A e 9=,- 1;A i. f-sk it -AC yn 1W.: A ZA MY
"Amm

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to !/-ok I s J/f mCs Aa R m o s
(Name of Property Owner)
property located at J s• /5 G�JPrrER 5�tre�
(Address, Lot, Block, Road, etc.)
on tOd i rE OAK in Sw A..l s g o ec (0,J5i-0`-) ' N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc n.
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)
RECEIVED
SEP 2 5 2019
DCM-MHD CITY
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 yo ish to waive the setback, you must initial the appropriate blank below.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
I ogtS RrnEs ARr2Q
Print or Type Nam
Mailing Address
s /��tSr3oR� nJc_ zSs"ts�
City/State/Zip
Tel phone Number/email dress d
Date '
`Valid for one calendar year after signature*
(Adjacent
Print or Type Name
Mailing Adgess
City/Sat 9)t
Telephone Number/Telephone Number/emai address
A,i-\ --5©- kS
Date*
(Revised Aug. 2014)

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1.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to L-ou Is S 6 R K &xv I
(Name of Property Owner)
property located at / S U R-T=K Sf� -r—
(Address, Lot, Block, Road, etc.)
on W N ITT OAK 1f1 vj P_ —,in N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
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)
RECE
SEP 2 5 2019
DCM-MHD CITY
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 yo wish to waive the setback, you must initial the appropriate blank below.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
L0U+.S Flihrs -64R v
Print or Type Name
PO r3ox
Mailing Address
Swan)S6C,&0 vC, �SSXS�
Ci4VState/Zip
,;_)5';2_ ?GV o T(P eay Lia
Telephone Number it address
s/_�1/z
Date I
*Valid for one calendar year after signature*
Property Oyvner Information)
M i�gporessT.NL C�7 0
SK' 'pa o2�5 � - g1L9 7�t-ll�l
Telejona Ny tuber/email address
Date's
(Revised Aug. 2014)

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