75689A_Forehand, Clarence & Jane_20191210

CAMA / --'DREDGE & FILL
iGENERAL PERMIT
]New, ❑Modification ❑Complete Reissue El Partial Reissue
No. 75689
Previous permit #
Date previous permit issued
B D
As authorized by the State of North Carolina, Department of Environmental Quality t�
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / �r / / C J `t 7 A/, / Z
es attached.
Applicant Name (�,'Ot t- en c c q- .� 0. n e r:Z� r-e_Act /1 d
Address %y� �J, D/ci C" V, k 4
City o ci State NC- ZIP 2% 9 S i
Phone # ) 6 S'o -11,43 E-Mail ► n S' 4"
Authorized Agent __..
Affected ❑ CW 'gEW )4,,"A J45S &PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
�
Agf or Applicant Print Name
Signature ** Please read compliance statement on back of permit **'
Application Fee(s) Check #
Project Location: County 'D cC ( ;;,—
Street Address/ State Road/ Lot #(s) L b -- / Y
Vy, Did C- vQ _9d,
Subdivision Zj f 4 Al o, q S Ne a J C6 ✓� , 5' c c
city nig,1s qe�d J ZIP 2,-72159
Phone # (— ) ' River Basin
Adj. Wtr. Body_ 4 r, a (nat / an /unkn)
VO"i'l - C G-1- mot/
Permit Officer's Printed Name
Sign re
Issu' g 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 (252-946-648I) 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

D:\2D1 6\P1 B091\DFOringe\i 1tlUYG-)FGII:H-J�N.Owq IC/CO/CV O \
NOTES-
1. CURRENT OWNER: CLARENCE E. & JANE B. FOREHAND
219 SIR OLIVER RD
NORFOLK, VA 23505
2. PIN / PID: 9891-1295-4815 / 006145000 11
3. PROPERTY ADDRESS: 141 OLD COVE RD. c a-rd L Siti
4. LOT AREA - 6.571 RqH / 0.15 O (TO BULKHEAD)
(AREAS BY COORDINATE METHOD.)
5. SUBJECT REFERENCES DO 2069. PG BP MB 4, PG 3;.
8. PROPERTY IS LOCATED IN NFlP FLOOD ZONE AE (EL9') AND SUBJECT TO CHANGES BASED ON
COMMUNITY CID NO. 375355; PANEL 9891; SUFFIX J. (MAP NUMBER 372D98910GJ) EFFECTIVE
DATE: 09/20/2006
7. THIS SURVEY SUBJECT TO ANY FACTS, INCLUDING BUILDING SETBACK RESTRICTIONS EASEMENTS
COVENANTS, ETC., THAT MAY BE REVEALED BY A FULL AND ACCURATE TITLE SEARCH.
& ALL DISTANCES ARE US SURVEY FEET AND HORIZONTAL GROUND
9. THE SUBJECT PROPERTY IS LOCATED WITHIN THE TOWN OF NAGS HEAD ZONE R-2;MEDIUM
DENSTY RESIDENTIAL
10. BOUNDARY AND TOPOGRAPHIC DATA BASED ON FIELD SURVEY INFORMATIONS BY OUIBLE h
ASSOCIATES P.C., DATED 11/16/18
11. LOT COVERAGES:
- EXISTING: 2455.40 SF (37.4%)
DEMO: 160 SF
PROPOSED: 160 SF
- TOTAL' 2445.40 SF (37.4R-NO NET INCREASE)
(TOTAL EXCLUDES PROPOSED 2 FT BULKHEAD CAP)
VF
BRIM L. CAft VE L
DO 1970, P6 560
LOT 15
hB 4, P153
BONITO
hG�TE Y
EXISTING
DOCK TO BE
PR OSED REMOVED
FIXED
N 26' 14' 47- /V P TFORM
40Lb' 22.0'
661' MA6 P
35' hGCD
9CE
� y WEXISTNG
PROPOSED
12 FT BY 13 FT
TO BE PRE-EXISTING
\]�
REMOVED '.WOOD WALK
THAT HAS BEEN
REPLACE PROPOSED I REMOVED
EXISTING FENCE --, NEW STAIRSf •;
ROOF
, LCLX
DECK 1
I
LOT /a
I
p I
eJ,J sn
r
STAJO II 1
T 1 i I
r-1 2 5TCRY
SFD ON
PROPOSED
NEW 4FT
F
II I
WADE
3 L 1 P ES'
1
PLAN t—
PLATFORMS
sxu, I 10
I
a 22Ir 3.2'
—T—�--
�y I
o \\ 1
I PROPOSED
f m I 3F7 WIDE
WOOD WALK
I L 1
J
1 rE `.
X r
G0=1B31'
N IB' 31' 43' E
4 PROPOSED
<L �7 L .�
' PLATFORM I
'r
10 (-A- L C
P1.0 LSE AS
�P63
PER MB4
e C+
6 w /'- d/
PROPOSED I
—155 LF
nT
VVVV
NEW BULKHEAD
I
ryry
G
UI I
8
EXISTING IRON PIPE, EIP
- EXISTING IRON ROD, EIR
PROPOSED
CAL NAIL
- CALCULATED POINT
4 FT WIDE
BOARDWALK
- WATER METER
- TELEPHONE PED
(2 FT OVER
- CABLE TV PED
WATER, 2 FT
- MAILBOX
BULKHEAD CAP)
- LP GAS TANK
(7J - TOTAL DISTANCE
nulo
A6- ABOVE GRADE
p,- BELOW GRADE
1.25'BP
N A%77Lsn47o,PT
E 2444,468.7E .9P7
60,0LY
—
— —
ae 42 Y
1
SET M46 s Wr
OLD COVE RO of
,Asfxv. r bOl R/iN g 1. Q `.
`Im
N`.66 NCWL T/ 166'
N MA515.22 SIFT lam'
E 31,",72d eFr
i
i
PROTECT
PI6094
LOPYRIGNT ©2018
OUIBLE t ASSOCIATES. P.C.
THIS DOCUMENT IS THE PROPERTY OF`,y""
QUIBLE k ASSOCATES. P.C. ANY
ALTERATION OF THIS DOCUMENT IS
SM PLAN
AA - A- NC Ue9nRR/: C-0206
�, ��,•O uible
O
LOT 14
DRAWN BY
PROHIBITED,
� � & Associates, P.C.
m�,IMH
IF THIS DOCUMENT NOT SIGNED AND
SEALED BY A LICENSED PROFESSIONAL
THEN THIS DOCUMENT SHALL BE
OLD NAGS HEAD COVE
;
sue,' ENGINEERING-- - CONSULTING - PUNNING
ENVIRONMENTAL SCIENCES - SURVEYING --
CHECKED BY
TOWN OF NAGS HEAD DARE COUNTY
Mws
CONSIDERED PRELIMINARY, NOT A
CERTIFIED DOCUMENT AND SHALL NOT
BE USED FOR CONSTRUCTION.
NORTH CAROUNA
L-ENG./$UR. NOT OFFERED AT BLACK MN. OFFICE`-
6466 C.—k, N.Y. Po.MI- Poinl, NC 21956
9(v�,�• Pnon-: (262) 491 -61 AT Car: (252) 19t-61 A6
��-`� """
O 10
DATE
RECORDATION. SALES OR LAND
CONVEYANCES•NOTEDSS OTHERWISE
Q �� 0 Cnurcn St. Sf-. 9. BIOCR M.—I , NC 26T11
'• STRP,p� Pnun-: (828) 793-039a 491-51 A6
12�13�i6
GRAPHIC SCALE IN FEET 1•-20'
yuiel:z62)

F
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: 9-(�A
Project Address:
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
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 ptoposing. A description or drawing, with dimensions, must be provided with this letter.
Zhave 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) 2W901. 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 sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Applicant/Property Owner Information) (Adjacent Property Owner Information)
oe
Signature Signature
¢�/1 r/�/ ,�3x✓mac �, �� tie
Print or Type Name
(y I U 0Id t-6LX, U�
Mailing Address (VASS iR 4 1 C-
27 95 1
Print or Type Name
,,3q'wo,(�i�r.� l��
Mailing Address

City/State/Zip City/State/Zip
s-) 6 sU tG 73
Telephone Number/Email Address Telephone Number/Email Address
r/Is Id-e 7-76S Ma,/ ,CC,^
true
Oaw*
*Valid for one calendar year after signature* Revised 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner
Project Address
Agent's Name #
Agent's phone
(Lot or Street #. Street or Road, City-& County)
5 ^ lo, e A5 � �/ v-, 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 pfoposing. Adescription 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 [phone]. 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 sign the appropriate blank below.)
I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement
Az-e�
(Applicant/Property Owner Information) (Adjacent Property Owner Information)
�r�nunu�
Print nrType Name
.Signature
Print or Type Name
17
d-M 9
Madifiy Address Mailing Address

CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELI
ame of Adja nt arian Property caner
A ress
ity, giatie tip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
A^J fol ate 42
I0k1�Q�►�
on my property at LA)Q �� (�vQ r�J N �S I �� Z7 959
in CA " County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property Owner's Name
�5�-65a-167J
Telephone Number
Address City State Zip
✓ I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspond e ce.
Adjacent Ripa ignature Date
La
Pri t +OT�ype Name
as 3- (PL-1
Telephone Number
Address City State Zip

City/State/Zip
C+ty/StatefZip
Telephone Number / Email Address
IM
Telephone Number / Emad Address
Pam
'Valid for one calendar year after signature` Revised 2017

EXISTING
DOCK TO HE
i)RoposED
REMOYE:D-�
FIXED
PLATFORM
N 26 74' 4 7- H
Cw
roxv
04'f
(cm.
EXISTING
STAIRS
To BE
PRE-EXISTING
REMOVED
WOOD WALK
THAT HAS BEEN
REPLACE
PROPOSED
REMOYEE)
EXISTING PENCE -",=.
NEW STAIRS
410
UNDER
EXISTING�
ROOT
>
f;y
PeAe
PROPOSED
NEW 4FT
YADE
W000
STAIRS
w rH r—
PLATFORMS
PROPOSED
12 FT By 13 FT
BOATUFf
IN
NO-
4--0- 3,-'43- F
PROPOSED
FLOATING
PLATfORM
r, !.toe A'.
r-FR -V -( Wi Y 1
PROPOSED
—155 LF
NEW BULKHEAD
PFAN A�.PROVLIJ
DCDHH, DPH, EH UNIT
i DATE
..k.
ki RE HS 3trQ �L�N . G IRON PIVE, EIP
QPQ FIR
- MAC NAIL
PROPOSED - CALCULATED POINT
A FT 'AIDE WATER METER
RnARf)VdA( k TFI'79"fWF VFJ'-

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r t ' s Ya s '" ' r °F THISURVEY IS SUIJECT TO ANY FACTS THAT MAY 9E w 1tN +i ' Tj°;
Dfe D BY A MAL' AND ACCURATE TITLE SEARCH.
Z AIlEA`OT.COORDNATE COMPUTATION s %503 Swi. (TQ BUUQIEADj 3pr' t r `' '�' .t,C t t t •a ..} } },:a • s r , ''.F,t•R}. .3.. f l O. ,, �E: X.
1
4. PIN NO"14 9M 12 95 3337 a r
. c f J r '•}'y't ar` RIECbgOED MB 4. PG 3 }
LINES (MO.) SHOVIN HEREON ARE PER THE
CURNENY LOCAL f P
,' al j srt Pf/ii.'tlJq( f ' ZONNO REGULATIONS. OTHER SETBACKS + liygr
AND/OR RESTM110N5 MAY APPLY AND MUST BE VE1tlFIED: Y'
TRUCTION. 'F'Rlbk TO CONS
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tOM GROUND • BUUMG — 8.3' a r 0r
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