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'CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
I�New ❑Modification ❑Complete Reissue El Partial Reissue
No. 73 724 e B C D
Previous permit #
Date previous permit issued
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 SA NCAC (fill • + 2�
ii� Rules attached.
Applicant Name &deslr f St CAJ /' 11it1TCh"*2r-
Address i)wI
CC '�2(0 - ► I�ivt~iL�//LLt, �L
City l rb L l( State ZIP 2 �4 :�v
Phone # _A18:z E-Mail
Authorized Agent
Affected ❑ CW AW AtTA ❑ ES ❑ PTS
AEC(s): ° OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / no
Project Location: County ClLi ,A&I
Street Address/ State Road/ Lot #(s)
/ I , lily+ u.v � +3 4C o % % A r L
Subdivision 154_r N
.'C+ %1c ek ZIP
Phone # ( ) 3#4144- River Basin
Adj. Wtr. Body Ct&wo4 u Ri va-te (rfat/man /unkn)
Closest Maj. Wtr. Body
-
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Agent or Applicant Printed Name
Signature
** Please read com nce statem nt on back of permit
'Pl
Application Fee(s) Check #
L- i"w VIATHIS
Permit Officer's Printed Name
Signatui'
Ai�,r iL. 7�,. 7�U Awl- .-7-.;yl 21-1
Issuing bate xpirat on 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 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(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
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
jo GvtVVNe
MC 4793 Z
1 Agent"
XNq
! ` ddressee
B. Redived by (Printed Name) C. Phte of Delivery
D. Is delivery address different from item 19 ❑ Yes
If YES, enter delivery address below: ❑ No
I
3. Service Type
❑ Priority Mail Express®
II
I
IIIIII
IIII
III I
II
I I
I
�i I
I
I
I
II' I
❑ Adult Signature
❑Registered MaiIT'"
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricte
9590 9402 3917 8060 6763 64
LJ Certified Mails
0 Certified Mail Restricted Delivery
Delivery
El Return Receipt for
❑ Collect on Delivery
Merchandise
2. Article Numhpr
0001 5647
i Delivery Restricted Delivery
8379 ail
Signature ConfirmationT"
❑ Signature Confirmation
? 018 0680
,nsurea Mail Restricted Delivery
Restricted Delivery
(over $500)
__
PC Fnrm AAI1 .Ir dv 9hiA acne 7-in_no_nnn_onrn
nnmactic Rah irn Rpcpint
USPS TRAGKNG
9590 9402 3917 8060 6763 64
United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box•
72( 45. j2�v
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to 20,3e,4 i� 1`r�i�-�>�� 's
(Name of Property Owner)
property located at log, //O Z
Project Site: Address, Lot, Block, Road, etc.)
on r t2 , in �l.IOe 'a N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #:
Agent's phone #:
Mailing Address.-
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
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) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
(Property O r Inform
(Adjacent Property Owner Information)
Signature Signature
Print or Type Name Print or Type Name
Mailing Address Mailing Address
City/State/Zip City/State/Zip
95-1 b 7 6 q7d Z arw4-.1 ofol-4,,,
Telephone Number / Email Address Telephone Number / Email Address
Date IDate*
``Valid for one calendar year after signature" Revised Jan.2017
oil
n4
7
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to T�a-7 is
(Name of Property Owner)
property located at �� 08, //U r 112- C> -iZ-}y e—
(Project Site: Address, Lot, Block, Road, etc.)
on 4f141C)6- -� /"�i veill-- , in , N.C.
(Waterbody)
Agent's Name #:
Agent's phone #:
(City/Town and/or County)
Mailing Address:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
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) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information)
Signature
Print or Type Name
ZZ�l C
Mailing Address
City/State/Zip
7S--'7 7 G 47�Z02-
Telephone Number/Email Address
Date
rty Owner Information)
is�ignatuff*
Bill dA&W44
Print or Type Name
l/y �-r,���•�ebR�zs- to
Mailing Alddress
City/StatelZip
-)s7- a7,71- k/?i
Telephone Number/Email Address
l s L ,�2-//
Date*
*Valid for one calendar year after signature* Revised Jan.2017
�►nvpw �)
,:V 0-7
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'Chowan County, NC
Disclamer:
The materials available at this web site are for informational purposes only and
do not constitute a legal document.
rC, wUG� tf ') 20 m Apr/18/2019
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NC Division of Coastal Mgt. Habitat lr+r>spact Computer Sheet
Applicant: 1'?&6nT �' Sifit►2cqU J, �CIJZ'7 Permit#. -7G-73 ,l
Date: ba<< 7--j zc''/ y f�
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 amounttemp
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
im ads)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
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 ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
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