78511A_Druelinger, III, Diane & Leo_20200210

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CAMA /'--'DREDGE & FILL N9 78511 CA g C D
GtNERAL PERMIT Previous permit #
❑New ❑Modification El Complete Reissue El Partial Reissue 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
❑ Rules attached.
Applicant Name T)'1CkV\L $ t ec,
Address 1 41 ` DPW '9 ree
City VAC Ic ADD t c State t\ C ZIP 3t J6 9(A
Phone # (AZ) - `16'19 E-Mail
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ® PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / io
Type of Project/ Activity
Pier (dock) ler
Fixed Platforn
Floating Platfc
Finger pier(s)_
Groin length
number
Bulkhead/ Rip
avg dicta
max dist
Basin, channe'
cubic yai
Boat ramp
Boathouse/ Bo
Beach Bulldog
Other
Shoreline Len
SAV: n
Moratorium:
Photos:
Waiver Attacl
Project Location: County lilt
.!
Street Address/ State Road/ Lot #(s)
b� 5t��
Subdivisionr 0 alS CC) (()n, a
City iaC.40[1 ZIP %Ct-(Lj
Phone # ( ) River Basin t ' !Ya L1_rOaC,n 3
is � Adj. Wtr. Body y m a r (, Sound 6�Nrnan /unkn)
Closest Maj. Wtr. Body 01 ri ' 1 F SC�L' r•c,
A building permit may be required by: [)E f �(A iX'NN[i_n }011►,-1
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read comi�ance statement on back of permit
Application Fee(s) Check #
(Scale: j " 30' )
❑ See note on back regarding River Basin rules.
Permit i/er's P4,tq Name
Signature '
L //0/ZG
Issuing 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/ 1-888ARCOAST 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

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 I r l_ vW_ r J -c 0 (4 s
(Name of Property Owner)
property located at ! Q 5 we bb 9 Ye&t NC <4 V
(Project Site: Address, Lot, Block, Road, etc.)
on .k"tyYi, 44 .t !'1CL , in i-k-F-0 ��CL N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #::D�� Mailing Address: 0Cl,
3 ��W
Agent's phone #:5�- 3- 7 5 °
4�r"� �', Email _ r (' i � t a rr-, �- Th:� Cam=-,r�
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 fill in description below or attach a site drawing)
oCCU kyact Akctoco"
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.
(Property Owner Information)_,1 (Adjacent Property Owner Information)
Signature ` ig�nat6re*
hatlf I(t.lN ,� I ,t ( /� 1
Print or Type Name Pn ,or Type Nam
�r ( /I c
Mailing Address
Crx �
City/State2ip
Telephone Number/Email Address
"-4ch rlyl�_Jc
Date
PC -
Mailing Address
ez
CitylStatel2ip
Telephone Number/Email Address
Date'
"Valid for one calendar year after signature' Revised Jan. 2017

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 , s
(Name of Property Owner)
property located at
(Project Site: Address, Lot, Block, Road, etc.)
on , , ; iF in 1 ` N C.
(Waterbody) (City/Town and/or County)
Agent's Name #_ Mailing Address:
Agent's phone #: _ �,- Email
He/She has described to me as shown below the development he/she s proposing at that
location. and I have no objections to the proposal.
---------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill 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 [phone]. 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
Mailing Address
City/State/Zip
Telephone Number/Email Address
Date
"Valid for one calendar year after signature'
(Adjacent P perty Owner Information)
Signature .
�iav-�h are h c, F e v g-iv 7
Print or Type Name
Mailing Address
-
City/State/Zip
Telephone Number / Email Address
Fe A Y - .ZO 2,0
Date
Revised Jan. 2017

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