Waller, Thomas & Anne

©CAMA/ ❑DREDGE & FILL' jvl? 78903 A B CD
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Par ii [Reissue Date pr wous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality i - -' ^
and the Coastal Resou ces Commission in an a ea of environmental concern pursuant to I SA NCAC
R les a f achgd.
Applicant Name ��' l / �-il Project Location: County ! f fP
r:
Address VL' C-( Y' Street Address/ State Road/ Lot #(s)
City State ZIP
Subdivision
Authorized Agent
City_
OCW ❑EW El PTA ❑ES ❑PTS
Phone# (.'
Affected
AEC(s): EJ OEA ❑ HHF ❑ IH ❑ UBA O N/A
Adj. Wtr. Body
❑ PWS:
Closest Mal. A
ORW: yes / no PNA yes / no
Type of Project/ Activity
Pier (dock) length_
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshor,
Basin, channel
cubic
Boat ramp
Beach
Other
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
(Scale
❑ See note on back regarding River Basin rules.
PermliOfficers rin# a e
1
Signat re
Issui g Expiration Date

I hereby certify that I own property adjacent to
Property located at
Address
on c1 r dti�llt�6 — —, in
(Waterbody)
I
rope Owner)
rivu
aC.)
N.C.
r and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
V�e cons �rttc� cq QrYAC � e F i ('r ai r)( 1) o A I ► -{
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 initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 16 setback requirement.
(Property Owner Information)
Date
(Adjacent Property Owner Information)
RECEIVED
(Revised Aug. 2014)
*Valid for one calendar year after signature'
FEB 1 2 2020
M
DCM-MWD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ��n �� cn nr I h �' s
(Name of Property Owner)
property located at 7��, ��d S A 1-0c 1 � :. f N -:..o -
S(Addresins, Lot, Block, Road, etc.)
on pp ) _ .
, N.C.WatebodyCty wnand/orCounty) The appli ant has described to me, as shown below, the development proposed at the above
location
( 1 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)
Re CID ns lc�kCO) bO6J � f �I
WAIVER SECTION
1 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
95- - 9-dt9- 4'f,� 3—
Telephone Numberl email address
Date
Information)
P I or TyRe e
F cl)q• X 0
17
City/ jate,Qr�n.� i I
9 C rj�J 37�I
Telep ne Numberl emai a� ddress —
= Xa)
Date*
' tE.CEIVFD
(Revised Aug. 201 )
*Valid for one calendar year after signature*
DCM-MHD CITY

AfiAA / ❑DREDGE & FILL
ENERAL PERMIT
w ❑Modification ❑Complete Reissue ❑Partial• Reissue
As auth aed by the State o(North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concerqq pursuant to I SA
..4M :
Applicant Name 1 E711 1(t�
Phone #
Authorized Agent
AffectedEl CW NEW .PTA ❑ ES ❑ PTS
AEC(s): El OEA HHF IH ❑ UBA ❑ N/A
vO PWS:+,
ORW: es. / no PNA yes / o
N2 71307 A B ' o
Previous permit #
Project Location: County
Street Address/"Stiff Roao/f Lot
City ur,
Phone # b — '` er Basin
Adj. Wtr. Body
Closest Maj. Wtr. Bodyt�
Type of Project/ Activity Z•l / f
/ ,
ill
(Scale:
Pier (dock) length —
Fixed Platform(s).�- w w.-
Floating Platforms-_ -
!
Finger pier(s) _
Groin lengefi�--
number
Bulkhead/ Riprap length """""•'� ~' _ ,' _r-
_ 1, i -
avg distance offshore
distance
max offshore—
Basin, channel -
—
—
I
L cubic yards
Boat ramp �^'' --- -
Boathous B atlift1 (/
V )`
! r
_- —�.,
C
-
— }
Beach Bulldozing
Other
Shoreline Length
y
SAV: notsure yes n -
—-+---y-•
�iLULU
Moratorium: n/a yes -_
_ _
Photos: yes o�IiMFIM1�11Q17f
Waiver Attached: yes o"----
— '—"—
A building permit maybe required by: A i .. .l U'
( Note Local Planning Jurisdiction) •+
n ❑ See note on back regarding River / Basin rules..
.i -
Ali, i
t ,`,
i 1 �•lJ
L l�1 j �(
i(
Notes/ Special conditions L��
(
compliance statement on back of permit **
Application Fee(s) Check #
i I
PermhO IEer's Printed Nanfe,/ i
Signat re / is.
lss�ulng Date I Expiraton Date

AMA / L�DREDGE & FILL N? 69839 A B C
ENE L PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑ Partial. Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources t
and the Coastal Resources Commission in an area of environm ntaI /concern pursuant to 15A NCAC
l}�—�4 1 County
e a the
Applicant Name Project Location: Coun
Phone #�_
Authorized Agent
Affected t
A
AEC(s): oE
, no
Po
WS
ORW: es \/ no
EW *PTA RES ❑ PTS
HHF ❑IH ❑UBA ❑N/A
PNA yes / n /
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Application Fee(s) Check #
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PermitO ic'r's t d me
Signatuurre [ /
Issuing Date Expiration Date