75437_AJ Stancill_20200228

OFCAMA / DREDGE & FILL JD 4 L26 157 No. 75437 1
GENERAL PERMIT S Previous permit# A B J i./ r Ai-
>Z New Modification Complete Reissue Partial Reissue Date previous permit issued „/ /,41.
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 :=7 7 y-4 • ' / `-' `-'' .
I Rules attached.
Applicant Name Ate' 3-r-A,..l c.l L. Project Location: County hcA r-i F-d�z-i ' - ,
Address / 51'Z3 Pe-ifa fit- S -0 Street Address/State Road/Lot#(s) -],_ i 1
City .5,l Enl1/ii. State ?0 .ZIP -721�3SL (� /. --- 7 /.,)Gy, 4 -75 „��
Phone # ( r2) c7/6 - ..'7 6 7'E-Mail Subdivision Z.A ).•S "v &-- /—.14.);Lt3
Authorized Agent /44PL-'.-/s /t / ,> - City ...,--ioe.e-, J,4J-,T 'j ZIP L-7 'v <
Affected CW ❑EW ETA ❑ES ) PTS Phone # ( ) River Basin 71 ,toz- 1 4,, i,
❑OEA ❑HHF ❑IH ❑UBA LN/A
AEC(s): Adj. Wtr. Body :"-`/ -/4"-4404= .4-0 nat kn)
E PWS: —7 _------7
ORW: yes / no ) PNA yes±110—�
Closest Maj.Wtr. Body -7' 1"1 0 /"- r 41, '
Type of Project/Activity ,-_.Oicf-r...e� -- -7 G 2, , --.,- •-r
A
(Scale: ) _ - ' )
Pier(dock)length
Fixed Platform(s) alFloating Platform(s) I I
Finger pier(s) I
Groin length
number ' lf' - p',.4,-0¢ -r"Ar'24R-1 ,
dBulkh Riprap length__ ( ' ,
._t_____
avg distance offshore '
max distance offshore 2
Basin,channel 4- 1 S'7 r a c- f
I.
cubic yards Vi
Boat ramp
Boathouse/Boatlift Z I '..2
4
\\,/ : ,
Beach Bulldozing 1/4.,r ' i Ai t }
Other
L — • ST++c e �
, \
`,-- .),,,
Shoreline Length -? L. ,_- __
f 1
SAV: not sure) yes no i .e, , t ?Is
Moratorium: n/a yes now
j1I
Photos: yes 695 _ 1
Waiver Attached: yes ,
A building permit may be required by: _fib--a-7- r..7,1 7- �Q. . 0 See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/Special Conditions -(D 7 i , A ' -i,-4-7/.-}--,,- , ' « w ri(
'< , e , /,-, , ,, --:)- ,a-7.—Z.---1 '5 fr i 1.1.6.;'---1
t Agey or 'cant 'n d Name Permit icer's Printed Name ,
/ '% -- -
Signature **Please read compliance statement on back of permit** Signature •
L li t-- f +0c7-- ' - - 6 S'-7 i' 3. '2..,c,2o 2 ..-.] ._, ,,i_..r -Z4-)2 Q
Application Fee(s) Check# 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 (252-946-648 I) or the
Wilmington Regional Office(910-796-72 15)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/ I-888-4RCOAST 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves: Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: / ,,,/ ,7 k c° 1LE- 11y (-6/4-s
Mailing Address: /cs3.3 FAcC u S 72e AO
t 7n�F i V
Phone Number: 2_52— 1/4, -- '9/4, 4
Email Address: et AA , Lceo
I certify that I have authorized A/pileMIS 111m-i
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: St;4.g ff 400
at my property located at IS 7 a E s .-8fir1/4,oe-- i &° �;.,,�,•
in 3y. ,r2-1 County.
I furthermore certify that / 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:
Signature
n
�?` : • •• 4?f11 CI CZ-,Priht or Type Name
Title
z I zv / 'Zv
Date
This certification is valid through / /

ADJACENT RIPARIAN PROPE TY OWNER STATEMENT
I hereby certify that I own property adjacent to - S�AA,A.c1 l 's
(Name of Property Owner)
property located at 151 ttkA 4S►de
Address, Lit, Block, Ro d, etc.
on C�oc .D�.i � f ols to,_ . , in C-knc k. ,.,./, BeAki p(' , N.C.
d (City/To C n(Waterbod� ( ty o County)
The applicant has described to me, as shown below, the development proposed at the above
locatiolr.
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)
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.)
N I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Own Information) (Adjacent Property Owner Information)
Sig atur Sig t e
ut ..) . S 4-c,,,tic ,\
Print or Type Name Print or pe Name
l O'.-3 f ry esS ie � i ng 'Kin 3 CtJl c„ R 3
Mailing Address Mailing Address •, f
G re-eativ.�`e__ ,all 134.1 Pri eit e 4'Or\ rVG 56
Ci,tyy/�State/Zip City/State/Zip
1— C) 1 � • c' c III - '�.Wl- S99v
Telephone Number/email address Telephone Number/email address
Date 1 1,�� Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _ 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town 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)
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 15' setback requirement.
(Property Owner Information) (AdQ ent Pr pe Owner Information)
Signature nature
-� P--v de-5
Print or Type Name Pri t or T pe Na
Mailing Address Meg Address •
City/State/Zip City/ te/Zip/‘,/ 'lp 6 r?
Telephone Number/email address Telephone Number/email address
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

NC Division of Coastal Mgt. Habitat impact Computer Shaul
Applicant A..x. 'S rA rl e t L.L.
Date: 2 5 Ftr'S A,ri,y Z D
General Permit#:'1 5 4-3"7 —3
Describe below the HABITAT disturbances for the application. All values should match he name,and units of measurement
found in your Habitat code sheet
TOTAL Sq. Ft ? FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any •
anticipated restoration any anticipated restoration and/or
restoration or and/or emp restoration or temp impact
temp impacts) impactarnwrd) temp impacts) amount)
Dredge❑ Fill❑ Both ❑ Other ❑ —7 6 �� 1 .�J
g
4.4 a>.Lor.0
a •
Dredge Fill Both2 t rd dg ❑ �J ❑ Other ❑ 1 S 2 fit- /52 �;
11tUµ -
UP-0 u tom. Dredge❑ Fill CIBoth ❑ Other 1st 4 2./4- F4- 6Z/4 14-
Dredge❑ Fill❑ Both ❑ Other ❑
• Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑ I
Dredge❑ Fill❑ Both 0 Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge El Fill❑ Both ❑ Other Cl
Dredge❑ Fill❑ Both ❑ Other ❑
j