78542A_Johnson, Keith_20200219

K/C �
YCAMA / ❑ DREDGE & FILL N9 78542 A B C D
GENERAL PERMIT Previous permit #
CgNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality I L 12
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC f . t
,{ Rules attached.
Applicant Name I' `C ii�l J0y'1N 'O N
Address i `1. -c- wrxv-e. 'P
City WlNckcol�e r State 1 A'1iP 2 Z
Ap
Phone # _ 52!ft E-Mail
Authorized Agent ft� I15koti e N1cur , N p,
Affected '4-ew— )(Ew IRPTA krES OPTS
AEC(s): ❑ OFA ❑ HHF ❑ IH ❑ UIRA ❑ N/A
❑ PWS:
ORW: yes / no. PNA yes / V
Type of Project/ Activity
V
Pier (dock) length
Fixed Platform(s) b 0
Floating Platform(s)
Finger pier(s) —
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore'
max distance offshore
Basin, channel ---- ----
cubic yards ----_..
Boat ramp
Boathouse/ Boatlift -
Beach Bulldozing
Other
Project Location: County pare.
Street Address/ State Road/ Lot #(s) 193 L e V
LAX, i`1
Subdivision Cd I N G lON harbor Se C P
City. ZIP }�$
Phone # ( ) River Basin
Adj. Wtr. Body CGr-3cil (nat /6—an /unkn)
Closest Maj. Wtr. Body q,%e Mal` Le S0014d
Shoreline Length 78 rTV'j
SAV: not sure yes ® -
_. _. _
Moratorium: n/a yes no7
. ..... _.
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: \' U i 1 I , j vla C&
( Note Local Planning jurisdiction)
Notes/ Special Conditions
X
Agent or Applicant Printed Name
Signature '- e/a-sse read c,Qmpltw a statement on back of permiitt "
Application Fee(s) Check #
(Scale: = f D )
❑ See note on back regarding River Basin rules.

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 1) 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/ 1-888-41RCOAST 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

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date / . 91.2
Name of Property Owner Applying for Permit:
ex;,n-I 3a04;S�v
Mailing_ Address:
1 U2- t�n,2rL 9bc/i-
4)r�ck(-, i/--&/L- A. :2,2-6oz
I certify that I have authorized (agent) AAZZQtr, to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) (,Az�Si%WG% %? )t ry Q?S -/<
at (my property located at) t n,,,-
This certification is valid thru (date)
Property Owner Signature Date

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Owner:
Address of Property: ZKf- 6L2 1LU A C, DO&L
(Lot or Street #, Street or Road, City & County)
Agent's Name #: A'twlr,)rc Mailing Address: 26�M / 1A1r-r—r1 OnW
Agent's phone #: 2r7V-- 2,iz 7i nq) A) C . 2 1-Sry
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 proposing. A description or drawing, with dimensions, must be provided with this letter.
f' ` I have no objections to this proposal. $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. Contact information for DCM offices is
available at http://www.nccoastalmanagement. net/web/cm/staff-listing or by calling 1-888-4RCOAST.
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, or lift 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)
Signature
Print or Type Name
1 n
��i✓ li.Y',�6i �'�n c"rz
Mailing Address fr1
I.��.CIIn�Si� U/f ?2C.Do
City/State/Zip
Telephone Number/Email Address
Date
(Riparian Property Owner Information)
mature
Ili JSS.r c c
rint or Type Name
113 i p / �ti1 abxT
Mailing Address
I-J9/z� An . 2a 6S--2
City/State ip
-WO - Y-N -S97o rosu )I -(;Ad er .cam
Telephone Number/Email Address
Date
JLC
(Revised Aug. 2014)

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to f 3 W) J soj 's
(Name of Property Owner)
property located at J J`1 1-n ,�- GLu ,2'r—
(Address, Lot, Block, Road, etc.)
on %l<ChR 5c'�C)Yvl) _, in hx<<- Ard FL IA-rus N.C.
(Waterbody)
Agent's Name #: gipvtzOL-
Agent's phone #: 2 rz --267 - 2/� -7,e
(City/Town and/or County)
Mailing Address: lb cjZ, Mikft--79,t- &)CY9 /J(L-
/knW J , C, 2 7 SC- 1
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)
6'03s,'(ZJ,7- A PJ,Z—� 4cC,/1
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. Contact information for DCM offices is
available at www.nccoastalmangement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information)
Sig ure
Print or Type Name
63 t/"-Tt' P/cc
Mailing Address
Gv. e,4 14r4 - ✓ A '906 a0
City/State/Zip
Telephone Number
/,-) L9 7r/9
Date
(Riparian Property Owner Information)
1� /) wz�4�
l
Signature
z<< � Cfsd Re-1 �
Prime Type Name
i2 / 3 PL 3a- gr-1Q PP -
Mailing Address
JIB- acLI , di . Y -r
City/State/Zip
Telephone Number
L/ y
Date

PJ
•1 f4' yq a
Ilk
at
d
,t �
y
4 'R
"N
`
This map is prepared
from data used for the 149 Lee CT Owners: Johnson, Keith H -Primary Tax District: Colington
ti11' ( )`_ inventory of the real Colington NC, 27948 Owner Subdivision: Colington Harbor Sec P
,,• • �J�� property for tax Parcel: 020128000 Johnson, Barbara A -Primary Owner Lot BLK-Sec: lot: 49 Blk: Sec: P 6
purposes. Primary Pin: 986420808394 Building Value: $177,400 Property Use: Residential 9
urs '
information sources such g p
as recorded deeds, plats, Land Value: $126,900 Building Type: Beach Box
wills, and other primary Misc Value: $6,200 Year Built: 2018
fir public records should be
consulted for verification Total Value: $310,500
of the information
contained in this map.

Untitled Map
Write a description for your map.
f.
� .e
r� F,• , T� •rd +��
�.
All
• ,� F .: ,4, r •
b ;
y • i « } 1�
Y • i � 1 ��
•
Legend
149 Lee Ct
®
Dadaab Refugee Camp
0
Feature 1
®
Feature 2
Howard Reef
®
Larsen Ice Shelf