78526A_Rayfield, Timothy & Angela_20200227

dCAMA / ❑ DREDGE & FILL N9 78526 B C D
9ENERAL 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 A� j�. ICU 'P ��"� Project Location: County ( 1 4 � C V�
2
Address
City N ,vcf State ,U, ZIP
Phone # (757) �I 3- 3?SS E-Mail
Authorized Agent ►R, - ► I�„ds
Affected ❑ CW ❑ EW W(PTA ❑ ES 1APTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW: yes / no' PNA yes / no
Street Address/ State Road/ Lot #(s) 12c.> C� Iw f Ll /ram
)t I(
Subdivision j - j IS Iry r_ _ 4
City AAA-,VCc k- ZIP
Phone # ( ) River Basin 111
Adj. Wtr. Bod(nat /ma_ n Junkn)
Closest Maj. Wtr. Body i:.,—
Type of Project/ Activity i ! ;P, i , h 3c� i^ a cII M f , ' / / T7 l> /�` �G GI �/JGv Cn,4 11 � 16
(Scale: I " = -3 )
Pier (dock) length I I
Fixed Platform(s) Gk SG
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathous Boatlift t
i x j
Beach Bulldozing
Other ' 3C fxllSwa�i
Shoreline Length - 3 �_
SAV: not sure yes no
Moratorium: r n/a;yes no L
= ... T
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: rGJI 141 C k C �.,-f �/ ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/Special Conditions AL LL4 Cf a(- S41��r1"', `4cd L- C4 4L, Gv,�
Tn�lr Applicant Printed Name
Siinature " Please read compliance statement on back of permit
I ;Loc C3- '((r 3S
Application Fee(s) Check #
o4l+ ca 6
Permit Officer's Printed Name
Signature
CD 0
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/ 1-888-4RCOAST 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:Hportal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

DIVISION OF COASTAL MANAGEMENT
AGENCY FORM FOR PERMIT APPLICATIONS
I -- . os"•ner of the property located at:
(prope • • owner)
J Zc� 17,yV,4 � 5 .t
�sdC rt/C_ 27 ei ��-
(proPer-::_ „_....:: ;:::.ress;
do hereby authorize ; ca {;,•� �/i��, , ,,_ ,e ,
(naM _ _ ..: - _ - acting as agent)
to act as my agent for the purpose of obtaining=
an� �.yy.' - .g al Area Management Act and/or
Dredge and Fill Act permits, that may be nor: Ye _.onosed development at the above -
indicated property, which entails:
ltr9 ItV/t/ / k pe 0 ' �t3 5,q 1),'j4
4
(describe proposed development or r:ch permits are being sought)
This agency authorization is limited to the specific activities described above, and will expire on:
(date on which agency authorization expires )
d_-_d�zz_
(si ature)
(printed name of owner)
2/� 22�20
(date)
(title, if officer of corp. owner or trustee for property)

.M-
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: f,,,.�.,�t-�_. 2A-,,- j,j
Address of Property: 1 2D C fortfie. A.Mow Q ^ , 7� S
(Lot or Street #, Street or Road, tity & County)
Agent's Name #: �cu 0,J ,,.,y\ l n--e Mailing Address: 1315 +„ i I s Cry l✓ rd
Agent's phone #: 2S-"3 �(�'�ty-Z—
I hereby certify that 1 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
t are pr osing. A ...., . o With
I have no objections to this proposal. I 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 athttc://www.nccoastaimanaaement.net/web/cm/staff-listing orbycaHing 14RU1-4RCOAST.
No response is considered the same as no objection if you have been notified by Ceitihed 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.
not wish to waive the 15' setback requirement.
(Pr Own of atio
C-,-.
lure
Print or Typ Name
jsz J
Mailing Address
C 4,,.,u0, A 4L t/,+; 7-332 36r4z6q
City/Stat ip
37,:
Telephone Number/Email Address
,;vZZ4-4
Date
tt or Type Name
ock�ly�
�D %
elephone Number/Email Address
(Revised Aug. 2014)

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: % u �l ,, 11 i0so-y A-elQ/
Address of Property: I Z O CraAtiE r- 43T Wriaac� I 1n_.. 7�-; SLR
(Lot or Street*, Street or Road, City & Co nty) �
Agent's Name* i31f o-re Mailing Address: t 3 i �;- +J t IS Q'ee K (- -
Agent's phone #: Z 5 Z -33 3- 0 3 (v Z yjL 27 q 1-5-91
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 ftar of
Y'� ✓ I have no objections to this proposal. I have objections to this proposal.
Ifyou have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within to days of receipt of this notice. Contact information for DCM offices is
available athttA://www.nccoastaimanaaement.net/web/cm/staff-iistin4 orbycalling 9-888-4RC OAST.
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.
Signature
Pfint or 7)q Name I
Mailing Address
Ct#StaAZfp
/ -,) Z,7
Telephone Number/Email Addmss
Dad
(Riparian Property Own Information)
A 4 - i10 N4-«- W l0 S CE
ifnt or Name
Wading Add
cu
YY �V1W
phone Number/Email Address
X Z / z r/zo
(Revised Aug. 2014)

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www.co.currituck.nc.us/Geographic-Information-Services.cfm shown on this map.
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