78513A_Waters, Derek & Michelle_20200218

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XCAMA / ❑ DREDGE & FILL N9 78513 OA B C D
GENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑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 15A NCAC
21 Rules attached.
Applicant Name lie r e k E C }\ e(l t U _fie rS Project Location: County_ E r n ,� e . -n �, A
Address I f�1 Iri A I'r_k p1v� r� Street Address/ State Road/ Lot #(s)
City ((E c'1't Or G, State PC- ZIP �� I i I u i i f i I )CA & Lt�
Phone # Q 5 Z) 3 39I ' 3 1) E-Mail Aft V- V c,1111" 0) ;yNO�, Subdivision
Authorized Agent City k r I f or I _ ZIP 7ggq
Affected ElCW ElEW ® PTA El ES M PTS Phone # ( ) River Basin CA
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Bod Cr 0 r. n /man /unkn
)
❑ PWS:
Closest Maj. Wtr. Body
ORW: yes / no PNA yes / no
.'e of Pro*ect/ Activity A' i
III 6_
Pier (dock) length I
ONN
Fixed Platform(s) NO-VA"MUMP-5
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead( Riprap length 7'Ci
avg distance offshore__
max distance offshore I U
A building permit may be required by: r n o Ow t4 ❑ See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction) rrr
Notes/ Special Conditions y bG ar c r t Le- 4'Q I R 64 e+ ('�-+(O ► CJ5
Lc Lug �1a,.r� �.c.InS�rcJ� C'r6Sir.t
i,.. lt: lar- r� /1 d r,o.rnni e d
1
Agent or Applicant Printed Name Permit Off er's Printed Name,
--- rll J 7.�C-
Signature ** Please read compliance statement on back of permit ** tignature
er447- v
Application Fee(s) Check # Issuing Date E piration 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 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/ 1-888-4RCOAST 252-946-6481
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
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)
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 711361 \7

CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Date
)4 (4 I I c/
Name of Adjacent Property Owner
145 M 11 ?,4 fla" L a" C.
Address
)J,.xdfr,rJ Nc 2-24y4
City, State Zip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit
to b%rdd a 010cK aA"t r-I r,,,P Shne- 1,,c- (3ao sec.+\
on my property at ) (o 1'" ll e f %qc 4 GgA C— py Y in
County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to
me as soon as possible. If no comments are received within 10 days of receipt of this notice, it will be
considered that you have no comments or objections regarding this project. If you have any questions about the
project, please do not hesitate to contact me at my address/number listed below.
If you have objections or concerns about the project, please mark the appropriate statement below and send your
correspondence to the NC Division of Coastal Management (DCM) at 401 S. Griffin St., Ste 300, Elizabeth
City, NC 27909. The staff at DCM can be reached at 252-264-3901.
Sincerely,
z rct- b-3 Zsz - 5.-3 9 - 36-7 3
Property Owner's Name Telephone Number
Address city State Zip
X— I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
,e� e�w
Adjacent Rip ature
Print or Type Name / Date
Telephone Number
Em—aVAddresLJ
Address city State Zip

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Par%,C-I JL, +- EGaj

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■ Complete items 1, 2, and 3. At
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space Dermits.
Article Addressed to:
Zo c�+
NC Z7S y9
A. Si nature
❑ Agent
X
❑ Addresse
B. Received by (Printed Name)
C. Date of Deliver
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
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Signaturre
❑ Adult Signature
❑ RegisteredMaillTTMss®
9590 9402 5510 9249 9569 82
❑ Adult Signature Restricted Delivery
❑ Certified Mail®
❑ Registered Mail Restrict
Delivery
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
9 Grfirlo Ni imhar /Trnncfpr frnm c—iro laholl
❑Collect on Delivery Restricted Delivery
❑ Signature ConfirmationT
❑ Signature Confirmation
7 018 0680 0000 7627 7342
fired Mail
fired Mail Restricted Delivery
Restricted Delivery
...ar$500)
PS Form 3811. July 2015 PSN 7530-02-000-9053
Domestic Return Receip

USPS TRACFWG #
First -Class Mail
Postage,& Fees Paid
USPS
Permit No. G-10
9590 9402 45 139�49 9569 82
United States
Postal Service
• Sender: Please print your name, address, and ZIP+4® in this box*
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Perquimans GIS
For tax purposes only. Not a legal document or survey. Perquimans nor State of NC assume any liability resulting from use of this map.