75393_Michael Bass_20200623

gor CAMA/ 'DREDGE & FILL P�S No. 75393 A C D
GENERAL PERMIT I°WL2L°L Cil Previous permit# ,,f//A,.
> KNew ❑Modification ❑Complete Reissue rilPartial Reissue Date previous permit issued �//9
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 --I=- U////, 1(6(...) .
�/ BRules attached.
Applicant Name/ / <L, / /i:I/ Project Location: County I-,-', /-., /
Address
324/ e,,. e 7j�e /'/ 4( Street Addresss//State Road/Lot#(ss))._.7 V ,f-? e
City 1J� 1� State,f/L ZIP � 7C /i�,, /`,� _)
Phone#fg.,12)a'(- 9711, E-Mail Subdivision ------
Authorized Agent v f1, 1 - �,J / //h ' /,J City $< // ZIP o7 -Ze?
Affected fCw CHEW ❑PTA 2ES JZPiS Phone# ('>-1 )-`- 'C - ?7/7 River Basin 74:;///ti'r+
❑OEA ❑HHF ❑IH ❑UBA ❑N/A �„ a �,� � at /man /unkn)
AEC(s): Adj.Wtr. Body_ `,
❑ PWS:
ORW: yes no PNA yes /yno� Closest Maj.Wtr. Body I`_i'' I !1 "e-
Type of Project/Activity ' . %//., . I/ ' / "7 r,�- C -2 e..', %, kr,._/ a/ -�- r-l_.. p-'U e:i/7
I,. I (Scale: /, , 41r i
Pier(dock)length
Fixed Platform(s) I __ I , i _- . •
g O 4 i I ,
Floating Platforms I
Finger pier(s) p ,� t e,
Ada i
Groin length i
number ; I I
BulkheafLprapngth WO
1 - 1
avg distance offshore 17
4 �"
max distance offshore s .,e'
Basin,channel i -
cubic yards I I I --- -- ___
Boat ramp i
, ,
Boathouse/Boatlift —
,re
- ....._.
\ I I i
Beach Bulldozing i ---
Other ; ;: ; ‘,i— i" /4/flip& _I
� � � � C.',,�,� r�-
l
.7./ 1------t---•._
1..i •Shoreline Length f/6 -- ot• (1 />'f/ �/`
11 t / , j
SAV: not sure yes r�q �r..+..w_� ... ... J - �.I 1 I I i Q
v < I 1 ./
Moratorium: n/a yes j i i — � 2, /
Photos: Cep no —._.. — ' --4
Y. i i I
Waiver Attached: yes no
A building permit may be required by: /1 ; /,, / . V See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) / � /
Notes/Special Conditions 6,e Q //,,Z(/(,O) ' b c /� <// c� 1 gii j/ r7,- / ft,- /
M\C \Oa-C:2-) C-- V''):Z‘\))S
Agent or Applicant Print Nam PermitQf 's Printed Name
Signature ** lease read compliance statement on back of permit** Signature /
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 n 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 (252-946-648I) or the
Wilmington Regional Office(9 I 0-796-7215)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/ I-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 Wilmington District
40 I S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 9I0-796-7215
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

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N.C. DIVISION OF COASTAL MANAGEMENT
• AGENT AUTHORIZATION FORM
• 442acich-
Date •
•
Name of Prope Owner Applying for Permit:
•
Mailing Address:
32 rn' i''\NI T ec R(:k-\\
r M3X
I certify that I have authorized(agent) 1;C.\W-Vi4tli(1Gy rite. to act on my
behalf,for the purpose of applying for and obtaining all CAMA Gi Permits necessary to
�1 n.
install or construct(activity) �f 1 C 'Ce` e s\YA c'e
at(my property.located at) 3 g T_4 T i n e T'lre e ?Mt)1 •
This certification is valid thru(date)
Pro Owner Signature Date
•
3 of 3 6/18/2020,9:35 AM

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r -- --- - - ---
ADJACENT RIPARIAN PROPERTY OWNE STATEMENT
I hereby certify that I own property adjacent to j!! l;eke Atisis
-�- ame of Property Owner)
property located at fgt./ ifle free 1
�p (Address,Lot,Stock,MAtc.)
. on Ti7M11. Q liter ,in N.C.
(Waterbody) (City own andlor County)
The applicant has described to me, as shown below, the development proposed at the above
location.
L/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill ht description below or attach a site drawing)
WAIVER SECTION
I understand that a pier,dock, mooring pilings,breakwater, boathouse,lift,or groin must be set
back a minimum distance of 16 from my area of ilparian access unless waived by ma Of you
wish to waive the setback,you must initial the appropriate blank below.)
t/ l do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement
(Property Owner Information) (Adjacent Prope rr I rotation)
ut !_ 1fAcaj fN1SS S' jt7j';jilank 1��
� t7 '(l
T Y( R l PineatecTY S4'5160\ )3. 1-
AWAIT ;1-go2 Itgaterityw FAA ?AA tic a7742
W -g7/4 7:MI-s-)R9b
Teieph lVj{rlrbera� Teleph eNailerz
Lime Dare
Dare Nailer
(Revised 6/182012)
I of 1 4/9/2020, 11:19 AM

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AD.AC.ENTRIPARte@ ei r,i 1
IhlirebY CBIU tlnt I own properly aliment o
Properly located at 32q Tine Tree ' Pn Owner)
(Addn
on Cl1M\1C QlV Lets g �gaha,et:.).
(Waterbody) IyC liownmawCounty) N.C.
The applicanthas described to me, as she an below,the development proposed at the above
l I have no objection to gas pn posai.
I have objections to this prop seal. '
DESCRIPTION AND/OR DRAB SING OF PROPOSED DEVELOPMENT
(ZAm ul pfopoe, devadopntentnum fill In*scvfpEon below or attach a alto drawlna
wittess
Soretwe
MTh
I understand f a PIS.dock,nioodtg PEE Is,bSalevater,boathouse,lift,or groin must be set
bade Mhttium e cliam ,of.'15 from my a ea Of*ads t saw Mess;waived•by me.(If you
wish to waive the setback,you Sit Muhl'he.spp oprtale btgrlk beicw.)
L wish to wales the 15 setbi dt taquireg ant,
I do not witch to waive the le 'Mack
•
(Prom*Owner lationatki (AdjacentPropelty,; erlawma&n)•
j�t1;clp�r 1� nss _
•
Minter
fl
anie— 9�-L 21Cs x_ .
T Number
Date XD ,,
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1 of 1 6/18/2020, 12:41 PM

II
NC Division of Coastal Mgt Habitat Impao# Computer Sheet I !
Applicant Ao G Ec
8 '
Date: J, cp. 3 a.2e
General Permit It: 'S 3'9'3
Describe below the HABITAT disturbances for the application. Ail values should match the name,and units of measurement
found in your Habitat code sheet.
TOTAL Sq.Ft FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipatedfoaal (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance . Disturbance disturbance.
Habitat Name Choose One • includes any Excludes ant total includes Excludes any •
anticipated restoration any anticipated restoration and/or '
restoration or and/or temp restoration or temp impact
temp impacts) impact am curt) temp impacts) amount)
SkaAa Dredge❑ Fill 2 Both ❑ Other ❑ ./A0 I/O'
XL' 1,'4‘ Dredge All E Both 0 Other 0 5S0
Dredge❑ FII❑ Both 0 Other 0
Dredge 0 Fill 0 Both 0 Other 0 i
Dredge 0 Far❑ Both 0 Other 0•
•
Dredge 0 Fill❑ Both 0 Other ❑
• Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other 0 -
•
Dredge 0 Fill❑ Both 0 Other 0
Dredge 0 Fill 0 Both ❑ Other ❑
•
Dredge❑ Fill❑ Both ❑ Other 0 •
Dredge Fill Both ❑ Other 0
Dredge❑ Fill❑ Both 0 Other ❑
•
Dredge❑ Fill❑ Both 0 Other 0 •