76837A_Waltemeyer, Robert & Ramona_20200806

VCAMA / ❑ DREDGE & FILL
GENERAL PERMIT
New -Modification Complete Reissue ❑Partial Reissue
N° 76837 (3) B C D
Previous permit #
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 -7-9l iuc>.' 7-A-(. 14c )
;� U'Rules attached.
Applicant Name Qp i' Rn�C.2cl +P�'�e%� Project Location: County f:&QA_
Address j I C? j„��i' rnt �s�r. IC �r c.e. Street Address/ State Road/ Lot #(s)� �� Sy— C�•c t,i'�iC�
City (G;C. State_ ZIP �119 L:.t ('
Phone # ($71 ) 2SC-0-'93 E-Mail )1,1b -l4rP MrP
Authorized Agent I ,off. &I/J-erc1S
Affected ❑ CW 4EW aPTA 4S ❑ PTS
AEC(s): ElOEA ❑ HHF ❑ IH ElUBA ❑ N/A
❑ PWS:
ORW: yes no PNA yes /(nq
Subdivision
City C is i Lc ZIP a?CY29
Phone # ( ) River Basin c.��
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Closest Maj. Wtr. Body C�s'''ycc d
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Agent or Applicant Printed Name
Permit Officer's Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Signature
!�&_9-'P,© IP_ -G- :13
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 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/ 1-888ARCOAST 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

AGENT AUTHORtzATIQN FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:..t
Mailing Address:
Phone Number:
Email Address: l' �� ..., t; e�„ .{ cr (� < < • ;"� 1 i
I certify that 1 have authorized #�xx c G, 1 1 t �, cE� i fill ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: " .
1�i � jCi �, �c �1r^.•C � r� {.� :1 '� :i 1.�. 1. ;, ' jtd h'•G.Ytt , lv. i` 1'1ti:rti .
IA''s 1"'S4e:t`1 4
at my property located at ; tG
in
County.
1 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
Print or Type Name �—
<;- j:!�t D1,�
—� itle—
(��
Date
This certification is valid through ,/ G 1 30 1 1* 7-6

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to t u �j _ wa. ij} O 's
(Name of Pr perty wner)
property located at /a �-d� c4nvA.s �2* A- r,y�
(Address, Lot, Block, (toad, etc.)
on _ �c>%f! 1"t� G v tc � in f v le 4, 4-- N.C.
(Waterbody) (Citytrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Io t_
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(IndfvkhW proposing devekVMrrt must lilt in dvscrlpdon below or aftch a site drawkV)
(Z.cc wt C'
A-k ev
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.
(Proert Qwner Infor ti n) (Adjacent Property Owner Information)
S
Si rure* ure �8
Print or Type Name J Print or Type Name
11 0 (• W CAN VAS RAr t !D&
M�iing Add Mq#ing Address
. %.k-Cg 1 �r 2-tg2.9 Nc- -:2—RA
Ci4olState2p Orb j-- 14-Me.3t- Cifwstateo i
5"L 1- z2 c-G5�3 3 �m t ,car ; �7 — X �;, os-1t cad l,t 3 r+i i . twr►
Telephone Number / eh7ail address Telephone Number / email address
Dare tJ 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 a.2 7e. % e�"v s
(Name of Property Owner)
property located at -1>
(Address, Lot, Block, Road, etc.)
on in ��rc'u -) Gk_ 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 abjection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(fnditrtdtW proposing dovokpment rrttrat Off to doSetIpt#on betnw Or attach a Me drawfi 9)
4AA>4 Alto
WAIVER SECTION
I understand that a 6ler, dock, mooring pilings, boat ramp`"bretkwater, 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.)
rs 1 do wish to waive the 15' setback requirement.
r+, j4-_ 1 do not wish to waive the 15' setback requirement.
(Property Owner Information)
Znatupre 11�-o s C a
Print or T pe Name )
knifingV16 to
ddress
C' /Stat ip
ant - Z,>"7 tort 21p
'-Telephone Number/email address
X-74r_
_(.,/C�
Dtue
; 34r,C1,,bvl �h vsds , ► ! . c c
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
ItnatureoInvt
Print or Type Name
Mailing Address
CitrState/Z#i
Telephone Number/email address
Date*
(Revised Aug. 2014)

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