76079_Benjamin Simmons III_20200811

R�5 0❑ ❑ No. 76079
CAMA/ DREDGE & FILL ��
GENERAL PERMIT � � Previous permit# ,V/-' "' C D
> Z RN.ew ❑Modification ❑Complete Reissue III Partial Reissue Date previous permit issued y�Ll
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 /.100 /7>/. //G,G%
_ [1ules attached.
Applicant Name /e'-,j e�J.,, -- ' ,'-;:,, 71- Project Location: County- � /V,,,-/.. ( c /
Address 70 ,,-, ,,k,,, z,„` Street Address/State Road/Lot#(s) // -;'/ // ,7,,, 1 i//
/
{ City 4• 7d State ,'U ZIP ..-(9! c'5.- I.�� �i; V � �: '�-::f� ., - �- /
Phone# ( ?) ?`/7 -._.1.,:-. E-Mail Subdivision '
/ r
Authorized Agent / , J. zit C'.>/,,i /, , //,.. City .. '( f' 4,,,., ZIP —2 jk 7.-::
❑Cw [fi'EW 2-PTA 51-ES L-pTS Phone# ( ) ' c' River Basin ! ; r//fir.,
Affected E OEA ❑HHF E 1H ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body `,, , • i ;, 14 4/•`r (nat an /unkn)
❑ PWS:
r ORW: yes trio PNA yes I no Closest Maj.Wtr. Body 1
Type of Project/Activity /,-:s'(/ ' G '
i L 'G . / r (Scale: / ` 7 )
Pie (dock)length /Q'9/*-4 ' .
/7' '/ '' I
Fixed Platform(s)
Floating Platform(s) t l
Finger pier(s) / tU / " AL'y/L
Groin length I c, !tJJc �'' '! I
number -� 'l t �, 1 '
I � 1 Qulkhea�Riprap length �C� �� i + i 1
avg distance offshore C) ` r l , .0# 'l l
max distance offshore
Basin,channel v f^
I t ) C
` V i
cubic yards _ -
i t
EE Boat ramp
, �� i
Boathouse/ oatli /3 /I
Beach Bulldozing j ,,�t :- -
Other
". 11 � i/l 1 I
_ I
. _ i I 1 1
+ i I -}
Shoreline Length f OO I I 1 i
SAV: not sure yes no ,.. C..J" hat 1 i''',..,../., / /u �� Y i L 9 Ar ia/
yesE T 1 � �
Moratorium: n/a o J q .. �r..t�s� I { j
Photos: cye� no --- i j
Waiver Attached: yes no ._____:
1 q
A building permit may be required by: /. 61 e ( D . FrSee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
p C /(. / 4'. t i 1 i/ /�. / 1/l
• Notes/S Special Conditions �:/ �liU �,r�r/ ;r� / � F-.ur'ii� �b0 r•� M 4% .�,. ��
`�/ /J�c,... ,•• /.it,. ci / / y/(�6/'
fe( 6;7//, //6e,)
PA t 1
i'_5 U--)r)o (ri ye() :::37,...-; ,re: 7: 57
Agent 111
©rlk plicant Printed Nam Permit Officer's Printed Name ?
. ' CSC./ l/ a,(J Vf/' �� , f :t r_e .�� ./
Signatures //**Please read compliance statement on back of permit** Signature
-/ (� .(/'/.'., /. i ' .J (7 , ,,,/, .. ,./ /C24 // a ./ _.../c%�-d
Application Fee(s) Check# Issuing-bate 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 (252-946-648 I) 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/ 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
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
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

0 Lil CAMA/ _ 'DREDGE & FILL No. 76079
GENERAL PERMIT ��` `` �� Previous permit# A B.. C D
��—% New —Modification ❑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 I 5A NCAC ic' c
❑Rules attached.
Applicant Name Project Location: County :"-=- - , ! /r.
Address Street Address/State Road/Lot#(s) 1 i :."f
lCity State ZIP
Phone# ( ) E-Mail Subdivision
Authorized Agent City ZIP
Affected ❑CW ❑EW D PTA ❑ES ❑PTS Phone# ( ) River Basin
AEC(s): ILOEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity
(Scale: / )
c.
Pier(dock)length ,
Fixed Platform(s) C
l
Floating Platform(s)
1 j
Finger pier(s) 4 i
Groin length
number f ' ' D'_
, Bulkhead/Riprap length
avg distance offshore r T , , —
max distance offshore
i . . . .
Basin,channel / /
cubic yards
Boat ramp ti--�
Boathouse/Boatlift
I
Beach Bulldozing i
Other 9
r .-.._ —._-1 / -' 1 - ._ 42:;, . ._
Shoreline Length
SAV: not sure yes no __ _____ i l /4/4t
a ' . . f'
Moratorium: n/a yes no 1 /,' r
Photos: yes no i
•
Waiver Attached: yes no - I
A building permit may be required by: % . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
Agent or Applicant Printed Name Permit Officer's Printed Name
Signature **Please read compliance statement on back of permit** Signature
/' 4
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 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(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
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
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

Authorized Agent consent Ag reerfge;0
je
,herby authorize Tobin Jay Tetterton of(Property Owner(s))
TJ's Marine Construction, LLC to act on my behalf in obtaining CAMA permits fol.
-,tie location listed below.
PROPERTY ADDRESS:
//9 A/ lAide--A— a 7-.P7/ 14
C5 ret•A-10') Ak..---- 9?1 /1-/
PROPERTY OWNER'S MAILING DRESS:
-70 5, /11 (Y1 eri,..5 a)/
F(-2,-,.'4,)e/cg C----
N
Phone No `' 1 -3 6 7[J
PROPERTY OWNER'S SIGNATURE:
AUTHORIZED AGENT SIGNATURE: 7°0-4-A-
7.11,(1 /7 -----
TOBIN TETTERTON
DATE: — 3 2t2o
r`''---
W/Authorized Agent Consent Agree. •

AD AC NT RIP N PROP RTY W ER STATE ENT
I hereby certify that I own property adjacent to n
property I ated at (N a of Property Owner}
on
(Address, lac R a I etc,
(Vllateri3ody) in , N.C.
(City/Town and/or County)
lagai.The applicant has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAUVING OF PROPOSED DEVELOPMENT
(!ndivieual proposing development must NI in description below or attach a site drawing)
arUC_+i`er 0-e- c5d '61:-) V'n Sots ead
, /*)
Pile_o I g 'I -
p/c4rrr �(.56�59` -6/)
Socrtiv:-P-fr r
:,,::
I understand that a pier, dock, moorinWA1VEg R SEC r 6Oly
pilings, er,
must be set back a minimum distance of15 from°my areat a of riparian a cess unless
boathouse, lift, or�ess waived br by
me. (If you wish to waive the setback,you must initial the appropriate blank unly
below.)
a do wish to waive the 15' setback requirement.
112 I do not wish to waive the 15'setback requirement.
(Pro "ty Owner Information? {.gd)aceert Propettir®caner information)
'0natu a 1 .
fk.1 A '+►ri M SZa 2Qd2U'e'
tts .11l /,5 �'llL Print y Name
Print or Ty e Name
Adailing re s cp
` ,'wisp Mal Address
Cat%S te2�p V ' 1)
Lit6
City/ te/Zip
5—
Tel hone Number/email address
3 Telepho e N'mberl email address
Date --. 8��/ZOZU
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

A I' OP
A T
I hereby certify that I own propertyadjacent to (� I ` iii =
property 1 tad at Q ( e of Property Owner)
cn �� (Address,tag Imo , R a ,etc,)
(Waterbody) (City/Town and/or County)
Th •piicant has described to me, as shown below, the developmentr
racz on. proposed at the above
1 I have no objection to this proposal.
i_..„.,: I have objections to this proposal.
DESCRIPTION AND/OR DRAvvir G OF PROPOSED DEVELOPMENT
(individual proposing development must till in description below or attach a site drawing)
3,,,s+,,,,,,,e,, ( C56 `67(-) itr'n / v341 /}ead
91'c ' / y ' mil-)
s -A oco--4:-P-i—
,,,,,,...,..„-)P ()LE./
:_.::ccsr l
..„air£:,, 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
:-.,,,It me. Of you wish to waive the setback, you must I tiler the ap
propriate ppropriata blank below.)
i do wish to waive the 15'setback requirement.
do not wish to waive the 15'setback requir- /
(Pro ., : Owner Information
(A : `- • erty Owner Information)
/---
aftt e
rin� Name or T G A ��
t1 N1
6deiling s G � (�
J /U[, f dreC�J►A RD z V i lG y�-
Ts ho��ne Number 1 email address 1 4e ����
' c � !a o ' �(uml�r/ iss
DateDate4 czao
3(J`j
(Revised Aug.2014)
`Valid for one calendar year after signature*

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NC Division of Coastal Mgt. Habitat Impact Comp ter Sheet
Applicant:
Date: If A/4., --2-4920
General Permit 4: 76 079 f
Describe below the HABITAT disturbances for the application. All values should match he hare,and units of measurement
found in your Habitat code sheet
TOTAL Sq. Ft FINAL Sq. Ft. ; TOTAL Feet FINAL Feet
(Applied for. (Anticipatedfral I (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance Disturbance . disturbance.
Habitat flame Choose One includes any Excludes a-' includes Excludes any i -
anticipated restoration any anticipated restoration and/or
restoration or and/or emp restoration or temp impact
temp impacts) impact am cut) emp impacts) amount)
,Gtor- l; g I 5b �v
�n e h� Dredge❑ Fill� eoth ❑ Other ❑ --
Dredge❑ Fill❑ Both ❑ Other Er 73 O
Dr- tide- Dredge❑ Fill❑ Both ❑ Other ❑ 4 6-2
Dredge❑ Fill❑ Both ❑ Other ❑
' I
•
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
i � I
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other ❑ 1
Dredge❑ Fdt❑ Both ❑ Other ❑
it
Dredge❑ Fill❑ Both ❑ Other ❑ i
Dredge❑ Fill❑ Both ❑ Other ❑