Merrell, Mark

AMA / ❑ DREDGE & FILL No. 76318 A B G D
NERAL PERMIT Previous permit#y
Date previous permit issued
W ❑Modification ❑Complete Reissue ❑Partial Reissue ��
As authorized by the State of North Carolina, Department of Environmental Quality w
and the Coastal Resources Commiss n in an area of environmental concern pursuant to I SA NCAC El Rules Chad.
GHQ i Applicant Name _ _ Location: County G —
'Project�.
Address � Street Address State Ro /Lot #(s)
Phone #)ayl— E-Mal .— Subdivision
City_ ZIP
Authorized Agent -—
i.r� Phone # (_) r Basin
Affected '�A DES OPTS /
p OEA ❑ HHF ❑ lH ❑ UBA O N/A Adj. Wtr. Body toy na .man unkn
AEC(s): Get .�—
PWs: 1---4 Closest Maj. Wtr. Body -�
ORW: yes (no` PNA( yesJ1 no
Type of Project/ Activity
Pier (dock) length_
Fixed Platforms) _
Floating Platform(s)
Groin length _
number _
Bulkhead/ Riprap
avg distance
max distanc
Basin, channel _
Boat ramp
Boathouse/
Beach
Other
Shoreline Length _=q.� Z_
SAM notsure yes
Moratoriums n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Speciai Conditions
e=,.."* Please read compliance statementonbaFeels)
(Scale./// )
1 ❑See note on back regarding River Basin rules.
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AMA/.❑ DREDGE & FILL No. 76318
—� A B / C D
"GENERAL PERMIT Previous permit# L/
ew ❑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 environmel/ntal concern pursuant to 15A NCAC /r/ a
❑ Rules ttached.
Applicant Name /���y'� Project Location: County C G`ye�
Address
City_
Phone #
Authorized Agent
Affected •,
AEC(s):
❑ PWf
T StreetAddress/ State Road/ Lot #(s)
/ /t12�i'f rr
,p;EW �A ❑ ES ❑ PTS
❑HHF ❑IH ❑UBA ❑N/A
ORW: yes no/ PN,
Type of Project/ Activity
Pier (dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap lengt
avg distance offsh e
max distance offsho e_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length 4
SAV: not sure yes
Moratorium:n/a yes
Photos: yes
Waiver Attached: yes
yesj/ no
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
CC/
'^c
tyte *'t Please read compliance statement on back ofpermit �
t lic/at,�ion F�ee,(s) �� Check #
Subdivision
City by ZIP /
Phone# () River Basiny '-
Adj. Wtr. Body Frl�a l'��C` na man unkn
Closest Mal. Wtr. Body
/A
11XY6
(Scale-,-L/f
❑ See note on back regarding River Basin rules.
Gkl
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
Iandowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar -Pamlico River Basin Buffer Rules ❑ Other:
I_INeuseRiver 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
(Name of Pr peCty 99wner)
property located at zO/2 L /+�l v�� /,� h'. /� L -,e
tl (Address, Lot, Block, Rd, etc.)
on k is 17N.C.
(Waterbody) (City/Town and/or County)
The applican .has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
V (Individual proposing development must till in description below or attach a site drawing)
v --
s r'
ZX
tf
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.
(Property Owner Information)
Signature
�FIt / rGY/6 l/
Print or Type Name
ding Ad s
City/Stal jp
Z 5Z
Telephone Number/email address
6/Z_o
Date
*Valid for one calendar year after signature*
Owner Information)
Mallin dddress )/ �S!
City/StateR9. �7c3'9 6
Tele hpyne JVumber/emall address
_S11.5/70
Date
(Revised Aug. 2014)

�JO(e
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I `fir AAL,-` 's
Property _ C)p�� ���� p(Name of Property Owner)
located at
(Address, Lot, Block, Road, etc,,,.i�
on )0t in �� rn8A:�`e N.C.
aterbody) (City/Town and/or County)
The applicant has described to me, as
local, ?I shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
J (individual proposing development must fill in description below or attach a site drawing)
v
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 doot wish to waive the 15' setback requirement.
or
Date _
'Valid for one calendar year after signature'
(Adjacerst Property Owner Information)
Signatures'
Print or Type Name
Mailing Address
City/State/Z/p
Telephone Number/email address
Date*
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR LAMA MINOR PERMITS
1 horebY certify that' own property adjacent to
of
Property located at(�e Property Owner)_%O
on AY
'n` Address, Lot, Block, Road, etc.)
.�i�� (i�/�p �1 in i�V1 P .1/'G�.Qd `�G DO
(Waterbody) (Town andlor County) N.C.
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
Signatur11e
Print or Type Name
zsZ-bzz_ ��II.�
Telephone Number
3 iJS Z0ZD
Date

3-13-20
Adjacent Property Ow
JO/D Eiti s. G/ ��• ✓L
Mailing Addr ss
City, State, Zip Code
Receipts
or
Certified Mail
)
(Staple He
Dear Adjacent Property:
This letter Is to inform you that I, zs/ ;pave applied for a CAM k Minor
Property Owna q
Permit on my property at ;7 1Z /+��� /
In Carteret County,
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and pr ject
drawing(s) as notification of my proposed project. No action Is required from you or you may sign 81 id return
the enclosed no objection form. If you have any questions or comments about my proposed project please
contact meat —757 ZYl 77 6 /
or by mail at the address listed below. If you vish to
Applicant's Telephone
file written comments or objections with the Town of Emerald Isle CAMA Minor Permit Program, yo J may submit
them to:
Local Permit Officer for: Town of Emerald Isl
7500 Emerald Dri ie
Emerald Isle, NC 28594
Gm4 c✓a'r,(
Mailing Address _ I
AmCrl -)1i .7-Slc fN L
City, State, Zip Code `�

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