76846A_F&R Family Holdings_20200824

OREEDGE & FILL B C D
ICANAP L PERMIT Previous permit
GENERA Complete Reissue partial Reissue Date previous permit issued_____,
to Modification Environmental Quality
"I, carohro, Department of lq:c
As Commission in an area of environmental concern pursuant to I SA NCAC ZC>' by the State 011,10 Rules attached.
"'i Ent Coastal Resources
tect Location: County cc-p'- +-Lc
Applicant Name rr'�
pp Street Address/ State Road/ Lot
Address PO 13D*,e 35
State A
City ivlo�k, - -)' ZIP Subdivision
Phone# E-Mail
Authorized Agent
cw "Aw ✓fTA ES PTS
Affected OEA HHF IH USA WA
AEC(s): FWS' --
ORW yes "0 PNA (/I'esl no
city7--
K'- ZIP
Phone # River Basin
Adj. Wtr. Body C(na) /man /unkn,)
Closest Mai, Wtr. Body Cal -I h-c k
Type of Project/ Activity
(Scale:
Pier (dock) length � Lif
Fixed Ptatform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkheadi Riprap length
avg distance offshore
max distance offshore
Basin. channel
-U
cubic yards
Boat ramp
Boathouwj Boatl;ft
Beach Bulldozing
4
Shoreline Length
SW not snare (Yes
Moratorium, Grva) g) - av-V f"op
Photos: 90 t lot)
Wawer Attached Yes C---)
A building permit may be required by: See note on back regarding River Basin rules.
� Note Local Planning jurisdiction)
Notes/ Special Conditions
:36� M- a -'re,
Agent or AppIkAn( Printed Name
slitwurt �ease read compliance statement on back of permit
Applicarimf Fee(%
t -] tie 1-1 - ------- -
Signature
Issuing Date Expiration Date

VERFORM
DIVISION OF COASTAL- MANAGEMENT
NTIFCATIONIWAJ
ADJACENT RIPARIAN PROP
�T RERUEOSTEiD or HA D DEL EERRED,,
CERTIFIED MAIL RETURN RE p
12 k _
Name of Property Owner.
i
Address of Property: Road, City & CountY7
(Lot or Street #, Street or
Mailing Address:
Agent's Name #
Agent's phone #: --'�
that I own property adjacent to the above referenced property. The individual
I hereby certify I
applying for this permit has described to me as shown on the attached drawing the devef l p er n
they are proposing. on or ra ' d*m nsions m be rovid
V I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St:, Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264
390J No response is considered the same as no objection if you have been noted by Certified Mail,
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, lnf rmation)
Signature
Print or Type Nern
Mallrng Address
Ncqr tJi"7C}
citylStat®flip
Telephone Numberl Email Address
Dare -- --• ,M — _ _ ._
"Valid for one calendar year after signature"
(Adjacent Property Owner Information)
Signature
Print or Type Name
Mailing Address
A , J
L,nylStafw zip
Telephone Number/ Email Address
Due•
Revised Jan. 2017

DIVISION OF COASTAL MANAGEMENT DELIVERED
AN PROPERTY OWNER NOTIFICAT OAN DAIVER FORM
ADJACENT RIF UESTED or
f-co-n17iFn MAIL • RETURN RECEIPT RE
Name of Property Owner: i
Address of Property. (Lot or Street #, Street or Road, City & County)
Mailing Address:
Agent's Name #:
Agent's phone #:
hereby certify that I own property adjacent to the above referenced property.
The individual
applying for this permit has described to me as shownmmensr the
mushy drawing the development I
they are proposing. n ^ A . or dr
I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin SL, Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901 No response is considered the same as no objection if you have been notified by Certified Mail.
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 Ow=
S ure
Print or Type Name
Mailing Address
+CxsklsvzLipl�-I�_.___,�
�-�2 _ 2 3 - 2t �-�-
�repnone Number l EmaiJ Address
Date
(Adja ent Propefly qwner Info
L
�i arure
V,
Print or Type Name
'Pb ?1--�, 1, 4
Mailing Address
A- V
ylsrr ip
Telephone Number l Emaid Address
"Valid for one calendar year after signature* Dor�
Revised Jan. 2017

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 0 ZO
Name of Property Owner Applying for Permit: ,\
S P 14 P Y-LE &F-F-g,5 v
Mailing Address:
� 1116- 7 Aj
W o
I C,
I certify that I have authorized (agent) /U— ;-1 J k106 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
Cd W 5'7"jev CTI d Aj
at (my property located at) k—L l A) .
This certification is valid thru (date)
Property 0ar Signature

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J100 ft - ■Find: tiond_9
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