77284_Stephen Kivat_20200917

2�5
Ø' CAMA/ DREDGE & FILL -�-J�+N-ff_ �/0(�}' N. 77284 A B) C D
GENERAL PERMIT ��T Previous permit#
>' ❑New _Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued = 4
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
Rules attached.
Applicant Name �,1 /i i I Project Location: County �-
Address 75 h/i3O v-A < •� /Z�( Street Address/State Road/Lot#(s) ? ,{�,e !�,;
City i ' - --I. State `,)C ZIP 25 S-5 C., -7/,` / > - =
Phone#(._�f?) Subdivision !I/4
,�.? � ��-.-� E-Mail� _
Authorized Agent /..//"f City 7;1 f ZIP I,{33C--J
Affected ❑CW 1-)ifEW ✓ PTA VES 'PTS Phone# (if ') 5 1 56.2.s River Basin !ve-: .<P
❑OEA ❑HHF ❑IH ❑UBA ❑N/A AEC s . Adj.W r. Body '��/ ;�7
/1 nat man /unkn)
❑ PWS:ORW: yes / no PNA yes / no
Closest Maj.Wtr. Body /•u`-,e �' '
Type of Project/Activity -4. /' /2 O/ f '"l``
(Scale: / '410 )
Pier(dock)length _
Fixed Platform(s) P t `
Floating Platform(s) __ 1 1� ` �[
Finger pier(s) I P Y
Groin length I
number .. '--_.. _...__ —_...._._ . -
Bulkhead/Riprap length/.2 U r -
avg distance offshore /0'
max distance offshore /a / ' fl. /) ?�✓f
Basin,channel I4--"( I N �e ��(P
4 *i r l id„ I.✓�
cubic yards ,i, .r /��y 4 t i
Boat ramp (.1 i p J iP�J i �.[P/ / /\ P/ (
Boathouse/Boatlift - „t ,...ax..- -—— — i;.t" )
� ...
P4
42 t
- ,
........ ,
i., vI
} — . ! !
41-PI ` �' �
Beach Bulldozing // I G1,f *".1 CO O Q• Y t^
Other i
/ IN : ,i rv� 67-fp
Shoreline Length - -.C ? IDA cht i -
SAV: not sure yes no i ' -._ ; .._ � i '
Moratorium: n/a yes no.7o
Photos: yes C-iio . .... i i 1 i �__....— .
Waiver Attached: yes - i 1 } i
A building permit may be required by: T` /i;' 0 'FlSee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions f.. {. ,., e i /.rl l t ) V, P' /1.�-'mac %
-4 /4 rh'•-s.----
Agent or Applicant Printed Name Permit icOfT e Printed Name
PP 7
'f V ( A
Si nature' •
/Please read compliane tatement on back of permit** Signat r i'
C (___ is {, f . /5-2 /� i ? Zo //, 2 ?�
ApplicationFee(s) Check# IssuingDate 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(910-796-72 15)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 252-946-648 I
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

CAMA/ Li DREDGE & FILL
OGENERAL PERMIT
T vD S I,7 v 16% N� 77284 A B C D
l!/
>' New -Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality Previous permit#
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC .
O Rules attached.
Applicant Name !; Project Location: County
Address Street Address/State Road/Lot#(s)
City -: State ZIP
Phone#( ) .L ' E-Mail - Subdivision
Authorized Agent C:'/ `i City ZIP
Affected ❑CW SEW 9 PTA ❑ES CIPTS Phone# ( ) River Basin
AEC(s): IIIoEA ❑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: / )
Pier(dock)length
I I
Fixed Platform(s) 1
Floating Platform(s) .i 1
Finger pier(s)
i
Groin length , i
i
number -_—._.
I
Bulkhead/Riprap length - I-- -- —_ ..... I -
I !
avg distance offshore .
i f
max distance offshore /(` '
if.
i p
Basin,channel — ' -
'°
i ll
cubic yards , ' / ` Rn
Boat ramp A t � f I
Boathouse/Boatlift r �_ .__.._.. ..---- - ........ _..__. C) f' j—
•
Beach Bulldozing - � cef r �,�=a..——a t N'L I.�.,, k��
Other i� ( 0(2C'v �#�i <..s ' �.A{��y '� r r i )
C s , ! C'
i
-, ; F.
Shoreline Length —" 1 }
SAV: not sure yes no - -- 1 I , . l
Moratorium: n/a yes no 1 'I _ I I
Photos: yes no — — I —
Waiver Attached: yes no I _ T }
A building permit may be required by: I -I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions i ?
f' i i ',
/
Agent or Applicant Printed Name Permit Officer's Printed Name /
j A,,,
` Signature **Please read compliance statement on back of permit** Signatu"r ` ('
l
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 (252-946-648 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to s'�� '�, v � �( �� 's
G
n
//y� ' (Name of Property Owner)
property located at 0(0 �,1�P.�t(/ter �-f�"1 r Kd I
p (Address, Lot, Block, Road, etc.)
on QI1 , in ?t rk- , 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 objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
ce_ -2'‘F.)( ,)iia (34 n
(0(0,14 A
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.
(Prope Owner I f ti ) (Adjacent Property Owner Information)
S' atur Signgture* -
P V.. va7- r (, t ''11
Print or Type Name i Print or Ty e Nye
MailingAddress MailingAddress
Hrt rT MO- Z c Kk9-I pt , C Z76o9
CitdState/Zip City/State/Zip
.}52 5 3 5(eZ> LK;✓e, ,�v9m�t, f. l► 4.6 -It"- tiCC H
Telephone Number/email address Telephone Nu ber/email address
C - — .4 C) 5
Date Date l
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 91--p�'1 /,
,1 1p , (Name of Property Owner)
property located at `l ,
S6 WAQU.veR ��ct M f2 /`d
n
(Address, Lot, Block, Road, etc.)
on 3�•l ►l tv'eg% in I`tiG , 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 objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
Individual proposing development must fill in description below or attach a site drawing)
or-7
tot
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.
(Prope Owner nfo io ) (Adjacent Property Owner Information)
A
Sign ure Signature*
�
h J V v� ( , I( ‘v4- - ,4liz I e/y
Print or Type Name Print o Type Name
(�I zu Ve-r � p 5 0 L3 TRC"at
Mailing Address Medina Address
f'1err�TT� IA: , N. C. 2"-Z,y
City/State/Zip �, City/State/ ip
352 s L3 5( �3 eK�vc;r0i ./.0.0 C)�s `f 2- 2-a 6 4-
Telephone Nu b r/email address Telephone Number/email address
�Tt It 151 z
Date Date*
(Revised Aug. 2014)
"Valid for one calendar year after signature"

C DiVjsioia of Coastal�� /fig-L Habitat impact Gorr¢-sitar
Applicant: Z>/6'' ` /-7 /�
Date: 9ft Z/o -4r)
Denerai errnit#: -7 70?g 17 8
Descrbe elcw:he -AST. :listLrbarces or:he apeiicaticn. . li values should matca be lame; and units pt measurement
found in your Habitat code sheet
TOTAL Sq_ Ft. F NAL Sq. :=t. 7 OTAL Feet FINAL Feet
'Spoked:cr. Anticipated:nal ;cpoiied'or. Anticipated inai
DISTURB TYPE Disturbance:oral oisturoar Disturoance aisturbance.
'iabitat Mane house One rcludes any =:etudes :r? :c[ai rdudes =chides any
artic:bated -stcracir any anticipated -esstoraticn andler
-:storation or ardor am a -estoraticn r :emc'mcac
:emc mpacts': mcactamcuff( :ecnp mpac,$) amount)
�,,{,t) Dredge 7_ ='il X 3oth Other = hD p — -
y' -1; Dredge J =i11 Seth Other / — /f 0
Dredge_ =11 Both Other
:recce 1 =i1_ loth Omer
Dredge_ Fir_ 3cth 7 Other
:recce ='il _ 30th. _ Daher
ecce _ =`.I _ 3cm _ :ter
Dredge ='ll 3cm Other
_recce _ =11 3Crr � Other
D recce =II 3cm _ Other _
:redge_ =,i1 _ 3cch
7ecge ='il _ loch _ Other _
it Ea!" *-her _
0cecce_ ='il_ loth :ter _