Bryson, James

FILL
PERMIT
complete Rrtissue Parttai Remstse Date provAous porn*
AL* :1a91`101410d by Ow, Uu# of North C*rt11tA, Depwtinent of f(my anntental Quality
atr�# t#i Cc+ ttti Re3x C t#t tt it, Art#iAA of envirwune c€ ern purm"nt toI SA
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k6AMA / -L (DREDGE & FILL .' 6 ,` y' `; A B C D
GENERAL PERMIT Previous permit#
[ 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 15A NCAC Q /✓tT/
(� ®'Rules attac ed.
Applicant Name V Project Location: County ^ J
Address I q V Street Address/ State Road/ Lot #(s)
M± ' - � '-'cif
Phone # (�,Yf
)E-Mail
Authorized Agent
Affected ❑ CW ! � VW ',I "A A ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / P noNA yes
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distanc�hore --d
Basi ; channel x c'
cubic yards C
Boat ramp
Boathouse/ Boatlift '
Beach Bulldozing
Other
r
Shoreline Length / ENV
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)^
Notes/ Special Conditions
I � t
Subdivis"'911
City J
Phone # (2a) -
Adj. Wtr. Body C
Closest Maj. Wtr. Body
tC� ZIP � c
River Ba in
j4e- a J
Z C nat /unki
T—
(Scale:
r (�'KA i?-t JAOVP�-S ❑ See note on back regarding River Basin rules.
I AA
41
J�
Age t or Applicant Printed Name
Sig ure Please read compliance statement on back of permit"
I _
7,369
Application Fee(s) Check #

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Fc°
Property Owner Requesting Permit: �
Mailing Address:
Phone Number: —o�k
Email Address:��- f�>��< ^r� �%ic, S
I certify that I have authorized �/9r/ 1347W,�T LIVccD /YKGK
Agent i Ccintractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Silt-l'=7�1.
at my property located at %,>-I?f�i�1/�Zv��'� � '%N I!��'�� Sl .►'�
in �r. �' County.
1 furthermore certify- that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the focal Permit Officer and their agents to enter
..on..the aforementioned lands in connection with evaluating information _related to this
permit application.
Property Owner Information:
Print or Type
Title
cE7 l 1 c, i 20
Date
This certification -is valid through !
JUN 10 2020
CCM-MHC CITY

I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to %3r jp-J 3
(Name of P operty Owner)
property located at 16P,4 Aw/twOD.D we u[. J xa-
��_� (Add ess, Lot, Block, Road, etc.)
on �n-L— in f rwe— /two r t_ J�k7U_-r _, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
_- A i have no objection to this proposal,
have objectionalo_this proposal..
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
i
WAIVER SECTION. _.
I understand that a pier, dock, mooring pilings, 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.
(P operty Owner Information) (Adjacent Property 0 r information)
Si hwe guar a �r
P rnt or Ty a Name Print or T o Not
a ling Address Mrrilinc dress
amity State i S C' atelzip Z�St Z
Teinph ne N tuber Teiop
ZO
bate RECEIVED
(Revises! E/1812012)
JUN 10 2020
DCM-MMD CITY

ADJACENT RIPARIAN PROPERTY 0WNFR ..gTATEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _S( (Name �'S
P p rty Owner)
property located at hs ,6 / "0�� �^rE k✓°LL J;
(Add ess, Lot, Block, Road, etc.)
on in 'rN� /;.� " dd--ru.� , N.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
Ix I have no objection to this proposal.
_avobje ions_tnthis_proposaL---.........-. ._.__._.--------- ---- — -__---
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
b 0
WAIVER SECTION _ . —
I understand that a pier, dock, mooring pilings, 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.
(P operty Owner Information) (Ad* cent Property Owner Information)
Si lure ature L
jor T�p e Name Prirrt or Type Name
Prin
,, a t Gb�lL&16 PA -I � 4 el-e e��•
n Addre`s�
,4 1`r
a ling Address A'L--
��mxt�W,G,�c 27284 _
1Stat r City/StatelLip
36- -vyGy ��s-a-a ? S
Telephone Number Telephone �Nurnb
to
r IN
� o
Date DatE RECEiVE®
(Revised 611812012)
JUN 10 2020

AGENT AUTHORIZATION FOR CAMA PERMIT. APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: c� I `� e L&r4 j2Z-k06,E
Phone Number:
Email Address: " S W .'� �� � �r A,���,
I certify that I have authorized
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: S1t-FP41: S1- fe
at my property located at
in2r--T" County.
1 furthermore certify that 1 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:
Print or Type
Title
Date
RECEIVED
This certification is valid through
JUN 10 2020
DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �n'%f �''"' I
(Name of P perty Owner)
property located at Af---oc.L f{k
(Address, Lot, Block, Road, etc.)
on in 1�4— , 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.
have objecton_s_to_this_pr_oposaL________.._.__.___..
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Ls
J
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
(P Owner Information)
(Adjacent Property Owner Information)
;:�
FV—
Si ture
Signature
P int or Type Name
Print or Type Name
i ailing Address
Mailing Address
ity State_ �i
-6 -
City/State/Zip
Telephone Number
Telephone Number
Date Date
RECEIVE®
(Revised 611812012)
JUN 10 2020
DCM-MHiD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J/Me�s- k3niINJ Is
(Name of P perty Owner)
property located at ��� � f�w0�� ; �'<�� kr'VC-L f
(Address, Lot, Block, Road, etc.)
on I ' %I'L-- in �'��' / rs f N�nL� N.C. .
(Waterbody) (City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual ,proposing development must fill in description below or attach a site drawing)
6 0
i
WAIVER SECTION _ - -_—
I understand that a pier, dock, mooring pilings, 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.
WAIVER SECTION _ - -_—
I understand that a pier, dock, mooring pilings, 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.
(P operty Owner Information)
(Adjacent Property Owner Information)
Si ture
Signature
P I or Ty e Name
Print or Type Name
�I I Cb PA -
Mailing Address
Mailing Address
it State i
City/State/Zip
Telephone Number
Telephone Number
Date
Date RECEIVED
(Revised 611812012)
JUN 10 2020
DCM-MHD CITY