78627A_Spencer, Bernard & Patti_20201028

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�r✓ CAMA / -. DREDGE & FILL NJ(1 'i X 61 I
-. A= B C °
�NERAL PERMIT Previous permit# (
New Modification ! lComplete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina. Depart rent of Environmental Quality fd>
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 28
/
LL Rules attached.
Applicant Name_er A ar� f. JOatt ce!- Project Location: County l-e
Address P- a . a X —% �% -- Street Address/ State Road/ Lot #(s)_Z
City__Fr,i Tcot------ ---State A k- ZIP -793S.- S/(Sin
Phone # /I_�_ E-Mail <-%-�► s fto c ar- Q Subdivision Pw- a /� • f o s A s,-s
G qyS/aAC- rd c-aYn Z
Authorized Agent G ar ��a",t_�oc-t - City__ _C' Sce _ -- ZIP _ �% %.3
cw V4'°` r➢ rwA _ES n PTS Phone # ( ) River Basin /° a "64-04 /k
Affected
_] HHF LI IH - UBA � 1 WA G 4 � A
AEC(s): PW Adj. Wtr. Body -- _-_-- _(nat._ a)unkn)
PWS:
ORW: yes / no PNA yes no
Closest Mal. Wtr. Body
Type of Project/ Activity CA S ("-
(Scale: �r = Z o ' )
Pier (dock) length
Fixed Platform(s)
Floating Pladorm(s)
Finger pier(s)- -
Groin'length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel `
cubic yards— + _ ----
Boat ramp �tfifl
-7Boathou-
Beach Bulldozing
ly n Mo cK CAA
.Fe Bo•t.+- Sots;w
i
I
r
Other.
Shoreline Length O � C f�
SAV: not sure yes no� t [se•P i j ,
Moratorium: n/a yes no 1
Photos: yes no
Waiver Attached: yes no P= r
A building permit may be required by: 0. r S-ft v. n See note on back regarding River Basin rules.
e Local Planning jurisdiction)
ote Special4ilwtdlaWm 6 a'441 F4- MR —S / y - -A 4' _ 1. -4 4.
a-.r - p f- --e-
Agent or AA p f t Printed Name
Si ature Please re compliance statement on back of permit ss
Application Fee(s) Check #
Pe . Officer's Printed Name
�at. r e
Issuing Date Expiration Date

CPA
13 , I k A-s,-qA

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Stgneure
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T`etaphone Number/ Ema# Ass
*Valid for one calerf3ar year after sinaturv,'

UNITED STATES
R90 SERVICE
September 29, 2020
Dear gary price:
The following is in response to your request for proof of delivery on your item with the tracking number:
7019 2280 0001 7261 2822.
Item Details
Status:
Status Date / Time:
Location:
Postal Product:
Extra Services:
Weight:
Delivered, Left with Individual
September 24, 2020, 3:35 pm
ELIZABETH CITY, NC 27909
First -Class Mail®
Certified MaiITM'
Return Receipt Electronic
1.0oz
Signature of Recipient: Kat�
1000 RIVERSHORE RD
EUZABETH CITY, NC 27909
Address of Recipient:
Note: Scanned image may reflect a different destination address due to Intended Recipient's delivery instructions on file.
Thank you for selecting the United States Postal Service® for your mailing needs. If you require additional
assistance, please contact your local Post Officer"" or a Postal representative at 1-800-222-1811.
Sincerely,
United States Postal Service®
475 L'Enfant Plaza SW
Washington, D.C. 20260-0004

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICA ION FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to 6emizrd C, SPe-rleer^ 's
(Name of Property Owner)
property located at 1 1 e & 0-
(Project Site: Address, Lot, Block, Road, etc.)
on C! rFF 21muc Sicol '- ,in w1Sc� N.0
ry+»
(Waterbody) (CityfTown and/or County)
Agent's Name #: ��k_T turf c.e- Mailing Address: 1993 5,,47Laiuycd- 5
Agent's phone #: h-6 2' 30,,5 & 3Lf? ,f� E��'f �—i{�� 3tt 5� `7
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
,5e e A-�Che_d 5 Ke 1-ck.._
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. CorTespondence should be mailed to 1367 US
17 South, Elizabeth City, NC, 27909. DCM representatives can also be contacted at [phone]. No
response Is considered the same as no objection ff you have been noted by Certified Mail.
(Property Owner Information)
(Adjacent Property Owner Information)
Signature
Signature`
&-r-na (�-J C, .Speoe-�elr-
Print or Type Name
Print or Type Name
F o, ire x` ,
Mailing Address
Mailing Address
Fri S Cc, /V C , 2'7 q.3
City/Statelzip
City/Statwzip
qi q- 9g/• ?1i l
Tele'p(1ho(nee' Number/Email Address
Telephone Number/Email Address
( (
Date
Date*
*Valid for one calendar year after signature*