77456_Roy & Marilyn Ray_20201116

CAMA / ❑DREDGE & FILL ./J� /.'�� 0 No 77456 A BCD
GENERAL PERMIT •f-�/ u/ , -' 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 I 5A NCAC /<-'& +
�� �� El Rules attached.
Applicant Name U� . Project Location: County /'i;1( „ r
Address G L2 ,c Street Address/State Road/Lot#(s)
City /�e 4.. -, State "V!' ZIP --1,- .f7 6/
Phone#(2= ) `Cf7 --iL' E-Mail Subdivision j//
Authorized Agent City /1.7/< .h ZIP 2 %�l(/
Affected ❑CW El EW El PTA El ES ❑PTS Phone# ( ) _ River Basin 71,,�, .�
❑OEA ❑HHF ❑I ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body J_,(-- ,..l, /e (-Tie e � 6c./man /unkn)
❑ PWS: Q
ORW: yes L no PNA yes / no Closest Maj.Wtr. Body / �`
Type of Project/Activity , / i�� /err, /A r �>/'/�r-- .
/iv i /
, �j i,�►w _ .2' 1 T 6 (Scale: / ' G
Pier(dock)length )
I 1
Fixed Platform(s) /6 ,a .(�t E f`J;
Floating Platform(s) `S-K -1 r- t- `'rc ( c k ....II*
.. I.�N_ f
Finger pier(s) ,�' `1 �. f
Groin length I I I I I _
�number - --- -+ ,......_ -_ --�t---.Y � i
Bulkhead/Riprap length - — --
{
avg distance offshore P
max distance offshore /-1
Basin,channel fiI 1 1� I
cubic yards f I / ii,
I / 11/
� I ( to t i `�Boat ram I
P •
Boathouse/Boatlift/J I'/J - ..._.._.�.._.._............ — — 'f �.— —.............._._
i
I .
Beach Bulldozing ;, �l/ N
Other ' CI r l `J .
s1 '� !f� 'f ,
Shoreline Length -36 I j I I
SAV: not sure yes n r ; j/ �l
i
Moratorium: n/a es c, / -Y Y�
Photos: yes I
Waiver Attached: yes nd Y
A building permit may be required by: 4 Ck.•>:-- / C E aee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions ,-e t b 7/( I.2 O 0 Iv `1'1 t!? 19. /+-,4 / `
cliif
l /1i -v & f j . f f,/,
Agent licant Printed Name PermitO Printed Name
Signature **Please read compli ce statement on back of permit** Signature
,-2 0 5 /b 4/
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 (252-946-6481) or the
Wilmington Regional Office(9 I 0-796-72 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

er T CAMA/ D DREDGE & FILL
GENERAL PERMIT ' " NO 77456 A BCD
TT)-;:- ) Previous permit#
-><------'' HNew —Modification LilComplete Reissue EPartial 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 I 5A NCAC
El Rules attached.
Applicant Name Project Location: County
Address Street Address/State Road/Lot#(s) /.•
..
City State ZIP
Phone#( ) E-Mail Subdivision ,.
Authorized Agent City ZIP
L CW E EW E PTA LI ES E PTS Phone# ( ) River Basin
Affected
O OEA 111 HHF El IH O UBA 111 N/A
AEC(s): Adj.Wtr. Body (nat /man /unkn)
E PWS:
Closest Maj.Wtr. Body —
ORW: yes / no PNA yes / no
Type of Project/Activity
(Scale: / )
Pier(dock)length ;
, , i ! ! I ;
Fixed Platform(s) IL /./ 1 I I — ' 1
Floating Platform(s) ( il I 1 (161 ic
....----i-1"; - ii/ "
•!...ti.4.......„.: ___i
.
Groin length ! . . ,
• lf I 1 I
number
i 1 ,
Bulkhead/Riprap length - _ it • ! '
•-"' 1-1—
. ! I I
avg distance offshore
max distance offshore ) ! 0 1
1 i/ /....._ : il iii 1 ' II:" , / / 1 1
Basin,channel 1 .
,
- , I 7
.
I " 4-
ii /7
cubic yards 1 , • ,. i , : 1
; --r
Boat ramp I I
Boathouse/Boatlif /. / .7 1
.
-i-
/
, 1 .I '
Beach Bulldozing ..
i
..,-
I 1. ' . ., . .
Other ! ,
! i . . • i i ' I
, 1 I
/ 1 I
..-
/I „i
;(S1- • • - ‘ i t .
1 ,
.
. ! 1 I
I-
'' t' ' f' ...
Shoreline Length -6& / I ' - , '
SAV: not sure yes rp) ,1 ! : 1
i I 1I I
, ___---•••:-.7_,-....- ;•-c. ,i _1 ''. ,
Moratorium: n/a yes :12. _1,
I
Waiver Attached: yes n I
A building permit may be required by: ' , -
i / (-: . 1,--i See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions C.)77/. I ;CO) lia. f; / .,d /I /
/ ,..,
,
, ---br7 /
i
7/ /liti/4-11-VI „t) o Id , t, ,. ,
.
Agentiv "licant Printed Name Permit Officer's Printed Name
\,,,1 a/.....••••10-' -
iN1 ,. ---
Signature **Please read complic'e statement on back of permit** Signature
?, ---- CL-I
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 (252-946-6481) 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 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: 9 I 0-395-3964
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

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Dti ectuz
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 02B.0233 & .0259.The
Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation.
>. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees)unless otherwise approved by DCM. The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
z. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This
drawing will be used to aid in compliance and monitoring efforts.
• Pre-project site conditions: /4'1�... ��:,c c' kc�H
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
that all information provided is complete and accurate.
Agent or Applicant Printed Name Permit Officer's Signatu
Agent or Applicant Signature Issue Date p
CAMA GENERAL PERMIT#:
State of North Carolina I Environmental Quality I Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 27889 1252-946-6481
Wilmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-3845 1910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit ' '` ( 14/2 I Iv icc;uey
1
Mailing Address: 3s(P . D )1
Phone Number: -S a 7
Email Address:
1 certify that I have authorized /91 V'
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development ,8 6-4,4 ,`
= e� -1
at myyr loca at
in r County.
I furthermore certify that I 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:
. nature
Pant or T lvame
Tlfe
/( I . 5
Date
This certification is valid through I I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Y / �r l �l ✓� G`'y 's
(Name of Property. Owner)
property located at , V e
(Address, tit, Blpck, Road, etc.)
on :Sc1/4�'-tty' INC121 e week , in kl G.rLfl/�3e(. 4fc> 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.
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)
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) (Adjace rty Information)
Signature Si e*
l�Xq iJ 'V Qn61e1I's
Print or Type Name T !Name
`t P4,14, Pry vc
MailingAddress
M'aNngAdaress 1.1, L 17 ,e
Cdy/State/Ztp City
Telephone Number/email address TelephoneNumber/erneiladdiess
Yf -gY- f
Date Date' (////2
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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