Stumpf, Katherine 76611C

CAMA / J DREDGE & FILL �C) 76611
y GENERAL PERMITA B O D
Previous permit #
,Ugevv I7Modification ❑Complete Reissue JPartlal 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 SA NCAC_ 92 , �, 00
Applicant Name ya�J ' - ^P�'1-sa .
t Project Location: County o q 2/ (j(/
Address— P t Street Address/ State Road/ Lot # s
City S S State �/�' ZIP, O_P'
Phone # ft)7/0---qq7,2E_Mall Subdivision_
Authorzed Agent � 141n e, G,17� _ City Zip
Affected DCW ,g�CW JO(PTA DES ❑PM Phone# (_) River Basin
AEC(s): Dom' "^`tF ❑IH DUBA ❑N/A
❑ PWS: Adj. Wtr. Body[�(�
ORW: yes no PNA yes / not,' Closest Maj, Wtr. Body
Type of Project/ Activity pu )Jp,(7/3 _ R ! 7 L) (USA f ,7
Pier (dock) length
Flxe
Float
Fing,
Groi
Bulkl
Basir
Boat
Boad
Bead
othe
sha,
SAV:
Mora
Phot,
Waiv
(Scale: /
i Platform(s)
/■ll■1►a
■p
H■■■��■®■�h�
,i length
number
�5::
®Cchannel
��■■.■
'
cubic yards'r—
:'C::ramp
will
ill
ONE
WN
�,:.■
......�■
.alga
sun
....■.■.■
..
..
WE
■
d�
■
,
t
•..��
■
■...
ONE
■■■
it
■■■
■
■■■■
OEMP
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions n/.: i
on back of permit'+
1
❑ Sea rate on back regarding River Basin rules.

®M.'CAA / DREDGE & FILL J 76611 A B CO D
❑ No GENERAL PERMIT Previous permit#
L�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 .200
�itules attached.
Applicant Name I '�+L(Al Project Location: County n n S�Qf/V
Address '20—I y4e, Street Address/ State Road/ Lot #(s) cQ�
City S S 5?:CY stateAIC�ZIPP��
Phone# VJ-)70--
Y77;iE-lvlall Subdivision
Authorized Agent /I�� NJ�c►�, lye$ City ZIP
AffectedW JTTA ❑ ES ❑ PTS Phone # ( ) '�/ River BasinAEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA El WA Adj. Wtr. Body nat m unkn
❑ PWS:
ORW: yes no PNA ye / no Closest Maj. Wtr. Body
Type of Project/ Activity Py'60 + 7x f 7
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
/
Finger pier(s)
�
Groin length
/
number
Bulkhead/ Piprap length
avg distance offshore
max distance offshore '
Basin, channel
/
cubic yards —r
T
Boat ramp !
Boathous Boatr %c
Beach B o 'ng ` i--'�
Other
T 1—
I i
Shoreline Length
SAM not sure yes o
Moratorium: n/a yes n
Photos: yes
Waiver Attached: & no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ S ecial Conditions
*s' Please read compliance statement on back of permit"
Application Fee(s)
ii cgo
(Scale: i )
❑ See note on back regarding River Basin rules.
&aA G�r I
PermltOfFlcer's P i d Name
Signat re
�glao - �hlmzo
issulingD e xpiraion�e

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 1) 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 howto comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/I7

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
1 certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: J11,00 CxI 5-hl I 1<)
at my property located at i m y i e to J 1 ii V �, oe (-15 tei'7.t
in t �f�,��n(,l) County.
I furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff,
on the aforementioned lands in conn
permit application.
Property Owner Information:
Signature
Print or Type Name `
Title
1 // 1 o?daZO
Date
This certification is valid through
the Local Permit Officer and their agents to enter
?ction with evaluating information related -to -this,
7��T�►Tl�i:
MAY 15 ZUZ0
W—M-MHD CITY

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ADJACENT RIPARIAN PROPF,I,R/,TYjg�ATEMENT
I hereby certify that I own property adjacent to IYETIIt i' I lil ) + (I) )� ; - Is
_ (Name of Property Owner)
Property located at -� ) i L ;YCI i'� )1 � P I d) ]�y�
}} (Address, Lot, Block, Road etc.)
on -- L in ( < t> .>-I, N.C.
(Waterbody) (CltylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
L` )1 I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development musfflll`7n description below or attach a site drawing)
WAIVER SECTION
1 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.)
�lAjl,' I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Pro ert I) � p y Qwnpr Information)
rr.
Date
email
"Valid for one calendar year after signature"
(Revised Aug., W41 5 Z�0
DCM-Wl) C►Ty

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ADJACENT RIPARIAN PRQPE'8rLQI WNER STATEMF�NT
t hereby certify that I own property adjacent to _ l� 1 r11C]" 1 f� r j II t Is
Property located at
(Name of Property O er)
�, i � �_: E C11� 1 � ! E� u f Tt'
(Address, Lot, Block Fto�a etc.)
on_.L 1 i.� in ��c C t ; Rut: N.C.
*terbody) (Cityrrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locati
lid I have no objection to this proposal,
yal
i I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing developmsfttmust nil In description below or et(ach a site -drawing)
WAIVER SErUI N
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.)
—-- 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Pro�ner Information)
'Valid for one calendar year after signature -
�tECE1VED
(Revised Aug. 2014)
MAY 15 ZOO
DCM.MHD CITY

Project_ By _
Subject Page _ of
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