Lee, Matthew 76784C

"XCAMA / DREDGE i FILL W 76784 A 8 '2 D
ENERAL PERMIT Previous permit#
tIAWIXrNeve _ Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the Sate of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 1A,.�
� ` uMs atuched.
Applicant Namem 1 `enh i a W L-e-6 Project Location: County C- C�V e4 i —
AddressD`C1` G _ (fie Nee K _ //'�� Street Address/ State Road/ Lot #(s) c��
City.__QGiv�.�QG nQ__ State.N�iZIP ✓Clr-
Phone #(q��,Qyw7E-Mall Subdivision -'
Authorized Agent
.affected Cw EW - PTA XS
OEA HHF IH USA
PWS-_______ _..
ORW: yell nd PNA yes
Type of Project/ Activity
Plan (dock) length
Fraed Putfccnvsj
FAW" %.stfc," ,..
Faju powfs; _.
G,d bn$Ih
mw b �'��ra
Bu&head flip, e. lengthrfol
avg divance offshore
mm d,snme offshore
Basin, channel
cubic yards
Boat ramp
6aatMnscl livsthft
Beach Bundoting
/
Ether
Sfr elure Length �W /
SAY: at sure yes
Moratorlum: n/a yes no
Photosyes no
Wmver Attach yes n
A building perm" may be required by:
( Note Local Planning jurisdiction) s 1
Notes/ Spedal�onditlons iAulr
I
V I,
City ZIP �__/.
PTS Phone # ( ) � RI er `B/asisin( / � cL,( -e
NIA Adj. Wtr. Body Nl/usy ✓`�.— l v`"— - t('/nt"r /unkn)
Closest Maj. Wtc Body-- _Pam I1 C(1
c I (T) )
Scale:
Vor
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(1A1
Lee
ahX1 See note on back regarding River Basin rules.
Mal Lee
Agent N br.�inrr
S,gp urc/q"/�Pleyuread compliance statement on back permit
1v)
pplaatron I crpl Check #
�_('aj_
Pcno.tOlhcer's Printed Na/mq%/
Sigwal e
Issuipg Dat .
/apirOtlon` Date

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VcAMA / ❑ DREDGE & FILL �� N9 76784 A B D
ENERAL PERMIT Previous permit#
1922,91,Jew ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ��j
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 0 / —7 4 4,1 Q2
ules attached.
Applicant Name
7 p V Project Location: County AVPda
�
Address ,� O (�� t ii� Street Address/ State Road/ Lot #(s)
City -
Phone # (4
Authorized Agent
Affected El CW ❑ EW ❑ PTA � r ❑ PTS
AEC(s): El IDEA ❑HHF ❑IH ❑UBA El N/A
❑ PWS:
ORW: ye (Ln PNA yes
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s) i
i
Floating Platform(s)
Finger pier(s)
Groin length i
m,mher
aVg distance offshore
max distance offshore
Basin, channel ✓
cubic yards�a
Boat ramp
Boathouse/ Boadift l
Subdivision
City ZIP
Phone # ( ) Ri er,B/assiin� t�erLCSi
Adj. Wtr. Body ' I ff l�1 AORImp lunkn
Closest Maj. Wtr. Body C-'
U
n
(Scale:
Shoreline Length ✓LAJ I I, ' i
SAV: not sure yes -
L
Moratorium: n/a yes
Photos: yes—
'�
Waiver Attached: yes n
A building permit may be required by: Un � See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Specialf"F�yonditions (/9/� l x LQL _C II
M& Lee
Xetor lict Printed Name
ure ••Pie a read compliance statement on back of permit*•
a1w
AAplication Fee(s) Check #
Permit Officer's
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 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888ARCOAST 252-946-6481
Fax: [phone] 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)
(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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT )
hereby certify that I own property adjacent to A7�-Ma� ' 6 •1&' A e F ��Cv W17 1 -I f -"'s
I ) t, D 1 (Name of Pro erty Ow er)
property located at
on (Vek5'Q- R1Jw
(Waterbody)
(Address, Lot, loc , Road, etc.)
in MVe o N.C.
(City own and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locating
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)
DO
RECEIVED
JUL 07 2020
DCM-MHD CITY
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.)
l�_ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number
(Adja ent Property Owner Information)
251- ti6S-oZ2�
Date
G <6 ��Zo
(Revised 6/18/2012)

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■ complete items t, e, anu o.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
i. Article Addressed to:
9590 9402 5632 9308 109
;ry address di 0m item1? ❑ Yes
enter delivery address below: ❑ No
El
Restricted Delivery ❑
I Express®
Mai.
Mail Restricts
Delivery ❑ signature conri mationll
❑ Signature Gonf,"ation
ry Restricted Delivery
Domestic Return Receipt
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4.JVty-MVjv CITY