Parker, Linwood 77111C

V� CAMA1' DREDGEdtFILL N9 77.11 A 8
rvevit C)
GENERAL PERMIT Poospermlt#_ �tT wA
New Modification Complete Reissue ..:Partial Reissue ©ate previous permit issued_
As anthotized by the State of North Carolina, Department of Envirrconimmtal Quality t ,�
and the Coastal Resourcrs Comm+sswo in an area of environmental concern pursuant to I SA
Applicant Naive � t f? Lk!* Pas ( �'.� i-l�„ Project Location: County Gar. 4e^ (7 +�
!address _ rO 6r l ii_t D Street Address/ State Road/ Lot N(s1 p( Rein
(! j Ix n
City Yaea%t t�t�%�'[ State f(,: ZIP ai-1f1j
Phone # 0.X-PI) - Y E-Mail Subdivision
Authorized Agent Oei()fl I `* city fC'#1 tin L L' ZIP -
Affected "�;� W .t#'TA , k $ Pis Phone # [ i River Basin
-qEA HNF IH USA iN(A
AEC(s) C a� i:� SS 1�5/A,!!�lstmkrtj
Adj. Wtr. Body /� It lust 3v t4
PWS r t1
` Closest Mai. Wtr. Body
CiRW.. yrs �rr� PNA -, yet+ no
Type of Project! Activity _�.. .. ...... r--�
(Scale: i
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SAY: MA uttC yes O'_
?Awilr m: A!* yesPhht,tos: ycytva,r,er Anxt*& yas
See note on back regarding River Basin nk,,
t Note Local Planning jurisdiction)
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��91CAMA / ❑ DREDGE & FILL �liqG NO 77111 A B O D
"GENERAL PERMIT Previous permit#
U—IWNew ❑Modification ❑Complete Reissue C Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality .-7 n�
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC © J
I IXRules attar d.
Applicant Naameeq L I � Project Location: County P� l
Address 1 f-/ &1 1190 Street Address/ State Road/ Lot #(s),Of
City lAu� �' I State ZIPF29�?
Phone # )e �(�� E-Mail
Authorized Agent VT-F Dann i s
Affected --kr&GW J�rTA WS OPTS
AEC(s): Ll OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes Yy PNA ye / no
Type of Project/ Activity
Subdivision
CityAt-t 6C j ZIP
Phone # (_) River Basin
Adj. Wtr. Body 955E man unkn
Closest Maj. Wtr. Body ® f
Pier (dock) lengthirJ
I
�
Fixed Platform(s)
��-
Floating Platform(s)
_
I�
Finger pier(s)
Groin length
number
Bulkhead/ ftiprap length
-
-
-
l
avg distance offshore
max distance offshore
_
---
J
Basin, channel
-
cubic yards
Boat ramp
�I
I �
Boathouse/ BoatliR
i14
_ --
Beach Bulldozing
Other
T
Shoreline Length �o —❑'
SAV: not sure yes
Moratorium n/a yes
Photos: yes no
jfrn/
l (j�
Waiver Attached. yes n -
A building permit may be required by: �` 1 Vl �LJf4y �•
//
( Note Local Planning Jurisdiction) (e� S�
^ ; ��_
Notes/ Special Conditions 1 rO Po
11 )T t
6/ - �'I
I t / '
or Applicant Printed Name
PermitO ficer's
ii f
(Scale:I �'M )
A141 W -
i
❑ See note on back regarding River Basin rules.
{ 1740 ,s0`1t., Z& !c�e
nature ** Please read compliance statement on backof ermit� Signat re
_'Sy-((//00 2G�
pplication Fee(s) Check # Iss ng Date x iratio ate

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 how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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 Pander Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: �ct115�noa� Fr?ak,- �
Mailing address: a(/
CWC-M::j � p-L 28 S/&
Telephone Number: 2-�:-2 - 2` 1- `1�6& -
I certify that I have authorized (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of .60 ' h
at my property located at
This certification is valid through
(Property Owner Information) Cc K#�-
�
Signature
l LALwcYb 14P.k'i<9
Print or Type Name
C./Nydo i�) Yt (' = a -
Title, co. owner or trustee for property
2uar->
Date I RECEIVED
E2-2*/-ell,&3
(date).
Telephone Number JUL 15 2020
L4 " ���z11�r (�D��3-ti p DCM-MHD CITY
Email Address

i

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L /trwaa,D l eke - 's
property located at / q �', a of Property Owner)
(Address, Lot, Bock, RoQad, etc.)
on "Cot',— 2iue� in-tAtav4iq-- )-C. �7- 9.1-74, , 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.
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)
/S MrV-2 /M 461+6.D
WAIVER SECTION
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.
0SI - -Z41- GlGG i
Telephone Number/email address
6-?A Z�z�
Date
(Adjacent Property Owner Information)
X
S'o�ai h Y�►�1�-
Print or ype Name
l9 In//It1 X lPotntr ;'ZOAb
Ma' "�q Ad ress
fiU,hpr,---AJ'C 7-6514 —
city/state/Zi
0Sg- 2ql - , -5
Telephon Number/email address
-'9- zow
Date*
*Valid for one calendar year after signature*
(Revised Aug. 2014)

I hereby certify that I own property adjacent to (i(N °c
(Name of
property located at
I
�7 traauress, wL oivcn, vau
on KU55ca ��'��% in RGt r�ca . 285 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.
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)
615 Mr4-17 4T, -klev
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 fawner Information)
rrmr or t ype tvame
P`)Pwx
Maili Addre s
Pu ri ��IG ZRsy(o
City/State/Zip
.5 a '2'ki
Telephone Number/email address
/9-d7-Z020
(Adjacent
Property Owner Information)
-A) l 44,-.4 w P2 k& TICE
Print or Type Name
1174 Pi4eixir.S' CeefK-)eO4P
Address
- r/- Y . PZD
Date*
) c- (Y rx.2jz.vom
-"Valid for one calendar year after signature*
(Revised Aug. 2014)

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