Campbell, William 77143C

f XCAMA / ":DREDGE & FILL A B D
G ERAL PERMIT Previous permit#
NewN.;Modification . 'Complete Reissue !-;Partial Reissue Date previous permit issued,__ ..__.__.
As authorized by the State of Notth Carolina, Department of Environmental Quality , I 2, ,
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC^O
� +1 rTv ___ _--._---
t J Rules attached
Applicant Name Lti1�IJCtfy) �t /Y\� ll Project Location: County _ Cg-CAum
Address.53 ,Spyneli `K-'lve, Street Address/ State Road/ Lot # (s)
City 00VeAoGk State NC ZIPV 39 1 / `7
Phone # (417 '/- Kiy E-Mail Subdivision WA I fwWAp i{�' i e
Authorized Agent M t �(, A414 City ZIP /j /
Affected � CW '�W '\-PTA ES PTS Phone # ( ) Jp� �rRiver Basin r ". 4 S e
AEC(s): OEA HHF IH UBA N/A Adj. Wtr. Body Aye m , l/1_ etL (0/ )
o Q n man [unkn
PWS
ORW: yes V PNA yes &
Type of Project/ Activity i
Pier (dock)length
Faced Platform(s)
Floating Platform(s)
Finger por(s)__... .._
Groin length i
number
Bulkhe;f/d( >ral length 100
avg d�i�s.-t..annn'. oflstwre f
max distance offshore
Basin, channel
s_
cubic yards _
Boat ramp �.
Boathouse/ Boaddt
Beach Bulldozing
Other
Shoreline length /f es
$AVM not sure yes no
Closest Ma(. Wtr. Body I �& ��t f ) {/e-r
✓A ikJMS
(Scale: /yi ?j[j� )
RECEIVED
AUG 2 5 2020
DCM-MHD CITY
r
Moratorium: Na yesU:0
`t/^y' s"vti \`w w� r��13111Z �'
Photos: yes � ( NV r�
Waiver Attached: yes _. (`,'�j„`„f
A building permit maybe required by: ( fit A le. f Ln rl '�X See note on back regarding River Basin rules.
( Note Local Planning Jut isdiction� I
Notes/ Special Conditions pl_"X�'t
/Aeosh or App�, t'„nted , ntr, , -
Sig nue "Plead compli u statement on backof permit••
Wgoo, lil 11 y 0
Application fecM Chock #
PermitOfficer's rented
yid ✓
St�n/at/,t�ra//�1s
Is dngD to pirati nDate

LRCAMA / 9DREDGE & FILL
"GENERAL PERMIT
GEU(New ❑Modification ❑Complete Reissue ❑Partial Reissue
NO 77143
Previous permit #_
Date previous permit
A B © D
As authorized by the State of North Carolina, Department of Environmental Quality 'yam
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
IJ�I jj jj n ulesattached.
Applicant Name WIIhUlYI CamDkaN�ll Project Location: County ( f.'GtVP./l
//
ryry —r
Addres�st5'5D J�'nynl�t 0(,wye, pp Street Address/ State Road/ Lot #(s) 1tQ�
City IA&'VACC� State �ZIP/^gyF5 a
Phone # (M) f E-Mail /� Subdivision WA $ Q�
Authorized Agent 75 �� 6 eSQ mu 5 City ZIP
Affected -N'CW .A'EW _k"A DES ❑ PTS Phone # ( ) River Basin I V S t%
AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body Yf S n man unkn
ORW: yes f n9 PNA yes no Closest Maj. Wr. Body— L°J�
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) T
Finger pier(s)��
Groin length
number
avg distance offshore
max distance offshore
Basin, channel _
cubic yards
Boat ramp
Boathouse/
Beach Bulldozing
Other
Shoreline Length [ rt%w/
SAV: not sure yes
Moratorium: n/a yes(no
Photos: yes
Waiver Attached: yes V I /I�
A building permit may be required by: 1 r('U l 0 f /4:)�
( Note Local Planning jurisdiction) , /_ I
Notes/ Special Conditions
Age or Applicant�nt -�J
Le
cure ** Pleaseread compliance statement on backofpermit**
goo t� I/Yo
Application Fee(s) Check #
(Scale: /153®
Fit note on back regarding River Basin rules.
PermitOfficer's
Signayt� re �6
n,
Isoing D to tpirati n 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 isinspected 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
Iandowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis 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 howtocomplywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
534 do`toz,>.y, -
NAo�Wc.� ..mac,
S-A \ - A s%w-N
OM
/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Q 9. aQ
at my property located at
in GQ.ca,)-.0 County.
1 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:
2Da
Signature
Print or Type Name
Title
Date
FtECE1VE
This certification is valid through
BUG 2 Q 2Q2D
�C,JIHD CITY

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I
(Name of Property Owner)
property located at S3R So w� tea S ve
(Address, L t, Block, Road, etc.)
on in 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, 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]
�Itm a \00,
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)
Signature
w���•.P:� a• C.ArCQ,�i.�.
Print or Type Name
5-Ls Sow ay. ts R
Mailing Address
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cityCity/State/Zip
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Telephone Number/email address
-%\ 11A\ -�
Date
Owner Information)
or Type
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Telephone Number/email address
3w111 ( 2 ozc)
Date*
*Valid for one calendar year after signature*
(Revised Aug. 2014)

}. d. X s /..;i :.A,;i."�"'r-r ✓.1i''� JI;iYr-s _✓ � wt.? ! xJ�'-r t i• �. "! �� Jw '�. >'.. f 5?: �.% »'S7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc:)
on PlIArS C5A--w6_y-- in C0.PJ%-y3 N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
.a
��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)
P"V Q ,QQAQ 10 V"j- �s-c,>JG, \oo1 ��-CaSL �OoN-cA(,h, �-AQQ-A
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)
Signature
Print or Type Name
�Q-
Mailing Address
City/State/Zip
Telephone Number/email address
., \ ,H \ 'a-b
Date
(A p t Pr a Own r Information)
_0
0 -L) pal
Mailirtq*Arjere�st
UILY/ IL
Telep o e Number/email address
)4 vO'LCZ
Date* (
*Valid for one calendar year after signature*
(Revised Aug. 2014)

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