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DREDGE & FILL N. 77534 A B C
GENERAL PERMIT Previous permit#
> Z -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 — . /i - L.) .
1 � ❑Rules attached.
Applicant Name C berhA l k5�(
vc._ Project Location: County ►J i..,n`)._ , t, l(....
Address 2/0
Boll,.;)i/ -p o k. ^C f Street Address/State Road/Lot#(s) ( js•- ,v,—,i
City ( he sTP,F�c�G State ��I ZIP'CS Z367 C- .
Phone# (')'O ', L t 12- (E-Mail Pbf"hG-d ko:-,''c cif.A.0 Subdivision
0,,-
Authorized Agent e r( M\\\ S City ()C'e- 1; 14 6 e K c in ZIP 2 ey(n 9
Affected ❑Cw ❑EW 'HPTA NI ES ❑PTS Phone# ( ) River Basin 1. .,i*Lt i❑OEA ❑HHF ❑IH ❑UBA ❑WA )
AEC(s): Adj.Wtr. Body , `(S ye... _ /man /unkn)
CI] PWS: rr
Closest Maj.Wtr. BodyI t h c 0Lc.
ORW: yes I. no )__ PNA yes / no?
Type of Project/Activity ,1_. 1-. .,,^, ( 1 nr,n+
(Scale: N ( J )
Pier(dock)length
I. 1 I I I I
Fixed Platform(s) l I
Floating Platform(s) i i
Finger pier(s) -it- /��_
Groin length I _ i
, , �uJ j
number '
Bulkhead/Riprap length 14 I -'
avg distance offshore !. �' �Y�l r i
max distance offshore �j r'� •"N���' a i
Basin,channel I .,i'ii, WATE w �+}fit ► ae • 'f
cubic yards /2d of +r.,Ilini,�_ _ At
i
Boat ramp bI``
-- -Boathouse/Boatlift -- r 1 - -�--- —
I '
____ _ . t :I : IFF — --,i 1---
— .�,�
i
Beach Bulldozing ~
— -�-- � -
Other I I
I
Shoreline Length `I� 1 w- �,,�N•w � I j k�t ,1 0A t (j�'
ali �f
SAV: not sure yes i
Moratorium: n/a yes n I I
Photos: yes — ( .S Qi.........1"._i U? _ _ ........ -_ _ —._ ��..._
Waiver Attached: yes n `
A building permit may be required by: J(c a IN l s1 c. 3 , (,c Y1 . I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 0 C. 0\>',.\i.ii c a l iA, e cik" e,"'(✓uc C L \n 1 u roc,S1n., w c44an A S
C Q c �., / �� (? _l c_ �((0,I CE
Agent or Applicant Printed Name Permit Offi 's-Ps ted Name
r.\---- —I --
Signature **Please read compliance statement on back of permit** Signature
�} (i v0 ` T- 2'133 giii�0zo 3 l 9/z02-1
Application Fee(s) Check# Issuing Date Ex iration 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(910-796-72 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

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: /. ibtRac4.12D fThie;sk,q
Mailing Address: 310 ;DDt CiJ `-
1J, Ck.e 2P,e() (. 4 , 33(
Phone Number: �d1 30� - c9 '
Email Address: t-be;AL kk �iG1 c i, vl/�
I certify that I have authorized at if r 1"\
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
A._ r
necessary for the following proposed development: r `f O __ 1 U �
at my property located at (P ` 3 k v t" `ee �t�v�2 c-D2 (L,
in I (Uv\5- 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:
AAAtetAk4.49-
Signature
Lele_g_daj 0S11),q
Print or Type Name
Title
I I i I Z , ?©av
Date
This certification is valid through / /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
• i hereby certify that I own property adjacent to rQep 44) k/ 's
I LL /n� _ Name of Prq Owner)
property located at(OS 6hLM YY1��Wv Cr 1"
(Address, Lot, Bloc?, etc
on , in aPe'1 t I-P ex-cei&_ , N.C.
(Waterbody) (City/Town and/or County)
/ The applicant has described to me, as shown below, the development proposed at the above location.
7-- J 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, 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) (Alfa t Prop7 Owner Information) n �
.1 aV
Signature 8 k11 cf kD9 Si ) cce.t. t 11
flint or Type Name Prin or Type Name
,71O 1 ?Y�(11,,3BR6 C fl4 f'o c(k)-`d
• ss
M�iliaAd e a.) 23,
�33 Mta.,
d 1,\c •�L Z?S�\.�
Ci tate/Zip City tate/Zi
Oy- 30-4- 1a9( io. .1\w
Telephope Nurpber Telephone Number
Date Date "
(Revised 6/18/2012)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED. - •
•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
• Name of Property Owner: E13fJe) c')51ci
Address of Property: 61, 61V rnrr\e12
(Lot or Street#, Street or Road, City&County)
Agent's Name#: r^ Y A j L� Mailing Address: 17 G 06-G09 i Pi'LQ.
'
y
Agent's phone* 9/0 20 3_3 __ _C. 022 (1)0
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing.A description or drawing, with dimensions, must be provided with this letter.
�✓�U
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response is
considered the same as no objection if you have been notified by Certified Mail.
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Ad' nt Pr ner Information)
illAaA4ft VOIVek,
Signature Signa ure
pig / )5 PLY- La t) Xte\
Print or Type Name Print or Type Name
3 ID f3i)IiIn56 13n bi-YDA
Mailing Address 1�/� a Mailing Address
!V ' � Y.f t 3a33 � -44D(l /6, 4Rgb
City/Slate/Zip City/State/Zip
SOLI -3o I- aq( C350- '7(04p- 55
Telephone Number Telephone Number
IIII7, zvza In -9D— oacz
Date - Date
Revised 6/18/2012

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Check
Date Received Date Dapw/W Check From(Name) Name of Permit Holder Vendor 11/ amount Perm/{Number/Comments Receipt or Refund/Reallocated
Cokmrn1 Colunwt2 Cokrmn3 Column{ Column5 — _ COkmeM Column? Colunm8 Column9
12/8/2020 Willie Clarence Richardson/Richardson Cc James and Elizabeth Merrill BB&T 7842 $ 400.00 GP#77635D Ben rd.12468
12/8/2020 Allied Marine Contractors LLC William Cherry FCB 9598 $ 200.00 1GP#77522D JD rd.11674
12/8/2020, •Delta Dock and Boatlift Julia and Frank Sharron FCB 8990 $ 200.00 GP#77513D JD rot.11673
12/8/2020 Jerry Mills Construction Eberhard Kosken First Bank 2933 $ 400.00 GP#77534D BB rct.12446
12/8/2020 Richard L Chasteen same TD Bank 2807 $ 200.00 GP#77518D JD rot_11732
12/8/2020 Bruce Marek,P.E. Bald Head Association I Wells Fargo 1739 $ 200.00 GP#77812D Tmac rcL 11616