77661D - Fish

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a :"CAMA/ ❑DREDGE & FILL N° 77661 A B C C....)
GENERAL PERMIT Previous permit#
)1.--------- Clew ❑Modification CI Complete Reissue ❑Partial Reissue Date previous permit issued 77'
As authorized by the State of North Carolina,Department of Environmental Quality /; i Zip Cs
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC .
6s1,,
�j ❑Rules attached.
Applicant Name r 0,6v a� _ ,
Project Location: County i ' u n �w i.
Address l' 1 31° �iannC t L- p r' Street Address/State Road/Lot#(s)
City I O1cde.V {7Pqcl-, State NC- ZIP 2C1{&Z ' jy ;�.l +l Et D►- .
Phone# (q/q) y/ 7 17( 9 E-Mail deboratn 4C/ Si-‘ &bemG• subdivision �". - II , //,,
Authorized Agent UGC,, D ((_/ orq City -f'C 7' ae a W ZIP 2 S1 lJ L-
Affected ❑CW jW YRTA ❑ES ❑PTS Phone# ( ..---1".----- River River Basin i_ur.b
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body Cilv`' a. (nat ►ra),/unkn)
❑ PWS: l.V
l Closest Maj.Wtr. Body
ORW: yes /I j PNA yes /ro
1 .
Type of Project/Activity Iv e DoC*-111 Ta C 1 1 1
(Scale: I = Z U )
Pier(dock)length (4,X j 4
/. I i 4
Fixed Platform(s)
Floating Platform(s) l�x S to 1 r,, jam_ �f1�V T
- 1.9 !
Finger piers) --�
I
n 4049
Groin length 1 fd�
.\') t ose
number -._.._._..._,— �3�'--- --- `.-- � °� -- -1-�.___—�_�__.___...._. -----...---- '—
I
Bulkhead/Riprap length �- a �'' �— / % f j
avg distance offsh�ek� �,tC c7
0 ! , ! / ,
i
max distance ofshore
Basin,channel / Iq'S\ I ; •
pt .X,,•tf + �tl � l I j
cubic yards j ow� S t i 11 f i
Boat ramp j u. e • -\ I /�:::: :1 '
p/
Other A. *1
CloSVc:Arti,:rits,,tclC r '�` i '•�� I ;II
lor`°) ` 1 ' 16,AI(�' 1
i I >,ey 1
` \ i AQ I I ye-Shoreline Length 7n I 1 Pic/ i 1 1 1
SAV: not sure yes OP 1 _,
Moratorium: n/a yes 0S0 C423— f11_ jr_463,4-Th , : :
Photos: yes no �' (4 �1 f I.
Waiver Attached: yes no �1 , /
A building permit may be,required by: Wc)l dV\ � ' . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) //� /
Notes/Special Conditions Atk-f;taye.,s D-4- 71 J 1' /zoo loco! r-ta I, 4 i r�1 �a/ re ,/1 d loh c
4Pf,Iy , N0 '
,Ave (v ove.'/ caas \ w _ 0.yNdS • 2 cl'IFS ')er►- i
-Delooit r I,i g 1r l"\11
Age or Applicant Printed Name
•1n{m% Permit•' s Print-• -
( L 1)o. A " / f-----'
SignA ure **Please read compliance statement on back of permit** Signature
-7�' g 10/27/zo2o ).-/ / c'zt
Application Fee(s) Check# Issuing Date Expiration 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 (252-946-648 I) 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
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

•
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 1--•
4. 1Led-N k. 15 h
Mailing Address: k 3 4 Sett ( .sin -1)e_
Phone Number: -11 q - y-1 .q-- 1-4- , q
Email Address: Tbi,1po , -t tsk .Z ' •gi C . v?
I certify that I have authorized / Lc - ,
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: lDoc. ICir 'c t.Lt.,41
O- (34 SARI - sk
at my property located at \3 4 cli 1 51,.\, ,
in 71A.,t,0e043k CAL- 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:
cioaJ-\ .4AD
Signature
10ott-aL„ ( . �ic'l_
Print or Type Name
Title
De) l as l a12120
Date
This certification is valid through / /

•
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 'D-6°otki► k. R 5 K. 's
Name ot.Property Owner)
property located at 13 4 5,x t i'R S h 21 ✓e.
(Address, Lot, Blo k, Road, et )
on CaLna,� , in tkol cL n 1' Ch , 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)
See �k c,hed so,4-chi
k_kci iiii(kCAJ +
¶o-a-h o c ( R ' K 1(1
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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 withlt 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) (Adjacent Property Owner Information)
.60atdiN ‘,/K/W
Si atu a Sia re*
000tet ,, k� FS �, ov us 4SKr lei kct-
Print or Type Name ' Print or pe Name
�1 c 1 -�i�, fat✓� Son 4 SmaIL.'rc Rawl. PI
Mailing A dres MailingAddress
� .h �2ac.L nk aBgG a ,
i /St te/Zi _ City/Sta?e r
e ep one?lumber/email address Telephone Number email a dress
oci a g a oa [J d L12r)
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature* 1 r {�
L k -C_ e- I214 <aI I I7Sik

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 694 i QgDu J/ )C6)a) 's
�` Game of Property Owner)
property located at / 34 �x"J /!!s) bR i ye_
/�
(Address, Lot, Block, Rpad, etc.)
on & /tic? ( , in I-l-01 ." 13P , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
X 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)
e 4-ifcc c-11e6( SAC e-kk)
tt, t (ik)al kc.J 40
oak;"4-
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.)
l
�do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
UjbokLK7t ) 0/.64,(01 , pp c
Si atu e Signature*
p. lOed& i �i sh iberao Ca-1+fist,, N est tj1 u 2 T
Print or Tye Name " Print or Type Name
sat I i sk ��.�ve n I �s ice, 1)11 .Le,
M il'ng� dress Mailing Address
v a{IN eta(� c. a gq6 c kP n fea ca (\k_ 84<0.2
City/State/Zip City/State/Zip
qq ��.fiB �� R(0 / �D,�uh 1
Telephbnee u b /email a dres� R�NC` TelephoneNumber/eM it address
9 �a8Ia0Ap 00 .2 ? /aogn
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
(Ann Y .4- (34 Sea t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to b.Lbava_4 K. lick 's
(Name of Property Owner)
property located at 1724 Go, In Dr.
(Address, Lot, Block, Road, etc.)
on C- .rt4-4 , in W I . , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatjon.
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 cti A--H-et_ h e
/A-A . Wa k.�.w a y -h -fit Deck,
I tat
ak4vA. l—i-F--�-
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 ou 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) (Adj. ent Property formation)
O
Signature ofature*
-kov-- Cleba,ra_h i,�-, 3ohnrue Aridericr,
Print or Type Name Print or Type Name
3b3 Nv I n b#a r1n Rk St./ 11'8 51 Nc- I-lw y '"7 V
Mailing Address Mailing Address
6 o W N c.- �gti4 l�z i e.z- 1 nl G 2 39 a__City/ f to p City/State/Zip
to g l b- g ln2-c14 7
Telephone Number/email address Telephone Number/email address
jh I ti+17-6zO I4){14,7.071 3
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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Date Received Date Deposited Check From(Name) Name of Permit Molder Vender Check Number amount Permit Number/Commend Receipt or Refund/Reallocated
_Column) Column1 Column. Column! Coumn5 ColumnsColumn))mn? Column& Column
10/27/2020 Lighthouse Marine Construction,Inc. Jeremy and Shelly Norris Coastal Bank and Trust 3445 $ 600.00 GP#77673D JD rct.11770
10/27/2020 Lighthouse Marine Construction,Inc. Vance Wade Coastal Bank and Trust 3444 $ 200.00 GP#77672D JD rct.11769
10/27/2020 Richard Penny Construction,LLC Scott Sutton Navy Federal CU 1171 $ 200.00 GP#77671D JD rct.11768
10/27/2020 Land to Sea Construction,LLC Felice&Richard Brenner FCB 317 $ 200.00 GP#77686D KE rct.12406
10/27/2020 VCC,Inc. ,Scott Ussery BB&T 7919 $ 400.00 GP#77662D Ben rct.11720 _
10/27/2020 VCC,Inc. Deborah Fish BB&T 7918 $ 200.00 GP#77661D Ben rct.11722
10/27/2020 VCC,Inc. Douglas Keith i BB&T 7917 $ 200.00 GP#77663D Ben rct.11721
10/27/2020 Jerry Ennett Bruce and Patsy Jones Coastal Bank and Trust 3411 $ 400.00 GP#73582D JD rct.11771