Crews, Michael 78354C

C3dAMA / El DREDGE & FILL N9 78354 A B CC,D
G NERAL "PERMIT Previous permit#
Mgj;ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued'
As authorized by the State of North Carolina, Department of Environmental Quality —^^'°i l ` e96'6
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / /`7 "'V
❑ ules attached.
Applicant Name I �' -' / i✓f `�> Project Location: County 4✓/�Y: till
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Phone # ( '7/!)) ))r
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Agent or Applicant Printed Name
Signat� Please read compliance statement on back ofpermit r
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`_Application Fee s) Check #

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
Iandowner(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:
UTar- PamlicoRiverBasinBufferRules U Other:
U 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/1-888-411COAST 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 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 1)1j r,1446L L- C_f—k�S
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
272_1 E I N&I G-15 a
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m�r?�F-t..���?6S�f r��`��o�Jve►C�in
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 0 rm�(_d vJ
l> Q1C,k- v1 k 2.oy
at my property located at
in �)N<' W`y County.
1 furthermore certify that 1 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 Informati n:
L�
Signa e
� 1,��Cj6��
Print or Type Name
Title
Date
This certification is valid through V1 tN / I l tl` a
�No LV%"wJ
RECEIVED
JAN 0 4 2021
DCM-MHD CITY

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER-NOTIFICATIONNVAIVER FORM -
Name of Property Owner:
Address of Property:
1 I ((Lot or Street #, Street or Road, City & County) 1 �f Q
Agent's Name* �� �Q "I I\, (ZI (� Ia) Mailing Address: 10 / W W N �� / U
Agent's phone#:
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
propposing.' ads p`t�rmd a 'g "th ltnet s�resrt "u b Q� :ed "th lett .
- J(_6&aave no objections to this proposal. I leave objections to this proposal.
If you have objections to what is being proposed, you m ust notifythe Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 28557, DCM representatives can also be contacted at(252) 808-
2808 No response is considered the same as no objection if you have been notified by Certffied 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. Of you
wish to waive the setback, you must initial the appropriate blank below.)
�y (Ido wish to waive the 15.' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Ow er Inf
mation)
IdsZ14,1
Signature
Print or Type Name
a7�&1
e) b (, 12
Mailing Address
City/state,Lip
0i3-3T?-'7
77
Telephone Number
Date
(Adjacent Property Owner Information)
Si ature
6 0 & n✓tll �Sst
Print or Type Name
;(�o T-, lvU ham: ��d Dr
Mailing Address
flube-rt AI C 2 D9
City/statefzip
Telephone Number
I i x�- I a o
Date I
Revised 6/18/2012

CERTIFIED MAIL � RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
- --- -- ADJACENT RIPARIAN PROPERTY OWNER-NOTIFICATION/WAIVER-FORM
Name of Property Owner: jze1JaE L
Address of Property: 0�7 E lV 2111 �rE
(Lot or Street #, Street or Road, City & County)
Agent's Name#: a0QM1j R2) ?'l-) Mailing Address:�O) WA22Cv I A�PL�e
Agent's phone #: (-10 S S q O� 75 �� Il ( n A
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.'��se p ian��r lt�tm oh nr'1
ea 01 t be id1-1gr � Metter.
� 3 i I have no objections to this proposal. I lave objections to this proposal.
if you have objections to what is being proposed, you must notifythe Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 26557, DCM representatives can also be contacted at (252) 808-
2808. No response is considered the same as no objection if youhave been notified by'Cerfified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
hack a minimum distances of I6 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
ygcc- �--
Print or Type Name
a� 6 Vyglz�i� iJa
Mailing Address
kbgeEa .Jc
City/statelzip
910- 1-7
Telephone Number
lo/v�
/�o
Date J
(Adjacent Property Owner Information)
ACZ -A, )-- ��--
Signature
Print or Type Name
15n iz-: T✓C.
Mailing Address
�4 V�4Z,r-t Nc
City/statelzip
qla 3k� S�69
Telephone Number
100,81a07.0
Date
Revised 6/18/2012
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