Clark, Kristina 78323C

W;N
/GE & FILL N° 78323 A B �, D
PERMIT Previous permit #
ew ❑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 enviro�tmen al concern pursuant to I SA NCAC
❑ Rul s attached.
Applicant Name KV I /' I ✓' . . �✓ c Project Location: County � e-P
j U �7 r l / (W Street Address/ State Road/ of #(s)
, State&( — zip G' 113
Phone # U 1 1) A' /L
Authorized
Affected CAN OePTA
AEC(s): ❑OEA flHHF ❑IH
❑ PW\S:
ORW: yes / no 1 PNA yes
Type of Project/ Activity
Pier (dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore.
max distance offshore
Basin, channel
Boat ramp,
Boathouse/
Beach
Other
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes (nof Li""Photos: ye n
Waiver Attached: es no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Subdivision c
(• t t City ZIP /
�fjES ❑PTS Phone # (_) River Basin
OUBA ❑N/A Adj. Wtr. Body - U it\ �u't --I _ rat /man /unkn)
Closest Maj. Wt.. B_d, &_ 7 G (--1
f
10-
(Scale:,A,'1 ) )
( . h,' ( (• ❑ See note on back regarding River Basin rules.
-c i��G1Yl
Agent or Applicant Printed Name
Signature •* Please read compliance statement on backof permit"*
Gu I
Application Fee(s) Check #
e-, / �/r= l.0, �
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 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
❑ Neuse River Basin Buffer Rules
❑ Other:
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 (252-946-648I) 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
252-808-2808/1-888-411COAST
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 Mail
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Berrie, 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:Hportal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

Name of Property Owner
Mailing Address:
Phone Number:
Permit: K r; S h r a C.1 a r K
�Tauwa_
Email Address: _,l�dme 69LcD �mciil Gorn
I
I certify that I have authorized JuS:tjn 01C;VLcinncih Gnchrcty)
j Agent Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: J f' n 1 ai (\Y-) 1'Ci i�SCA�
o-F -Fhe rurr=± dQCK ar1'a'' Gi ` AC On bf Ch fDnG1'C'i C' GiC1Gk
J
at my property located at I tV atCV iN L l l d Y 1 V e
in _COY-"eYet County.
I furthermore certify that f am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Loca! Permit Officer and their agents to enter
on the aforementioned Jands in 'connoction with evaluating information related to this
permit application.
Property Owner information:
Sign tore
Krisii O G1arK
Print or Type Name
4 vy v� PX'
Title
Date
This certification Is valid through 7 /

I hereby certify that I own property
property located at
on l G
The applicant has described to rr
foc�tio
I have no objection
I have objections to
DESCRIPTION
(Individual proposing dev
to_Y6S-H)o GIaY k 's
(Name of Property Owner)
(Address, Lot, Block,
. in ('j PA of r i
/ CQr-rCXCt N.C.
and/or Countvl
as shown below, the development proposed at the above
this proposal.
proposal.
DRAWING OF PROPOSED DEVELOPMENT
roust fill in description below or attach a site drawing)
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.)
' ' 1 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)
Si�rrature*
St�nnxa5 nr k�-t•-Fy NgVf�Y1
Pont or Type Name
leS 01=)L iSlnr(J ✓nniJ
Mailing Address
S�ivGlrlShe�vn v�G
citylstate/Zip
Dare
Telephonee Numberl ematl address
'Valid for one calendar year after signature" (Revised Aug. 2014)

ADJACENT RIPARIAN_ PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to is
(Name of Property owner)
property located at—i l3 \N2 t y WCt� idtly c'
on ( �/ ( (Address, Lot, Block, Road, etc )
(Waterbody) ' in CedAr.p j nL zGn r �0V C+ N.C.
(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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift; or groin
must beset back a minimum distance of 15 from my area of riparian access unless waived by
e. (If yoi�wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
Date
I do not wish to waive the 15' setback requirement.
.Telephone Number eemail address
'Valid for one calendar year after signature' (Revised Aug. 2014)

12/23/2020 Carteret County GIS Website
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POST TYPE: DRIVE
ESN: 2824 -
BUILDING:
GC EXCEPTION:
SITE_NGUID: [e-mail]
DlscrpAglD: camicsot,carteret.nc.us
PREDIR LEG .
POSTDIR_LEG:
FULL ADDRESS LEG 113 WATERWAY DR
STREET NAME LEG: WATERWAY
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