77521D - Ellington

2 CAMA/ 11 DREDGE & FILL No 77521 A B C
GENERAL PERMIT Previous permit #
>( E,XiNew JModification ❑Complete Reissue . Partial Reissue Date previous permit issued tSZN
As authorized by the State of North Carolina, Department of Environmental Quality CJ 1 �i�7 /E 'r7 „ 6 •
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC .
PP Ct £rj Ij ' County Q.Ryles attached.
Applicant Name J V ��r/�� Project Location: ///L "'/,eA,,,._
Address r Ai • e tor7e A- Ave , Street Address/State Road/Lot #(s)
rr 1 tf /
City i Pl'k State ,�:./C ZIP ?' L1O)�
W J.'L., t- i V C kt/ '!'" . /v
Phone#Qf0 ) 670 IS " E-Mail Subdivision Authorized Agent D f rG /'v-.1-'7/A, r City A- 1(..(51t-4 ZIP Zer" N/ I
Affected ❑cw )61 EW NC PTA ❑ES ❑PTS Phone # ( 1-----,-----, River Basin t ' 0
AEC(s): ❑OEA CI ❑IH ❑UBA ❑WA AEC(s): Adj.Wtr. Body 1 r;9�'ci4 < <. $ 'U N d man /unkn)
0 PWS: /
ORW: yes PNA no Closest Maj.Wtr. Body 7! '' i S I- ,v p
Type of Project/Activity (M irf G I r r r -a 1 1t4,l L y i(
(Scale: I 50 )
Pier(dock)length ill 1C Z-S 0
Fixed Platform(s) 8 .� I _
{ I
Floating Platform(s) ' ' W e A-""'.
Finger pier(s) I ij I 1
Groin length / i
I
number — _... .._. .____- -- — — �---._._44 -: T.._.. j
Bulkhead/Riprap length +
avg distance offshore - j ^N
I I
max distance offshore_ i �� t
I
Basin,channel f 4 �) 0I O, ;
i he
cubic rds
Boat ramp j 1
Boathouse/Boatlih 1 J
f
Beach Bulldozing 1 N.
—Tppp he t/� . � '—
oti l mk I
. \— z xr�
Shoreline Length(' roO �\ ; 1
SAV: not sure yes 7, . N \�
.
Moratorium: n/a yes i0 i i
Photos: yes _� __ ... $'f � 1
f 15 , ; i
Waiver Attached: yes no -
A building permit may be required by: 9/L/v-`-Cv'•- �'• 7 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
••Mb flA 4/Z77 )
ent or Applicant Printed Name P ittO'icer's Printed Name
Signa' re Please read compliance statement on backit's'"' Si -
D17m / r /7' 31) ' Zv `(, 34 ' Zl
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 252-946-648 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Mic-6.ct Pill 's
property located at � a (Name o roperty Owner)
tl , (Address,Lot, Block, Road,etc.)
on r C. wLfP * in .cs L t c ankh' 3 N.C.
(Waterbody) � (City/Town and/or County) •
r
The applicant has described to me, as shown below, the development proposed at the above
to
r/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)
ea l I .
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Ofle. poll
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i -114 L i iklFez
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 •
/siir I do not wish to waive the 15'setback requirement .
(Property Owner Informati ) (Adjy-nt Pry•arer I ormation
)
Signature Si1 e/
P �o�l/Giro-rint or Type NamelZA(//:,
Type NarrjeNicifIck't Ell-in n 429t•-..10`"`jam r&t, fige.
Mailing Address idress AO!D N P(p IZe 62 . 0% �� �� "
City/State2i C1T
h,/ �/�F ' _
Telephone umbek/email address Telephone Number/ - ail ddress
9 /d -� � -L�La .i/ 7 Cow •
Date i(f 11 0 az Date*
}
f
*Valid for one calendar year after signature (Revised Aug. 2014)
•

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to (`tic 6.21, =s _
(Name o Property Owner)
property located at tak 5cy ,c\•V �.>
(Address, Lot,Block, Road,etc.)
on r M,r+' , in c� Ira N.e 2� �t.1 ,N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
an
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 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.
FIP I do not wish to waive the 15'setback requirement. •
(Property ner Informs ion) (A ' erty Owner Information)
Signature ,g�Yflu Pe,
Print or Type Name P.gnt or Type 1
A01 D N pA •R oe .5�'Z /Loce.�c L
Mailing Addre`ss-WWII (c. �ytIO6 inc`�Ad ss /' p
gity/Stat isCity/
Telephone Number/email address Telepho a N.umberj email address
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: AVGlfts'ZJ €L I.i ff �✓
Mailing Address: 2e/D /v /24 Mlle
v, 63=774 i 6 2P05`
Phone Number: 9%D I Z O /5'
Email Address:
I certify that I have authorized ('/1.l ss iQj .- A D2 4- €960( i•• ITdA/V& r
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 1)DC.
•
at my property located at / 2 9 .fa a fib Vie e 1
in ? 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:
ignature
hick -e)(
46
Print or Type ame 1
nod lik-or
Title
1t I 1 g I Z-401-0
Date
This certification is valid through 1 I

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor 11/ snwunt Pro ntt Number/Commrtte Beet or Refund/Reallocated
Cokennt Cdumni CoNmn3 Column Cotumn5 Cdumn6 Column? Column8 Column!?
12/3012020' Overbeck Marine Const./Daniel Shirley Bill Edwards SunTrust 5387 $ 200.00 GP#77589D KE rut.13659 _
12/30/2020 F and S Marine Contractors.Inc. Julie Smith PNC 8955 $ 200.00.GP#77575D _ arrt.13655
12/30/2020: •F and S Manse Contractors Inc. Franz Hueber PNC Bank 8954 $ 200.00.GP#775080 KE rd.13658
12/30/2020 B end B Marine Construction Town of 01B Wells Fargo 1544.$ 400.0 GP#77586D BB rct.13639
12/30/2020 AMW Docks and Manne Construction LLC Patrick Lomansney BB&T 6074 $ 200.00 GP#77580D ___ BB rct.13638
12/30/2020: Lighthouse Marine Construction Robby and Lynn Spain Coastal Bank and Trust _ ' _ 3555:$ 600.00 GP#73592D _ _ JD rct.12382
12/30/2020i Robert C On Robin Orr Bank of America 6775 $ 200.00 GP#73591D JO rot 12381 _ _
12/30/21)20 H5 Construction.LLC Jonathan Warren BB&T 25331 3 200.00 GP#77632D Ben ref.12472
12/30/2020 B and B Manne Construction Kerry and Rachel Vachon Wells Fargo 1541 $ 400.00 GP#776530 Ben rct.12473
12/30/2020 ncwrc same Electronic Payment 128354 $ 200.00 GP#775790 none-taken by Patrick Amico _
12/30/2020 Delta Dock and Boallift Michael Ellington FCB 9021 $ 200.00 GP#77521D JO rct.11743