Sewell, Raeford 78336C

In
AMA / r DREDGE & FILL N9 78336 A B C ' D
r. GENERAL PERMIT Previous permit #
ew DModification ❑Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources ommission in an area of nvironme to concern pursuant to I SA NCAC 7
❑ RuI attached.
Applicant Name ' �.�
— � � ����� �`� � Project Location: County___
Address_ Street Address/ State Roa /Lot
City c StateiJ
_ ZIP Z-'"c
[
Phone # {) E_Mai Subdivision
Authorized Agent -- _ City I C t !Ott` f 01 ZIp
Affected -W r""` A_:� ES El PTS Phone # fiver Basin`" �✓ " '
AEC(S}: ' OEA ❑ HHF C IH ❑ UBA ❑ N/A f�
C PWS: Adj. Wtr. Body_ L nat man unkn)
ORW: yes (nod ) PNA yes no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale j4_/T i }
Pier (dock) length
Fixed Platform(s)h!
- i - l
Floating Platform(s) i i i �"- i • /p - -�---
Finger pier(s) .. _._l ; _
Groin length E-- - (- i i I—�-j-1- * - - F t #
1
I
Bulkhea y Riprap length f --
--A J
g distance offshore -j
max distance offshore
- I
Basin, channel
r _+
cubic yards i
Boat ramp -i - -
Boathouse/Boatlift
j { i
;
Beach Bulldozing_
Other
J
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes o
Photos: yes no
QYye
Waiver Attached: no A building permit mrequired by: �'y' " �' ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions t (` �-�,, �fc{•4� ��, J. J��, �� �„ ft�F,
Agent or Applicant Printed Name PermitOfficer' P 'rated r
Si t "Please read compliance statement on back of permit s Signatur _—
pplication Fee(s) Check # Issuin ate_
g 4Expiraaate

AMA / ❑DREDGE & FILL
GENERAL PERMIT
ew ❑Modification [-]Complete Reissue ❑Partial Reissue
Asa thorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resourcesommission in an/area of nvironme to concern pursuant to
Applicant Name ( r/�' V_ V-C 7 Proje
N° 78336 A B C D
Previous permit #
Date previous permit isssuued/I
. / 15A NCAC 7/0/-1 % /�
❑ uul `attachhed.
:t Location: County I/
Address ' li f Street Address/ State Road/ Lot #(s�
City State ML ZIP-�L 6 - ✓\C'�C
Phone # ( ) E-Ma'
Authorized Agent
Affected W �v A� ❑ PTS
AEC(s): Ll OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes (no PNA
s
Type of Project/ Activity _
n
M
Pier (dock) length I NX)
Fixed Platform(s) Rh'/U
Floating Platform(s) t
Finger pier(s)
Groin length
0ber
Bulkhea / Piprap length
g distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes
Moratorium: n/a yes o
yes f no
UV
Subdivision
City I C 1'f�f ZIP �U n
Phone# O iverBasin '�
Adj. Wtr. Body L nat man unkn
Closest Maj. Wtr. Body
(3Q(Af /^'I (ScaleA/— f )
1 i i I
Photos: yes no _i _ _I I UJ e t_ t el // t /-q
Waiver Attached: /ye no w I '` I-
A building permit m w e required by: Ct'I'V ❑See note on back
( Note Local Planning jurisdiction) Notes/ Special Conditions P'p.
�rl Ct �✓�fc �c'�� G�J''�J �����` l
Agent or Applicant Printed Name
River Basin rules.
r4-�
Si to 'ts' Please read compliance statement on backo(permit"
C- U j()qqq
plication Fee(s) Check #
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 isinspected 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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar -Pamlico River Basin Buffer Rules ❑
❑ 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/1-8884RCOAST
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 Mall
Washington, NC 27889
252-946-6481
Fax:[phone]
(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 Render Counties)
http://portal. ncdenr.org/web/cm/dc m-home
Revised 7/06/17

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to B42211 �Ei l/Gu ,s
property located at /o ff
/� Name of Property Owner)
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t ( /� /�� (Address, Lot, BIQck, �}oad, tC.)
on i��n(Te 041( C[Il�� in C'f}2YcP�� �DU�,Ii�/ N.C.
(Waterbody) (CityRown and/or— Cry)
The ap�nt has described to me, as shown below, the development proposed at the above
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)
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5 F
WAIVER SECTION
1 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
R(if you ish 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.
/email address
(Adjacent Property Owner Information)
Signal
Print or Tvoe Name
ki,� -3
/ email address
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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I hereby certify that I own property adjacent to JAZ fit` W Li� Is
property
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property located at C�t� l Property Owner)
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on aj4 e ©/Y{C !� (� �tL in L �iiQ L p 7'1 N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatign
✓�rA I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
jM$0dital proposing development must fill in description below or attach a site drawing)
�ryf
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AW )P'Jf FOIAII)AA!o
1 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 yp 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.
(Pr party Owner Info)
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Printorr T15e Na
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(Adjacent Property Owner Inf m tion)
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Date* l /
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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