77528D - Fortanini

0 . CAMA / DREDGE & FILL N9 77528 A B C
GENERAL PERMIT Previous permit#
)C ,'New . Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State,of North Carolina, Department of Environmental Quality (:).--/
, ZOO
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
n n 1 �j^�, 1 ' ` ❑Rules attached.
Applicant Name bt)b C. KO t V 1C ' J-TAMi i/Project Location: County C01-)C4---
Address . /4 U r )-C/ O /A7T Street Address/State Road/Lot#(s)
City /'-.PL X State /-&ZIP 7s o2 I LW �io c/T
Phone# (K)j-5:50'/I /'7b r mail Subdivision �f�
Authorized Agent 1,- 1— -� �G ) City / Olp S' IL ' ' ZIP " `1
Affected CW OTA ❑ES ❑PTS Phone# ( ) River Basin W,c9 t
OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body f Q/U A k 7- (nat fan-pnkn)
❑ PWS:
Closest Maj.Wtr. Body (��5A/L �/
ORW: yes / PNA yes / no,,./
Type of Project/Activity . rQp/,......- ` -.., , /I / f 449c %tir-
1Ii 1 / (Scale: N_
Pier(dock)length ( `�
j 1
Fixed Platform(s) I Y.. • f I i
j 7 /
Floating Platform(s) j d
Finger piec(s) r r ij,.
Groin lengt j r Y
number
Bulkhead/Riprap length 1 + 1 i I --
t - _ / 1 I . _
avg distance offshore ` _H_^ •lam tO
max distance offshore 1
Basin,channel ,/ _-
cubic yards r o e' '
littzkoxitol'
Boat ramp i f 4 poreck
1
i
x -... �.___..-._....._. _._.�..� 14
Boathouse/Boadift1 7 (� .. + ..
_ j /
Beach Bulldozin -i
/ � r•GW AMA
Other I i
I
f !
Shoreline Length ...? (' i 11..
SAV: not sure yes do
1
1I
Moratorium: n/a yes i F
Photos: yes }
Waiver Attached: COP 7Sr - - - -
A building permit may be required by:_ ' P7 ; [,k-- fl' ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
i-- .-,
Ap licant Printed Name /rm ic�ted DPanfe ..
Signature '""*Please read compliance statement on back of permit** Si re
/ 60 5 1 % 2,5 ' 2--\ ' 2S r 2(
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 (252-946-6481) or the
Wilmington Regional Office(9 I 0-796-72 1 5)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

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10 LAMA!C3 DREDGE#it FILL ,± No,, 7 2 - m B c
ENERAL .'PERMIT' s ` `
Previous permit#
'� ' ew UMot tftion-, DCortiplete,Reissue .".' . a"'I.-dal Ret&sue• Date previous permit issued .
[s asutharaed by the State of North Carolina,Department otEnvb'onme ital Quality; II •� `.
nd the Coastal Resotrc Gpaxnisslo99 in an otter of eriviro9xna concern t to ISA t.1GSC
a6,i. � f
tppiicanthtapie DI w ikAiNi roecttocation County ',. ' . .
i y
treet Mess/State (s}__
�'ress .� �. `� "'S Ra�df Lot� =-_ -
hity w stets r C-zip -" f, e' 'i, ,•
e* t Subdry slog t, -
pity
#uthotfzed Agent - _ .
dCW TA ;': ES L PTS :,phone# ,• ) r River`Bas�ir► t 1
JQEA 1Q40 F t7iH CiUBA . ON/A.-1 p } Wte•Body -i�- 14- T h , a�" $� + )
Closest Mai.Wtr.Body• f `:1' '- - ' n
9ltit4' YeS. 7�
s sP it I)
ttype of Pe<t/�actfi �ty y f
# .. 1 (St:Met tar . )
. ....._
Pier` 3�" .3, h r 2 -,---• • �'-` { `� � , .%,
f?iatform{s} L -V
}} , F �V
v / c' r" xg 4 3 1,-, °.•i • �A 4 t l 4 ,
s ? t f; s
GrarA" t z R r : T f}
d r'' 1 4 ie '1', i_ 'L R�. 1 4 ;L 1. y' ..y x.� L R C zi r t t „ x, 1,
. F q
$tlkhesd/P prop +,r,�• } w� / r 4r
"` a ttoisrance6 x y j{ rj 1 NEN t t o - 4 -,t,V 1 «�J -;f• 5 �i
main distance ▪ dt ,,, 1 i k iS '
i Basin,-cnannrt. `Pa ro # 1 - i''f IF ,, a .t a t
X - •r
f 4 a r 4 L Atlk 1 s
]y r , . � �1, a 1 3
1
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9. p�,4t.,gi?L 4ej BouRt x 5., t '_• e , t .9 1 tie: y
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1 333jc.SAV 110t itre i� y�3 .� - 1 t 7: r .�_ `....r l.. i t $ , qq
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MOraturlttt»Y, eta ,ycs t 1 3•. 1 e .i-' .{ ,µ 4 `
j r•'l�i
,, ` ..w� �..,� s r: -.. ..,i. .. �:..i, { '.k -,� ° _.,_. "3 i ...t
A building permit may,be required by' -, T-- %'{' ?r t! f , See note on back reg rdinn Rive'Ias4n rules
(Nate°Local Ptinirfrig jueisdictio9t) °°
Notes!Special Condition -
p� s
r '
y f;
r itiialne
Signature- '*,Pieasereadeomplwticestateinentonbac kofpernCit Sig ` /
?AppC{conFee(s) k# issuingflate Expiration Dire'
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent toToca on : cA FoAk;. :n, 's
(Name of Property Owner)
property located at /0 7 to '4 f4✓c
// (Lot, Block,Road,/etc.)
on (3445 Cn &nnel , in 'l pca;! �i 1i 1)164rler (‘1cn.. 1C.
(Waterbody) (Town and/o County)un-
Applicant's phone#: 'o2 F-.2S) ' 9W y Mailing Address: o25/y Z redo 77-a ce
Ate-it NC 750 2
He has described to me,as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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 not wish to waive
XII°I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual pr posing develo,,� •,t
*II 1;0- S Fe P`eT"`8 S-to n e5
glt la
di f 1.4 C�ccc„71 X,
1`{+ RECEIVED
JAN 1 2 2021
DCM WILMINGTON, NC
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
dsig ;Fre to lace,
Mailing Address Signature
0'enc N C a 75 o a Kenneth W. Stone
City/State/Zip Print or Type Name
F.a g- g V 0 - (j/5/ 919-744-9747
Tele ho e Number Telephone Number
,., /(/y/2o 11/24/20
Signature Date Date
1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
! / I hereby certify that I own property adjacent to / il d 's
(Name of Property Owner)
property located at /0 7 Trt J`f 4
(Lot,Block,Road, etc.)
on , in - I o psa.:I 1 ,C\---- ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: 13sZg Jo al°1 q Mailing Address: as/q
4,ex_He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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 not wish to waive
`L- atI do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development) RECEIVED
2cia tee ( c/
JAN122021
DCM WIL6MINGTO ►
lb
(Information for Property Owner Applying (Ri arian Property Owner Information)
for Permit)
asi y rtAVvfo?
Mailing Address ,ignature
,<ri 0-/5- \Ja . &( GtOf
City/State/Zip Print or Ty Name
,ta-g -Witt 57O — $S(f - (osoqN
Telephone Num er Telephone Number
9iggpoo
• Signature Date Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Re Requesting Permit: . J o�J F n,'C� %r) r
4 9.
Mailing Address: a 51 y . /:e ice. i m 'Tr 4. ce-
Phone Number: 4 y 0,' o/ 'f
Email Address: cdb n •k. +n j,t; 3 6 y4,11 o o C
I certify that I.have authorized H I rd 4•1 a i
Adent/Contractor
to act on my behalf,for the purpose of applying for and:obtaining all CAMA permits
necessary for the following proposed development
hoed—
at
my property located at 107 '7 'o Aveye Ta Pue:-(i P31
1189/3
in TG Ar 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:
Signature
ld (
i%4'eta .z•
Print or Type Name ..
Du'" . _
Me - RECEIVED
Date .
JAN 12 2021.
0CM WILMINGTO N, NC
This certification is valid through I' 2 l 31 t al

•
Crock
Dale illimeN.d DM.Dap.M."od Crock From(Nam.) Name of Permit Hold., Vendor 11/ amount Permit Numb C.mnonro Romp!or RNund/R«Ilocarod
Coln.N Cakmn2 Column) CWYTM Column. Column. Column7 Column." Column9 ,
_1/26/2021 'Davey Resource Group Inc 7 Beach Bay Lane,LLC United Bank 2170 $ 200.00 GP#77757D KE rct.13662
1/26/2021 Clements Marine Construction ,Anthony Patterson FCB 5627,$ 400.00 GP#77748D KE rd.13663
�1l26/2021 Allied Marine Contractors LLC - Todd and Ronica Fortanini FCB _ - 9756 $ 200.00 GP t77528D JD rct.13610
1/26/2021 Southeastern Coastal Construction Co. Gary&Sara Olson South _
State Bank 12068 $ 200.00 GP N77525D JD rct.13609 .