76182D - Sirgo

0 CAMA / DREDGE & FILL No. 76182 A B C
61)
GENERAL PERMIT Previous permit #
_.New. 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 environmental concern pursuant to I SA NCAC i1 7Cj. t4 0/G .
/�' Rules attached.
!V Applicant Name t IL 'l/50 Project Location: County /ibe f/f_
Address .606 r\e/ Did Y C• Street Address/State Road/Lot#(s) - __
City g'ct C eccfit State ik.2IPP�p -760 Sr 4 0l vu --}!1 Is 1?✓
Phone # (q_l_() %/ I);3 E-Mail iA 5+rq U e t'S✓1.(,rvf Subdivision /t( , 7' //5
Authorized Agent ;in/ A/-tk. City kuti / 7 ZIP Z4'61 _
Affected ❑Cw LAW r,virrA ❑ES ❑PTS Phone # ( ) _ - River Basin !d- (/K G
0 OEA 0 HHF 0 IH 0 UBA ❑N/A
AEC(s): Adj. Wtr. Body gI u/o/ .c /i`it /man /unkn)
ORW: )4/ no PNAs� no Closest Maj.Wtr. Body ����
Type of Project/Activity 1 r•
// i /' !bs///1
tale: 4 )
Pier(dock)length
r----_-.
Fixed Platform(s)_ 1 "_,,. •` iel P t
ifir ... i.
Floating Platform(s)
Finger pier(s) Aix le"? �111g 1�,,` `
_Groin length a?S T ay • r _ i ( y�-�V�- 4,14 1
number r-'--- 01 � -r i 4,____ � y
•
Bulkhead/Riprap length 5
avg distance offshore .---- it 1 • ' Ct
max distance offshore d AOr +
Basin,channel +
V 6k-7a.
cubic yards �� _
Boat ramp
rl)
Boathouse/a /3 k 13/ I . . I
F L --I-
.
I - r �� �k.Beach Bulldozing -- \\ v
Other - I
Shoreline Length _811"... i e
,
SAV: not sure yes aI ( —._____"1—
Moratorium: n/a yes a46 fo �c6^ `
Photos: yes a 1 _. �VI
Waiver Attached: yes 9,541,404 , i rill) M + ' ;4 SO 0. / i S ,
A building permit may be required by: ",/,11/#7240•411--&-ZeriiV 7 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) �,C�
Notes/Special Conditions ,� � p (� /�-� /jT�7 /2 ' •1 ' 50/rl 7T rS//2.5G
� 'f`in IUr •' I^ ick Brit%CO
Agent orAppli, rintekl Name . ...(.4_ PermitOfficer'siPri�nted Name
/
Signature ' ` leasad compliance statement on back of permit' Signature •
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(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 252-946-6481
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
40I 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

AhtIV I AU I t1UKl[A I ION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: (11 ,4 0.-kk 4 . S i 2 t C7
Mailing Address: 0 (, Lv A N ,' 02 t,;.Z
PV C-CA (0 4 y /J c 2:76 08
Phone Number: q i c1 Z ? 0 Z 3 co
Email Address: PtS I.2Cti0 co Ms Al .C ()A4
I certify that I have authorized ,l i',���t 4 C�
A� - It ,
AgeSit/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: .�Nj iG i�
G'-..
l-Scc t 'fl-
at my property located at ,9,5 L-2 d /-/,' //5 )
in /Ur',-,.) tea �o 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 Own li
Id rmation: 47
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Signature
M Mk:. A- . 5.IR.60
Print or Type Name
NJ/4—
Title
I
12I 1L1
Date
This certification is valid through I 1

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to lea /� 5 I r S 1 s
(Name of Property Owner)
property located at (1 H" //s
(Address, Lot, Block, Road, etc.)
on I C CO 60 , in G-J % //-1 a__Th qo . N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
•
VI 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, 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.
\f 4,9I do not wish to waive the 15' setback requirement.
;II.: (Prose y Ownpr Information) (Adjacent Property Owner Information)
Signature Sign Lure -
Print or Type Name Print or Type Name v Url
Ca0G L...; A+ -.I: �!� . 25V At 1 MY/S r-
Mailing Address Medina Address
City/State/Zip City/�ate/Zip /
Telephone Number Telephone Nurn er
, /G / ?-02t i 2I
Date Date
(Revised 6/18/2012)

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Check
Date Received Date Deposited Check From(Name) Noma of Permit Holder Vendor VP amount Permit Numbenrommenb Racelpt or Refund/Reallocated
•
Columnt , Column2 Column3 ColumM Columnb Column8 Column? Column8 Column,
2/9/2021 Allied Marine Contractors LLC Laura Olsen FCB 9832 $ 400.00 GP#77742D JD rct.12387
2/92021 Allied Marine Contractors LLC Nancy and Bob Carr FCB - 9831 $ 400.00 GP#77743D - JD rct.12388
2/9/2021 Allied Marine Contractors LLC Robert and Sarah Clark FCB 9758 $ 200.00 GP#77766D JD rd.13822
2/9/2021 Sea Dog Marine Construction,LLC Donald McVickers First Bank 1230 $ 200.00 GP#74368D Tmac rct.13592
2/9/2021 _Sea Dog Marine Construction,LLC Christine Cichan First Bank 1233 $ 200.00 GP#77804D Tmac rd.13595
2/9/2021 Sea Dog Marine Construction,LLC Edwin and Wanda Turlington First Bank 104 $ 400.00 GP#77540D Tmac rct.13594
2/9/2021 Coastal Marine Piers Bulkheads LLC Mark Sirgo Wells Fargo 23717 $ 200.00.GP#76182D PA rct.11583
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2/9/2021 Coastal Marine Piers Bulkheads LLC Douglas Horne Wells Fargo 23718 $ 400.00 GP#76176D ;PA rct.11584