Woodruff, Alex 78347C

AMA / : OR EDGE & r-tLL
6 N EPAL PERMIT
ff . Modification `-Complete Reissue ';Partial Reissue
As as vtharix d by the State pi North Camllna, Department of LfMronmental Quality
and the Caastal Resources Gommission i� area ofe environmental coiwern pursuant w I SA NCAC
&
N9 78347 A B D
Previous pit #
Date previous permit issued
Fif+iP.S m7mhid.
Apptreant Name Project Location; County _
Address- �;0_30 1`r �+ Street Addres5f State Road/ Lot #(s)
City l;�xV - State ZIP I LlrC 1 rsr
Phone ee30 E-Mail _Subdivision
Authorized Agent T - — City. j�-#'�- ZIP � f
. cw ;; TS Phone. nAff€cted : �
AEC(s) ; P S: ' W iF I : Uf3A ::1V14 Adj. tr- t Oman lunkrr}
Closest R 1aj- Wtr Body
oftw; no P1+4 yes i;o -- ----
Type of Projectf Activity
Pier (deck} 24srgth ;> A(Y b
Fixed Pladonn(s) I 3m.
Flaltiwg Flatforml
Finger pjeg!;) rg
Groin length
number
IkAh `adl Riprap length _
avg distance oflshom
max distance offshare,
Ba-sin, channel
cubic yards
BOdS rlmp
aoa[houseJ 80aflik
(?•each 8ulido-zing
Other
Shoreline Lengtfr 1
1-7
SAY_ r`M skim yes no
Moratorium: nJ,1 p{s in
MOMS: yes
,iAu Attached: yes o
A building permit mmy be required by-.
( Note LocAt Plaririing Jurisdiction)
Notes! Sp&cial Conditions
(Scale -,A/ —JD )
v f SCC note on back regarding River Basin rules-
le'4v`IY� - �fiC'l� 0f7I"f1
Agern or ant I
rimed Name
Iva
5i to Masts read com9lja+xe statement orr bac it *_ff
Per,rw[DiG rs flamt
6
Expiration Date

AMA / ❑ DREDGE & FILL
NERAL PERMIT
evi ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of a vironmental concern pursuant to 15A NCAC
N° 78347 A
Previous permit #
Date previous permit issue
Applicant Name e-7 �` �" Project Location: County C11)'0".1—
City 41gyt N . -u St
Phone # ( 34 E-Mail
Authorized Agent
Affected ❑ CW ; l
AEC(s): Ll OEA ❑ HHF ❑ IH
Y L-" 1
zip OS7t
❑ES ❑PTS
❑UBA ❑N/A
ORW:' yes ) no PNA yes( no/
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Finger pier(s) Yl A
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshor(
Basin, channel
cubic
Boat ramp
Boathouse/
Beach
Other
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Gs7
0
Agent or Applicant Printed Name
Si tur ** Please read compliance statementon back of permit
)**
..G. 3`15n
ig lHc ion Fee(s) Check#
B /C D
Street Address/ State Road/ Lot #(s)
C � z �� ��Io•1
Subdivision
City G' [ zips `f1
Phone # Nver Basin
Adj. Wtr. Body C t t"�—_)4k*A sit<V/man /unkn)
Closest Maj. Wt.. Body GyZ_ L vrr N/t
(Scale: /A% )'
3'X l-)
❑ See note on back regarding River Basin rules.
C,
Date

Statement ofZomplianceand-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, certifythatthis project is consistentwith 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 (252-946-648I) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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 Pender Counties)
http://portal. ncden r. org/web/cm/dcm-home
Revised 7/06/17

aVFnYJ uua Y
they are proposing A fe--C Yvon or-drMY n' with dimensions must o provided with t is e ec
i/,/ I have no objections to this proposal I have objcctions to this proposal
If you have ob%ection s to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalrnangemenLrret/confact-dcm.htm or by calling: 1-888-4RCOAST. No
resoonse is borisidered tl:e 5an1r as no objection if you have been notified by Certified Mail.
WAIVER SECTION -
I understand thaka pier, dock; mooring pilings breakwater, boathouse, or lift must be setback a h
minimum distance of 15' from illy area of npaianaccess unless waived by me. (If you wish to s
waive the setback, you miss initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive tie 15' setback requirement.
(Property Owner Information) : '�� (Riparian Property Owner Information)
4 Sigrakrrc Signntlme �kRd
dleX W00df2-F LiL MX,1 �/�✓9�is i lu.. i>[�iV� _ �rtt
Print orT Name .
PrintarTypeName YP.a .
303D 13i1ou�✓oNl� la He (O fvtr �fly r'
Mailing Address. Mailing Address;
t,
Lrxi.Y2,�yL_%Y
City/Stafe2rp K City/statelzile
�b b � 3U y, 6 2� 9 91 - 5 v' � 3 Job
--- —
Tetephorc Number , Telephone Number
Date �Dute -
_ __-__..�..... _—.m-,-':':; ;''3r�-�-Yf'"'$L°�:°a=:'TRv'c9•?di'.�c'�'t"&

CERTIFIED MAIL_ - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIF�ICATIO/N,IWAIVER FORM
Name of Property Owner lnt or/.,. P4 ><�+ ur h tA/40v/rM ti j r
Address of Property: /r/2 Y.tnpoN ZOS4- �}i4w 't
(Lot or Street It, street or Road, City R County)
Applicant phone #: 6t? 3��/' 6 za 4 Mailing Address: -3q
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for is permit has described to me as shown on the attached dravring the development
they are. oposing. A_ gascripfion or drawing, with dimensions. must be nrovlded w th ibis Ie1teL.
f have no objections to this proposal. ._ I bavc objections to this proposal.
/f you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact darnAtur or by calling 1-8884RCOAST. No
response is considered the same as no objection if you have been nodfied by CerdNed Mail,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 s ack, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
'41e )e waa der r' r n-
Print or Tyjw Name
303a 1��rok'won,< lcrfe
Malting Address
Liul.ir KY os/s
City/Staf lip
¢6-3uy- 62a y
Telephone Number
pure
(Riparian Property ner information)
Signature n/��
23('nr e08'R&r< C6M
Print or Typo Name
2701 Gza('Voo 61 s 4"
Maiing Address
P-+1-:76tc . NC_ 27GOg
City/Stale/Zip
ToJephono Number _
a�s-ao2l
Dole

BLUEGRASS
3J25 LANSDOWNE DR
LEXINGTON, KY 40517-9998
[phone]
02/OS/202i 01:57 PM
Product Oty Unit Price
Price �n\
First -class -Mail® 1 --- ---------- $0.55
Latter \`
Pitisbca•o, NC 27312
Neighs: 0 ib 0.80 oD �a \
Estimated Delivery Date
Fri 02/05/2021
Certified Mail1 $3,sp
Tracking N:
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Affixed postage -$0.55
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Total $3.60
Grand Total: $3:60
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Card Namo: MasterCard
Accost B: XXXXXXXXXXXX9897
Approval #
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