79040_Steve Lacy_20210216

• LICAMA/ EDREDGE & FUL L , . No 79040 A � ) C D
GENERAL PERMIT 1-Q4(2�� Previous permit#
> L2 New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued f-'
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 5A NCAC / /2e,i..
®Rules attached.
Applicant Name _,` L,.c, ( Project Location: County �' "ji c_.).
Address -SC E--E c. - r 5 \--C- , *— " . Street Address/State Road/Lot#(s) i1Y, "4 5
City r-aerY\e /c State NC—ZIP 2.,,}5751.5-27 f; .::
Phone#(.?"Z) �7o 9 S E-Mail Subdivision __
Authorized Agent `� t`-'� r- " 4 City t� "' t ZIP
❑CW CH EW ' PTA ❑ES ❑PTS Phone# (-52-) (<76 'i 9 2 s River Basin
Affected ❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body -') r , Cr lc (nat /man /unkn)
❑PWS:
ORW: yes no PNA no Closest Maj.Wtr. Body y 1�`v'''/-
Type of Project/Activity ;-: ') '/"
(Scale: / 30 )
Pier(dock)length
/ I
Fixed Platform(s) I f • 1T1C f ;Floating Platform(s) 1 ' Ill ;I
i _� • .....
Finger pier(s) 1
Groin length . I ) I
number I
Bulkhead/Riprap length --- _• — —._ I -
avg distance offshore ;
max distance offshore i
Basin,channel 1 I I
cubic yards , 5 ` ,•) f"
Boat ramp ' ,( , �✓ i ( ;'
r '
i i /� JC t
Boathouse/Boatlift I ) l'; L( k — :...... ... .... t1.._ .
3 X O 13.-,s c flt-t,SSc--- __.
i 1
Beach Bulldozing _ I -- -� I —'
Other t /M f
Shoreline Length / /v 6 v 2
SAV: not sure yes no - T°...(0)%cv) _Laf-, j — t`�: Y
n r yyyy
Moratorium: n/a yes o� �q L r
Photos: yes no
•f
��t9 111 5-r� 1f fi � �
Waiver Attached: yes no I '
A building permit may be required by: �%', '' C o C c-, . [ee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
/F ,
�.�r yl 4- V -4 ` i1(.�
of Agent Applicant Printed Name PeYmitOfficer's!tinted Na 7
1
"�" z
Signature **Please read compliance statement on back of permit** Signature
/41 J'r '_ . - 6, 1 CO , 2-°2 I — Le.,,.4.— i C-i 2-0, 24
Application Fee(s) Check# Issuing Date Expiration Date

I ^
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
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

—P-1'
•EJCAMA/ LIDREDGE & HLL ' O9040
GENERAL PERMIT � lo���� No.Previous permit A B C D
>C —___,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 15A NCAC
O Rules attached.
Applicant Name Project Location: County
Address Street Address/State Road/Lot#(s) '
City State ZIP
Phone#( ) E-Mail Subdivision
Authorized Agent City ZIP
Affected E CW ❑EW E PTA ❑ES ❑PTS Phone# ( ) River Basin'
AEC(s): ❑O� ❑HHF ❑IH LiUBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity
(Scale: , )
Pier(dock)length
Fixed Platform(s) ` - - i ;dr �� I
Floating Platform(s) ( j i , 5
1 1
Finger pier(s) i ' I _ {
i
Groin length 4 ' , ,
number _.._._.-...-......_..
Bulkhead/Riprap length ____ ` -F — --
avg distance offshore
max distance offshore j! {I
Basin,channel
. / I ( I
•
r- f
cubic yards a
Boat rampI 1 '
— -,G., f
Boathouse/Boatlift ` + I. r'_�._. — f ___
ttl
I ...
Beach Bulldozing
Other ,
Shoreline Length /(` (i
SAV: not sure yes no l t:I,-.0 I , 1'F , I -i-, ! `
Moratorium: i ! +n/a yes no' �. . I —�_..__ I .. 'r
Photos: yes no 7
.__ . { 1 _ __i ._.
Waiver Attached: yes no
i i
A building permit may be required by: . If 1 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
, v:-4 t I
Agent or Applicant Printed Name Permit Officer's Printed Name/
Signature **Please read compliance statement on back of permit** Signature `.✓
—r l' 1 , 2(,-21 • IC-1202i
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 (252-946-648I) or the
Wilmington Regional Office(9 I 0-796-72 15)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

Atios_...)66
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue,Governor James H. Gregson, Director Dee Freeman,Secretary
Date /Z?/ o/ o
Name of Property Owner Applying for Permit:
cue by D 9E0c 17/
Mailing Address:
-5. I-6 IJTE/6 Pormu i '/Z06-
V iN 01 E ci-1G�e_E) it) e.._. . - S—';? 7
I certify that I have authorized (agent) 7F--k)T pi. .c -7--7— to act on my
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) ' c- - T- L/ P7
at(my property located at) /f-i iJ7p?_c ibiA.37 / ilre-- ) (/�t/�& &C1JJc_
This certification is valid thru (date) ,l 3 I -Z.,/ .
IP Ijik.. --# /4.2/00
li►
IN rope Owner Signatur Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity\Affirmative Action Employer—50%Recycled 110%Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 14/671112 ivakel V's
(Name of Property Owner) /
property located at#l Z) Fit+N TEi?S AD rc.9T 7)R
(Lot,Block,Road,etc.)
on 714 Cia6EK , in VA4-)T.>✓MrvteE Pi4Mt-CIn C ae1U7/N.C.
(Waterbody) (Town alad/or County)
Applicant's phone# -67, 99 E Slailing Address: 2 6 / ce-AR75a-C lam/ die
�/9yV//�ii•�SCE _Lk 5
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
God ��T Li 7i
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
fitagE12s iAJ /)z2,Uc
Mailing Address Signature
VA-N Dem�Lc / /Vc, S'�f� ��7, • � �J-
City/State/Zip Print or Type Name
Te hone Number Telep one Number
e Da a Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to weio / 4 cgU' t_or'3 's
(Name of Property Owner)
property located at Z> (�G(#J7L72S Pa I A)T [7jt!6 VAfi17?EM , NL,
(Lot, Block, Road, etc.)
on SM •11+ , in p.4-M c u Afri ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#X2-&' '-`I`1--Mailing Address: Zs'b /4c.ekree.S Pourrp�
vowDemriz , aas
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
Cot /LE7 /. -;
1..
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) f
a S l�its De.i ve &6(Vi I�/' geld _ 1 / ' /
Mailing Address v� n _ ature I
- (
VA/Obe C-- �L ;- PR I(I( � ocJLeT( 2
K
City/State/Zip Pri t o t ypv 1 1Ln:
25z. - 670 - 992s-- - -- ' - 11 ' -6 7( -a693
Te ne N ber el ne N be-r-
e
Date Dat

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that(own property,adjacent to . 'Z ti mvv
(Name of PropertyOwner)
property located at 2- ' /-IcW7 2S A /.UT /)Ri Va r !//4/tr►)GAi&/2 .JL
(Address, Lot, Block, Road, etc.)
on 2Nva2/G/ttp,J &WA< , in f/'ik.Y�c�S44 -#2&/ /l/4ML/Lb dd . , N.C.
aterbody) (City/ToWn and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatipn.
✓ 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)
n�cx scx
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.
✓ I do not wish to waive the 15' setback requirement.
P rty Owner Information) (Adjac petty Owner Inform ion)
natu i na e*
Pri
nt or a Na me f Prim or Type Name
Type
Ma
UJI)� j �G ,-3? Mailing
City/State/Zip City/State/Zip
S 44e4P r.►ey141.c)scciri\ ' '1 - 1, r I}
Tele ho N ber/email address Telephone Number/email address
Sr/ YI cyl
Date Date*
(Revised Aug. 2014)
`Valid for one calendar year after signature*