79067_George Clarke_20210219

MKS
0 CAMA / DREDGE & FILL •-D 4 lV 4 i ,,,r1 CZ 0 A 46 ' 79067 (Be) C D
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
and the Coastal Resources Commission in an area.of environmental concern pursuant to 15A NCAC -
` � /a, r ,, ,.. Rules attached.
Applicant Name %, ,J, L/ter I e ((' .<4,/,..I ! Project Location: County . ,
Address /2 j. /�. l"- /;/'.,/( / "7''`'s, 7 /, %'')Street Address/State Road/Lot# s ,
City /1,.„r, State i/L ZIP rr2 7 /& / !/ _.ram. /l _, 1. ;, F i
Phone#(2..S`) '//- BJjr6 E-Mail ,-✓/-1 Subdivision ,v/:.'
Authorized Agent ,v// Cityl . ./O
/1�� ,�,.�H ZIP -2 7
Affected ❑CW El [PTA DES ©-PTS Phone# (:7:1) 7/7 ,1 dG River Basin T; //'..,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body , ./-' (.- ( (nat /6.aDn unkn)
PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body 5 - "t , v ` -
Type of Project/Activity A. 4,+1 c ' . I
(Scale: / ....
�/V 1 ,)
Pier(dock)length
Fixed Platform(s) 1,,j, - �ry` ' l ' ' A/ 1., L.
Floating Platform(s) I — '� I . I
Finger pier(s) d 4 ��
Groin length 1 i \� r { lit
number L. _ ► \!-::____1_ 4.1,
I r 1�6
Bulkhead/Riprap length — _ / _..._
avg distance offshore p V I IT e
max distance offshore4/ ` i j �
Basin,channel l 1 i
cubic yards '' 1 /
Boat ramp ' ' i i /-
(goathous�Boatlift /'j.,?� =._._._....................__. —Lt._
" "rt,, ><,- 1
, ,
y. c is G
y j� i
Beach Bulldozing /' I -- , , ,
i , , !-- — ! I
Other I I i " / I 1 t
1 �wCw �! 'rG* le { �*
J ilj 6. 4. t,-, \ I
Shoreline Length .•2°- I ( IL 11
i
SAV: not sure yes no j j }...-___ I
Y 1
Moratorium: n/a yes no s i — =
Photos: (ys.sj no <„, "' ! `? { - +-- - ! l ,, ,
Waiver Attached: V no
A building permit may be required by: /rGcr.,t(- I . H See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions -- -- 0 7((, 1l•20� J-,,, J / :;I //. b..„,/1.01,,,e ,•1::,../ , e r r, `/i,9.,e c
L: / is ,
Agent or Applicant Pr Name PermitOfficer's rimed Name
Signature Please read complianc **e 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 (252-946-648I) or the
Wilmington Regional Office(9 I 0-796-72 I 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

j •
-;• : cAMA / DREDGE & F'LL
�0 (Dr 6 Lt 8 No 79067 A BCD
GENERAL PERMIT Previous permit#
)�—% El New ❑Modification ❑Complete Reissue III 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 I5A NCAC .
D 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
❑CW ❑EW ❑PTA ❑ES ❑PTS Phone# ( ) River Basin - -
Affected
AEC(s): ElOEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
L. PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity - .
(Scale: j )
Pier(dock)length .
Fixed Platforms) t / I ,ir G., ( i
L y_t
Floating Platform(s) ` r1
Finger pier(s) I } a I I I . . . i
Groin length i : - ; , . dr ! ! 1." t+
\- 1number T......t ..... , ,, ,
., —t
Bulkhead/Riprap length --' r } * ..__ __-- —. i_ —
avgdistance offshore •
max distance offshore / j I
Basin,channel i j 1
•
•
cubic yards ( ,
; t • 1
•
•
Boat ramp ' .-. �, / f I!
i I ' / s
Boathouse/'Boatlift .1J —' 1— — --., .__ ! ;-
I !� i
Beach Bulldozing_ i ----- ' i v I - -
• 1I I a }
Other I li
,,i✓ IvCtt i�iiit'f I`'/ ' l i I i I / I _...
f
• i j .P �,{ I
•
I It ,
<
Shoreline Length ' '"I ti i
SAV: not sure yes no` ---.--- j —
Moratorium: n/a yes noj { -- t— —
Photos: yes no ! t i s:,2 ;
% . 5,r1. ' � ea
_ •
- _ —
,
Waiver Attached: yes no L - -
A building permit may be required by: / t, . fSee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) /'
Notes/Special Conditions ,. - // /J[,�,.�V. . ) 1 II.
J
'.j /
, 7, / / /�
Agent or Applicant Printed Name Permit Off cer's rinted Name �.�•
/` t ;r
Signature Please read comp ce statement on back of permit** Signature
E_. r---
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 (252-946-648 I) 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 252-946-6481
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

ROY COOPER
.:a Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Director
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 026.0233 & .0259. The
Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation.
i. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly (which is defined as between 75 and 105 degrees) unless otherwise approved by DCM. The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This
drawing will be used to aid in compliance and monitoring efforts.
• Pre-project site conditions: Pl‹,'h�s.'�e,d /4 ,,.h
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
that all information provided is complete and accurate.
f-c-' G C 7X _ Z,-
Agent or Ap scant Printed Name Permit Officer's Si natur
— see —2
Agent or Applican Signature Iss Date
CAMA GENERAL PERMIT#: 796 G 7 5
State of North Carolina I Environmental Quality I Coastal Management
Washington Office 1943 Washington Square Mall Washington,NC 27889 1252-946-6481
Wilmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-3845 1910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808

FYI ec'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Gam;, G�- rat s
p ;r lame of Property Owner)
property located at ) 2 ) 1 i,cn c. I rc..,
i � ddress, Lo Bloc , Road, etc.)
on cG��l 1'�� t in ��.�. v.�Road,
N.C.
and/o4-County)
(Waterbod�i) (City/Town
The applicant has described to me, as shown below, the development proposed at the above
location. '
j( 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)
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.)
X I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner (Information) (Ad' cent Pro rty wner Information)
Sign ure tgn re*
(7-e-o,.�"" (L A. rank ri4(ry
Print or TiP Name Print or Type Name
IZ3 �cz, 7ic i Jv r�.. � �7 I
M to ddres Ma�' ig Address
/llC. 27�ty DeIhc-Vev\ N.C . 2:7
City/State/Zip City/St e/Zip
25-2-7J7 l}L �j't�c>�1c.� ✓�c'fvt� `•c t,�,�-. $70 - - l-II G
Telephone Number/email addres' Telephone Number/email address
Z- 2 "2oZ) Z " .c,l
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 6Tersit. C�cy k � gr-4/.0e-r 's
U (Name of ropertywner)
property located at I 2 3 ' Lt n raki
p Address, Lot, Bock, oad, etc
on (;avIel pf P& v Cam- , in Du= .^f" a+^`�''� , N.C.
Waterbod�) (City/Town and/or Ce+ttnty)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
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)
Ct. I
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.
(Property Owner Information) (Adjacent Property Owner Information)
"Tie
Sigg�,�a re Si ture* n ,
Lrifi �. c! 7-rt ttit.es L . r 6'L'CI-VA
Print or T e Name Print or T e Na e
/23 % 7rc� l PU.1 °I
ivir= Jz-
rets , Mailing Addres 9
Cit /State/Zip City/State/Zip
5-2 — 7/7- 55Y4, & e;,C.L c ccric.i 2�'z_(1ii —cc5
Telephone Number/email addresg Telephone umber/email address
vLGt
-2 Zozi Z "
f.S
Date Dat
(Revised Aug. 2014)
`Valid for one calendar year after signature*

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: (Seer C. 16 vk 4,63
Mailing Address: 12 3 12a h o rret', ! ct„go I la Acc.
B-elhc-treny AaL. 27ylc 6e(1 ✓ /C �>8b
Phone Number: 5 2 — 7/ 7— 54 6 - -3�y$
Email Address: J et. .lam) r e r►PIc,i( •L v v+A wei✓th 4°" `'16
I certify that I have authorized NA
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in 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:
Ceorr CLrit
-/AiL Regv4.1.
Signature ]
62eorCki'1-
1 s
Print or Type Name
Title � l � A
I
2 / 0 / ,2b2i (/
Date
This certification is valid through / /

z

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 6ec (,(, IfC/ 8 's
? Name of roperty_Owner)
property located at /2 3 /"fit& c, 1 �`t%t I
//�ff
( ddress, Lot, Block, R ad, et )
on CeN'lci� b'CT �uh a C in -f1 , N.C.
(Waterbody (City/Town and/or Count
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
1 d c%r w:et ei
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.)
A' I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
auAL
Sipa re Signature
lrea avvit-
Print or Tj ie Name Print or ,Tod Na e
/2 3 i° '- �� `lez,1 21 I U' /(c I�fC e.SS
Mai g ddres6 Mailin Addre ss
. veil ALC. 2 73lu /3eI l covP,t/NC 2>�/�
Cit /State/Zip City/State ip •
52 - 7/ 7--SiL ge4cdajr �,�� .i 2 �- 9115:3/9�
Telephone Number/email address .tu'"^ Telephone Number/email address
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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