80215D - Thomas

eCAMA,/
• DREDGE & FILL No 80215 A B C
GENERAL PERMIT Previous permit# I
)G :1�New odification 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 0 -i'!1• ,2-0
❑Rules attached.
Applicant Name Jr.--. Y4 \-.• 7 iN o.-,'. `- Project Location: County �t�." L..• , C1(-
Address L,.L C (A u.y.a t C. Street Address/State Road/Lot#(s)
City )v\aAto1' c State t`JC ZIP 2 $9 90 /
Phone # (110) L11-O 1101 E-Mail_aaSC i-@ct4,^c-vlc Subdivision _
Authorized Agent C�t•-,�. i"""�C.Lj City / ZIP -_ 1/
Affected ❑CW t&EW [p PTA ❑ES ❑PTS Phone # ( ) `` River BBasin La�- o L"
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ID N/A Adj. Wtr. Body "77c..,1 U!t.-e..- 121\1 c- /man /unkn)
❑ PWS: n
ORW: yes no PNA(' no
Closest Maj.Wtr. Body ' `'�\°�� '''"`'�
Type of Project/Activity ` 5��\\ n�.w ��' - (''l c r - c. \ bL\
2 6 i-,�1 , Z S 1, , S (Scale: IN1 t 5 )
Pier(dock)length
i
Fixed Platform(s) i i i f
Floating Platform(s) ' i II _
Finger pier(s) ' i i
/ .
Groin length
! '
! jf�`r `\ V V Vr
number 1 — �
, I
Bulkhead/Riprap length —E -"••a.��.
i i I I
avg distance offshore i j
max distance offshor .l
i
Basin,channel -t
cubic yards t �+ 7
"►
ramp Vt.'
Boat ' I I
Boathouse/ oatlift n 1' 1 t c 1
(.n- I — J
Beach Bulldozing ( �`� - N ec— li1 •
1 t. V
Other `
vi I e i_
I
1 i
- 5 5 U ,�
Shoreline Length �►r.+ ��v r►► f I jat
SAV: not sure yes no ` i "22 el --C hz "- 5{ 'e — 1
Moratorium: n/a yes I ' j 1 i i 1 i
Photos: yes —.._.._.._._ _ ._ i_ —
1
Waiver Attached: yes no ' I
jr 11 -
A building permit may be required by: \J f-1-^S-.•c,(L `.W n{ . I I See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/Special Conditions ? 1•('3 O�V. Q r CZ, ‘i^�'" , S PR'h. t^t'
kAcr ( .II Ti., , L 1 14 - V) „ A(e .. /,(_ (/,(_ (..."/, "
cent or Applicant Printed N e Permit Officer' Nam
Signature ""Please read co • ce statement on back of permit*" Signatur
\ 2 4 Ti- 9I; 2 3 11l(11-1 1- I-3 `) z0z
i
Application Fees) Check# Issuing
�D,�•�e � � Q p Expiration Date
r"W\Th i f 'A,Z 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 (252-946-648 I) 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 252-946-6481
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

r s
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Sc -_ .r . s -i S 's
property 'Z.25 L- (Name of Property Owner)
located at -T a ►-►�•1 p c
(Address, Lot,,Block, Road, etc.)
on s1..\\� � . 11`Vt� , in ,s\.. a��--�,r - , N.C.
(Waterbody) (City/Town and/or County)
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)
• �,S,,u end � Is' st, (Orl-c-
•
7v WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lit, 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.)
' D j I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Owner Inforrmaatti-o.n) (Adjacent Property Owner Information)
SiA.Owt_ca .) je-
ature Signature*
v.t 1)_ \X0►nnc LyAI P. 3a.-*S o x/
Print orTypq Name Print or Type Name
2.25 7t.c & J e • 2'1 .
M Ad Me lln Addres
Sal _ ,� L .2. Y Do ti..\\...V �- k%-( -,dt.
ty/Sta City/State/Zip
Teteph2ne Number/email address Telephone Number/email address
Dais Date*
Veld for one calendar ar year aver signature* (Revised Aug..Z0t4J

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 5���"A •
Mailing Address: a
24 - - 1 p i .
Phone Number:
Flo - -� - 15 0►
Email Address: ,SS 4- 6 kM L
I certify that I have authorized t
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
13. 44 LI
2' .. c L I f ` i i L -2 (,
at my property ioc�ated�at ( ��' �� • 1 �
in SwiL\� 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
4. . 1 t,b WveS
Print or Type Name
1 "DUI JJ h-+ r
Title
Date
This certification is valid through 1 /

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to S C c, o tv\cS 's
(Name of Property Owner)
property located at .22S •
(Address, Lot, Bock, i , etc.)
V on c�.i\% �� &- r , in S `1 , N_C.
(Waterbody) (Clty/Town and/or County)
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)
op 8'
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)
Siture Signature* n
Print or Type Name Print or Type Name 2 � jZ�n^� �:
2 2.4 l7-0 .�, �1 j t . L.1- 2.' e ; 1-.�-� 22�'
Maili g Address Mailing dress S L
City/State/Zip City/State/Zip .2 s c.
y7- - / -z
6I Sjo . 4, J--t_3i1- I ed-1-4.,,.,(p. e6„.„:.
Telephone Number/email address Telephone Number/email address
Date Date*
(Revised Aug_ 2014)
'Vaud for one calendar year after signature*

Check _
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated .
Columnl Column2 Column3 Column4 Columns Columns Column7 Column9 Column9 e ♦
4/1/2021 4/6/2021 Edward R Thomas IV Sandra D Thomas FCB _ 4332 $ 200.00 GP#80215D BB rct.129B9
pyr_ 4/1/2021 4/6/2021 Cornerstone Proties of Dallas,LLC same Capital Bank 1031 $ 200.00 GP#80195D BB rct.12987 ^
_ 4/1/2021 4/6/2021 Grice Construction of Brunswick County In Frank McGougan Nesmith Family'BB&T _ 14528 $ 200.00 GP#80214D BB rct.12988
4/1/2021 4/6/2021 Patrick Bristow Jean-Claude Corbi FCB 8111 $ 200.00 GP#80256D PA rct.12751
4/1/2021 4/6/2021 Gilbert R Chenery Peter J Chenery Suntrust 1007 $ 200.00 GP#80244D JD rct.13465