Maynard, William 79530C

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AMA DREDGE & FILL W 79530
LAMA
A 8 D
NERAL PERMIT Previous permit #
- Is
ew Modification F)'Complete Reissue .!Partial Reissue Date- previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality —/ /,,/. / U/U
and the Coastal I Resourcls Commispion in an area of environmental concern pursuant to 15A NCAC o^E3 ROP attached.
Applicant Name Project Location- County,
State Road/ L
Address Street Address!#(s
City, State ZIPP, -1 16U
Phone # E- Subdivision
Authorized Agent City -- Z J4� fle IP
;XW r�A DES 0 PTS Phone # River Rassin
Affected
AEC(s): U HHF �], IN F- USA 0 HIA Adj, Wtr. Body, /unk-n)
Iw�:——/Closest Maj. Wtr. Body
.
QRW. yes i na PNA syno
T f V
ype of Project/ Activity Ll do- C 010rt.wl
Pier (dock) Wngthj4—
Fixed Platform(s) IU�O
Floating fUtform(s)
Finger pfer(s)__
Groin length
number
Bulkhead/ RWap length_
avg distance offshore
max distance offshore
Basin,
cubic yards
Boat ramp
Boathou ;�9
Beach Bulldortng
Other
Shoreline Length
SAM, not sure yes
Moratorium: n1a yes
Photos: Yes
Waiver Attached; Yes
A building permit may be rei
(Note Local Planning Jurisdi
Notes/ Sp"iall Conditions
Agent or Applicant Printed Name PermitO Name
'
Signa ">I Please read compliance statement an back of permit
Z'
cation
Fee(s) Check #
ligno, is$ uln date
(Scale: /f,
bx iratt Date

Stateni*nt 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 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 lord
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
lanclowner(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 doastal Management Program.
River Basin Rules Applicable To Your Project.
ED Tar - Pamlico River Basin Buffer Rules Other:
M 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
MR hSad—ci"CAdquartm
400 Commerce Ave
Morehead City, NC 28557
252-808-280811-888-4RCOAST
Fax: [phone]
(serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
F14A§tt--h gity !2istrict
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)
http://Portal,ncdenr.orVweb/cnVdcm-h , � . ome
Washington District
943 Washington Square Mail
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bernie, Hartford, 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 Now River Inlet.
and Pander Counties)
Rervised 7/06117

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: kiayrtard-
Mailing Address: /ia P Ale &,k R il-
Phone Number: Z SZ- SS03-S9/3
Email Address: NY/ j4P JCMJ cam
I certify that I have authorized C3 Scott, Inc
Agent t Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
174
is
at my property located at 169 Id,;Ae dAe &,B rf-P RJ- AMA. AQ, ZX5Va,
in C04ere� County.
I furthermore certify that 1 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:
Signatures/
Print or Typef Name
61-,Jn [.r-
Title
3 I Zq ILOzt
Date
This certification is valid through

__ ___ _. _ viuwiuy rrepmeu oy: w acuu, nu
Date: 8/5/21
%r Scale: 1 ": 40'
White Oak River
North
is
PO
r
Channel at Caleb Branch off White
a
Oak River
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5'-0"
,
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Marsh
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170'-0"
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a
170 White Oak Bluff Rd 168 White Oak Bluff Rd

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ADJACENT RIPARIAN PROPERTY OWNER STATEMEENT
I hereby certify that I own property adjacent to bt_l�'. Ala r wh7 _'s
+
(Name of roperty Owner)
property located at i '"Z " b(� +6 0aJr al �a
(Address, Lot, Block Road, etc.)
on 9AA40+ Cregiy - in N.C.
(Waterbody) (CitylTown and/or County)
nitial The applicant has described to me, as shown below, the development proposed at the above
sere on I
ane of
I have no objection to this proposal.
..,
hose I have objections to this proposal.
Ines
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
Initial me. (If you wish to waive the setback, you must initial the appropriate blank below.)
Here on I ish to waive the 15' setback requirement.
one of
these _--�`,— Cdd Ot wish to waive the 15' setback requirement
Tines _. _ mac-_—
(Property Owner Information)
//V-& Z::�
ail address
VL-
(Revised Aug. 2014)
-Valid for one calendar year after signature"

ADJACENT RIPARIAN PROPERT
/Y
OWNER STATEMENT
I hereby certify that 1 own property adjacent to W i (1'AM r') MAVAA 's
property located at l4 $ Ak to Q.Z- ,�'�u>et(t'ci of Pr party Owner)
/'
(Address, Lot, Block, Road etc.)
on NAe1no Cirt� , in _-YAe7/4 N.C.
(Waterbody) (City/Town and/or County)
nitial The appliqant has described to me, as shown below, the development proposed at the above
sere on to ation
me of I have no objection to this proposal.
hese
1 have objections to this proposal.
Ines
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
Initial me. (If you wish to waive the setback, you must initial the appropriate blank below.)
Here on 1 do wish to waive the 15' setback requirement.
one of
these I do not wish to waive the 15' setback requirement.
tines
irroperty Owner Information)
Property Owner Information)
address
'Valid for one calendar year after signature" (Revised Aug. 2014)

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