Wall, Jeremy 79532C

7GI
GE & FILL
ERAL PERMIT
❑Modification ❑Complete Reissue ❑Partial Reissue
N9 79532
Previous permit #_
Date previous permit
A B C D
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of envifogfnental concern pursuant to I SA NCAC
Applicant Name �c
Address C1
City
Phone #
Authorized Agent
Affected CW �A Li ES ❑ PTS
A
Affecte 71 OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
PWs:
ORW: es / no PNA yes no
Rues ttached.
Project Location: Countyo V
Street Address/ SttatteRoad/ Lot #(s)_
`7.12 /i' '�c=ccc
Subdivision
city /y zip
Phone # (_) r Basm/ '!
Adj. Wtr. Body fµ,/ t' K at man unkn
Closest Maj. WItt, dy L4'-�"
Type of Project/ Activity I t�
D ah
(Scale:
Pier (dock) length
Fixed Platform(s)��
_
;T
-
FloatingPlatform(s)-
~i
Finger pier(s)
j
Groin length
numberloffshore
--
—�
•�
-
Bulkhead/ Itip-
_
-
I
.._
avg distamax
distBasin, channe
i
cubic yards
Boat ramp
Ti
I
I
_
I
--1
/
-
-
L-
Boathouse/ oatlif
�' _
Beach Bulldozing - -
i
Other
--
--
- -
r
- -
Shoreline Length
I If
SAV: not sure yes o
,
--
_t
- -
- — --
Moratorium: n/a-
Photos: n
Waiver Attached: es no
A building permit may be required by:
( Note Local Planning Jurisdiction)
�0
/
❑ See/note on back regarding River Basin rules.
4,
S�1 A
Notes Special Conditions
w VP/J ()) b-e�
Agent or Applicant Printed Name
X
Ila)
Please read compliance statement on back of permitia17
n Fee(s) Check #

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 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, 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 howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
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.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:a!
Mailing Address: C)-19 Cv l LAN
Phone Number: 16- &ia.- 341a
Email Address: wit —200f [ .wta: I ,4h.
I certify that I have authorized C3 Scott, Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: C.. %`1*'s ':"� (41e_ dly'k
at my property located at
in 0ein)Du) 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:
Signature
�c�(me
Print o ype Name
r lkw eta✓'
Title
t A t PDA f
Date
This certification is valid through IF I

F

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to L1T'f ¢ �'U. t s
,,, , , I (Name of Property Owner)
property located at
on
nitial The applicant has described to me, as shown below, the development proposed at the above
sere on location.
)ne of f h' I have no objection to this proposal.
hese 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
one of
these
lines
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Owner Information) (Adjacent Property Owner Information)
or
Mailing Address U
ity/StatelZip
Telephone Number/email address
Date
*Valid for one calendar year after signature`
Signature..*,p
j s %
V ".fS �tr'
••
Print or Type Namer
2ili
lF,
Mailing Ad rgss
F
�r
City/state2ip
Telephone Number/email address
Date*
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
f,
hereby certify that I own property adjacent to<-,y , .,, r'.?,';. 1 j 's
(Name of roperty Owner)
property located at alAa�7
(Address, L' Block, Ro etc.)
on ��fi�> ��� la"'6'to , in .iP Vw �Ye)(' i5.ot ,N.C.
(Waterbody) 0 (Ci�n and/or County)
nitial The applicant has described to me, as shown below, the development proposed at the above
sere on location..,
me of
i r I have no objection to this proposal.
hese j
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
1 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, /t I do wish to waive the 15' setback requirement.
one of
these I do not wish to waive the 15' setback requirement.
lines
(Prppe'yty Owner Information) (Adjacent Property gyvner Information)
Telephone Number/email address
:3 •
Date
"Valid for one calendar year after signature`
Mailing Address
City/State/Zip
"i i'1 c) Dq.Or
Telephone Number/email address
"i'?b-'z
Date*
(Revised Aug. 2014)

late: 3/5/21
;Cale: 1 ": 20'
'rooerty Address: 212 E. Seagull Way, Hubert, NC
'top ' ' Owner: Jeremy Wall
Intracostal Water Way
Existing Boat Lifts
y
! YYYY \ YY Y'
proposer! New Work: ' ^'
Install 2- New :tingle Pole
ti>avEte
Marsh
North
i 12'-11" to property 5v '
line of 210 E. Seagull Way
421 Goose Creek Rd I
212 E. Seagull Way �

T
T
v
m
V
D
m
a
N CD
o
m
°.
3 m
w
D
a
o
w�
m
z
: l
Z a
T
o
N
3
3
N
n
Mk'
v
n <'
N �
3 7
f�D O
vi -"
O0
A Ul
ai w
CD g
N w
0 3
a w
a cn
CD
CD