80210D - Klass

OF .CAMA / i DREDGE & FILL N° 80210 A B
GENERAL PERMIT Previous permit# 4
Y� • New' ❑Modification ❑Complete Reissue Partial Reissue Date previous permit issued
As auth ized by the State of North Carolina,Department of Environmental Quality ,/\ �/j !,O
and the oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC C�� 1' \ `(J
n `' ❑Rules attached.
Applicant Name�l.,v 1L 7�e.tOt C�(G, S i Project Location: County_ /vim S 1 64—•
Address tb 1 C. Sc ., A .-r-.c `(- Street Address/State Road/Lot#(s) 2..(.Q Pc....A-[i✓
City 6-1.,)," t0 brn State tiG ZIP 2 7 Li 11,6 -
Phone # ( ) E-Mail Subdivision r
Authorized Agent _ City ,(,,,.. t 0 t �, c'-4, ZIP 2 (.0 c
Affected IDCW ❑EW ❑PTA ❑ES ❑PTS Phone# ( ) River Basin
AEC(s): ❑OEA ❑HHF CIIH ❑UBA ❑WA ��`Adj.Wtr. Body • , Oat n unkn)
❑ PWS:
ORW: yes / no PNA yes I no Closest Maj.Wtr. Body A 1 W
Type of Project/Activity 1V1/4 1L\` A.r2A_ 11 doc L..: ...-` c I l .•-. lk1 2 tU,,Mc.( 1 Z. _c1'
S `J (Scale: i-J ( s )
Pier(dock)length 9 v q
Fixed Platform(s) / I v f �, I I
Floating Platform(s) R - ' 1 ��..,,/
Finger pier(s) �` �� __
— -T •
F—
Groin length I }
number _.._. ..... C
Bulkhead!Riprap length t`s( ' J
avg distance offshore I /' 7
max distance offshore j ' . VII + 0 \(e. . I i
Basin,channel ... i
cubic yards i .
Boat ramp !` t _ 1, . , 1 tJ 0
r i I
Boathouse/Boatlift " -, I
v
Beach Bulldozing " - . NI 1 v . ` . r r , 1 d r+ + ; , Ah • r
Other 9 i IP<<
}
-
I i I I U `
Shoreline Length.. ._ )Y t Co_ . I ! \ , %S
•
Zoo ee^ Sam
SAV: not sure yes no / 1 .^ -
Moratorium: n/a yes o • r `S'�Oy"
Photos: yes o _._ ' , 1 ti
i L i
Waiver Attached: es no , ' i - I
A building permit may be required by: fit„ ( ' -t ( L ❑See note on back regardin Riycr�B,sii lvles: ;
(Note Local Planning Jurisdiction)
Notes/Special Conditions ��.. �T c,` `,.A ,. o ll STk6 ( (c y�e`�. •n-(
......\L„,....
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Agent•• ,•• Printed Name Permit Offic Name
�� -- - .— �— -
Signatur **Please read compliance statement on back of permit** Signature g p (A �( L.<a j
Application Fee(s) Check# Issuing Datb Ex irat11011
n 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 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 1 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 252-946-6481
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

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1' j 4 v , -R .UL REC .It) R s
F.,x' 4; , , ,ii -- t OF COASTAL MANAGEMENT ..
- a'b mow: 'ERTY.OWNER roan+ -rEONIW R FORM
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�3r� Lifts t/V`I=Is
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a
0 ,440
�4 /gnts,Name#: a °- ,a< e
' ors Phone#,, - ,�lG cis- o J
i i try certify that't t p op erLy adjacent the above,referenced property. 't`he individual
r this fit has desearfi try mta as shavrrr►"on the attached drawiog_the development `
,ap .Y IiJ A4. - dratr�►itt�, 4h�ilsnensic mast is �°
Y emy are proposing-
t �ticlt�i"w1�tilt'Vetter,
_t have no objections to th s ro sosap. I have objections to this proposal.
1y err i� v ob ns tea what is being proposed, t notify rho Division of ManagementCoastal
- ( -In yr r wo days`�rf efpr of this notice. Contact infomxadon for .of Is
aysifabhsa�tb /JG MccoasMlma�eauenient-net hicinfstaff-fisti►�arbycalling1-888#RC0AST_, ,
No raspoitaa is cons-
form'the same as n0 objection if you have bean notified`hi/Certified Mall J
WAti1E�'SECTION
q
. 1 t(" s,boat ram breakwater;boathouse,or rift must
1 t i understand t a pier,dock,maoa'in9 pilings p.
'( L be et back a minimum distance 15'from ray area of riparian access un waived by me.(if.
C , the appropriate blank below.}
�+o wish to waive the eetiack, .
1 do wish to waive the 5 setback requirement CI _
,l'r .
I do not wish to waive the 15'shuck requirement
(Pr Ornwr,Information) (Rip ProOwnerInformation)
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Signature Err/lure,
PrintarTyp •
e Name Pont or Type Nam' .
! gitt sr, 54
. A drat.$ 7ct, '
l fir g Address - r Q' Marling Address �a p�,
City/State/Zip Cily/StafeIZip
AddressTelep
hone T$lep d e IVumlrCr/E'dali Address '
Ua t,
(RevsedAug*201
' 117-7921-filItT"'r'rl*7 ,,:wilft ,-,4„,..-....,:_:,t,,,„ -_,-,„
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,a 0 -WI.a 1.,
,GAMA€��I r ':1
Aar FOR ►1�
.F' _ • .rely
Ns+ off''t�efty
owner er Re queong Permit _ ' t 1 ' -- � S
mailing Address,. if , " fc..✓
Phone Number: 33 49 -° '0 -41041 Zi . .
Email Address: Yh ,
ax—ji - - 7�`t/ - . s
1 certify that I have authorized
Agernt i conttactc r
o
to act my behalf, for the purpose of applying for and obtaining all C;P►MA: PcIrin,„:,si
necessary for the following proposed development
at my# +mated at . .-2 6 T" •A. e r';a)j")'e `�- c�.
in r'Ut• s+�. :county
fitrfheimore certify that I am authorized��to grant, and do in'fact grant permission to F,
Division of`Ioast�`Management staff,. the Local Permit C?Fficor and their:agerlts..�fQ;inter ,„ ';
on the aforementionedlands it connection^with evaluating information relatedto this
permit application,
Prapsrtywtter lnf
' Signature .
/ '
Print or Type Name
Title
I
This certification is valid through______ _ ^ /
u
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a(Ct �{ .
1 t 7' Ir° ' RETU 'RECEIPT•RE UESTE[S. -
t• D MAIL
E ENT"
l' r''e� `�k r -. DMStON(Q� COAST°AL MANAG M , ., .
(0 //f ``•°pCENT RIp ►RIAN,PROPERTY OV INER NOTIFICATIAN/iNAiNER FORM
r
3 Gr ! f.
Zb�y' '�,=� _e of propertyYOwner_ -`- _
ad 4�" Az , J�
Address,of Property 5 et or Road Coun
Lotor Street#;-Stre ,C¢y& tyl `3 • i , .,
e� , ¢. �- �G,S.`` Mailing•Address / -/�
PAg6i t's''Name }
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r"'y 'A '{ ,. _ry i-A, -: _ '17 , _'-;'.: l;.,',,,__ --x r ro a �Tt18;��ndMdUal 2 ri^J 3..=�
_il`hereby rtify that'I owns properb dJacent,to ttie aboy1-igf®rencedop p 41 , --._ : . x
�6d:t #he,development
i-•; 4 :- applying fothis,rerrnft-has`dc�scn a to:me.as`shown�on the attached�drawmg_.
P they proposing.A description=or drawing.with dimensions.must be provided with this letter
/1A. q�•- ,_ I have objections to this proposal_
i ��``Ihave no-obJecttons to tlus,proposal � J
=4 r enenf
If youhave objections to what Is being proposed,you must otlfy.: D - _-ion of I Ma
n the kris Cgasta. nag
(QCII�) in writing`within'10 days of`receipt`of this.notce. Contact.Information for0CM offices Is
available atP tta//www:nccoastalinanairementneUweti%m/staff-`llstrna orbyrcalling 1.8884RCOAST (g.
._ No response Is.considered.the.same as no"objection`if you-havebeen notified bylCertified Mail':r '
-
' •_' WAIVER�SECTION
boat ram ,breakwater,boathouse;or lift must
l,understartd that alpier,dock;moonng`,pilih-OS , P
•beset back a minimum distance of 15':fromi my area of npanan access.unless;,waived`by me::(If
you:wish:to warve`tha-setback,you1must:initial the appropnate'blankrbelow) ;
t
,�C['fV T r � a
-�'A' �L I do wish.to waive the 15':setback requirement: c,
I do not wish to waive>the 15'setback requirement !,
r f �
. r
'.-- e 'Information) :r Ri a%R .Uwner��, _. - . -
--�= �` Ran
info aUon)
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Signature Signa „� }•.
<< <<LA-�s
Print or T.% e Na`e
Print or Type Name. ) 3,
Mailing Address Mailing Address -'
City/Sfate/Zip :r r 2P: i'f
.City/State � .: �
r
(b ,.1
Telephone Number/Email.Address;: , Teleph ne.Number/Final!Address
Date Da e .
(Revised Aug.,2014),
st is

Check
Dade Received Date Cepa:Med Check From(Name) Name of Permit Holder Vendor Chock number amount Permit Numb reCorn ente Rea/pt or RN und/Reallocat.d
Columns Column2 Cobnn3 Columns . C olumn5 Coknnn➢ Column) CounnD CoiomnD
4/15/2021 Jason Nista same Wells Fargo 332 $ 200.00 GP/80284D KE rd.13427
4/15/2021 Alan W Perdue same BB&T 1077 $ 600.00 GP$80259D IPA rct.12753
4/15/2021 AMW Docks and Marine George and McLaine Farmer BB&T 6186 $ 200.00 GP#80217D BB rot.13103
4/15/2021 Robert Winston same BB&T __ 6291 $ 200.00 GP 880300D KE rot.13429
r---4/15/2021 Willie Clarence Richardson Charles and Wanda Bardill BBBT 7934$ 400.00 GP/80273D .BB rot.12995
4/15/2021 AMW Docks and Marine Mark and Dabney Klass BB&T i_ 6171 $ 200.00 GP#80210D BB rct.12996
4/15/2021 Carolina Bluewater Scott Quaintance BBBT 1255 $ 400.00 GP#80272D BB rot.12997
4/152021 Grace Construction Parker and Kathleen Grubbs BBBT 14564 $ 200.00 GP/80271 D BB rd.12998
4/1520211 Grice Construction William and Teresa Ferret BBBT 15465 $ 200.00 GP/80270D BB rot 13000
4/15/2021 Holden Beach Manna Pisces Venture LLC BBBT 16202 $ 400.00 GP#80216D _ BB mt.13102
4/15/2021 Dale R.Brodeur,Jr. dale and cindy brodeur State Employees CU 3976 $ 200.00 GP#80222D KE rot.13430
4/15/2021 Robert Wells same _ USAA Federal Savings Bank 2020 $ 600.00 GP/80253D JD mt.13408
4/15/2021 CLTMC,Inc. Steven M.Reed _ First Citizens Bank 1179 $ 200.00 GP$77549D BH rd.12706
4/15/2021: CLTMC,Inc. Davis Clark First Citizens Bank 1177 $ 200.00 GP#77548D BH rd.12705
4/15/2021 Jesse Brock Knight same State Employees CU 8521 $ 200.00 GP/80265D PA rd.11600
4/15/2021 Rhonda McCall James Creech _ Bank of America 1090 $ 200.00 GP#80287D _ PA rot.12752
4/15/2021 George G Adams Glenn Adams State Employees CU 1217 $ 400.00 GP#80288D PA rd.12754
4/15/2021 Coastal Marine Piers Bulkheads Richard Paschal _Wells Fargo 23492 $ 200.00 GP#77854D KE rot.13431
4/15/2021 Lighthouse Marine Construction Man Schumann Coastal Bank and Trust 3710 $ 600.00 1GP 11'80163D JD rd.12396