Myers, Troy 78232C

�*CAMA / ❑ DREDGE & FILL N9 78131 A B
NERAL PE
RMIT Previouspermit#
L New ❑Modification iComplete Reissue CJPartial Reissue Date revlous permit Issued
As autho zed by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environtgptoncern pursuant to I5A NCAC
/�� �. les at Chad.
Applicant Name I 1 Project Location: County ,_--_....--_.___
Address tc _ Street A In/ State a Lot # s)CityState yV� ZIP,
Phone # )_ E-+Mail----�
Subdivi Ion
Authorized Agent _- q�..
City
-__ ZIP_C
Affected ❑cW ❑EW- oPTA �'r(1 ES .7 PTS
Phone# _
iipverBasiinb
_ R/
AEC(s)7 00FA D HHP ❑ IH ] UBA ❑ WA
Adj. Wtr. Body -
,
_
;W PWS:__
QRW: / PNA /
Closest Mal. Wtr. Body
es no
Typeof Project/ Activity
T (scale ;
Pier (dock) length -- - - —
n
Fixed Platform(s)
Floating Platfonnazfonn(s) Finger pler(s)((
l 1 7' s 5/
Groin length
Bu has ftipraplength }
avg distance offsho
mu distance offshoi
Basin, channel. �- -.
cubic yards.\,_)
Boat romp .__--
Boathouse/ Boatllft `�
Beach Bulldozing __—
Other
j(
Shoreline Length._._.....__,
SAV. not sure yes no '-
Moratonum: n/a yes o
Phews: yes no �?
Waiver Attached: yes 1ti(
A building permit may be required by-
( Note Local Planning Jurisdiction)„
Not esd Speccllal Conditions^

r.ICAMA / ❑ DREDGE & FILL N9 78232 A B
® ENERAL PERMIT Previous permit#
_ 0
TNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date rev'ous permit issued
As authed 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
ules att ched.
Applicant Name Project Location: County
Address St dr s/ State ad Lot # S)(�
City ( /'2 State I1w
Phone # Subdivision
Authorized Agent -L.M
Affected El CW ❑ EW ❑ PTA
AEC(s): OEA ❑ HHF ❑ IH
❑ PWS:
ORW: C;`es)/ no PNA
Type of Project/ Activity _
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger Pier(s)
Groin length
max distance offshore
Basin, channel ~' '
Boat ramp _
Boathouse/ Boatlift
Beach
Other
Shoreline Length
SAV: nots7yes
Moratorium: Photos:Waiver Attached:
A building permit may be required
( Note Local Planning Jurisdiction)
�J0,t sV Speccial Conditions^ _
El PTS Phone #)."NOPA7win
El NIA .j Wtr. Body -AC),
ZIP
River Basin
(Scale:
( eft
❑ See note on back regarding River Basin rules.
read compliance statement on bask of permit **
Feels) f i Check#' ` IssuinglDate I f E*iration 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 ❑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/ 1-888ARCOAST
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

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: —�Uj �) V — \\ S M.
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(ACM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at hftp://www.nccoastalmanagement.nef/web/cm/staff-lfstinp or by caning 1-888-4RCOAST.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by m . (if
you wish to waive the setback, you must initial the appropriate blank below.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature
�� Q S
Print or Type Name
12
, C` .
Mailing Address
City/State/Zip
%Q"�x � k C-g xp \ �a �y4✓ lc ` c 11- LPN*
Telephone Nurnberl Email Address
Lo) GG�` o
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la4L
Signature
Print or Type Name J
30,ai I I rn4 i Q r�
Mailing Address '
City/Sta e2lp
q-`Stay - 3✓71i ll)
Telephone Number/Email Address
Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: yk4&s
Address of Property: g � • --�-qsA L-L Qom.
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
Mailing
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
�'f'� I have no objections to this proposal. I have objections to this proposal.
If you have objections to what Is being proposed, you mustnotity the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices Is
available ate://www.nccoastalmanagement.net/web/cm/staff-Ilstino or by calling 1-888.4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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)
Signature
Print or Type Name
Mailing Address
City/state/Zip
Telephone Number /Email Address
iO1`L"1 � Zb�to
Date
(Riparian Property Owner Information)
z"I" P9:� Y
Signature
(1��1G2c�510 s ✓�CC�3r' 3-P
Print or Type Name
/ 96 c 41IJ&
Mailing Address
City/State/Zip
3ya c�v(
Telephone Number / Email Address
//-3 -ate
Date
(Revised Aug. 2014)

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H botldmg pernvc may be requimred b l� / 1. C.�'� 1'`l+�l i. t.. See note on back regarding River Basin rules.
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit. 7 r
Mailing Address:
(9'!�59©
Phone Number: �%py .
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and ob�laining all CAMA permits
necessary for the following proposed development:
at my property located at
in CtaPTLeFT County.
l furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit O " er and their agents to enter
on the aforementioned lands in connection with evaluati'ig information related to this
permit application.
Property Owner formation:
Signature
l�Z /yIt
P nt or Ty Name _
Title
04 1 08 12020
Date
This certification is valid through I I

ADJACENT
Name of Property Owner:
Address of Property:
Agent's Name M
Agent's phone M
(Lot or Street #, Street or, R}�9I�
Malmo
E .?I
I hereby certify that I own property adjacent to the above re erenced prdpi
applying for this permit has described tome as shown on the attached driC
they are proposing. A description or drawing.with dimensions, must be
j ~ �l have no objections to this proposal. I havt objections to
I j / If you have objections to whatis being proposed, you mustnotify f ieDivision of
(DCM) in writing within 10 days of receipt of this notice. Cont ct information
avaitabfeatitttPIl/ytvnv.nccoastaimanagement.tietivieb/cm/staN-li tin orbycalp
I ` No response is considered the same as no objection if you have eon noted b
WAIVER SECTION
LI I I understand that a pier, dock, mooring pilings, boat ramp, breaCwater, boatho
j be set back a minimum distance of 15' from my area of riparian access unless
J you wish to waive the setback, you must initial the appropriate blank below.)
f✓I I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information
(Riparian roperty S n6
,A
a
Signature S`1 n4t?tiYt
Pnnt or Type Name P,
icA
(JC`ity/�S`tato2tp
Telephone Nurnbor/i mail Address
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DIVISION OF MANA
EMET
COASTAL
ADJACENT RIPARIAN PROPERTYOWNER NOT�FI ATiON/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, Cil I & County)
Agent's Name #:
MaiiingA dress:
Agent's phone #:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing,with pment
dimensions must be rovi with this pme
4 [ have no objections to this proposal, — --- I havo objections to this proposal.
If you have oblections to what is being proposed, you mustnotify I he Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
availableatht�;//wwwnecoastafrnanaaementnet/weWcm/ taHt tin or by callingl-888-4RCOAST.
r
No res onse rs considered the same as no Objection ifYou have.been notified by Certified Mail.
WAIVER SECTION
ll I understand that a pier, dock, mooring pilings, boat ramp, brea cwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
Q you wish to waive the setback, you must Initial the appropriate blank below.)
! I do wish to waive the I F setback requirement.
I do not wish to waive the 15' setback require Iant.
(Property Owner Information) (Riparian Property Owner Information)
Signature lr lA
Signah
TPrn\ My��fec
Pnnt or Type Name Print or
3ci\ gay c�� cz�LUAZ
mailing Address Mailing,
CIA
City tata2lp
City/Stai
�4.(KF� l 09 �t e t �ti�IF-o�rn. �u (i„s,,,G�\.Coh�I-
Telephone Number/Email Address Telenr,n.
y\k4\2o2n �_ _
Date � .
(Revised Aug. 2014)

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