Goines, Susan 79550C

AMA / ❑DREDGE & FILL NO 79550 A B (D
W
NERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State o(North Carolina, Department of Environmental Quality %
and the Coastal Resources Commission In an area of environmental concern pursuant to 15A NCAC
j. ❑ RuIGs attachy.
Applicant Name Vl G •^ 60 f n -e;�> Project Location: County /�ry ` Y/
Address �3 vrv�? Zt2 Street Address/,S�}to/,Road//Lot #(s)
City C /`d ueq- �/ State / ZIP �'o ,) �� t J 1 L U Uri"�
Phone # _) '�>U _-E-(Mail Subdivision
Authorized Agent-t a �� City_ P� f Py ZIP_
Affected ,�?W , ,E ,�TA ❑ Es ❑ PTs Phone # (_) River Basin V 1J � (Jr �
AEC(s): ""A' ""' E,, OUBA ❑N/A Adj. Wtr. Body_ �� /1 t! �OL nat man unkn)
❑ PWs:
ORW: yes / no / PNA yes /�J Closest Maj. Wtr. Body —
0
Type of Project) Activity
Pier (dock)length_
Fixed Platform(s) I
Floating Platform(s)
Finger piers)
Groin length _
number
avg distance offshor i { -I I
max distance o(fsho i I -_ �
Basin, channel I �--I'D
Boat ramp.
Boathouse/
Beach
Other
Shoreline Length.__/ � V //
SAV: not sure yes _
Moratorium: n/a yes Q4Q4//
Photos: yes i.
Waiver Attached: yes �no/
L / ....
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ special Conditions
s`° ease read compliancestatement on backof per/mi�tr** Signaturre/"
ee(s) Check# Issuing Da
(Scale:
❑ See note on back regarding Pover

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 [)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 ❑
❑ 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 Offire (910-796-7919) for more information on how toromplywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-8884RCOAST
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, Bartle, 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 Pander Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

dotloop signature verification: dtlp.us1UVRe-794d-gaJD
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Susan Goines
Mailing Address: 131 Lowery Lane
Swansboro NC 28584
Phone Number: 252-728-0063
Email Address: [e-mail]
I certify that I have authorized Harber Marine Construction
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Install a hogslat dock
at my property located at 131 Lowery Lane ,
in Carteret 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:
donoop verged
W30121 12 19 AM EDT
KORH/ OL/GCO� ZKNFY3Y6AYAR30NV
Signature
Susan Goines
Print or Type Name
Owners
Title
April 29, 2021
Date
This certification is valid through _,_9-Q_/ 13, 21 _

AD ACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Susan comes
s
Property located at?31 Lowery (Name of Property Owner)
)
On Raymonds Gut/White Oak
tnaareSS, Lot, Block, Road, etc.) _
in Carteret
(Waterbody) N.C.
(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)
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.)
_X1 "r I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Pro e r in o m
�,10
ucvrr�siaea eCOT enM
zovagpsrtuaa
Signature
Susan Goines
Print or Type Name
131 Lowery Lane
Mailing Address
Swansboro NC 28584
City/State/Zip
252-728-0063 / [e-mail]
Telephone Number/email address
April 29, 2021
Date
(Adjacent Property Owner Information)
it �UufPS
11 1
,.JI/V(Oiv ►VV a059
etc One Nurnber/email address
21
t z'YV1
*Valid for one calendar year after signature* (Revised Aug. 2014)

I hereby certify that I own property adjacent to sum oolnaa s
(Name of Property Owner)
property located at 131 Lo Ofy Lann
(Address, Lot, Blank, Road, etc.)
on anymmxis cuerwl,uo oak , p) csdoroi N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location:'
(!!hL I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fIH in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, meeting 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 16' setback requirement.
I do not wish to waive the IV setback requirement.
Signature
Susan GDlnoo
Print or Typo Namo
131 Lo"iy Lane
Malting Address
Swansboro NC 28SB4_J_
Cltylstatelzlp
262.72"DO 1 egolnoa2000�'ygnmll-cam
Tolophono Number l small address
ri120 20 21 T _... ,.
'Valid for one calendar year after signature'
(Adjacent Property Owner Information)
Ib O,Wb,
tJ1
, ignaH�, I AWN, MAN,
Lee Ann Murray
Prin1 or Typo Name
12 eel Santellu
Mailingy Address
Lake E1Sinore, CA 92S32_____-__.
Citylsialolzip — `-
252-571-OIS0 [e-mail]
Tolophono Numberlomall address
lYnlrr
(✓?o vlsod Aug. 20 1 4)

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