79961D - 136

CAMA / DREDGE & FILL N° 79961 A BCD
GENERAL PERMIT Previous permit#
> New EModification ❑Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality j
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC :� I /I UU - ()"7ki r20C:)
` ❑Rules attached.
Applicant Name tZG U(.12 ti-A Lc ( j` .]A-)., k ,-z .•l• Project Location: County 4,^S , c(`
Address T 08 A e by/L,, 11 Ln Street Address/State Road/Lot#(s) / 3 6
City "t,(I 5(-).4i.,� State nic ZIP 2/SiC U .0 rI '7' l I .
Phone# ( J) E-Mail J"k L % c ii,..t h`c..c" Subdivision
Authorized Agent 7 v ci (4 e ( ,-. S City O C.e,. ,t- ' `` L- ZIP 1 6-I to 1
tlacw 5z]EW PTA >ES ❑PTS Phone # ( ) _ River Basin L.v k's "
Affected ❑OEA ElHHF /B'❑IH ❑UBA ❑N/A -,
AEC(s): Adj.Wtr. Body / ,N k S C/t< (C.�n drrian /unkn)
❑ PWS: I
Closest Maj.Wtr. Body J, '` ft S (-`'i` (`.7
ORW: yes�� PNA yes‹;?-" rr
Type of Project/Activity i I ( ( e -. c �
., 6,,l( e , , t( 1 -
�( -(a (Scale: ki 1 )
Pier(dock)length 9 x(S
Fixed Platform(s) (114 i0 i ,� iJ
l�� C' (Floating Platform(s) y I0 `
P
Fing er pier s . I -
Groin length ( . , I i
number 1 — i ,,
Bulkhead/Riprap length 5o j _ i i
avg distance offshore' 1. 1 Iv `�
max distance offshore 1 c) i
Basin,channel !
I ! - µ i ? cdc.�1-4\ I.<�!0-#d
cubic yards j I � I '; i ;
j
Boat ramp I , ; 4,05 i I b�I,``n C^...j . {
n 5 i
Boathouse/Boatlift -- - — - }--t - _._._........_.._Cw C 5r z
p
j tV., _ ' _
Beach Bulldozing
! i TM r5k �. ` jOther vli vl ro
l,
to
I v)t iA u o l 1/k U" i fit-v" Crd- _
Shoreline Length I 1N.rV e I
SAV: not sureyes 0 I - ':. T —1 _ T - 1-11L'
I 1
Moratorium: n/a es 2 i ;
f '_ _ r a r{.r
(}+4 ) J
Y t
Photos: yes no t s I go V
Waiver Attached: (I no .. 11 - -
A building permit may be required by: (CG^ \S!t a(c.c ^ E See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/-- flSpeciall Conditions ) ,,0(Loc. tIV /\i' 1...\\ [a,-.SI c L` '�' kS �7 + It��e4� WAS, i'vt llc r�.
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-re_.,_ /e — a \ ,,,cI�
Agent or Applicant Printed Name Permit Officer Name
Signa T '�*Uu Please read compliance statement on back of rmit v* Signature
� /dad c, 5 fo 2 6Zf lito( ZoZI
Application Fee(s) Check# Issuing Dat Expiration 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 I)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 (252-946-648 I) or the
Wilmington Regional Office(910-796-7215)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 252-946-648 I
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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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 3hr) J<IO ZLJC
Mailing Address: f3Og #rbOrhi I 1 Lm
Wo)1 Spri`n95 1 Mr_ fl9-1O
Phone Number:
Email Address: the l+r� rC '1
I certify that I have authorized rr t - '3 lied Hk_fM
/ gait/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Ai I .pac-1 ,,e r
at my property located t 13C, Li 3ird 51-r 0/13
in `'(iri Jl C_C County.
I furthermore certify that I 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:
ctc,4
Signature
(bhv1 OZcAZ__
Print or Type Name
OLA '-1C '
Title
5l / l 21
Date
This certification is valid through I I

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
• Name of Property Owner: a0}fin �0j .c-
Address of Property: I ')L) &) J� f.1 dl
(Lot or Street#, Street or Road, City& County)
Agent's Name #: it'd tk. 5, I f f,1. ielfreat Mailing Address: 5 3C® Cc ) O •
Agent's phone#: lie 11y j"41 , I IA , 1'11 •,2Y',c' /
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..drawinq, with'dimensions;:must be.brovided with this letter.
ieu �`Uif._ A,(w 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
(DCM in-writing-within 10 days of receipt Of this notice. Contact information for DCM offices is - -
available at http://www.nccoastalmanagement.net/web/cm/staff-listing 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.)
1-11 /(1..(i`-/ I do wish to waive the 15' setback requirement.
itu
' 'd I do not wish to waive the 15' setback requirement.
(Property Owner Information) • (Riparian Property Owner Information) r---,‘I' l
Li' , y ,,6_, ___Lc-- z_r_Th_________ -X-
Signature Signature
--e -- . - " (Cr -- i---- i -- -
/i(I 1--T-9,./
Print or Type Name Print or Type Name
5 a3q 6eac.di De_ . . -'7,5-Z l E (3)4N0_,0 606 - a
Mailing Address Mailing Address
n( i s a641- rP C,,R.ff,.on- AJ -2 3 2--
City/State/Zip City/State/Zip
9io- .3-- Li g T ,w 82f, 7 cr 5 7
Telephone Number/Email Address Telephone Number/Email Address
d71/57 1 I L /C•,2-- I
Date ! Date
(Revised Aug. 2014)

5/3/2021 USPS.com®-USPS Tracking®Results
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Tracking Number: 70202450000036336300
Your item was delivered to the front desk, reception area, or mail room at 2:18 pm on April 16, 2021
in APEX, NC 27539.
•
Delivered, Front Desk/Reception/Mail Room
April 16, 2021 at 2:18 pm 0-n
APEX, NC 27539
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Check
Data Ree.Ned Oats Depuclted Check From(Name) Name d Permit Holler Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Cohannl Column2 Column3 Column) Colurtrn5 Column! Column7 Column! C fumn9
5/13/2021 Backwater Marine of NC LLC Sheryl Andrews 8B&T 1302 $ 200.00 GP#799600 BB rct 13124
5/132021 Backwater Marine of NC LLC 136 Ocean LLC BB&T 1300 $ 600.00 GP#799610 BB rct.13125
5113/2021 David Gripe Money Order Jeffrey&Laurie Hill Wells Fargo 17-768053784 $- 400.00 GP#79959D(overpaid by$200.has$200 credit for next Dermal BB rct.14927
5/13/2021 _ Castle Home Builders Sal Migliari PNC Bank 4824 $ 400.00 GP#79914D TP rct 10325
5/13/2021 _ American Marine Construction,Inc Brian and Teresa Kanzler _First Citizens Bank 89350 $_ 200.00 GP#803070 tmac rct 13008
5/13/2021 Grice Construction Michael and Lorna Greene BB&T 14603 $ 200.00 OP#801960 BB rct.13122
5/13/2021. Gold One.LLC same Wells Fargo 2696 $ 200.00_GP#799630 BB rct.13118
5/13/2021 Charles V Reed Jr same First Citizens Bank 4338 S 600 00 GP#802000 88 rct.13119
5/13/2021 Lawrence Zborowski same BMO Harris Bank 6187 $ 600 00 GP#799580 BB rct.13120
5/13/2021 Ricky McCorkle Rick and Lisa McCorkle SunTrust 2692 $ 200 00 GP#799640 BB rct.13121