Colvig, James 80413C

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CAMA / REDCIE 4 FILL NY 80413
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A B D
PERMIT Previous permit##
New ' OModification
GComplete Reissue—fMar—tial Reissue Due previous permit issued
As authorized by the State of North Carolina, Department of Emlronmental Quality I �/.�J
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and [h0 CoastalResourcu Comm I area environmental concern pursuant to 15A NCAC /`,l
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Applicant Nam
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Project Location: County
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Type of Project/ Activity
Pler(deek) length—,. _._-_____. ____—_-_, __—__..�__.. ..--r__
Floating Pladorms •. .-...
Finger pler(s)
Groin length � _ ._
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A building permit may 6e required by
( Note Local Planning jurisdiction)
Notes/ SBgplal Condldens
Signature
note on
(scale: II )
2 of 3 5/24/2021,11:11 AM

Dredging documents for lots at the end of Deer Creek Canal
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ��r�s �' • (-u L v'Cl
Mailing Address:
Phone Number: `t172-<i"iD\-'\�-'3
Email Address: O .v'i c� 5t�S5 ' CTA 1-
1 certify that I have authorized ,J ✓IG mai'i \�OPP O :Sfia
AgJR / Contractor —�
to act on my behalf, for the purpose of applying for and obtaining all C\AMA permits
necessary for the following proposed development: C'AYIAL- Ui T'c
A V�- G.\ t'Y LC �/tC�n / 1<�,7ra rtA/t ?CtVI'll OkLWIr'
at m/y� property located at a J_ t i1
in l AZ i�'� 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:
Signature
Print or Type Name
Title
Date
This certification is valid through L\ , ac!��
4/23/2021, 12:55 PM
6of7

Dredging documents for lots at the end of Deer Creek Canal
I
!
i ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
prdpP,fly IDCated a( \ t V\�I <_.'r l;h (Name of Property Othner)
-� (Address, Lot, Block, Road, etc.)
on 5 _2 �± Lj:�.e.t --_. in 4y 2'=,_ i. fi1:Yr_12r� _ _. _ N.G.
(Waterbody) (City/Town andlor County)
The applicant has described to rite, as shown balov,, ilia davelnpmanl pmpose0 al the above
bcatiol'/
y I h:wa ,:c to This nmposa..
-_-... ._ I nave cbjcc;lons to or.e prciposai.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT ^—
(individual proposing development must fill In description below or attach a site drawing)
T
I
WAIVER SECTION
I understand that a pier, dock, mooring pilings. Twat rimp. h!eakwotar, hnatnnusa, Idl. cr groin
mus: be set back a minimum dislarce of 15' from my Gran of riparian access .!nsess waived ny
m;-.. (if you ;nxn tc wawe the selbacrc, You must initial the acpropriate Nook below.)
I da w'isn!o wtivc the iv seibac:: �aeuire^:an!.
I do not vri& R wave the 15 selbam requirement.
(Property Owner Informatign) (Adjacent Property owner Inf oration) ne
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Taleytnon,c gumbo email I address r _ r a: address
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laiid fe-qua c !oodor peaa`! r; m- : , -
2 of 7 4/23/2021,12:55 PM

Dredging documents for lots at the end of Deer Creek Canal
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own properly adjacent to �..1 N"^ eS N (20v ✓t 9 s
(Name of Property ner)
propertylocatedat�`� t r\v�� �lZ L-oT
\ C �� (Address, Lot, Block, Road, etc.)
on �X z In GR _ t� i e �� N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. /
a/ 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)
/ CAnAt_.
sx szx3 12 /t/'T Cttic�/o���`c� �c�J
WAIVER R 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.)
Date
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
`i
*Valid for one calendar year after signature'
Date"
(Revised Aug. 2014)
4 of 7 4/23/2021,12:SS PM