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OFAMA / _ DREDGE & FILL N° 79770 ® C D
ENERAL PERMIT Previous permit# a
)C Oew _Modification ElComplete Reissue Partial Reissue Date previous permit issued /✓/'
As authorized 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 `7/r/ /20 0 .
/ /^� }� /p , ules attached.
Applicant Name J'�/� � /' fGw r , Project Location: County es a C 0
Address 0 �� Street Ad.ress/S..te Road/Lot#(s) 077 -
City5j:u StateDC— ZIP 27 SSZ �r/ - 'AV
Phone # 0 Q) sif.776D E-Mail/6 e.1�GY"��j�, Su sion y
Authorized Agent g,%a1LL � � �—City �Z-1// ZIP �r/U .
CW LPTA DES ❑PTS Phone # (,h) ) /�//40 River Basin /( -4t b4
Affected OEA F ❑IH ❑UBA ❑N/A
AEC(s): Adj. Wtr. Body ail 4.54/4... Okmairman /unkn)
PWS: �'}�
ORW: yes /� PNA es no Closest Maj.Wtr. Body K?i A�
Type of Project/Activity/ ` /C`�1� �-e -5 4o 1 h...S'�-� ( l •3Y/ 2 y
FQmt (• C4— /(Scale: •/SO )
Pier(dock)length
Fixed Platform(s) I (i-►c ._ '(J ��—�• j Pk NI
Floating Platform(s) (�1/� �L.�-
/ <p
Finger pier(s) I -....1t b of= P I 4J
Groin length 1 l
number — —.._......... —... —
Bulkhead/Riprap length -4__• -- - — _;_ _ -
i d
avg distance offshore I j
max distance offshore '
,
Basin,channel I j 1 I r C D
•
J.
cubic yards ] .C t 5'+"
— lip
? '
Boat ramp ^
LS
Boathouse/Boatlift t 3�13 —+ -- '" .
{ _q 4�0
I
Beach Bulldozing
Other
i
Y L
•
W
Shoreline Length '�d i i 1 1 1
a`
SAV: n sure yes no as/�-
i11 t
Moratorium: n/a yes dam/ 1 r 1 1 i J���j�„- `.,___,_ , ,
----
Photos:
ye �ICj. Prop 1
_
Waiver Attached: 0 no
A building permit may te req fired by: ;!..rv(j r c, (1) • . I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) f 7 / lNotes/Special Conditions �!D �l�'�ti v L1� �� (A, �nt r c c K- (5-
//
U
Agent or Applicant Printed Name Permit Imes Pri )7e
Sign 1)re Please read compliance statement on back of permit**,,_ igna e
Application Fee(s) Check# Issuing DSe 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 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(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: 9 I 0-395-3964
Fax: 252-264-3723 (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
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT/y�
I hereby certify that I own property adjacent to l&Ra r,Q f' ' G (0/ / 's
(Name of Pr erty caner)
property located at �7 rO:A 1 D �Z
j� Ad re , Lot, k, R etc.) / `o h..
on i` t 1. I /9S fl/irC c►-a , in 1G E /9 //9m11ID ,N.C.
(Waterbody) (City/T wn 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)
1.,,sin(/ 4 4441 /1 r pri, f i5r b^ � ' # s'uI rLi
tx,1; 614- fare � � (3/4 � °-� �'�
ba4 4-- Jac II-,
Ct�r+c L
3) .i_N s 4 4 t i rod( omit (rp r19 f) l41,41 s�i br I/,,t 1° r
er.Ds%oNNBar btu% (Amp.
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.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Ow7 Informn) (Acijacant rty -Information)
Signa re in 14 itel ir Sign re"
Prin or Type Name , L Print or Tr
A-7 (r-ort/--, >�D,/✓T �lo IA} c l'� Vi£tu - .
Mailin Add ► Maili A ss
rA ri /IL 2 7/12. fl7/= 1 i, t\;6 z FS-S-4
City/State5ip/ 0 7 `r 7'T
r City/State/Zip'7 i..� 7,2(
Te►ephon Number/email address Telephone Number/email adore.s
/n.4 y.2e24' F I y//)3/ yb<fek se rn4
Dare Date* a Al
(Revised Aug. 2014)
*Valid for one calendar year after signature`
ADJACENT RIPARIAN PROPERTY� OWNER STATEMENT
I hereby certify that I own property adjacent to I (' aG-e (` ` C I. /t 's
b , / (N me off//PJo erty wner)
property located at / O i N -t-
(Addre,ss, Lot,,,5,ock,Rp etc.) Loh..
on /' "�P 'f 19'S 4`(/irC Ci-d� , in v'i ri)' d�/9/N1/lD .c.
(Waterbody) (City/T wn an 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) f�
0 Intl/4 g �,4T f O/v r-J'rri4 y /1i7 -i-Ai 'P41' 'zit '/n
'�}�; f ./ 1 1 � 6114
�I J J��
2) 4 !( li- n ra✓1? -trc ( 44% )
3) .7_,4/s 4(t !"DcK i_ i�✓i 1 i (rg'p r4 p) A lcol s i7('R i/nL
I er.o_ ,N igi r- bOA+' rAM}7.
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.)
/Cti I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Own Information))if
(Adjacent Property Owner Information)
/Jy,3 ier,./i6.4'v\,
Sign,sr�re `` /� i��cr�•
J> C� �L��yYIJLt� �Q /'�/,U/F C. frti//,q A r tt.�
Prin�"or Ty Name Print or TypeNa
Mailin Add 1 / 7 �7G/a;6n Address
;ty�,� - .2 .Y3 2. � p ,�!c .� . _
/ 057 � 7' �b zJ! c')/
Telephon Number/email address Telephone Number/email address
s a y / s=,2 6' - ../
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
1
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 4 g, G/ / ' ' 7 0e/h/ 7, _
Mailing Address: a ' c C',Pvy,- i-)Vi"
__1 A/4-0 r4 4/ 27 5 '2'
Phone Number: q j p 6-7(1 -7 p2- !b
Email Address: 44GGtiAt'i 'rkAaQa'e24 4 {7AX "1
141
I certify that I have authorized i i rkj - pr0^
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: be0/14- r
tear ft
at my property located at O t rri��n�L
aesr�i6
in P114Wti 11_ D County.
I furthermore certify that I am authorized to grant, and do in fact grant pennjgpn
Division of Coastal Management staff, the Local Permit Officer and their agents
on the aforementioned lands in connection with evaluating information related t enter
permit application, to this
Property Owner Information:
Signature
Print or Type Name
Title
3— le_2....yi X 1
Date
This certification is valid through / J/
WM"
ROY GQ0PER
Goervar
tiiICHAEL S. REGAN
t�
I - BRAXTON D IS
Coastal Management
mviloAM[M t.L 41.....''• t
8UFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
•
throe h the Tar,par-tlicv � ,
parian buffer authorfxatiun,s rcUu„i o for pier and ducking facilities
ons 1SA NCAC o2a o233& -QZ53, T
,,,,i,:','",-''
'4cusc River r�rpari.ire buffer per Division of Water Resources(RWR) g with the Division at ti1L'ater
Uiv,„on of Coastal Management f DCMI,through a Memorandum of Understanding r ose d complies
Res4�urces to has rev,e•wed your project proposal and has determined that the project as P oP
with the aforementioned regulations.
Those activities covered by your Coas'JI Area Management Act(LAMA}perrrit have received Buffer Authorization
erovrr'e^#rho-,rojei' is corstructed in a manner that continues to meet: l"of the conditions listed below. Failure TO
comply with this Buffer Authorization may subject the property owner and tt.e part ntractorj performing i �n
tiDWR of upto$21.O0O per ,s, v ' ri:Jlation.
•construction and/or land cocoon to a civil penaltyby
g
. Crossing is Perpend,,,cular: Pier and Cocking facility access way must cross the 5O ft- riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees Lnlesc otherwise approved by RCM, the
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2 Pervious Materials:All reasonable measures shall be taken to ensure the access way is made of pervious
rnateria's like .pen-slatted wood or comoosite,mulch, or g-ass to meet the intent of the rules to the
maximum rti? ,nt practicable
i Access Width: The width of the pier or docking facility access way shad oe limited to six (6) feet.
Project Drawing; the drawing on the CAMA General Permit is considered the project arawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This
drawing will be used to aid in compliance and monitoring efforts.
• Pre-project site conditions. _kz 4-k'r ---s -k --/4 -,
By your signature below you agree to be held responsible for meeting all of the conditions listed a ove and verify
that all information provided is complete and accurate.
t . sirs,... 5 '—' , -
nt or itant Printed Name
AiAge r,4pp (cant Signature Perini Kees Signature
ate
LAMA GENERAL PERMIT p: -7 9.� 7n
Mare of t,aih e,cart LvvitolitntrilAi Q JIxy C'udsi:rj l tai\,1QCt tlt
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IAihntrtgibn Ooi:r' 11, t Adam+yunr•'ic 7II-444 1815 110 ;4►t) i:15
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