79791_Jason Matthews_20210609

❑CAMA/ DREDGE & FILL -1—D -4 u Q' 0 No 79791 A '0 C D
GENERAL PERMIT Previous permit# , / 11
>� ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued All/'/r
As authorized by the State of North Carolina,Department of Environmental Quality 7// /and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC / �' .
I � EI Rules attached.
Applicant Name � `�� ���� / `a Project Location: County ' -4..:.
Address - i 'C //-, C-% P? x 23 ' Street Address/State Road/Lot#(s) 2 ' 1, -,-K-4't
City ,e 1•n� -., State N -ZIP 2.75 3 //v E_._
Phone# ( ) )C _) 5-��- /E-Mail Subdivision ----
Phone
Authorized Agent // ') �'L- City /'�-t ,- • -4" ZIP 2 S'�a S--6
Affected ❑CW �EW I A C]ES D PTS Phone# (�2/�)15�'Y/f? 76 River Basin �f: 3-C
❑OEA ❑HHF ❑IH 0 UBA ❑N/A �i F( e -5//l'j'-/ya.* ( (fiat rrian�/unkn)
AEC(s): Adj.Wtr. Body (v
0 PWS: �
Closest Maj.Wtr. Body ' • f'""'�' (1—-
ORW: yes / no PNA yes / no
Type of Project/Activity - / i /,---.—P- / k 70 I Del_ k
0. (Scale: J.' 3 v )
Pier(dock)length
� II I
Fixed Platform(s)
< '�Floating Platform(s) 1
Finger pier(s) ( 1
r r--
Groin length i
number __.-,..__ — _..__ _ ___•
.
Bulkhead/Riprap length
_7L --1. ; , -1 -1 —
avg distance offshore 1
I rrti C
max distance offshore �� Q d , Jv ,� _�
Basin,channel
l/ ,p
cubic yards I j
Boat rN P / :)x / 1 c<.� o f 1
Boathouse/Boatlift 1 ' -------- I
—
i
i I 1
• I �
Beach Bulldozing
Other f � ��°Fj-14-i9---- - 4 �C _ u1t-- I
1
.1 1
•
ri
Shoreline Length ± 75 '5 1i'` -
SAV: not sure yes no ! IOp _ I I �......__ j_..__r_._.._T.........._._....._: —
I 1 I
Moratorium: n/a yes n �Pc.
Photos: yes ® _ —t �' -- I --
Waiver Attached: yes) I 1 i i I '
, L-
A building permit may be required by: I ""-1--') Z ro cif See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) _
Notes/Special Conditions . , &i . Vic. r`z i r. r _- ago (;'-4-('1,t,
/�] 17z-
/9),,i_a) _,I 7/ , ,,,--/,' 1.4-.___
Agent or Applicant Printed Name Permit icer's Pri
7
Signature **Please read compliance statement on back of permit** , ig tune
0
rr ('1� Tan ° /o V ; °21 - c)c( �I ,: 1
Application Fee(s) Check# I uing Date � 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(910-796-72 15)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: [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

i
0'ill CAMA / ❑' DREDGE & FILL N° 79791 A BCD
GENERAL PERMIT Previous permit#
> ❑New ❑Modification ❑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 I 5A NCAC .
Q Rules attached.
Applicant Name /l / Project Location: County
Address "22-,, 4114471-44''C , ' ' Street Address/State Road/Lot#(s)
City - State ' ZIP 7'
Phone# ( ) E-Mail Subdivision
Authorized Agent_ City ZIP
Affected ❑CW ❑EW ❑PTA ❑ES ElPTS Phone# ( )_ - River Basin
AEC(s): El0� ❑HHF `IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity
(Scale: i ,' )
Pier(dock)length •
Fixed Platform(s) ( I I Ilk' N
Floating Platform(s) I j f
I
Finger pier(s) • t _.— -- r —
I
Groin length
i
number __i.._._..._ .+ - — (..... I _...__............._...-._— _ ....-....a
Bulkhead/Riprap length —` ' I
avg distance offshore , E
max distance offshore ! t ( % ��%Y r 1�n•-• '
Basin,channel } i 1 I r I I J
cubic yards fi
Boat ramp .( } f r !
Boathouse/Boatlift '- - Ali
Beach Bulldozing �1
Other �'�� �xJ 1 i _
,,,,ii_ j
•
:_/
1 ' i
Shoreline Length "7.� J .,,PI'`, I
fSAV: not sure yes no _.._a_.....__-_.._1-'`, ___. i —I. j —._._. —
Moratorium: n/a yes no I P1°' ''v a I ' i
Photos: yes nab + ..._. — — 4 -- -- , :
I
Waiver Attached: yes no ! i I 1 : ' i ,
t
A building permit may be required by: . CI-See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions ,/ - ao
,,,,_-/ ) ....ei //„.. • , ,,„
Agent or Applicant Printed Name Permit Officer's Printed Name `
' V'f''—
Signature **Please read compliance statement on back of permit** Signature
r �,
Application Fee(s) Check# Issuing Date i 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 (252-946-6481) 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

•
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 1C.1`-L,11 (v\O klcU-Lc.., s
(Name of Property Owner)
property located at (f)Li ) 6 kid�`i .\ Ati'r'
(Address, Lot, Block, Road, etc.)
N.C.
(Waterbody) (City/Town and/or County)
below, the development The applicant has described to me, as shown proposed at the above
loca f
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)
.
/ V
LII
L ).3 /
3 0 / ,74,:v\ C---
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.
S
(Property Owner Information) (Adjacent Property Owner Information)
> /--- 6. apy,:...
�1 U1111'C 1tiit "i * C
4so.4.-- /71 a// c-u6.- Pa a U ►, ►is
Print or Type Name Print or Type Name
ie.)6 6,5,r- / a15 &-!mot ARM
Mailing Address Mailing Address
City?/9-- e City`/R /Zip
zzi !t/7.0 JX/10 PSI(?ouhook.tom
Telephone Number/email address Telephone Number/email address
Dale Date*
(Revised Aug 2014)
*Valid for one calendar year after signature*
1,

ADJACENT RIPARIAN n
PROPERTY
-OWNER STATEMENT
I hereby certify that I own property adjacent to �J ASOIJ I��AiTI�tVJS 's
(Name of Property Owner)
property located at 21'I"r7 �U XTv N Ave
(Address, Lot, Block, Road, etc.)
on Si L Tl-fO -N CEEB , in A ep t Tr , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatiop.
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)
v° 3 0
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.)
allb I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
/ h r'l
gnature Signature*
P is g-AAIDOU9I+ NI. fl Stloe Se,
Print or Type Name Print or Type Name
2 3/ Z/-tg Z HDIl i S ZIIV&s Cy-.d.
Mailing Address Mailing Address
/VC 2 7sy ' eyalA ninl4y, NC 2.705
City/.State/Zip City/State/Zip
Telephone Number/email address Telephone Number/email address
C-3- -1-0-2-/ Ca 3 -Zo7/
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*