79252A_Severa, Jeffery_20210603

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� A LAMA / _-DREDGE & FILL
I? '79252 a C D
GENERAL PERMIT
Previous permiti�,�#
?kNew Mwificatton lCompiete Reissue
I-`i wbai Reiss.* Date prWous pelt Ksued
As authorized by fie State of North Carolina, Departr»nnt aEnvww,mental Quality
and the CoasW l'tewumes Corrunission in an area of arvironmemal
concern pursuant to 15A NCAC I H— 1200
A pPlicant Nalne 3 e, lu P r-OL
Project Location: County
Address C C' ! � .�!.. ....__. _..
Street AddreW�State Roads Lot #(s) G f ?# 1?—
GR? 11�CCt1 State t4C- MP ��� 2gAJ 133ifli/F
�3�[ ,(►�C,, ��,�.._..__
Authorized Agent ._ _ _
ryn�
.. city P --.--M_ ZIP. _'775"T
Affected J CW W FW ki PTA L ES )d ifs
Phone # (_ --)` — River Basin ,i OyVk
<*A HHF -'.]AN 7 USA 0 NIA
AEC{s�: L.Adj.
kVtr. Bode.. Oi'Wwl.'..s1
J Pw&._
ORW: yes !J& PNA yes 1
Closest Maj. Wtr. Bcitly _.
Type of Pt'O*tJ ACtWit7r Gi
r ,
1 T 6, +'lC C # i q x � f f t
(Scwe. • �� '
t r
Fixed Platfarmfs)
=
Grote fmgth
SuikheaWRiprP h_�
i
y��
dl stance AWN'e
:°i" distance aflslwre
Basin, channel
f`iSC14G y:M1t4i4 �
}�V���
Boat rwr.,p
i
F
-
a i
i
Shwa fe
$AV: not swv Yes 10 . }
a lli yes no1 i
Phsstpb: no t�, .. ty
W4ver,A=cho& yes
A bo ;ding permit may be required by-,
Dote Loci Planning jurisdiction)
Notalesi Special Coadi,tiom .....-_._
r<
Aeoc or Apocaof Prod iVarr ,
S ire plianceststementonback oipermit
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,Apptcatk-;oo(s Chile#
i
..s.l....-.i. tom. .��`/,/•' ._� - it w.
fs �
See note on 63ck regarding River Basin rules.
P_cr' ova
Signaty
10/3/7..I .
issuing Hate Ex{ rVior Cate

DIVISION OF COASTAL MANAGEMENT F�C E I VE D
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOR
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
MAY } 2021
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, City & County)
Z;Ic6i
Agent's Name #: Cl l.,1 V0Un k—ir'eSL Mailing Address:
Nc, oe a Lko k s . Geri �fi� S�-
Agent's phone #: c3 5-72- — Z(oLi — 3 90 11 09
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 a roposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this
prop
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. Correspondence should be
mailed to 401 S. Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
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 sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
--All. - �11. I I I I do not wish to waive the 15' setback requirement.
(Property Owner I rmation)
igna
Print or Type Name
aceacent Pro erty O ner Information)
Signatur
�w141 /-fin s El C
Print or Type Name
a -/ q 6�,ou 517
Mailing Address Mailing Address

City/State2ip
-1, TIA�-33,[ �,C4n,sl
Telephone Number / Email Address
//Aq �7 /a
Date
City/State2ip
Telephone Number / Email Address
Date*
*Valid for one calendar year after signature* Revised 2017
RECEIVED
MAY 4 2021
DCM-EC

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
x MAIL, RETURN REcEiPT REQUESTED or HAND DELIVERED
Name ref Propegy 0wrict
Address of properly, >-'J
p�t F
1
Agents Name
r ca .R t p oncl
4 9 P
r'r s day cart=� that I own property ad acr n�t to the above referenced property. TP��
applvl='ip fo,r this permit has descr t - s €ire as shown on the attache drawin °the i�e�1eI�xt:
t`t y art r t Sir . A t a t t,. r, tt4lh , flCfit' 1 lCiCi #Ti d t +? P 7'�It £$ d€t this i to `.
if you have objections to what is being proposed, you must notity the Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 467 S. Griffin St., Ste 300, Elizabeth City, NC, 27909, DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
.. r crstarrc Mal a pfewr: C.00K, mooring prrrncgs, D(Iat ramp, nreaKwater, cioarrouse, 'ii-, or groin
;tn s be set bark a rninirnurn distance of 1 b' fron°r my area of riparian access unless ova ved by
-r li ;,IC) wisf� t�� v,�:°ive the s ttI ck, you must sign the appropriate blank below,)
_....,_._�,�!' I do wish to waive the 15' setback requiren°rent-
(Property Owner Into orr}
AE
�. ".,
0
I do not wish to waive the 15' setback requirement,
(Adja tit Prop y Owneelp rin tion)
2
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RECEIVE
APR 2 9 2021
®CM -EC

ConnectGJS Feature Report
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Bert24, 20 1
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�"Ql1l� Printed May 24, 2021
ETJ
Misc Parcel Lines
COUNTY BNDRY
— HOOK
LEADER LINES
LOT LINES
NEW WATER
RAIL -CENTER
SUBDIV BLOCK
SUBDIV BNDRY
TOWN BNDRY
Streets
Parcels
Ponds and Lakes
River
County Boundary
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