78051A_Kaplan. Charles & Valerie_20210310

A CAMA, / DREDGE & FILL : V 9 78051 Q!! B C D
-. GENERAL PERMIT Previous permit# ��.
>dNew —]Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality n
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
\ [ �an
® Rules attached.
Applicant Name�ar,ei a Vctien� Kcc Project Location: County hAwavi
Address t % a m-or ve Ave Street Address/ State Road/ Lot #(s) Ldl 34
City n er l d State CT zip `� `I Cauca Cab Qt �v2_
Phone # (25Z) 4 $2 _ 2-721 E-Mail C k �rha,� . cows Subdivision CO�A-&}K, C u-16 Delve.
Authorized Agent City Fal,2eliisn ZIP ;2
Affected ❑ CW [W EW JU PTA ❑ ES ❑ PTS Phone # ( —) 1 River Basin ?om Wit,
AEC(s): ❑ OEA ElHHF ElIH ❑ URA El WA Adj. Wtr. Body pffl �� S c k"t at yman /unkn)
❑ PWS:
Closest Maj. Wtr. Body At6
ORW: yes /� PNA yes / no)��-�'(R
Type of Project/ Activity
Pier (dock) length 4-'Y
Fixed Platform(s) y X
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore_
Basin, channel
cubic yards
�Rmlmm
S■l
,NEI
Mill_�
Boat ramp _
Boathouse/ oatli 13 ` 13i
Beach Bulldozing
Other
i/'
Gd
Shoreline Length
SAV: not sure
yes
no
Moratorium: n/a
yes
no
Photos:
es
no
Waiver Attached:
yes
0
145 , x 5
MMEMMMM�� M
�'-
A building permit may be required by: CKt)U-) ,n CUkf\ Rt
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
1 .6'y-�e� Ka &0v,)
Agent or Applicant Printed Nam
Signature ** Please read compliance statement on back of permit "
s acp , 11'� 3169
Application Fee(s) Check #
I ' X L1 ' 1
1,5' X /cr C
❑ See note on back regarding River Basin rules.
PermitOfAcelPrinted Name
SignaturtV
3 /10/ Z1 ���o�zl
Issuing 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 1) 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/ 1-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

0
�LAMA / 7 DREDGE it FILL
9 78051 B C D
4GENERAL PERMIT Previous pernxt #
11XNew DModification -JComplete Reissue Partial Reissue Date previous permit issued
As authorized by the Sme of North Carolina, Department of Environmental Quality ry
and the Coastal Resources Commvssion in an areaof environmental concern pursuant to I SA NCAC Ifl-
Pq
Applicant Name n_ja_C1E'�_.4 \Jqt ey- + .
Address 16,2 -1vuorpe
City (her 1 CJ'P YN State C1 ZIP GYM
Phone # (MV 4 NI ;Z IRA )an-lq�*t
E-Mail, 't—n C-M
Authorized Agent
Affected F, CW *EW )' PTA _— ES LL. rrs
AEqs): C, OEA ZI 14#0 Z 1H 17 URA Z NIA
C PM:
ORW: yes /(!f) PNA yes J(O
Project Location: County_,at,y LCY)
Street Address/ State Road/ Lot #(s) Ld1,4
N14 ccx"f-A-,' C"
SUOTIvision-f—M&M. N =W_Wfx7,w1wirJiv'e_
CitY_JG_aMV+VOL._'
Phone# River Basin
AAdJ..Wtr. B
Type of Project/ Activity
j2vex
w 14L'X-r- r'W4rrr\.
—
hAal�
1
Ck 15, 13' b a:
0 Ir k'
4 SO 1
(Scale:
Pier (dock) I
F Pfaftxm-(s) X
FtoaWVPWerrn(s)
Finger pkw(s)
Grol" Wlth
T-1 -Z
numbw
t
415-
Bulkhead/ Riprap length
dWance ofishore
nim distance oftore
Basin, channel
\1r
Ell;
cubic yards
%
N'
raffw
B=hOU�
AW
A_
%wh &Mdmft
L4
I
d ....... .... ['7­
Other
ne LAoVth
H_
SAV; not sure Yes no
-IT rr
Moratorium: nii ya no F_ I
PhPhotos:rw
Jr 4tL
_4 ----------
Wwer A=che& yes
A building permit may be required by:
01-k N
I See note on back regarding River Basin rules.
(Note Local planning Jurisdiction)
Notes/ SpedW Conditions
I
O_KoxlIe� kA AasN
A7gen ,Jrr Printed N
S,w-A
wre
read compliance stwAmenton bw*ofpermit**
s 9-co
Applicnion F*s) Check*
C' A I G, �_OL . o,: ................... . ..
—
PermitOdc7W Printed Nwm.
SignatunV
7/1 0/7.1
Issuing Date &*abon Date

RECEIVE[
DIVISION OF COASTAL MANAGEMENT
FEB 2 5 2021
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVEREDDCM-EC
of Property
Address of Property: I �tA C' `'� n de Str et #, Street or Road, City & County)
Agent's Name #: a�l(eS "C'ffe �14M a i l i n g
l Cocm >kle-- c� len 6�1 14 G
Agent's phone #: 7-52 — +32- — 2,72. I
Address:
277�32-
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 drawing, with dime ions, must be
provided with this letter.
✓ 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. 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
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 sign the appropriate
blank below.)
I do wish to waive the 15' setback
requirement.
I do not wish to waive the 15' setback
req reme
(Property Owner Information) (Adjacent Property Owner

I beanenA,-§i
-Ais esit no riv.
ilmawib rtfo

RECEIVED
Information)
�an�es �. • .�' e/Uioo�% � 5� �r(e I� . Slfe/
SiggQqre Signature
Print or Type Name Print or Type Name
Mailing Address Mailing Address
T�4-4i 4 NC 2-
City/State/Zip City/State/Zip
Telephone Number / Email Address
SSAtrcai000e Q) a-ol Goy
O
Date
*Valid for one calendar year after signature*
FEB 2 5 2021
DCM-EC
Telephone Number/Email Address
Date*
Revised 2017

S�,
�t
�. i� ; , C

PROPOSED NEW DOCK WITH LOWER PLATFORM, BOAT LIFT & MOORING
PILES @ 144 COUNTRY CLUB DRIVE, EDENTON, NC 27932-8903
FOR CHARLES D. KAPLAN & VALERIE A. KAPLAN
RIPARIAN DRAWING 1 OF 1 ~ 1" = 20' - 2-9-2021
IBY: SCOTT SMALL OF LSI MARINE CONSTRUCTION, LLC ~ 252-473-7695
PROPOSED NEW
10K TIDE TAMER BOAT LIFT WITH
NORTH 4 NEW 10" BUTT X 30' PILES
NV L-
ALBEMARI.L
SOUND
FEB 2 5 2021
[)cm Ev
146 COUNTRY CLUB DR
PROPERTY OF:
C YATES PARRISH, JR
MARY H PARRISH
381 OLD HERTFORD RD
EDENTON, NC 27932
1
I
1
I
15' OFFSET(
LSI MARINE CONSTRUCTION, LLC
1112 W Kitty Hawk Road, Kitty Hawk, NC 27949
261-1967 / wwwAsimarine.com
narine.com / [e-mail]
PROPOSED 2 NEW
8" BUTT X 25'
MOORING PILES
PROPOSED NEW 5' X 45'
: 1 DOCK WITH STEPS TO 4' X
! t 115' LOWER PLATFORM
z
1,
I
[5' OFFSET
i 00' +/- --- —>
144 COUNTRY CLUB DR
(PROPERTY OF:
KAPLAN
142 COUNTRY CLUB DR.
PROPERTY OF:
JAMES L SHERWOOD
SHIRLEY R SHERWOOD
142 COUNTRY CLUB DR
EDENTON, NC 27932
P/L
P/L

RECEIVED
DIVISION OF COASTAL MANAGEMENT E� p 5 2021
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVMQ
uuivi-EC
of Property
Address of Property: 4 CUt,'fly CILk >e / Eda� 7�i IN c 2-yg32-
(Lot or Street #, Street or Road, City & County)
Agent's Name#: Alf le(l�. 41m Mailing Address:
C �� f F��e47t�►,111G
Agent's phone #:2 — 2 �.
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 drawing, with dimensions, must be
pEovided with this letter.
I have no objections to this proposal. I have objections to this
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 nodfled by Cert/fled Mail.
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 sig1i the appropriate
blank below.)
1 do wish to waive the 15' setback
requirement.
-; 1 do not wish to waive the 15' setback
req ement.
(Property Owner Information) (Adjacent Property Owner

Information) , -
0, zd e- ?aril T . 4 f. paer
I -- !l^ L
Signature Signature
ltiey'S oT 1 Cove (��) � r F,4fj N G z- 3 2
Print or Type Name Print or Type Name
1 64 er-( /�Q la . s
Mailin Address Z Mailing Address 3' UC)�
City/State/Zip Cily/Stalaop = 1
Telephone Number/Email Address Telephone Number/Email Address
&. I &C, � Y,' a tt ran �
Date Date*
Valid for one calendar year after signature* Revised 2017
fz,b -2 4-
RECEIVED
FEB 2 5 2021
DCM-EC

PROPOSED NEW DOCK WITH LOWER PLATFORM, BOAT LIFT & MOORING
PILES @ 144 COUNTRY CLUB DRIVE, EDENTON, NC 27932-8903
FOR CHARLES D. KAPLAN & VALERIE A. KAPLAN
IRIPARIAN DRAWING 1 OF 1 ~ 1" = 20' ~ 2-9-2021
IBY: SCOTT SMALL OF LSI MARINE CONSTRUCTION, LLC ~ 252-473-7695
NORTH
ALBEMARLE
SOUND
PROPOSED NEW
10K TIDE TAMER BOAT LIFT WITH
4 NEW 10" BUTT X 30' PILES
LSI MARINE CONSTRUCTION, LLC
1112 W Kitty Hawk Road, Kitty Hawk, NC 27949
2-261-1967 / www.isimarine.com
s ottIsimarine.com / [e-mail]
PROPOSED 2 NEW
8" BUTT X 25'
MOORING PILES
RECEIVED-
\ PROPOSED NEW 5' X 45'
I DOCK WITH STEPS TO 4' X
I
FEB 2 5 2021 15' LOWER PLATFORM
i
®CM -EC I ,
I 1'�
I I
Is' OIFS>✓rl I W OFFSET
I
146 COUNTRY CLUB DR
PROPERTY OF:
C YATES PARRISH, JR
MARY H PARRISH
381 OLD HERTFORD RD
EDENTON, NC 27932
144 COUNTRY CLUB DR
PROPERTY OF:
KAPLAN
142 COUNTRY CLUB DR.
PROPERTY OF:
JAMES L SHERWOOD
SHIRLEY R SHERWOOD
142 COUNTRY CLUB DR
EDENTON, NC 27932
PAL I P/I.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
nn'' ,�,1j,,� (Name of Property O err
property located at (� W�� C�1 ���
(Address, Lot plock, Road, etc.) N.G.
on t�[ 4� 3A)4 , in E�
(Waterbody) (City/Town 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 rill in description below or attach a site drawing)
-b a+' dock , tie ave l►tY�s� 7'�sue
s�'f� a�l
�� Y� . �� anQ
t
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 Owner information)
l--- —
Slntr
PT o T�m „ ` r �.
Maigg Ad ress jt • Z3Z
-t '
City/Stafe2ip
7,472 -4:922 2r:�2-1
Telephone Number/email address
©4-
Z zl
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
tiZIf S �W f (:1tn.
orTypq JVag7p
C, 2-7`7 32.-
f�arfil5
Telephone Number/email address
AA A-0 I.1 '1. ' s 1 '
Date * " f
© (Revised Aug
2014)

PROPOSED NEW DOCK WITH LOWER PLATFORM, BOAT LIFT & MOORING
PILES @ 144 COUNTRY CLUB DRIVE, EDENTON, NC 27932-8903
FOR CHARLES D. KAPLAN & VALERIE A. KAPLAN
(REVISED RIPARIAN DRAWING 1 OF 1 — 1" = 20' — 4-28-2021
IBY: SCOTT SMALL OF LSI MARINE CONSTRUCTION, LLC 252-473-7695
NOVFH
REVISED
4:13 pm, Apr 28, 2021
ALBEMARLE
SOUND
146 COUNTRY CLUB DR
PROPERTY OF:
C YATES PARRISH, JR
MARY H PARRISH
381 OLD HERTFORD RD
EDENTON, NC 27932
PROPOSED NEW 10K
TIDE TAMER BOAT
LIFT WITH 4 NEW 10"
BUTT X 30' PILES
P/l,
144 COUNTRY
CLUB DR
`r � •
,KAPLAN
LSI MARINE CONSTRUCTION, LLC
1112 W Kitty Hawk Road, Kitty Hawk, NC 27949
252-261-1967 / www.isimarine.com
scott lsimannexom / monica tsimarine.com
PROPOSED NEW 5' X 45'
DOCK TO 10' X 15' DOCK
PLATFORM W/ STEPS TO
4' X 15' LOWER PLATFORM
PROPOSED
NEW 8" BUTT X
i 25' MOORING
PILES
P/L
142 COUNTRY CLUB DR.
PROPERTY OF:
JAMES L SHERWOOD
142 COUNTRY CLUB DR
EDENTON, NC 27932

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 01 �5 tRf 's
_(Name of Property O ner)
property located at ��t1t�y e-'
t- (j (A Tess, Lo! B ockt Road, etc.)
on A ( �� I�i`S" �_G(� in C P.YI"I" , N.C.
(Waterbody) (CitylTown 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 mast fill in description below or attach a site drawing)
dfawlil rev 1S teh .
�d
oak , t �c C'[e5 a VrJ
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 Owner Information)
Telephone Numberlemail address
Date
*Valid for one calendar year after signature*
Owne
rnn, c pr r ype va
—+1�,t—rn�g�L=, � GL,
f---r ess
, d rm G Z Y"r3 Z-
Cilsta e/z, '
Telephone Number/email address
Ap 1 30 z
(Revised Aug. 2014)

PROPOSED NEW DOCK WITH LOWER PLATFORM, BOAT LIFT & MOORING
PILES @ 144 COUNTRY CLUB DRIVE, EDENTON, NC 27932-8903
FOR CHARLES D. KAPLAN & VALERIE A. KAPLAN
REVISED RIPARIAN DRAWING 1 OF 1 - 1" = 20' ~ 4-28-2021
IBY: SCOTT SMALL OF LSI MARINE CONSTRUCTION, LLC - 252-473-7695
NORTH
01
REVISED
4:13 pm, Apr 24 2021
ALBHMARLE
SOUND
146 COUNTRY CLUB DR
PROPERTY OF:
C YATES PARRISH, JR
MARY H PARRISH
381 OLD HERTFORD RD
EDENTON, NC 27932
PROPOSED NEW 10K
TIDE TAMER BOAT
LIFT WITH 4 NEW 10"
BUTT X 30' PILES
15' OFFSET I
100' +/-
[EElvell
r r
(PROPERTY OF:
KAPLAN
LSI MARINE CONSTRUCTION, LLC
1112 W Kitty Hawk Road, Kitty Hawk, NC 27949
252-261-1967 / www.lsimarine.com
scott isimarine.com / monica0simarine.co-1
PROPOSED NEW 5' X 45'
DOCK TO 10' X 15' DOCK
PLATFORM W/ STEPS TO
4' X 15' LOWER PLATFORM
PROPOSED2
I NEW 8" BUTT X
i L25'MOORING
LES
1
I
115' OFF
142 COUNTRY CLUB DR.
PROPERTY OF:
JAMES L SHERWOOD
142 COUNTRY CLUB DR
EDENTON, NC 27932