79756_Tyler Fortner_20210623

to `CAMA / ❑DREDGE & FILL (0?g b N9 79756
PERMIT Previous permit# A $� C D
GENERAL
)c ❑New ❑Modification ❑Complete Reissue IA 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 I 5A NCAC f.26) G
_ El Rules attached.
Applicant Name 7f 4 ,- /`0- ' ,. Project Location: County / , /, . (--
Address //-'J ,G ,j/ /c I Street Address/State Road/Lot#(s) /,, _7/
City ; f r -r-v. 1'- J State 'U‘. ZIP ---'' :7 6";7 I /.),.i'�,. ,f C.:r,, l j"c! f.-
Phone# ('.5-- ) '>evi E-Mail _-.'_ Subdivision a:,.,,/ ci r
Authorized Agent c-fe// /�f e,,. L City t ��r ZIP c,2 7 i f 0
❑CW ❑EW p•PTA ❑ES ❑PTS Phone# ( ) e _ River Basin Tr/ " >z7
Affected ❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body nat man /unkn)
❑ PWS:
f Closest Maj.Wtr. Body_ .r
ORW: yes / no PNA yes /("lc)
Type of Project/Activity 6. v
/" ' ,/ • f
(Scale: )
Pier(dock)length v V' '
, 111
Fixed Platform(s) --�■ ■
Floating Platform(s) -- i
Finger pier(s)
Groin length
number }A f. c. rY I ■�
+ w �� I ■
Bulkhead/Riprap length
iiii
avg distance offshore 1111 �■r i ■■
max distance offshore s�1� ■T N1rifI1, ■■■�
Basin,channel 1 1 1 1
■ ■■�
cubic yards — ■ ■�
1111
/�
Boat ramp 1 ■ ■
Boathouse/Boatlift' �� '.
Beach Bulldozing ---- — { , ,
Other i 1111••••••111 1111 1MM
Shoreline Length /C�
()/Cy
■ ■■�
SAV: not sure yes a? _. ■ 1_.__...__— •— - _ Mili
Moratorium: n/a yes no ill',
Photos: yes no t...i ,1 ....
Waiver Attached: yes no ;
A building permit may be required by: r . - ` [ l . 1
/f� f See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions _ '/// /,'Z�
<-, i A.5� L-.)()i r(;" / / f 9/l
Agent or Applicant Printed Name PermitOAcer's Printed Name '
Signature * Please read compliance statement on back of permit** Signature
l
Application Fee(s) Check# 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 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 (252-946-648I) or the
Wilmington Regional Office(9 I 0-796-72 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 252-946-648 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

, ICAMAIEI.DREDGE & FII.L --� i,'x/�# �gS as NO 79756 ABCD
GENERAL PERMIT J�- Previous permit#
>' ❑New ❑Modification ❑Complete 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 I 5A NCAC
❑Rules attached.
Applicant Name Project Location: County
Address / ' % ' .+' Street Address/State Road/Lot#(s)
City / . i State ZIP
Phone# ( ) E-Mail - Subdivision '
Authorized Agent City ZIP Cl
Affected ClCW ❑EW CIPTA ❑ES ❑PTS Phone# ( ) River Basin
AEC(s): ❑0� ❑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 `c
(Scale: )
Pier(dock)length ; L }i
Fixed Platform(s) ; '� i � I 1
i
Floating Platform(s) 1 I I I I
Finger pier(s) 1
Groin length I . . . . ,
J f
number A —
/� 41 1
ir.
Bulkhead/Riprap length I -- 1 �—'` ! — i --i I
avg distance offshore I
�� I..
max distance offshore �- r (.
J 1 rG;l� i �// /:--`�--elk I i
Basin,channel -- ... �II/
I I
i yards
cubic I
Boat ramp
f
Boathouse/Boatlift / / -' ' 1 —`
• • 1
Y ,
,
I
Beach Bulldozing - [ — ---- --
Other
; III I r
I
Shoreline Length 1 1 I '
'
I ,
I i
SAV: not sure yes C no • -- t = — — 1_-..............
�
Moratorium: n/a yes (no I I 1 1 ,
Photos: yes (no r '- 1 _
Waiver Attached: yes no 1 I I ' I ! ;
A building permit may be required by: / . ISee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
i Agent or Applicant Printed Name Permit Officer's Printed Name
Signature **Please read compliance statement on back of permit** Signature
Application Fee(s) Check# 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 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 (252-946-648I) 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: [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

A ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Director
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 026.0233 & .0259. The
Division of Coastal Management(DCM), through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party(contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per day per violation.
i. Crossing is Perpendicular: Pier and docking facility access way must cross the S0 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees)unless otherwise approved by DCM. 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
materials like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing 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: /"1C•+t 4-,',,e.el 4 wh
By your signature below you agree to be held responsible for meeting ail of the conditions listed above and verify
that ail information provided is complete and accurate.
F _..., 4,---....... ------•
AgenAppli ant Printed Name Permit Officer's Signat e
......----------- 6/.2.V---(
Agent or Applicant Signature Issue Date
CAMA GENERAL PERMIT#: 7 9 7.5"C
State of North Carolina I Environmental Quality(Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 27889 1252-946-6481
Wilmington Office I l27 Cardinal Drive Ext.Wilmington,NC 28405-3845 1910-796-7215
Morehead City Office i 400 Commerce Avenue Morehead City.NC 28557 1252-808-2808

e 20'0" c y„ o
_ J Tyler&Ashley Fortner
Ladder 1120 Midlake Ct
Grimesland,NC 27837
^' BFW20210057
0
o Wet slip 2 Project Location:
Lot 31 Dowry Creek
Belhaven NC 27810
Hose bib&drain '
Not To Scale
\� J 3 o For permiting purposes only
70 Prepared by BF Warren&Sons Inc
c- -0,Tide Tamer
7K cradle lift
3
Sub panel&remote
ED ,t /' Date: 05/18/2021
co
A./
�5'0
g
15'0" 15'0"
Pungo River
\ N
Riparian Access
Riparian Access
iYG✓`
E N P/L
Shoreline 90ft
P/L Kolb property
e,,:s .tis L../ «
Trueblood property

B. F. Warren & Sons, Inc.
180 Taylor Farm Road. Belhaven NC 27810
Office(252)964-4628 Fax[phone]
Forrest cell(252)945-2492 Freddy cell(252)945-4240
NC General Contractor License#72600
www.ncpiers.com
Authorized Agent Consent Agreement
To:State of North Carolina Department or Local Govern n:r Department
from whom this permit is being applied fer.
I.the undersigr ee'property owner,do hereby authorize R.F.Warren&Sons INC.to act on my behalf in
obtaining the ne:essary permits fo the below listed projects.I have contracted there services to perform
the work permitted.This agreement is limited ont} to the s'erific activ:ty of obtaining permits for the
below specified projects.
Projects:
Concrete dock and boatlift
Project location'address:
Lot 31 Dowry Creek E
Belhaven.NC 27810
Body of Water:
Pungo River
Property Owner Mailing Address:
Tyler Former
1120 Midlake Ct
Grimesland,NC 27837
[phone]
A
:: :'::
Signature• Date:Signature:_ Date: o`

Adjacent Riparian Phvperty Owner Stattrment
Prepared by
B. F. Warren&Sons, Ina
180 Taylor Farm Road. Belhaven NC 27810
Office(252)964-4628 Fax[phone]
Fr'ddy Vlobi:r.[phone] Forest Vole(252)945-2492
NC General Contractor License#72600
www.ncniers corn
June 17, 2021
I,the undersigned propery :A,ter,do h::cby certify that 1 own property adjacent to Tyler
Fortnei s proc !water!at' o*31 flo':r) C-i.ek F ?'Ih1v4pn NC 27810 on Pungo River(body
of water),in Beaufort Couni'v NC
The applicant has described to me.as shown beiow,Inc development proposed at the above
location.I understand that any construction,excluding bulkl'eads.must be set back a minimum
distance of fifteen feet(15')tom my ilea of t iperi u acre;,unless waived by me.
Please initial the appropriate blank.sign and date below.
/'4 I ha,=t.. .bjei.'ior ;c J e)o;xt'u Fropos(;c,iu do not wish to waive the fifteen foot
(15')set back.
i have no objection to the project as proposed hut do wish to waive the fifteen foot(15')
setbac:..
I object to the project pro ose4.
Property owner-.ienaturf!
Printed name Cr 7)7,PlbioD
Address12.. V w1f C/`/6 b 2/V4U e \-) iv (' �7 t/p
Telephone number( sa)Oc ) FX3 Dad/
Date 6 // / o 0c /
Description and/or Drawing of Proposed Development
Concrete dock and baatlift and wet s!ip

Adjacent Riparian Property Owner Statement
Pleparcd by
P. E Warren &Sons, .Inc.
180 Taylor Farm Road, Belhaven NC 27810
Office(252)964-4628 Fax[phone]
Fr';ddy Mobilf; [phone] Forrest N'ob;le(252)945-2492
NC General Contractor License#72600
www.ncniers.com
June 17, 2021
I,the undersigned property owner, do hereby certify that I own property adjacent to Tyler
Fortner's prop arty located at Lot 1 Dowry Creek E, Peihaven NC 27810 on Pungo River(body
of water), in Beaufort County NC.
The applicant has described to me, as shown below,the development proposed at the above
location.I understand that any construction,excluding bulkheads,must be set back a minimum
distance of fifteen feet(15') from my area of riparka access unless waived by me.
Please initial the appropriate blank,sign and date below.
I hav•_no objection La the project as proposed bur do not wish to waive the fifteen foot
/ \ (15')set back.
I have no objection to the project as proposed but ao wish to waive the fifteen foot(15')
setback. /
I object to the project r osed. /
sti Property owner signature__ _ -- _
Printed name r---© Li-3
Address 0 C 1 2' efr--
Telephone number(_ " ) �1/5--- - a 70
,/
Date Zila_/ `, / , () 27/
Description and/or Drawing of Proposed Development
Concrete dock and boatlift and wet slip