Lowry Holdings 80469C

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MA 12 REDGE & FILL N9 80469
N�R/ ptw�Aq A B
L PEg'1tYgIT Previous permit#
❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit Issued
Asautby the State of North Carolina, De ett of Envimmental Quality
and the Coastal Reso ces Commission in a - o environmental concern pursuant to ISA NCAC
Applicant <Jun�_�--�M��-�----- Project Location: County
Phone _Mail Subdivision
(�
Authorized Agent
'City_jr _ '
ZIP
Affected _cw ;' G PTPhone iver BasinS
AEC s : ❑ OEA A C N/e
_ i_ PWS: Adj. Wtr. Body - �gt un
ORW: yes I PNA yes / Closest Mai, Wtr. Bod
Type of Project/ Activity VI r r
(Scale: i-�'J 1 )
Fixed Pladorm(s) �"'� _ - ..
Floating Plxdorm(s)
Finger pier(s)___}f
Groin length -'— ?s Qr'Uf
number—..,>
Bulk Mpnp
g distance offshore df y / `�'� y
max d[stance offshore
Basin, <hann,h
cubic s
Boat ramp _ l
Boat hous B Aft
.. rt)�
Beach Buhdozuig__
Other
Shoreline Length.
r`
sAV: not sure yes
ri
Mcratoum: ya
Photos:Yeto
Waiver Attached: es no
A building petma d�Ay"be' required by. See note on back regarding River Basin rules.
.(Note Loral Planning)uradicdon)
Naas) Special Conditions . ( Y
fd . .frerr__ 'i.c n _6 f. .. n 1 0o A Ili J

REDGE & FILL N9 80469 A B
NE L PERMIT Previous permit# ll/
w ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As auth ized by the State of North Carolina, Department of Environmental Quality V O (� 00
cr/ , I
and the Coastal Resot ces Commission in a ar alnvironmental concern pursuant to I SA NCAC ❑ (�( ules a hed.
Applicant Name Project Location: County
Addr-es S_ - Street Address/ State Road/,Got.*(s),
Phone
Authorized Agent L
Affected El Cw W PTA
AEC(s): El OEA ❑ HHF ❑ IH
❑ PWs
ORW: yes / 47 PNA yes /
Type of Project/ Activity
Pie
Fix
Flo
Fin
Gr
Bul
B
Bo
Bo
Be.
of
Sh
SA
MI
Ph
W.
city t L1EI7_Til►1 <n
lody
Closest Maj. W 'tr.
#
in length
g distance
mho
'0
mom
M��
nw �
r
i�1GN�
1
'
�
Ire
V: not sure yes
G1la .. "
MEN
��
�.
4 1 1
A building permit m �be required by:
( Note Local Planning jurisdictioon!n)1'
Notes/ Special Conditions AC�Y,( iL1A171�
J
❑ See note on back regarding River Basin rules.
Application Fee(s)

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
Iandowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistentwith 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 Wat�r 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: ')4A �Y� PE'c P6-
Phone Number: is ?l - Aq-- 2,a6,
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: )�EVWV--k Z& —__
at my property located at
in County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information;
1
sign Lure
1M�c,l'�e L..ov✓r
Print or Type Name
C• ��tiLF€Z
Title
/I Is_/ % W l
Date
This certification is valid through

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: 1 I
bJ r
or Street #, Street or
City & County)
Agents Name #: f ✓� Lo- rMailing Address: R d
Agent's phone#�zS�3y2-3;b3) J?�f\q, gno kor-4 /JG2$,sj2—
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 ordrawing, with dimensions 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. Contact information for DCM offices Is
available ate;//www.nccoasfalmanapeme>jf.neUweb/cm/staff (lsffnu orby calling 1-888-4RCOAST.
No response is considered the some as no oblection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
1 do wish to waive the 15' setback requirement
i do not wish to waive the 15' setback requirement.
(Property Owner Information)
Mailing Address
I SkurQ-s NC 2JJ i2
CitylStatelZip
(2S21112
-� Telephone
-n r�'�ec,r� cow Telephone Numb rlEmafl AddrOss
Unte----------
perty Owner Information)
Pfin}toorrType Name �(/
/ k^o 1 � ��CI.4
Mailing Address
1 � A. 1�•
CitylStatelZip
25Z_ I)n (-Py,4
Telephone Numberl Email Address
Date —
(Revised Aug. 2014)
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