78110A_McCann, Andrew & Lovie_20210518

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CAMA / DREDGE & FILL N9 78110 (A) B C D
-. GENERAL PERMIT Previous permit#
L 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 SA NCAC '7 1 , / Z
®Rules attached.
Applicant Name A 6r eL-Z 'Y L0 V I Project Location: County _1D v rg-
Address P. V ?` i Street Address/ State Road/ Lot #(s) L o f Z 8
City S '-6 State ZIP 2%i S9 7 i w s,L�6;
Phone # ) of a - $ $92 E-Mail e- C"0+ Art d 1 Z'4-1 �m6'. /' Subdivisiony J Ai c. 9 S 14; ­ sl CL, ve A
Authorized Agent L L /71 c4 r i r Co n s+. c L. c City /J <- s t* a <- ci ZIP ❑ ❑ El
7 9-5
CW OEW 6WA ES PTS� Phone # (DZl- 4
) River Basin r o S ,, Y
Affected OEA HHF ❑ IH ❑ UBA ❑ WA
AEC(s): ❑ ElAdj. Wtr. Body r' "I ^ 01 1 (nat /unkn)
❑ PWS: �
Closest Maj. Wtr. Body
ORW: yes / no PNA yes / no7
Type of Project/ Activity -2, ,� ' 5 D /ri
(Scale:
Pier (dock) length --
Fixed Platform(s) 3 x 35
Floating Platform(s) —
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
_
I
cubic yards
Boat ramp
Boathou BoatliR
Beach Bulldozing
Other
I
Shoreline Length / S
SAV: not sure yes no
Moratorium: ; n/a yes no
Photos: yes no
Waiver Attached: yes (no '
i
ir
N
D
?
T
A building permit may be required by: T W ^ JT N U y S %(RP d ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions % O S 5
NAbw(b' )M n L
Agent or Appl tcani Printed Npme t
Tkn�
Signature Please read compliance statement on back of permit
PermkOfficer s Printed Name
Signature
.S , 2 1
Issuing date Expiration Date
Application Fee(s) Check #

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/ 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
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)
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: Ill e- C ck tj
Mailing Address:
Phone Number:
Email Address:
57 --92--S90I7
I certify that I have authorized Scott C. Small / LSI Marine Construction. LLC
Agent / Contractor
C
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: to construct a new dock and install a boat lift
at my property located at _ 1 to �-� i c� W o�►a f� GAS tt F.ctct i j
in_Lj(kX\e-, 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:
, IJ- -Y24 C ( G"'.
Signature
\),yii c Cc,N d
Print or Type Name
Owner
Title
04 1 14 / 2021
Date
This certification is valid through I
4- 28 s"-A
C) 4 Iv w 3

PROPOSED NEW DOCK & TIDE TAMER 13K 4
BOAT LIFT @ 4616 COBIA WAY, NAGS HEAD, NC
FOR ANDREW D & LOVIE W MCCANN
IRIPARIAN DRAWING -- 1 OF 1 — 4/28/2021 —
NOT TO SCALE
BY: SCOTT C SMALL OF
LSI MARINE CONSTRUCTION, LLC — 252-473-7695
NCGC LICENSE #84568
EXISTING DOCK
NORTH
60' +/- ACROSS
CANAL —
PROPOSED NEW
TIDE TAMER 13,000 #
BOAT LIFT W/ 4 NEW
10" BUTT X 30' ROUND
2.5 CCA PILES /I.(- i,tz-�
•
PROPOSED NEW
bX 3' X 35' DOCK
--7)
LSI MARINE CONSTRUCTION, LLC
1112 W Kitty Hawk Road, Kitty Hawk, NC 27949
252-261-1967 / www.Isimarine.com
[e-mail] / [e-mail]
4614 S COBIA WAY
PROPERTY OF:
JAMES C ROBERIT
4614 COSIA WAY
NAGS HEAD NC 27959
I5' OFFSET
PL -
=�
1
?`1 I EXISTING WALKWA
75' +/-
4616 S COBIA WAY
PROPERTY OF:
I
MCCANN
Y
W-;;� v 4620 S COSIA WAY
15' OFFSET Pa'
PROPERTY OFF
MCCANN 17
4622 S COBIA WAY
PROPERTY OF:
THERESA W. SHARP
4609 S ROANOKE WAYS
i NAGS HEAD. NC 27959 2

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: ANDREW D MCCANN & LOVIE W MCCANN
Address of Property: 4616 S COBIA WAY, LOT #28, SECT A, NAGS HEAD / DARE
(Lot or Street #, Street or Road, City & County)
Agent's Name #: SCO77 C SMALU LSI MARINE LLC
Mailing Address: 1112 W KITTY HAWK RU
Agent's phone #: [phone]
KITTY HAWK, NC 27949
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 provided with,ts lei.
_-,/ 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 at http:Ilwww.ttccoastalmanauemeni netlweb/crWstaff IistincI or by calling 1-888-4RCOAST.
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, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
y 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)
,Signal ure
ANDREW D & LOV1E W MCCANN
Print or Type Name
PO BOX 7
Mailing Address
NAGS HEAD, NC 27959
CitylState/Zip
252-202-8892 / CAPTANDYI(dEMBARQMAIL.COM
Telephone Number/Email Address
04/29/2021
Date
(Riparian Property Own r nformation)
I- ts ) I 1ko &.ZQla GJ_
,Si���nutur•e
THERESA W SHARP
Print or Type Name
4609 S ROANOKE WAY
Mailing Address
NAGS HEAD, NC 27959
Clty/StatelZip
Telephone Number / Email Address
Date fo
(Revised Aug. 2014)

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: ANDREW D MCCANN & LOVIE W MCCANN
Address of Property: 4616 S COB1A WAY, LOT #28, SECT A, NAGS HEAD / DARE
(Lot or Street #, Street or Road, City & County)
Agent's Name #: SC'OTT C SMALL/ LSI MARINE LLC Mailing Address: 11 12 W KITTY HAWK RD
Agent's phone #: [phone]
KITTY HAWK, NC 27949
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
tney are proposing. A description or drawina with dimensions must be provided with this letter
�j 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 at ht*Jiwww.nccoastalmarragementnet/web/cm/staff listing or by calling 1-888-4RCOAST.
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, 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature
ANDREW D & LOVIE W MCCANN
Print or Type Name
PO BOX 7
Mailing Address
NAGS HEAD, NC 27959
City/state/Zip
252-202-8892 / CAPTANDYI(cuEMBARQMAIL.C'OM
Telephone Number/Email Address
04/29/2021
Date - - —
kni uture
JAMES C ROBERTS
Print or Type Name
4614 COBIA WAY
Mailing Address
NAGS HEAD, NC 27959
City/StatelZip 7 ( y
Telephone Number/Email Address
Date
(Revised Aug. 2014)

2021-05-