79851_Ann Vernelson_20210723

0 N.LAMA/ ❑DREDGE & FILL -D4f 09007 N° 79851 A _ C D
GENERAL PERMIT Previous permit# AJ
>' fiNew ❑Modification. ❑Complete,Reissue ❑Partial Reissue Date previous permit issued (1i/,
As authorized by the State of North Carolina,Department of Environmental Quality f Z��
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC , .
/ `©Rules attached.
Applicant Name IN)r4i, r \/ e . g/'c30h 1 Project Location: County r .1... ? r*
Address CI 1 Pt N(a,.1'S T.t'a 14 `i-,‘.e- Street Address/State Road/Lot#(s)
City £140/DGM/A1.I-- 1) . '.StateM ( _ ZIP ? 'c*,1-4:" 91 Ptzz,,✓' 5) t'.' -Dr`
Phone#($ )7�-,� - 5 E-Mail ® . Subdivision-t-,r)C 1`
Authorized'Agent 0 ie.rot- Yllve City C�0/1‘.. cc•tei,r1-4y- ZIP , �g 11
Affected ❑CW .©,EW , PTA ❑ES ❑PTS Phone# ( ) 6-51' CS River Basin 1-4W-
!!
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body/l :/Yl, be c t►"e,/ (nat pan /unkn) '
❑PWS:
ORW: yes / oo PNA yes / "�� Closest Maj.Wtr. Body 1.I't--r* .V�'�`
Type of Project/Activity-P)'4 +5�U 1_....r,544 1 1 (3� C d X 1 ' D/ 1'fbff/l ,.4- J r j. s
r
l? (Scale: /,fr 3 1 )
Pier(dock)length 11 ""
Fixed Platform(s) i_,i X l ' iIIiIII IIIIIIIIIMIIIIIMMMIIIEINIM I: I �■ • M••
IIIIIIIIIIIIIIII
Floating Platform(s) / 1IIIIII
Finger piers) g j } I......
Groin length BI i iiiii `i ! ; ;- .- I
number 4 i.. `► '�\�+i --
I
ry
Bulkhead/Riprap length �—,-�. .�. ' I -- -- - . _ --- <-1��
avg distance offshore\ :' 1 rEll1 i I- Ill - I i
max distance offshore( � � ! i i
Basin,channel { ��� �:
' 1
y •� I ,
cubic yards
I
Boat ramp I �111� �� .� I I I I W`
Boathouse/(Boatlift i S; 13 c __ -�.- I - y�''...---a--_ .-i -- , j t - - - ......._..._---- __.._
i
Beach Bulldozing 1 -� ��� 1 �✓ 4 . +-!
r,TLiI
Other I e a i 1
I1 q
q�p i► E
Shoreline Length 1` !9d ' NEE •����
SAV: not sure es no ---- _...* - .� D' _ IIIIIMIIII '— - —
Moratorium: n/a yes I � � i
Photos: yes now i ,Ti, � : ._. — - _.......... --1._ ... ■--..S,....- ' i.s -
Waiver Attached: yes �o i �" ' I j... i
A building permit maybe required by. / .F ' Co . . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) / 1 iki
Notes/Special Conditions ( � Yo7 0 ?f.✓';1.1 `-1 � y� 60
e) �L�i. A. s - )r .11 tit) ,f,
d ,
f 0 1-i1x a1I .,0�) 7 1i a":
t-:;FA9Ad ;') .� 4)1-q a\rci�'I;)(i
Agenpplica t Printed Name if _ Pe.mit Of cei s Printed Name
Signature '�please read comps cestatement on back of permit Signature U
CIr� � ob. 70)0 T p - StAly -20,73 E _ ?3— ILINI -s,Qzit 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:
n Tar-Pamlico River Basin Buffer Rules I I Other:
n 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 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves:Beaufort,Bettie,Hertford,Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
40I S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-390I Fax: 9 I 0-395-3964
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/I7

0 �rq,CAMA/ ❑DREDGE & FILL p 090 i N° 79851 A I C D
GENERAL PERMIT / Previous permit#. AJ/
>' L INew ❑Modification ❑Complete„Reissue ❑Partial Reissue Date previous permit issue'di k)I A,
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 3- / /2-
fl Rules attached.
Applicant Name c' N N V C ..NieL.'SO+,.,\ Project Location: County -FjFGtGe ,J
Address °I ` ?t N'(�,•l'S 1 (-' ` \r" ' Street Address/State Road/Lot#(s) . .
City (.!ii0i.0iui1,4;4- •1 State1J C_ ZIP c 5ci .C_t/ Pc.,k �r Tjr"
Phone#(79a) 74, '93 .E-Mail ._------- Subdivision r r ��`yrr
Authorized Agent �'ra 7k i 11)*' City �,1-1c. si~.,c,ii...4) ZI e?S 1
Affected ❑CW :'' J EW E PTA ❑ES ❑PTS •Phone# ( ) 7 -ca``j `S. River Basin TAR- z'
I.P1441
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC s : Ad).Wtr. Body 0)0)4 io L . C }"�� (nat�.mari /unkn)
❑ PWS:
•ORW: yes / q PNA yes / Closest Maj.Wtr. Body �`- 44- 1^�-L� 4 �'C1
Type of Project/Activity 7! '1 L r-5"1-et 1 C_)-F U r ' �/ 7'fb� 1 �- 1�r L r
1► 1'
(Scale: f`
t -Sc.,' ),,
Pier(dock)length `
!f
Fixed Platform(s) {- f\ � I
. Floating Platform(s) / I + I I I j i 1 •
Finger pier(s) i I -j
1-
Groin length 1 t'"'• I i \{
number --1-4 -- - I — I$g, ' c th\ 1� -- ---°- L- ---
Bulkhead/Riprap length • - ✓i 7- I �- -_ - - —'-I
avg distance offshore j — i _ I :
° max distance offshOr I J i I ; I
Basin,channel - i I '
cubic yards I ! I 1
Boat ramp I r I �° ?r '
l I
-1� ✓' iBoathouse/tBFoatlift /S y� Ij --�-------- � j 1,,f_,,,-,47.
,� = ! — t-------; � '
ire
I
Beach Bulldozing / -- ����_ —_ ( -
f 1 v.a 1 I
Other c
• 1
Shoreline Length I I I j
y `4- t 1
SAV: not sure yew no — _—�fe }-.6;sZ)Ilt------------ .A— -•---i -- ---
Moratorium: n/a yes Cno I 1 l K--..iPt, y ,1�� - I j
Photos: yes no ,„—,1 I r- — --4_ ' i —__.. —;
Waiver Attached: yes ( '. I i
f1 ,
' A building permit may be required by: r ,,,,, ( t I ('rU �1- x See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) / f y i
Notes/Special Conditions 6 c rt +•5; /" ) ;:f'-e'%-")e3 4 l,{-}A /4 1 f L.ir n i Uj W/ /76//"
/ 0 { 1 1( ail )k.i 2 2 -51. pj
•
,4,e,f1c Arrls- • 114)\.ey a,on;)(1
Agent or Applicant Printed Name PermitO,f�cner�s Printed ame
i
- .7'``" i, ., � 4444
Signature **Please read compliance statement on back of permit** Signature 7 f
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:
1 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 (252-946-648 I) 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
40I S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-390I 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

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON. DAVIS
ENVIRONMENTAL QUALITY Di/eL1ur.
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 50 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.
Li /
' •
® Pre-project site conditions: /f ��ft•, {�'t � l0 711
By your signature below you agree to be held responsible for meeting all of the conditions listed abov and verify
that all information provided is complete and accurate.
•
Ag n� t or Aepplica suited Name
eri it i er's Signet
___72",.;fear-1 /, 32�z)
Agent or Applicant Sithature I;re Dat::
CAMA GENERAL PERMIT#: 7—'"I 6?6 03 `,
State of North Carolina l Environmental Quality l Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 27889 1252-946-6481
• Wilmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-3845 1910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City,NC 28557 1252-808-2808

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 8_a yam- yof_Ae_Dori . 's
(Name of Property Owner)
property located at 9i Re-TsaaOP, De cj ;,', Jr /y- 0?7cf/7
• (Address, Lot, Block Road, etc.)
on Cana/ , in eh ace,w , N.C.
(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 fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
4`f`.1 e ket (Pro ert Owner nformatio ) (fit Property Owner Information)
Qx .e -�
Si ature Signature /' j
-A vrie
remi
Print or Type Name Print or Type Name
a.s-/y J'vi Siac h"/
Mailing Address Mailing Address
l'rrc n el'
City/State/Zip City/State/Zip
Telephone Number Telephone Number
jai� d2/ �v,�/ ; Z5- /
Date Date
(Revised 6/18/2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to IQ n r7 Y�r-,.,�.Se.-7 's
(Name of Property Owner)
property located at 9 / Pv (-7-5 ram— p 2 cil , a„„4„ A/c a,')a'17
• (Address, Lot, Block, Road, etc.)
on gr7-11a(0 , in (2.hpc,.4 of', ,4,, Nl , N.C.
(Waterbody) (City/Town andlbr County)
The applicant has described to me, as shown below, the development proposed at the above
location.
d•'' I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
/lt do not wish to waive the 15' setback requirement.
Viacr•Ys 1' (P party Owner Information)r (AdiavoRt Property Owner Information)
,./eYlitle.e/e /Jkay
Signa� el) id 4 Signature `
�f Am Ltexr�/rei/
Print or Type Na Print or Type Name
f 0 Nara vx x.55- 3G00 f 1r?41N6'/A f9/Vq'
Mailing64dcire S000 )1e �n Z'1� Mailing dd fif// ,A/ C
City/State/Zi I l Z�� City/State/Zip��/
p r7J 2 Z..71 l---%
7
Telephone Number Telephone Number
01a i AO 0 .0'Z) •Af 1 - -7 i S'77P
Date / / Date 2,... .Z`
(Revised 6/18/2012)

Authorized Agent Consent Agreement
I On rl Perne.is o n ,hereby authorize. 6yl/ aye to act on
(Property Owner) (Authorized Agent)
my behalf in obtaining CAMA permits for the location listed below. This agency
authorization is limited to the specific activities describes aDo
Property Address:
/ Qorrs cL
Ch.ocowt-), (. ;> I?
Property Owner's.Mailing Address and Phone Number -
I-its le if U.S ' )WW a-G 4' L.
C a 7133y
5�. • '7t4f - (0 'Fs 93
- Property O e s. ignature: iy� 7)
Authorized Agent Signature:
• Date:
Form:Authorized Agent Agreement as developed by NCDCM revised 7/29/OP