79352A_Melvin, David & Elizabeth_20210803

lufCAMA / ❑ DREDGE & FILL N9 79352 B C D
GENERAL PERMIT Previous permit#
ANew ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality _ ! 1
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC C:<i
Rules attached.
Applicant Name >J -i R i,_ 4k, Xe (LA, Project Location: County 1 r " )c LK
Address j0�1_ Ca4lr\er i� C (�1xtt Street Address/ State Road/ Lot #(s) jG,1 /V�a! �/ Ccd kefit, e
City State Vc ZIP a?� S 1y�1
Phone # ( ) 1 - {0 E-Mail i(2e\ cc, r s `l4 : C , a 1 C ©►^ Subdivision
Authorized Agent Z: C' k M!/L(�Sc`1� City r:o/ ZIP r2� �f Sg
Affected ❑ CW &AW VVTA ❑ ES ❑ PTS Phone # ( ) River Basin olDi t
AEC(s): ElOEA ❑ HHF ❑ IH El URA El WA It •�,I
❑ PWS:
ORW: yes / no PNA yes / rG
Adl. Mr. Body walLman unkn
Closest Maj. Wtr. Body ''' 4 - ', -,n4A
Type of Project/ Activity i0 I • cf �,,J 2C. I ewU fc rn NPt✓ — l i
'_1
Pier (dock) length > v _
Fixed Platform(s) ? 20
Floating Platform(s)
A Eger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
1
Boathous Boatli
Beach Bulldozing
Other 1.{ bfk lr'd�ore-u
Shoreline Length ± I
SAV: not sure yes no
Moratorium: yes no
Photos: yes n�o'
Waiver Attached: yes no ,
(Scale:
A building permit may be required by: See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions �►j'(c �Ur a[ `i�CE/I{S f TCIr I lttj
C 1�
Printed
Signature ** Please read compliance statement on back of pdrmit'i"i'
IN
Application Fee(s) Check #
Permit Officer's Printed
Signature
� ► �- - �
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
Neuse River Basin Buffer Rules
Other:
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/ 1-888ARCOAST 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

DIVISION OF COASTAL MANAGEMENT
AGENCY FORM FOR PERMIT APPLICATIONS
I v //'b ovN-ner of the property located at:
(propem� otivner) L
(Frcp� -�, .,.ddressj
n
(proper :fr.-,:����c;
do hereby authorize
to act as my agent for the purpose of ob =rg : : -. teded ".--oastal Area Management Act and/or
Dredge and Fill Act permits, that may be el_�_.-: _ T ale _=^xsed development at the above -
indicated property, which entails:
(describe proposed development =;r xnich permits are being sought)
This agency authorization is limited to the specific activities described above, and will expire on:
(date on which agency authorization expires)
(signature)
A PIA s A
(printed name of owner)
2 Z -2o AZ0I IV z
fd te)
(title, if officer of corp. owner or trustee for property)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, reet or Road, City & County) ;/ 7 /C���
Agent's Name #: jlj i ng Address: I I t IS CI�E',+C k Cj
Agent's phone #: 3E -- 0 3 Z _fVk2
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 drawinq the development
they are proposing.
>(1/ `;
'( -- I have no objections to this proposal. I have objections to this proposal.
ff 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 offraes is
available at nccoastafmanacxement net1web1cm1staff-iistina or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Cerdfied frail.
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)
Signature
Print or Type Name
z
Mailing Addiiss
City/Stataop
Telephone Number/Em 7Addre
Date
(Ripa 'an Property ner Information)
Signature
rd ►L�t E yn
Print or Type Name
j o 4
Mailing Address
CbvSfat90p
�
l k r Cl C e �15 lc0, c� nqa , . Ce, n-,
Telephone Number/Email Adefreg
D e
(Revised Aug. 2014)

pz��P ,� e� �e � �v� � �� � �� �

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Pro{" Owner:
" / /P0
Address of Properly: /
IV,41qk
(Lot or Street Street or Road, City & County) Zr'
Agent's Name #: " K�M "ng Address: �� �S ace,�
Agent's phone
hereby certify that 1 own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawin the development
they are proposing. A = .
0f 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
(DC* in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at htW.,Ilwww. nccoastaimanagement netlweblcm/staff iisting or by calling l-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified hWi.
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.)
y�-I do wish to waive the 15' setback requirement.
V� �l' I do not wish to waive the 15' setback requirement.
(Property Owner Information)
2��L
Signature
Print or Type Name
1&-2"7 gzz��ieAo \,
Malting Address
City temp
��7- (� /7
Telephone N�u/mber/Email Address ✓l
Date y -A p o O ; /
�l ([�ipya�a Pro e r Information)��
Signature
e vN,,,� 4- T cJ, -t h i4e7
Print or Type Name
1'7 /7 i*vbc2er>s
Mailing Address V
1f12jwe,-t ate- VA- 245-6
Q601$,tateop
�rl�,I c•��rt+(-,�, c a(� �r �u , (. C Uri
Telephone Number/Email Address
��
�(
Date
(Revised Aug. 2014)

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Currituck County GIS
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Colryock
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f Grabs Woods
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Harb"er
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6 Knot ts Island
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Currituck County
Aerial Photography (2011
4 NRed: Ban0_1
p`} EGreen: Band_2
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Blue: Band_3
This map should be used for general reference purposes only. Currituck County assumes no legal liability for the information
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