Burch, William 80679C

L CAMA / ❑DREDGE • FILL
ENERAL PERMIT
ew '17Modiflcation ['?Complete Reissu I.JPartial Reissue
As auth rued by the Stale of North Carolina, Departme9t of Environmental Quality
and the Coastal Resources Commission In an area of/enylronmental concern pkrsuwt to
f r�
Applicant ame_
Addr s
City_1 t, La State (!
Phone#IC4�)
Authorized✓Agent
I iCW
PTA
Affected
I
JOEA
AEC(s):
HHF
_.IH
� PWS:
ORW: asp//)no
PNA
yes /
Previous permit # G)
Date previous permit issued
wctycc� c ocation: Coun
w
Stree Adyyress/ $at Road/ Lot A
SubdivjErq._,
C -
City _
DES fJ PTS Phone#12 w..
USA (.-I NIA Adj. Wtr. Body_.
�) Closest Maj. Wtr.'
ZIP J -
r Basing, ) _ \
_(naman /un_
- r
Type of Project/ Activity ie' j C�
(Scale: )
Pier (dock) length 1C+'
Fixed Platform(s) ..
Floating Platform(s)
Finger pier(,). �-:.`�.�- __. y. ... �.`
Groin length _e'—'_
number.
�i
Bulkhavg distance
length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp -
K /,,,,,,III
Boathouse/ Boadift _ _ CV1����i'�—�J(aI/,f
Beach Bulldozing,*'--_-
Other(_1At(.1t,t/�X1 C�O 1„fE.
Shoreline LengthL,-�
SAV: not sure yes o
Moratorium: n/a yes no
Photos: yes
Waiver Atuched: /�re� no
(, ,: i p� y
A building permit may be required by: r°- / Pl.vt n L.,I See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction ;1 r ,
Notes/ $pecial Conditions
-
}/ Permit is S tint amet'�
Agent or licant Printed Name � , �
Signat *t Pl�� read compliance statement on back permit"° SignatuQ
1 l✓'L ``C'he k Issui Ee ,/l /��J��i� -- —I LcxPir9tlytt bate �,l
pkcazion Fees) 1

OAs,,th
AMA / ❑DREDGE & FILL
ENERAL PERMIT
ew ❑Modif cation ❑Complete Reissue [-]Partial Reissue
edby the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area offenironmental concern pursuant to
Phone #,cD))
Authorized Agent
El Affected GW wW PTA
AEC(s): �OEA ❑HHF IH
PWS:
ORW: s / no PNA yes /
Type of Project/ Activity. .L
Pier (dock) length R }C /(tea
Fixed Platform(s) —
Floating Platform(s)—
Finger pier(s) �--�—
Groin length e—
number �--�—
Bulkhead/ Mprap length
avg distance offshore
max distance offshore
Basin, channel �—
Boat ramp
Boathouse/ Boatlift 19l
Beach Bulldozing �
Shoreline Length
SAM not sure yes o
Moratorium: n/a yes no
Photos: yes- _
Waiver Attached: no
A building permit may be required by:
( Note Local Planning Jurisdiction,)
Notes/$ipecialConditions A1�\l
Printed
•�k
❑ES ❑PTS
❑ UBA ❑ N/A
t
statementon
City ( Y-=�
Phone #
Adj. Wtr. Body_
Closest Mal. Wtr.
N9 80679
Previous permit #_
Date previous permit
Road/ Lot
A B OD
ZIP_
Basin
I
(Scale: i��)
❑ See note on back regarding River Basin rules.
/ _ f A .., . _. 1 M

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, certifythatthis 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
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 complywith these buffer rules.
J
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/1-8884RCOAST
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:HPortal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

A29RT AM!HQft9A1QRfQA9AMA W
Name of Property Owner Requesting Permit:
Mailing Address. ------ -
I certify that t have authorized C3 Scott, Inc
to act on my behalf, for the purpose of applying for and obtainingall CAMA permits
necessary for the folio wing proposed development:
at try property located at Prkv(
�
In County
i furthermore certify that I am authorized to grant and do in fact grant Permi=or) M
Division of Constal Management staff, the Local Permit Officer and their agents to ornof
on the aforementioned lands in connection :with evaluating information related to tk
permit application.
Properly Owner InfortnalroW
it azure
-----
Prim o' Type Narrie
TWO
'7
Date
This conifir-atiop is valid through
91

E �' p

I hereby certify that I own property adjacent r
(Nam of Pr o part Y Own or)
property located at -Dal
ain KC.
♦ i
4#'1 have no objection to this
proposal
I have objections to tht5 (. TGPOSal
DESCRIPTION: # i DEVELOPMENT
r r.. :• r� r♦.f #:a ♦. •..:.
WAIVER SECTION
i understand that a pier. dock, wwring pilings, boat ramp, breakwater, boathouse, tit_ Of yrrrtri
must be set back a minimum distance 0 15' from my area of ripat}en access unless waived by
me. (It you wmh to waive the setback, you must initial the appropriate blank below_)
L)w,
a+' i dcr wish to waive the t 5' setback requirement.
I do not wish to waive the 15 setback requitement.
°vattd tar one calendar year sties %ie}naruo
(Adjacent
JProperty, Owner lntotmateon)
SiK/ FlTrte
7j
Print 0r f! { drr
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�51Xv�.ttot
`Q' rnrxtr I email address
(RernsedAug, 2014)

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218 Bayside Drive
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herebyown property i 1
locatedproperty
♦ , r
nWai the applicant has described to me, as shown treiow. the develOPrneW proposed at the shave
-fore are trot' ),
of i have no abjection to this proposal.
ttese i have objections to this proposal
tCYett
DESCRIPTION ANO/OR DRAMNG OF PROPOSED DEVELOPMENT
(hicrivfduai propoWng diti!! Hirt MOW ON In dwr4Xfon boiliow or attach 0 90 dnWkW)
WAiVI„R 51-CTIQN
1 understand that a pier, dock" mooring pllin95, boat ramp, breakwater, boathouse,, lift, of Vrcxr,
must be set hack a minimum distance of 15' trorn my area of riparian access unless waived by
me_ (it you wish to waive the Setback. You hVAU jtt" the appropriate blank below.)
2& t do wish to waive the t 5' setback requirement.
I do not wish to waive the 15'solback requirement"
(Property Owner Info(mation)
(Adjacent Property gwnor Information)
r ' '
St ttterera
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'vabd too one r�UIOOOW year auer &19rt,0=0e•

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