80230D - Humphrey

0,1, �CAMA/ ❑DREDGE & FILL No 80230
GENERAL PERMIT Previous permit# A C C
)�? New iModification Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality i /zO
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �f/-
jj,,.�� ❑,idles attached.
Applicant Name p cJ N�r4 /1 f pfit t" ` Project Location: County {"_)2"/71---
Address II/ c) Pt, (#,e f ,4'✓6- Street Address/State Road/Lot#(s)
)
City teF G�( StateNU ZIP 2/'/c-r— t_:IA.-mil
Phone#(S7')"34-I--7-41(°E-Mail Subdivision
Authorized Agent s i 4-CS- ,&! _ City ZIP
Affected ❑CW kEW )6 PTA ❑ES ❑PTS Phone# ( ) �[ /N River�B/asin 1 1' , v
AEC(s): ElO� ❑HHF ❑IH El UBA El WA Adj.Wtr. Body / .�A1V/t at man /unk
❑ PWS: _
ORW: yes /, no PNA yes /'no' Closest Maj.Wtr. Body cif'—/ L 0c}Aii ,
Type of Project/Activity 0 L r-
Pier(dock)length �-� I ST i 11(T ,
`/ATE (LS C-4 _►V (Scale: N Tc
2 Fixed Platform(s) ty '(/ 1 }
J
Floating Platforms)
Finger pier(s) i, (to I 1 �. __.J._. 7 1 r _ .
Groin lengtf( i i
number. ielP_fp i HO •
_.. 1 �
iI Bulkhead/RipraNength i L 4Ear— 1 r— ❑—
r
i
avg distance offshore t
max distance offshore ; E C i
Basin,channel \ I
cubic yards ! SI I
Boat ramp 4 '{
t \ ' '-1 . '
Boathou — — _T._. —
Beach Bulldozing r I
Other j i I s 4410'
Shoreline Length f'` SS • I { li..
i i , ''
SAV: not sure yes no +' ' r v
I
,i .,
-
Moratorium: n/a yes 11L i i I'l"1 11j' .. �t1 2i -11-' ! 1 ' 1 1 1 I_
Photos: yes 605 , t—__......, 1 I
Waiver Attached: no \ I i--Vs])eL4. I I i I i i l
A building permit may be required by: ' Ste, v(.TL/ ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) l
Notes/Special Conditions
12 IS i(1rbh' 17 ?P<IA- '-I I.2
Agen of r Applicant Printed Name 'Officer's Printed Name
C.
ignature **Please read compliance statement on back of permit** Si re
,9. - . .

' .
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...._ , -_- ,
. . / ._DREDGE 1.RILL N9 80230 ,
' GENERAL PERMIT Previous permit# __.
ir-7:1-: :New -.-.Modification . Complete Reissue C Partial Ro,ssue Date previous permit Issued
As authorised by the State of North Carolina.Department of Environmental Otyaity 6?/71- •/2490 •
4 and the Coastal P.P.,TCeS Corr.missson tn an area of environmental cancer',
I r..sEl Paps arusched.
ptr-s,lart to I SA NCAC
Applicant Name_ Pts-iff‘j(-::_1111:Gt-)- 111/V44 fC Protect Location: County / ---i•ii0-er-----__------
Address ill _If ti..-. (64-„eci,__ Street Address/State Road/Lot
QV _. -)te.F C-ITI-L State/ C--'ZIP 22,,-
----
Authorized Agant . 4' i 1 44'01- /1-‘,/c-- _ - City_ ..._ __
Affected ,..Cw 'Aw ),;!)PTA 'ES 1 YES Phone# ( _,) River Basin VW,c2....___
--,0EA tik4F 'IN USA N/A Adi.Wtr.Body_ 15A-Ivactibtj. __lunkni
Closest Mat.Wtr.Body _ T i,k__ 0e)l-/2_ -12Y5-- _- - (.,
ORW. yes rito PNA yes......t..„...773
Type of Project'Activity
(Scale: hi Tc,..
4
Per,doe..k)tersth ty_IsTiw--- , ,Fixed Pteforrnis) t7 \oil .1/4-----_____ ,
-I
,
• • i 1 1
45
Fosong Podortn0
Ftrqer pots', 6 is i tr ,------
1. .
reisrOey - l'Aftr. c: -. r' I. I trZ y r 4
Po-wheady Pt hgt, 1_ ,f...-."'").-- -•-• 1
ays&van.o .
max distance
. -
&sir,channel_ .,7
1I 1
cutec yards I ''''-i .
BoAt romp -1 . ---
Boat •42:00‘.2;`1. \- 1__-- 14
el
Seidl&Meting F
--
Other ii
' .--'--
t.tlfrc (
: -,-1--- ;-
,_ i 1
snof&Ina i.els* ti 7-____.5 i . I I -If
SAV Dot sure yes ep .
IL,,,,, 11'..11', 1 i 1,1?-.•el ' 1i_o Vkiel.k.
Photos yes e,,,c, . .
_
Wareer Attached: eiz..., ..,„.0 4 1--01:4.1. .. .
A buildqg permit may be required by °X 1)1 -i.;:e t-ty,-, _ See note on back regarding River Basin rules.
(Note 1...,A1 Planning Jurisdiction)
Notes;Special Conditions •
Age"App4' -Pnn1
ter2.Na --"`Offices Printec?Name ' -
pit
gra.- ..Please rea orn . e statement on back of perrrkt*4 St re
ZOD 404' cg ell -1—t 1-2._ —ti— 71
..., .
Apprk anon Fee(%) Check.* Issuing Date Ex pl ration Date
7:"-'7(--trgfialger(t,--14940..W(tketeat‘tr.,X.0

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: DU{�%C�j� . It m nh r?t
MailingAddress: r
� l � ��f,� hr�y ,��
N C `
Phone Number: -S41- LIMO
Email Address: b ni Yi CCrt ( r cc1 )q wr c. C o !y,
I certify that I have authorized G nn i' Ala tie0.4 fl5-1-0CT1 Q 1
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I 'X I li' deck /(D'x 161
/94 4044 L� f )U<:
4tPpator n j - 5 benches on() el etm th1-Aviv9 deck ctrd rrtncv
at my property located at /I I t j n p h r'y A Li 5o r-f <i ,
in Pe i')( -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:
jig ti vt
Signature
D [MC-CM / Fki hre
Print or Type Namb
Li ifl f.1(
Title
Date
This certification is valid through = '

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RECEIVED
AUG 0.,9 2021
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to NM COI) R m h t-. .y 's
(Name of Property Owner) 1
property located at I I I +IZl f1 P 1')re V ,�-il t°
I (Addre s, Lot. loc Road, etc.)
on TO_ (_t, , in ,J Lir CI +i , N.C.
(Waterbody) (Cityrrow i and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to io�
�' I have no objection to this proposal.
�nt
uI have objections to this proposal.
Ot
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site-drawing)
() ( eatie fee 1-1-1-0Cljed )rel (.vtn j .1
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
OntpP
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adlcent Property Owner Information)
->o4,,.,,,,,. fi : ).-4-4,,,,af--- r
si afore --, it- ' /'7''� ��'�' ' A- Dl e,a e
Sit", • e* r
IYICQii k �Zt»1eii 'eV ! A!/0/7`I �r�i� and
Print or Type Name j Print or T p�ewam �e G
111 tinphrec A-ve. iirr tl '.� I �'l��e
Mailing Aad e Ma►t e) ddress
f� , 5 '� s Ne
Git 1StateJZi City/St i
4146
Telephone Number/email address Telepho a ur r/email address
Date
Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L) l i n(an R . Ie'ry 's
(Name of Property Owner)
property located at III -f+u rn P h re y Ail f
(Add s, Lo1 loa Roacj, etc.)
on IL.1_�; in � C -hi
N.C.
(CityiTow�i and/or County)
The.applicant has described to me, as shown below, the development proposed at the above
loc i
111-1 �\t I have no objection to this proposal.
-k0 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)
4) jeQye ,9e„e 1-1-hc1 ecd at wi , .
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
_____ (_,Ls I do wish to waive the 15' setback requirement.
-10}jell
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Prope Owner Information)
� `` /4 i f•
Plea� e
Siature Signature*
Dt-iliCLII) k 1-}z.rrnehre yv 1 LDAu ,� ��>7, JAI //f stun and
Print or Type Name Print or Type me
111 ti phre�. A-ve, 1ZOlrh 141.1 — �`� pl�fe
Mailing A dress j Mailing Address,
��1;r C , N ' x4µ,5 li sA . L_ 709C), tiC -
Ci /State/Zi C' / te/Zip
502-Jill- 4r1q) f - G_33-7,t4S Av4A'y< A 6319dl .cO Telephone Number/email address Telephon Nu et./email address
Date / 7 ZO Z/
Date* f
*Valid for one calendar year after signature" (Revised Aug. 2014)

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