79216A_Johnson, Guy & Barbara_20210528

e V i 1/
AAMA / DREDGE & FILL N9 79216 B C D
NERAL PERMIT Previous permit #Jrqr pp(
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 71Y
_ ;,Mutes attached.
Appicant Name, .. _'1 _ �[ bra_ SG�� � Project Location: County, _66411Ack,
Address I13 (n; _. n,.t�,_• Street Address/ State Road/ Lot #(s)_LL�
City k State)t_ ZIP';, 1 lQ.,e-A _
Phone # (X-2.) 2 ?f f _ E-Mail 1jlm� �._A'X,,, Subdivision f C US _W,
Authorized Agent WJA City —�r �'�1r _ _ � � Z[P 2"%Zll
Affected LW Oa 6 �ra► c aS OM Phone # ( _ .__) -_ _ _ River Basin
} + OEA C HHF 0 IN R r WA USA
AEC(s). PWS W Adj. Wtr.
ORW. yes & PHA yes & Closest Maj. Wtr. Body
Type of Project( Activity 1�t1 s' 6fX 1-713��0_-^kit rx l (3 `��� i le.� ► , , cx.. 1
Nfc 2 8 x [-I' (Scale: )
Pier (dock) _L� - _ . - _ -
Feted P'latfcsr,n(s) s; 1We h�
-- w
Floating Platforn (s)
Finger pier(5).._^�•.�1 t _ _r
( Groin 4ngth
number
i
! Bulkhead! Riprap length
da+g diStanCe OlfSF10rC • y-��:"�"�.. ..._ �....... � .._ _
that dmtanos offshore
Basin, t Mom— .,...� (,,{�•en► L c `$ sc t ;....`j
OA
cubic yy. r�Y).
Boat rarnp
�_ i
seal' " AA rIe r!/
Odw
1
............
st ne ter%ch 4j
SAV- not wire yes '
Morttwiurn:yes no i jiiC�t 'tq{� o
Photos: yes no 61 4 qr6 tU A - t
;+YaiverAttact+ed. yes - ��.
A building permit may be required by: !t , r r . �f_r r See note on back regarding River Basin rules.
{ Note Local Planning Jurisdiction
Noted Special cwxotions 1 } w a • 1 �:( �a i G- 1
Sf'.Pk,) A'%•. 4s-.....1 .c+i A'- .v-r r r 'OJ 64) A <' i 4t, c._.J
Agent
xf
S gnature '• a rem complt a statement on back of perrra
A p > ,catwn Feels} Check #
�Zkc
PemtitOff�s rimed Name
Signature
Issuing Date ElOrati«, Date

DIVISION OF COASTAL MANAGEMENT R E C E I VE I
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
MAY 2 7 2021
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Project Site: Address, Lot, Block, Road, etc.) /
on CD J7 .J �•clC A- , in GvQe ► 7JC IC , N.C.
(Waterbody)
Agent's Name #:
Agent's phone #:
(City/Town and/or County)
Mailing Address:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
S� -Z v4
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. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
(Protcaner l Vn7ul on}
i
Sig ature
�4--, _�i�,J
Print or Type Name
LA) ,
Mailing Address
City/State2ip
Telephone Number / Email Address
ldj cent Pro erty Owner Information)
r
ignature *
Print or Type Name
Mailing Address
C o a2 ► 7--) /C �J C- Z 47-Z01
City/State2ip
Z-S-z - 23Z - ZZ q1
Telephone Number / Email Address
r
Date
*Valid for one calendar year after signature*
Date*/
Revised Jan. 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to e5or w " o- dfj S0' "
RECEIVED
(Name of Property Owner)
property located at / 3 '�� 'J pAJ S LA
_ (Project Site: Address, Lot, Block, Road, etc.)
on �1,J rcic A in
(Waterbody)
Agent's Name #:
Agent's phone #:
(City/Town and/or County)
Mailing Address:
MAY 2 7 2021
DGM-EC
N.C.
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
s�- -f-. 1A77we: �416
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. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
(Props ner Info a 'on)
Signat e f
PIA) C"OA
Print or Type Name
Mailing Address
r o e lz l -�r,r-x- lac- Z9II Z 15
City/State/Zip n
Telephone Number / Email Address
(Adja enIt Property Owner Information)
Signature*
Print or Type Name
/ — 9A4 A
Mailing Address
C�r� 2►7���c Nc
City/St/att e/Zip • /
Telephone Number / Email Address
Date Date*
*Valid for one calendar year after signature*
Revised Jan. 2017

RECEIVED
MAY 2 1 2021
DCM-EC
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-FLa< PcnA
v
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RECEIVED
MAY 2 7 2021
D -5fCp
16
56A

N �
3i� 1 RECEIVED
SCAZ�.
MAY 2 7 2021
DCM-EC

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SCALD.
✓ED
021
EC
76 AA
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