83108_Doug Blackman & Laurie Koehler_20210831

,ILLS
�`C MIViIA/ ❑�D:REDGE & FILL �g® -�;
- GENERAL PERMIT -1—L W c17° Prev iou83108 i,� (
B.
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®New ❑Modification • ❑Complete Reissue El Partial Reissue • Date previous permit issued ,.,.-•J.'/-
At authorized by the State of North Carolina,'Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r i'/ . () •
r- / ElRules attached.
Applicant Name / c.v. i k,t-r,;.�a,,. , ,,r,t /'e•/ (, /J Project Location: County ;cr,, c=,- f
f,, , .
- Address A:: ;.2 i/r. 1,f A' p e. i L. Street Address/State Road/Lot#(s) '"f. //
City .✓ e. i62 i,c H Statefl/e- ZIP r:-�7,?1(,) c. Amac:=- c
,.:/) y^'
Phone#(25 c,f t>S:3 -•-------" "`.�'"`ti"'
G E-Mail " --_
Subdivision -1/r'-//''
Authorized Agent ,fir..•` -fe t/ L,/«;/, e,., City 13,<74--,-r r, ZIP r,,'-rr-`';�;fc%ii
❑CW LIE 1 ]PTA ❑ES ❑PTS Phone# ( --K)`j^ ,:'-• River Basin / r s4,�'2 ,
Affected ❑OEA ❑HHF ❑IH DIUBA ❑N/A f""
AEC(s): Adj.Wtr. Body .1 c-: :1;- 6 ( ce c- (nat,/man /unkn)
❑ PWS: --.' 1/
Closest Maj.Wtr. Body -) f f4' '`r'
"no ORW: yes / PNA yes /(now,, .
•
r t 1 / f /
Type of Project/Activity /s :: f< ',/g ‘.f r f� /Z ;1;i:', <; h 0, �f/-> / .�a� ), f,'w , izev- i n a €�
;4, , 1,,'/ /j -- - . . F w :(2 ,.,, <'k:r //,f .,�'-'< (Scale: i r ' 71 )
y, r
Pier(doc()length ! I
( l I i
Fixed Platform(s) __> ■II�■■■■■■ ! , i ■ ■,-. s: i, t . ■■■■
Floating Platform(s) -� ■ ■■■1M ■� j I',-i, ,• , ■■■■■ ; ' ■
Finger pier(s) _ I ■■■r l,`�■■■I■I ' i' f ■■■■ !
Groin length I ( __1..._�._Iii r...::._HhlUiI - . li i
~•y (- .
Bulkhead/Riprap length .--- II I —
11111111
I 1IlliliF'
I. ( i
max distance offshore 1 i I iHhlill
Basin,channel -^.-- IIIHIIHIHIHIHIIII f I 111.1111111111=1
cubic yards. - , ■ ■ ■4 { _ ■■ „iv E , —, ■ 1,,,,,1„...„Boat ramp I i I 1 ! ,�f �.C,I I :,t ,7j l
1 ,,,,„
Boathouse/Boatlift - ./� r/, ia_i(1�n�it,� ■■ -{�fi
,,
„11 II
Beach Bulldozing -. .,._ = �-- ,- Wit= I_
Other --- 11. /1 rr,J°Uhhhl I 1ihhlhhhlhlIlhhhl
d ! I,.._ � I I
- i I e.} ME ill
• !1
Shoreline Length r )) °� ; • 1 lIli° I •i K
SAV: not sure yes (o1., ■ ■ l l-II - - -- --— —1—
.
-;-5-- ___ J EMIL • . I '
.,..t_L/ TH, ......._.-.1 _la
Moratorium: n/a yes Ia._ ; ■ _ I • ' pp��■�77 _ i
Photos: yes ,no f ■__ !It _ , ■ _—. _ _ '
Waiver Attached: o _ 'yes n ,�
A building,permit may be required by: i`.'�r. 4G%:fC--- -`' (,--.1 . t'l See note,on back regarding River Basin rules.
(Note Local Planning Jurisdiction) .
Notes/Special Conditions _re e ' .//1 r''. c' '
E1114,,.f1 iC, �^.-- /lif/f,'.ba: Jr•',I,1G'f %, , , Jr'1 ,',1/,-,,-,. • t_,/.',,,, �-+
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A fti f I' 'i f L,.` -.^'if-I. i ..�-' G,er a-? e .7 ,JT 74-;,2l�-,,
Agent or Applicant Printed�Name Permit Officer's Printed Name �1.
Signature **Please read compliance statement on back ofof permits *se Signature �"-
yy f F/
Application Fee(s) Check# Issuing Dale ' 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 n 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(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
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 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)
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http://portal.ncdenr.org/web/cm/dcm-home

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111•CAMA/ 1=1 CiftEDGE & FILle
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,---71- A- 170 ' Na 83108 - .A. 031..):, c :-D --,-,,
GENERAL PERMIT . Previous permit#
>"----=-,--n Kew OModification OComplete Reissue 0 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 5A NCAC L',.: /I /•-;'0(..,4
i. , BRules attached.
. ) - ,..-
r 1 I I..• / .
Applicant Name /._, ,I i, - , , :, . 4 /''. i , .1 62.,' 1 ' s' Project Location: County ,--",` ,.--,-, /
•.,:-' '
Address .,•i, /2 // .(. . /-,, , f• , t Vs•-, Street Address/State Road/Lot#(s) "'-,/ ..2 i.1
) ,
City ./. •4 i' • , :.•. State ,//16.' ZIP - --:' ;-:-/(.-• (-)Q3 7- • A
. , . . .
Phone#( .)-:•",;.) ', ' %. ,/.. „ Subdivision ,-/
Authorized Agent // -•-'f e ' /,/ ,- i • , City ., - // . ,-.• ZIP
• „...,
0 CW EFEW ' El lliTA I1J ES El PTS Phone# ( ') • p River Basin / ,-- / /. , -
Affected
0 0EA 0 HHF 0 IH 0 UBA O N/A , ..' -----
AEC(s): . Adj.Wtr. Body / . ,: //- ./, i'(nat /man /unkn)
ID PWS: .., . / ------.., ..•
..-
Closest Maj.Wtr. Body ,,, , : „• , ,
ORW: yes /-no -, PNA yes heco
,,-,-
,• ,,,ri '
,. ii f, ,./ / ii: fit,/ , . . ./ „/ y
Type of Project/Activity / '• , - . : ,i
..,
, . t//
..—
., .,,---....=4;.,- „..3.0 ,. , --- (Scale: / .)(, )
..,
Pier(dock)length --
I 1111 111101•1•••• • 111•11.1101.11 MI
Fixed Platform(s)
MI 11111•11111 , : :- '11=11111111•1=1111111.1 ' ' 11111
Floating Plitiorm(s) I 11•1 .
, ' I I S I•• I 1
Finger pier(s) , .
- ; -MEM=i i iiiiimMIIIIIiii iiMMEI _I
! rt '--:7 -- 1
Groin length
.1 . _ ,, 1 I _ ___ 111111 . I , I Eli _ _LP I
number ' 1
I .f , 1 i
. ._ .
Bulkhead/Riprap length _
111- -- "--I I ---1-— '1 t',,1 as
avg distance offshore - -111 11.10•11 1 1,-..;....-:__ ..17:;_---,11 1 I . 1111111111••• •
max distance offshore • NEM 1 i 11•1111101•1•11111•111110111111•11 •,
Basin ,channel IN 111111111111 ' 11=1111111111 us as : , a
II ! Ell MI . mil INIE111111111
.
SE 1111111111 1 M11111111111111 III ,
cubic yards .
-4 INIMM•11•111111 =11•1 .
Boat ramp asI - : -
.1 1 -4- ' ._ 1 i
Boathouse/Boatlift ..,' • _ ' - FEIJ_ _ . _
• •
- _ i ., , II
i
,. .1 L ,-, I I , ,, 4.
I ,,, I I 11111 '' -' II-. " . ' .-.• .111111.-':' '' -C . I.- '
Beach Bulldozing -- ,
.---- I --;., •••1•1111•1111111MINOM 1111 -.1- • ' - MI - I
Other ---- - . I 55/; ' '..' i 1 t -. . r:1111111111111111 1111111111111
011
1111111111•= , 1111111111111111
11$111111111111111111111111111=1111111111111111111 I RR
NO 111111111111 -i.- -:.., --::-. r Mal 1 1 • MI
Shoreline Length ;J.,:.'"/ ' 11•1 ;•I•1•••••lIl••••I••••••• as
SAV: not sure yes no - _I ' l'" I' — --—-- --'
, _ • - •
1 --- i .
1 -. , "...",-
Moratorium: n/a yes /no •-: , I 1 MN 1 1 M ---- -r--1 I - ____
Photos: yes ,no . I._ __Oil L.''' i,'.. i
.• •
t_ ''‘i it I ' I ' - ' -
Waiver Attached: yes no -
- .
A building permit may be required by: . I t.,I See note on back regarding River Basin rules. .
(Note Local Planning Jurisdiction)
Notes/Special Conditions , — - ' ' / ..'(.'63'
L 17/ i i
'I r • • ' i r.,./.-. r 1; _,-,....• ,- i . • , ,'• r• // 1.. .I .
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• - . / . . . •
....-, ..--
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- ,
Agent or Applicant Printed Name ' PermitOfficer's Printed Name . . .
- .. _,..._._....,—.... _
,- . - . '
.._
_.. ...,-
' -...,.,
Signature "Please read compliance statement on back of permit I* Signature
. t
_ .. ,,- ,
/ ..--),. ‘..-i<,...._._ / , . ,
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.._
. . - -, - i /..
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..: / - /
,..• • -
Application Fee(s) • • .
• Chetk# •' - Issuing Date .- ' • ' . Expiration Date •
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• , . .., .. . . . . - " • .

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 I Other:
Neuse River Basin Buffer Rules 0
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 0-796-7215)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,Bertie,Hertford,Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 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
D....:....J 7I lG/1 7

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w. F. Warren & Sons, Ina
ISO Taylor Farm Road,Belhaven NC 27810
Offtce-(252)9644628 Fax[phone]
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Forrest cell(252)945.2492 Freddy cell(252)9=15.42-10•
• NC General Contractor License#72600
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v:R.itc iet s:csr;n
Authorized agent Consent Agreement
To:State of North Carolina Department or Local Government Department •
- flout ishorirthis permit is being applied for. •
I,the undersigned property owner,do hereby authorize B.F.Warren Si Sons INC.to act on my behalf in
obtnin,no the necest permit's for the below listed projects.I have contracted there services to perform
the wort:permitted.This aereement'is limited only to the specific activity of obtaining permits for the
below specified projects.
• Projects:
• Boathouse,bostlift,bulkhead repairimaintainence
Project location`address,:-
812 Hubs Rec Rd
Belhaven,NC 278I0
•
Body of Water:
Pungo Creek
Property Owner Mailing Addreas:
Doug Blechman
812 Hubs RecRd
Belhaven,NC 27810 • •
[phone]• •
.
Property Owner Signature: Date: ilZG/Za z{
Authorized Anent Signature: • Date:gf bd___

• - N.C.DIVISION OF COASTAL-MANAGEMENT • '
•ADJACENTRIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM ..
• CERTIFIED MAIL•RETURN RECEIPT REQUESTED or HAND DELIVERY •
•
(op portion tto��'Se co upieted by owner or thou'agent)•
1V bi:a Property Omer,Po•s *Ohl..
Ohl r�v't q v1 .d' LQ / Ao e f+
Akkfress of.Properb/: 2/7 lh,.4L .. A�l t.�,. M Z7g16
mating Afciress of Ovtrr t:p!Z Aka ham. s.•A •A ha 'car,• 16. Z700'
Owner's ere ad p_Ps s b� snr�7�gi`'Or0e met s°Pt ai k ?Sz•-f Yff-Gs:SG
Agent's Name. 13 F Ltlaert.i J Saks Agent Phone ZSZ-fy Z4192
ngenl s E�narc:Farr r5i . a i e.�o:er's, a oryt
. ADJACENT RWARIAH PROPERTY OWNER'S CERTIFICATION .
- ' (Bottom Portion to be eornpteted by the Airracestrt Property Owner) .
I hereby certify that I own.property adjacent to the above referenced property.The tndrviduol applying for this
permit ti4s described to me,es shown on the ntlethed drawing,the development they am proposing R
desrrption or drawing with di me lions.must be provided with this letter.:
i/ . i DO NOT have obiections to Iles proposal. .I DO have oblations-to efts proposal
if you have,objections to what is being proposeck you must notify the N.C. Division of Coastal
• Menrigenrerrt( )in writing within 10 days of re-crrpt of this notice. Correspondence shoald be
meiled'to 943 Washington Square MatI Washingtofi,NC 2788911C!!i representatives can also be
contacted at(252)916-6481.No response is considered the sarrie,ez no objection if you have been
notified by Certified Mail, ,
WAIVER SECTION
.. . . I understand that any proposed'pier,dock.mooring c:Imgs.boat ramp;bieatavaler,boaUidese,hit,or
grom must be set brsrlra muianum distance of 15"from m y area of riparian access unless waived by me '
(this does not apply to bt*heads or rpiap revetments) (ll you trash to verve the setback,you m st sign:.
Ole aParopnate blank below.)
1 DO wish to waive sortie/all of the 15' etback •
pgrialrue of Adjacent lbpartan.ROOMY Owner
OR.
•
I do not Wish to waive the 15'setback requirement(irritral the •blank) ,/� . • - -- .
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• Signature of Adjacent Reparian PropcslyOwner\_��•:' ;->/ �I ' L
i : . .
Typed/Printed name of ARPO: • /"fe / • cf l���t
�/
•Mailing Address or ARPO: JD?. 'gad•i •kt: tif)Miai� //.( c 7y6 3
t .
ARPO's� i�v/�r'/.fci _i nfARPo':. 2f2 -Jai 7i'e 7
A
. _Date: %k�/ "waiver is Vefid for-up to"one year from ABPO's Signature'
Revised July 2021

I15,-4li boo f 1,-,6u 5 {
ciao/ h *w bo4f l,'fL
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Pay{ OIJ
bo41- 1;cl 4-0 1l Y'4
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if ' ek%sh�,5 bu�� Arcj

N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
,CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY,
(Top portion to be completed by owner or their agent)'/
Name of Property Owner /70 �✓14c It rrt 4•n # La r r,' c !r O e A
I r
Address of Property_ Co
Mailing Address of Owner. It/2 f/tw 45 tee LI AdeActiArpt, 4G Z7910
Owner's email:por.4e 6/I!4046.,.72 619 Owner s Ph neat: 25 Z- ggef-4 s-54'
Agents Name:,6 F tikrtcri 41.- Sons Agent Phone#: 252 - y`e/S- Zf-f` 2.
Agent's Email:-ear,est 0 4 C pa lees. C it
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
, .(Bottom portion to be completed by the Adjacent Property Owner)
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 drawing, the development they are proposing.6
description or drawing,with dimensions,must be provided with this letter.,
X ,l DO NOT have objections to this proposal. I DO have objections to this proposal.
lf you have objections to what is being proposed, you must notify the MC. Division of Coastal
Management(DCM)in writing within 10 days of receipt of this notice. Correspondence should be
malted to 943 Washington square Mall, Washington, NC 27889. DCM representatives can also be
Contacted at(252)9464481.No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed pier,dock,mooring pilings,boat ramp,breakwater,boathouse,lift,or
groin must be set back a minimum distance of 16 from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments).(If you wish to waive the setback,you rrittst sign
the appropriate blank below.)
I DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Properly Owner
-OR-
I do riot wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner pf p u.r u. IakA 1 ex,
name01
ProperAi'cs LL C. . • ..
pulling Address of ARPO: /2 oo n .-i ..i'e..t er. ,Dr, , iaplll All Alt. 2.7.
.7.S/7
Afro,*email: //yai/a i2 )9 ./.c`om ARPO's Phone#: 9'/ 9 -FT() -?j/
Data: 12 Z/2 I _ 'waiver Is valid for up to one year from ARPO's Signature*
// / Revised duly 2021

•
ROY COOPER.
•.a'• Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL.QUALITY
Director
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.
a Pre-project site conditions: /'"/ 'prri,I,) /t,�A,
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
that all information provided is complete and accurate.
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1--p s re L-Da rr`e✓1
Agent or Applicant Printed Name rmit Officer's Signat
•
Age Applicant Signature ��.7J/
Isute
CAMA GENERAL PERMIT#: 2- tZ
State of North Carolina I Environmental Quality I Coastal Management
Washington Office 1943 Washington Square Mall Washington,NC 27889 1252-946-6481
• Wilmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-38451 910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808