Hill, Jeff 79689C

CAMA /iL
REDGE & FILL 9 79689 A B 0 D
ENE PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality txE:7�
and the Coastal Resou , es Co mission in n area o environmental concern pursuant to 15A NCAC `
Applicant N e , Project Location: County
Addre cam/ Street Addres at Road/ Lot #�(s)
City tat ZIP
Phone # -Mail �"'� Subdivisjon
Authorized Agent ityJ ZIP
T Phone # River Basin col
Affected ❑ CW W [ETA ❑ ES ❑ P S
A f Affected
❑ OEA ❑ HHF ❑ I`H ❑ UBA ❑ N/A
PWS:
ORW: 9
no PNA yes /
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s) ..�-
Floating Platform(s)
Finger pier(s)
Groin length -
number �—
Bulkhead/ Riprap length
avg distance offshore_ i
max distance offshore
Basin, channel NY + l�
cubic yards
Boat ramp
Boathouse/ Boa i tom"`
�o — --
Beach Bulldozin'
Other
Shoreline Length /
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Note;/ Special Conditions .��il�(
or
Adj. Wtr. Body__ , p
Closest Maj. Wtr. Body
nat
(Scale: f r�/ )
❑ See note on back regarding River Basin rules.
At,re ease read compliance statement on bac f pe it Signature
2D777t
ation Feels) C eck # 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 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, 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 ❑ Other:
❑ 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.
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 - (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico Tyrrell and Washington Counties)
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)
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

Jeff Hill
207 Bayside Dr.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: `��rC�� �- l'✓�L
Mailing Address: -20 Z e f%i e—=-
Phone Number: .2 S2-7 �/
Email Address: /�l���07"' !/f�
I certify that I have authorized TD Eure Marine Construction, LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: /�,P�ralil/c� /z%
at my property located at . 2eD7Z i -'71:r
in Carteret County.
I furthermore certify that / 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:
Signature
Print or Type Name
Title
Z l.2<f52—
Date
This certification is valid through 09 / 30 / 2021

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �c-�—\ � \\ I
(Name of Property Owner)
property located at zo 0�ay 5, � C)n
(Address, Lot Block, Road, etc.)
f�
on , _ GCc Crye L, - in �Iayw N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to n.
I have no objection to this proposal.
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)
Or'C4'11-lb ' k) S?U' p
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.
I do not wish to waive the 15' setback requirement.
(Property er Information , (Adj ItProp rty ner Information)
Sig ure Sign u *
P int or Type Name Print or Type Name,
6 ���� ��� !�'•� , 2.cs 0` (a, ay S ilk �✓`
Mailing Address Mai ' g Address
City/Sf te/Zip City/State/Zip
NI
Telephone Num er/email address Telephone Number /ema l a dress
Date Date
(Revised Aug. 2014)
*Valid for one calendar year after signature`

t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _ �/ f�4 L I
(Name of Property Owner)
property located at��%���i S'/�� �� ..
(Address, Lot, Block, Road, etc.)
on inN.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc
X I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
�i �4 fib j �/U�ti�C /✓'��/.�6-Ii�,J� l,/1� ,�� % � I /�
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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Ow er Informatio )
Si ur
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Print or Type Name
Mailing Address
rty/State/Zip /
Telephone Number/email address
Date
(Adjacent Pr perry Ow formation)
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Signature*
Print or Type Name
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Mailing Address
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City/StatelZi I
Telephone Number / email address
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Date
(Revised Aug. 2014)
*Valid for one calendar year after signature'

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 4, \� I
(Name of Property Owner)
property located at 2-0-1'�jo�S� �- �!�
(Address, Lot Block, Road, etc.)
on (�)C�"` (�rQ,zV� , in �afl� �r�-� � , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to n.
I have no objection to this proposal.
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)
J�n
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.
I do not wish to waive the 15' setback requirement.
(Property er Information (Adj t Prop, rty ner Information)
Si ure sign
P int or Type Name Print or Type Name,
Mailing Address Mai g Address
CityvSkItelzip City/State2ip .
N1'I�d i'� ''cow
Telephone Number /email address Telephone Number/ ema 1 address
/4/-7 � S-, 2-z�> 21 In 4T261
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 tos
(Name of Property Owner)
property located ate_ �%���i SY/�� �� L
(Address, Lot, Block, Road, etc.)
on 4�`.L C�/� inC"r5 N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc
>C I have no objection to this proposal.
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)
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.
I do not wish to waive the 15' setback requirement.
(Property Ow er Informatio) (Adjacent Pr perry Ow •Information)
X {
Si ur Signature
Print or Type Name Print or Type Name
0: /: - <1-121- 12 Ems. 22 15/fir 12, .
Mailing Address Mailing Address �f
CilC�ii�
rty/State/Zrp City/State2j
G52 %x i`�-,� 7C���
Telephone Number / email address Telephone Number / email address
Date Date
(Revised Aug. 2014)
`Valid for one calendar year after signature`

Von.
is J.,