Moore, Alice 79690C

CAMA / DREDGE & FILL re /
/ 9601 A B CC)
D
ENE L PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous p mit issued
As authorized by the State of North Carolina, Department of Environmental Quality��W
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Cd" J s atta d.
Applicant Name Project Location: County
Address n 0 _ �. Street Add�QsV StatelRpad/ Lot #(s) n
City
Phone
Authorized Agent —
Affected ❑ CW
AEC(s): ❑ OEA
PWS:
ORW: Iles no
State ZIP
1 ail
El EW TA ElES ElPTS
H H F ❑ H ❑ UBA ❑ N/A
PNA yes /
cubic yards CV k�i
Boat ramp ------ —
Boathouse/ BoatliR®---'
Beach Bulldozing --
Other
Shoreline Length
SAV: not sure yes n
Moratorium: n/a yes no
Photos: yes
Waiver Attached: yes no
A building permit may be required
( Note Local Planning jurisdiction)
W1ps/ 5pecialAonditiAons
Agent or Applicant Printed NOrm
Signature ISase read compliance statement on ck p
—)
Application Fee(s) Check #
Subdivisi
ZIP
Basir
(Scale: ` % )
t Uf See note on back regarding River Basin rules.
Signature
Issbing ate I t Expi ation 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/ I-888-4RCOAST 252-946-6481
Fax: [phone] 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)
(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://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

Tracy Moore
219 Bayside Dr.

e
/
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i
•Y

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 4 1
Mailing Address:
Phone Number: 2-� 2-" 6 C/ �Z�cj
Email Address:
I certify that I have authorized TD Eure Marine Construction, LLC ,
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at ti// 5 fie. C�
in Carteret County.
1 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:
Signature
A I C.P Gore
Print or Type Name
Title
L-( I—Ll � Z- 1
Date
This certification is valid through Q9 130 I2021_
S7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Al rce Ae rle- s
(Name of Property Owner)
property located at
on Deer Creek North Extension
(Waterbody)
The applicant has described
location.
�. car
dress, Lot, Block, Road, etc.)
, in Cape Carteret, NC
(City/Town and/or County)
, N.C.
to me, as shown below, the development proposed at the above
I have no objection to this proposal.
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)
Maintenace Dredging of < 100 Cubic Yards
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.
� J" 1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
50K
Sigma ure Agnature `
a / -��
Print or Ty e Name Print or Type ame
Ma Address Address Mailing Address'
City/5ta /Zi — / Z Cityiltate/Zip
Telephone Number / email address Telep h
one Number/ email address
%2 Ci� '-( (kf2 G 2-
Date Date
(Revised Aue� 2014)
*Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent toC/ s
(Name of Property Owner)
property located at � .5 i d t � 0
(Addrr ess, Lot, Block, Road, etc.)
on Deer Creek North Extension in Cape Carteret, NC N.C.
(Waterbody) (City/Town and/or County)
The a licant has described to me, as shown below, the development proposed at the above
locaton.
/ 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)
Maintenace Dredging of < 100 Cubic Yards
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 Owner Information)
(Adjacent Proer Information)
Sin naul
Print or Type Nam
Print or pe Name g��
Mailin ddres
Mailing Ad�/ress
Alcl
(CC. �'w- Gi
CitylStatelZip
25 2- — /cl /, - �
City/ tatelZip
�� � 6
Telephone Number/+ e"mail address
Telephone Number / email address
Date
Date*
(Revised Aug. 2014)
"Valid for one calendar year after signature'

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