Gurganus, James 80433C

CAMA / DREDGE & FILL Li
r i
ENERAL
MIT Previous permit #
iE ew Modtfwaxion Complete ReNsue ` Partial Reissue Date previous permit issued
As autho ized by the State of North Carolina, Department +af tsnrnental Qvalky s
and the Coastal Resources Commission its an ar a cif env6rttntttt§tttat concern pursuant to Si i tC A''
l las aEii4
Applicant Name t , r �� � �°� oject Location. County ��
Addre `
` Street Addre ` eR d4w/)-b�n
#(s) City aIC6, .....
Phone €��, ) t. -M r sabtfi�r 'on
Atsti�tsrized Agent. , �• _ �.. �`�. City_ i s� iP"_ t
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Affected + �;6�v `rA Es F'h�ranc� �fi � .. � � ver
ptA HHF tip UGA WA
rAEC(sy Adj. Wtr. Body N� C t at lmarr no—O
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r" Closest Mai. Wtr. Body
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Type of Pr ojecO Activity . '
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A building permit may he requit8d by: : Eye site r�rs huk regarding River Bas4t€ ;sates.
Note Local Planning juresdirtioro p t
oeea;% Special Conditions �.,. W �., � � ,
N
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nxre' t� feid ��tnptatc� statement 7tac�sf perrtE t,t.e
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f Epp sae c pt E : Chock # to rag Date Exptr stsrs Mace

-. "CAMA / ❑ DREDGE & FILL
t3ii 3A
B D
ENERAL PERMIT
Previous ermit#
P
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 15A NCAC
Rules attac d.
Applicant Name RM
P oject Location: County OA
Address
A
Street Addre
tale R ad/ L t #(s)
City S e
r
ZIP
1 A
Phone # ( 1V -M it
Subdiv' 'on
Authorized Agent
City
Affected ❑ CWNEW TA ElES ❑ PTS
Phone # /� iver❑
ianat
91,pnkn)
OEAHHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body
❑ PWS:
ORW: sJ no PNA yes /(0
Closest Maj. Wtr. Body
or Applicant
f %_igna�� ** ease read compliance statement on Vml`�
Fee(s)
Date
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, certifythatthis project is consistentwith 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 howto 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
- --11
Name of Property Owner Requesting Permit; 6-11(.,j �Glj
Mailing Address:cl
Phone Number: r�+ �~ f 1l'_�
Email Address: C:'''_Gai, (--e✓�'`�
I certify that I have authorized C3 Scott, Inc
Agent i Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessaryfor the following proposed development: zo/�vG- d fF4}!��
'izr �'Cl jtl !{'0 'TLC, w� / / V .. bo c ''c r
at my property located at _� c !� J�f(1L�'/ %/ (* ,1� A � 1 1/4lj ,
in o ,4d T LA 17 ( County.
i furthermore certify that 1 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.
I�
lam'
Property Owner Informatioq:
tf
Signature
Print or Type Name
Title
/
Date
This certification is valid through /{ 1I ?) 1 t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that E own property adjacent to F /t'i 1' 5 �- lea �(� s
r _,
property located at �a �U�(,f/ fi/jl �G1;ry PA
(Name of Property Owner)
r r (Address, Lot, Block, Road, etc.)
on L:t;•Rf in 6G•VJk- , N.C.
(Waterbody) (City/Town and/or County)
Initial The applicant has described to me, as shown below, the development proposed at the above
Here on loc tion.
one of I have no objection to this proposal.
these I have objections to this proposal.
lines
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
Initial me. (If you wish to waive the setback, you must initial the appropriate blank below.)
Here on I do wish to waive the 15' setback requirement.
one of /
these/ i do not wish to waive the 15' setback requirement.
lines
(Property O er n rmation)
.�
Pfrlr,,a�J/Jor Type, Name ('
l pifinq Address i t L:�L f �./
City/S a e2ip „_ `
'7 _
Telephone Number / email address
Date
`Valid for one calendar year after signature`
(Adjacent Property
//Owner
Information)
qnatiire
���1f�v(f���--
PriiPrii,�.n nt Na
h c
fling Address `
Ci.Ata �e r�
�iic
,L.(.�-i�'S /
Telep_ hone Number/ email address
Date-,-"
(Revised Aug. 2014)

I hereby certify that I own property adjacent to J,4eo C- � �(��� �'�,�. � is
7, 1� 6 l ot� (Name fo Property Owner)
property located at /'�[{/o- l�r (i- !l�
(Address, Lot, Block, Road, etc.)
-
on c O` I - � , in )SaG q N.G.
(Waterb©dy) (City/Town and/or County)
Initial The applicant has described to me, as shown below, the development proposed at the above
Here on Iocati n.
one of I have no objection to this proposal.
these I have objections to this proposal.
lines
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 15from my area of riparian access unless waived by
Initial me. (If you wish to waive the setback, you must initial the appropriate blank below.)
Here on I do wish to waive the 15` setback requirement.
one of
these I do not wish to waive the 15' setback requirement.
lines
(Property Owne 1 formation) (Adjacent Property Owner Information)
C •
2na.lxre
Print or Ty e Name q _ R r n P Print or Type Name
t rk 6.1____
ailing Addres � r71 M ' ' g Addre _.
city. Stt3te/Z- city/state/Zlp ) 1
Telephone Number. /email address Telephone Nu ber/ ail address
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

t

irawing rrepareu Pay.flu
)ate-. 5,17/2021
3cale: 1": 30'
I - v v ^ 1,1 V jJIC4MJ; I II QL - I - k)tZ;IUVV tVAIZILII ly
dock and add a 3'-0" x 9'-0" kayak launch platform
-24" below existing dock. Total New Square footage
added 52sqft to existing 320 sqft dock for total of
372 sqft of platform
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