Higgins, Thomas 78376C

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/ 0DREDC39 A RILL Nn 78376 A I fC J D
ENERAL PERMIT
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0 CAMA / ElDREDGE & FILL N9 78376 A B D D
ENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality op -
and the Coastal Resour s Commission in an area of en ironmental concern pursuant to 15A NCAC
� ❑ ules 7tted.
Applicant Name Project Location: County_
r--
Address r ^ Street Address/ State ad/ Lot #(s)
City I State ZIP ✓J I
Phone # E-Mail n Subdivi�on� 4` n
Authorized Agent
CW
El4
" W
4 '
El ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH
❑ UBA ❑ N/A
❑ P S:
ORW: yes /
PNA
yes
Type of Project/ Activity
1 n In, c. I n_. A
Pier (dock) length 't —
Fixed Platform(s) W
i
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore '
max distance offshore
Basin, channel
cubic yards �--�
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other (WA AM /)
Shoreline Length
SAV: not sJyes
--
Moratorium: Photos: Waiver Attached: —
A building permit may be required by:
( Note Local Planning jurisdiction)
Notek/ Special Conditions
or Aotilicant Printdd Name
Sig�atur� 001ease read compliance statement
'A�p/�p�lica�t=ion Fee(s)
City?
Phone #� i
Adj. Wtr. Bod
Closest Maj. Wtr. Body
ZIP
/, at
(Scale: )
El See note on back
1regarding
/River Basin rules.
I
ration 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, certifythat this project is consistent with the North CarolinaCoastal 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 - (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

rNT AUTHORIZATION FOR CAMA PERMIT APPLICATION
if Property Owner Requesting Permit /itowtas,dlllaclAcg, k
Ailing Address: SZ 2 3 f loh Cowry- AoreA"W 6141116.
.
Phone Number: ZID -Ss34
r Email Address: <;J..O.0 i0 . cowl
I certify that I have authorized kkkC cJa�u- h(a..AML 60A$f- ZNCI
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits Qcoh"e— f0'"
pol,tcs
necessary for the following proposed development: Rc(ou; b2rKt NCO fjoav+:5
v 140, Ai4;., Jk54 Akin
R�,ob�;N, 6 yzs' fl�f;,v► Axle
at my property located at . 52 Z 3
T ,
in County.
1 furthermore certify that l 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 evaluab'ng information .related to this
permit application.
Property Owner Information:
Q 4w,".6
Signatu
i �Meo to #;' j9 Ns
Print or Type Name
Tdie
Iz 1 9 1 Zo-to
Date
This certification is valid through 11 11 l 202I

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CERTIFIED MAIL • RETURN RECEIPT REOUESTE
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner !
Address of Property:
(Lot or Street #, Street or Road, C & Courtly)
Agents Name # Mailing Address
Agents phone t
now
The individual
I he certify that I own property adjacent to the above referenced ProPee development
for this Pe has described to me as shown on the attached thi
applying ti or draw__ w' dimen ' ns u be
they are proposing A descri
I have objo�o� to this proP�'•
pos
I have no objections to this proal. — yreDlvlslon olCoestal "O'�
u must nobly n for DCN offices Is
have jections to what 1s being p� tp° this notice. Contact infonnalton for DQ COAST.
Ifyou within 10 days of ►eceiP ey/cm/staff 1lstrn orby ed MaU•
Rccnastalmana em n' have been notfied b CerfM
Rom, --
WAIVER SECTION boathouse, or lift must
twa waived by
flings, twat ramp, breakwater,unless me'
I understand that a pie,, �' MOOn' P area nan access
a minrrnum dance of 15' from my of rips blank below.)
be set back ou wishto " the setback, You mus__-!"�Il the aPProPnate
Y uirement.
I do wish to waive the 16 setback
nt
I do not wish to �� the 15' selbadk �u�
�_., o.Y,ne& Owner Inform
o atlon
rry si vQ/�,
print or Type Name
P TyAApe Name
' ��e Mailing Address
M ping Address C U� 0 �' J %�/+tNA�✓ /t C
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tmad ramp, aou� y�rved by
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RECEIVED
JAN 2 8 2021
DCM-MHD CITY

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