Giallo, John 79635C

AMA / ' FILL
N.r� A BrpENERAL PERMIT e
L
Previous permit # __.____.
New ] Modification :_.:Complete Reissue a xial Reissue Gate previous permit issued
As authorized -by the State of North Carolina, [Department of Environmental Quality a
and the Coastal Resources Commission in an area of environmental concern pursuant to ! SA NCAC
a � in
Applicant Name_ Project Location: County
t_ __..._. _ _..__ _.
Address _ Street Address/ State Read/ Lot (s)
City_ ..._._ � ; State .. }....... ZIP��
Phone # ..._ -Nia _._;..._.....-..,..-_.___.-. Subdivision
Authorized Agent __.._ .. ._.. -- - ----- city.__
,a
} Cw w PT PTS Phone # :.tad ..... _ ._..i" fiver B in
Affected _
� — - trsa �_ t�ta
cog
AEC�sj; _,HF4F tH Adj. Wtr. Body_ -------__-- -.-- (nat/nianjun rt)
i _ PwS:
R : yes l 1 PN yes (r n '
Closest Maj. lAttr. Body
--- --
�^
Pier (doer) length'--
-V
Fixed Platform(s) ..............
Floating PkrtEarm(s)... j._
Finger
DOC
pieris',�-..
Groin lengtia
numbers--
Bulkhead/ Ripr-ap length
avg distance offshore...-_
max ClisGiiace offshore ---^'.
Basin, channel
-
cubic yards
Boat ramp ._..- .:.'a_._
Beach Bulldozing...
Other -b-� 3_ r ......
Shoreline Length ��
SAS: not sure
Morawriui nta yes o V r .
Photos: yes
Waiver Attached: ,yes
A build
ing permit may 6e squired by:
( Note Local Planning jurisdiction r
Notes/ Special Conditions
Agin or Applicant Frinted Name I
Signature "Pleaseread compliances tar ~rie tonbac f
Application Fee(s) Check #
.47
r ... s
See note on hack rei~ riling River Basin rules.
Expiration bate

AMA / ❑ DREDGE & FILL 9 79635 A B D
ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Part;al Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ")41 � )AIQ
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
JLRILLes a ched.
Applicant Name 1 Project Location: County— �'AAT"-'t
Address Street Address/ State Road/ Lot (s)
City State ZIP
Phone # _Ma Subdivision
Authorized Agent City jj ZIP c
n w Cw NEId PTA n ES [IPTS Phone # � L /River Bain
Shoreline Length �� 1 i
i
SAV: not sure yes rno
� i-- - - - - - - - - - - -- -- - - -
i
Moratorium: n/a yes __ _._
�_i...._.. _. _.. a. ... -
Photos: yes — -
Waiver Attached: yes - - -- - '
1_
A building permit may be required by:MO
❑See note on back reg rding River Basin rules.
( Note Lope Planning jurisdiction)-.,f &k1 n ^ 1 PUA
n %) VNotes/ S ecial Conditions ,`.�'-��-yl'"/�_ �/ �/�1.�
T
r Applicant Printed Nt�me / PermitVtficer's rint d ame
Signature ** Pl�se read compliance stateme t on bac f e t Sijzriat r
rNICIA-)N 0', Q a
pplication Fee(s) Check # Issui g ate Expiration Date
A

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
❑ Neuse River Basin Buffer Rules
❑ Other:
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 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/ 1-888-4RCOAST 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

N
.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
-3-10-21
Date
Name of Property Owner Applying for Permit:
Mailing Address:
� 1 Z" ► I-4 o L ia
I certify that I have authorized (agent) CtZAaVON (,A¢On-�1 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) T k-"a' D°G1� /a`r�>- 1"FS' -'
-
at (my property located at) I2t'ti'`'1
4—JD -Z)
This certification is valid thru (date)
Property Owner Signature Date

o.

HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR A PIER/.1VlOORING PILINGSIBOATLIFTIBOATFIOUSE)
I hereby certify that I own property adjacent to 00" + � �� R�R s
(Name of Property Owner)
property located at C— 17-c% `-1 L�1� t �a G� % 1L NL
(Lot, Block, Road, etc.)
on T5o l-vlb _,in CIaR)-C-1 N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: okVot 603-19715Ma►ling Address: 5129 11., Lt,.c,
r%CTt: G i �
He has described to me, as shown below, the development he is proposing at that location, and, 1
have no objections to his proposal. I understand that a pier/mooring pilings / boailift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
I do wish to waive that setback requirement.
- -----------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DENTLOPMENT:
(To be filled in by individual proposing; development)
v3or-<3 i> -ocv- r, I, % � 1 Cif
SG-�C, S1LG�s�)
(Information for Property Owner Applying
for Permit)
5Q^ L, VV%-xv
Mailing Address
f�& vol>,,ia C -i , "C-1z 12
City/State/Zip Z52- 2.90 —94Z4
Telephone Number
C G D f rS, t.-+G.
(Riparian Property 0«ner Information)
Signature
Print or Type Name
Ctzw -v-1 GO#o-M 2-5-.2 -2 ? � r,-
Telephone Number
- >-10"Z)
1112
Signature Date Date

HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR A PIERIMOORING PILINGSIBOAT,LI,FTIBOATHOUSE)
I hereby certify that I own property adjacent to i DFAJ 4, :�o
(Name of Property Owner)
property located at �;l29
tn�1;— YWoRle-4 G %I", , PC
(Lo't, Block, Road, etc.)
on o l�u ��at� , in CrA fz-i 5� N.C.
(Waterbody) (Town and/or County)
Applicant's phone 19-1 Mailing Address: Q I &v
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boallift / boathouse
must be setback a miniinum distance of fifteen feet (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 not wish to waive
I do wish to waive that setback requirement.
- -------- ------------- ------------------------ ----------- -------------------------------------------------------------
DESCRIPTION AND/ DRAWING OF PROPOST�.D llFVEI OP1bI) ivT:
(To be filled in by individual propovina development)
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Lip
ZS , *LLi 0 --94S
Telephone' Number
(Riparian Property Owner Information)
Signature
GGn�I�' i--'L, Print or Type Name
ccwc*l c- �-m a S - 77,, -
Telephone Number
Signature Date Date

COMMON WOOD BULKHEAD
10 .02
S 85044'24" S.M.N. IN
MARSH WETLANDS BULKHEAD
1 NORMAL HIG 1.3
0.9 WAT0.6
RSH R LINE 10. M RSH
Ai M+-0.4
].0 TER LINE
MARSH A
RIP ER / N LINES PER
(SHED PIER HE D--�
+-1.7
+-1.7
V JOE AND MARY GIALLO
O 5129 HOLLY LANE
MOREHEAD CITY, NC
O Ctnn
PAYTON JACKSON ny o ANNE EASTMAN
5131 HOLLY LANE C7 5127 HOLLY LANE
MOREHEAD CITY, NC 0 y MOREHEAD CITY, NC
r d SAU
V +-1.8
b
+ Z.
SA V
A V EXISTING A
PLATFORM
SAV N
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Bogue No .6
S "5AV + -1.6
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END
RECEIVED
MAR 0 4 2 ZI
DCM_MHD CITY

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