Loynes, Maribeth 79644C

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A / ❑DREDGE & FILL N9 79644 A B C D
ERAL PERMIT Previous permit#
w❑Complete Reissue ❑Partial Reissue Date previous permit iss eAs auththe State of Norch Carolina, Department of Environmental Quality Q
and the Coastal Resources Commission 'n n area f environmental concern pursuant to I SA NCAC
t R es attache .
Applicant Namzb— P InProject Location: County n
Address I/YT � Street Address/ Stigte Roadj l,ot #(V)
City
Phone 0 E-h
Authorized Agent
Affected Li CW W TA
AEC(s): ❑ OEA ❑ HHF f1H
❑P
ORW: yes / o PNA yes /
Type of Project/ Activity
Pier (dock) length —'
Fixed Platform(s),_�
Floating Platform(s)
Finger piers)
Groin length ---------
number
Bulkhead/ %prap length
avg distance offshore
max distance offshore—,
Basin, channel
State ZIP
cubic yar�� =
Boat ramp IF
Boathouse/ Boatlift
Beach
Shoreline Length ,
SAV: not sure yes Un�
Moratorium: n/a yes Photos: es
Waiver Attached: ye no
A building permit may be required by:
( Note Local Planning Jurisdiction
Notes/ Special lConditions M
❑ ES ❑ PTS
❑ UBA ❑ N/A
Phone # (J
Adj. Wtr. Body
Closest Maj. Wtr.
(Scale:
❑ See note on back regarding RiXer Basin
Tj�
Application Fee(s)
statement on bask bf permit"

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 isinspected 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 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-8884RCOAST
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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(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:Hportal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

A V
NCB NR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director
Secretary
Date
Applicant Name
Mailing Address d 8 we,,4,/�f
I certify that I have authorized (agent) e'-r r [ E/,/, S to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
b dA 7 // at (location)
This certification is valid thru (date) .3 Ld YI a a
Signature
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An EQUA Oppor O41 AMnnelive Action Employer
NIX PPO�a
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DCM-MHD CITY

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
r 6
hereoy certify V)at I own property adjacent to �� �' �� o nor)
�a (IamoofProperty —
pr)perty located at
(Address, Lot, B o k, Roadr etc.) L fl C
,rinEi fx.----
(Waterbody) (City(Town andlor County)
Vt oas described to We as shown below, the de,?kDprrent = "c" sz i 3` t e jhove
�/ I h3Y8 n0 !}bfPCiIOPto this prOP083.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
;Individual proposing development must fill in description belowy� pchj3 j3 drawing)
P�°�rtki�k fi
I
WAIVER SECTION
• s' 3 R'er, dock, m000ny piimgs bre3b,,31ar [ : -
--,t i•:.r� n:v ire-� _' .3ra: �: ram- --
�ve;:e
do not rvisn ;C
djacent?roperty 0 r nforntaticnl
t t QC' _
�-opert' Owner Information)
�u
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3- 7,4-u:2 (
RECEIVED
MAR 29 7.071

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
rerecy cerulY tnat I own property adjacent to , (Nameof Pr rhr" nar)
�aE3 LJcl�'c�
propeny ,crated at
or 226,60
ss, Lot, B o k, Road% etc.)
in
irrr.,(Tnwn andlor County)
The applicant as described to me, aS shown below, the deMIP'
oca'ior
I have no rhjechen to this Praposa'
DESCRIPTION ANDIOR DRA'NING OF PROPOSED DEVELOPMENT
:Individual proposing development must fill in description aelow or att ch a site drawing)
�(0 0,5e(t 13f13
YVAIVER SECTION
must ioitial'T., :� ... . .
o•operty Cwiner informationl
3 - 2-t -J',2I
Adjacert?repertyOwnerinfor ticnl
a'/ If
—_r
fd $ aoo
Ck#6ra5
RECEIVED
MAR 2 9 ZOZI

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