White, Ron 78283C

AMA / ❑ DREDGE & FILL N9 781 R3 A B CC) D
r. ENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue El Partial Reissue Date p evious permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 9p,
and the Coastal R ces Commission in �narea f environmental concern pursuant to 15A NCAC
Rules at c ed.
Applicant Name Project Location: County
AddressVXO St et ddr s Stat Road/ Lot'�(s)
City State ZIP V

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/ 1-888ARCOAST 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

Styron, Meagher M.
From: Quinn McDaniel <[e-mail]>
Sent: Wednesday, January 6, 2021 8:03 AM
To: Styron, Heather M.
Subject: [External] Fwd: Cama permit forms
Attachments: 20201231_143425jpg;20201231_143404jpg;20201231_143334jpg;20201231_
143349jpg
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
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---------- Forwarded message ---------
From: Quinn McDaniel <quinnhmcdaniel89ggmail.com>
Date: Thu, Dec 31, 2020, 2:53 PM
Subject: Cama permit forms
To: <heather. m. styronAncdenr.gov>
Hello Heather. This is Quinn and here are the forms and drawings that you requested. If you would email any
and all correspondence from CAMA to me and Steve Foley his email is stfol766kgmail.com or you can call or
text either one of us at my number Quinn 252 - 571 - 8711 or Steve Foley at 252 - 229 - 6017. Thank you
Heather and have a great day and a Happy New Year.

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ADJACENfi RIPARIAN F'RUpERTY OWNERTATEAANT
I hereby certify that I own property adjacent to (NaMO of Property p„yner)
property located at _. �0etc.j 1. .
(Address, Lot, Block, Koad, _
on �VPa.} � tir-=---- �n -- (G tylTo n andlor County)
(Waterbody)
The applicant has described to me, as show
n below, .the cievelopinent proposed at tho ar5o
l do
I have no objection to this proposal. l
-- ASCRIPTION AND DRAWING OF PROPOSED DEVELOPMENT
h site drawing
(individual propvsing development must till In description below a
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I understand that a 'pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a mirimurn distance of 15' from my area of riparian access unless waived by me. (if you y
wish to waive the setback, you must initial the appropriate blank below,)
I do wish to waive the 15' setback requirement.
I o not wish t waive the 15' setback requirement.
(Prod caner lnfor i (Adjacent Property Owner Information)
Sign turn signature
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l'ririt or Type Name f Print or�ype N me
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Tolophone Number Telephone Number

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