Reynolds, Stacey 79586C

❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
N9 79586 A B C D
Previous permit #
Date previous permit issued
15ANCAC
❑ Rules attached.
f r
Applicant Name r -) ^
Project Location:
County ( r v
Address ' T'T %
x Street Address/ State
Road/ Lot #(s)
(
City ) r r State i/t ZIP i{ l .l
Phone # (?�)` ;( 1.( Mtn I
Subdivision-
Authorized Agent '
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ZIP y )
ocw ❑�w R67A El ES ❑Prs
Phone# O
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River Basin ..i
Affected
❑OEA 'LHHF ❑IH ❑UBA El N/A
AEC(s):
Adj. Wtr. Body
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❑ PWS:
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a
Iplicant rimed Name .r-� PermitOfficers Printed Name;
»G Please readcompliance statement on back of permit *'# Signatui`/ /
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Fee(s) Check# Issuing Date I ExpiratonDate

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 I) 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 INC 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
400 Commerce Ave
Morehead City, INC 28557
252-808-2808/ 1-888-4RCOAST
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, INC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, INC 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

a
,t 1;•;_;
Name of Property Owner Requesting Permit
Mailing Address: 1_15
2--
phone Number:
t mall Address: 't it S r 1 ah m� C 6ki'7
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
necessary for the following proposed development: & % yr^n f �'f
at my property located at t b'l a h fr�� ort
in CaY1,County.
I furthermore certify that I 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,
Property Owner Information:
Signal
Print or Type Memo
Tltle
Date
This certification is valid through 6,4 1 20 1 ad as

ADJAGENT RIPAMAN PROPERTY QWNPR STA &MM
I hereby cettify that I own property adjacent to u S 'e
(Warne of Pre rt}rWitter)
Property located at �n�y 1(A'F C,.w.� k �1.,. T7ocLt �j Y
on wl1,d, t>a K r'4 ✓t°Y ddrese, Lot Block, Roa.tc.j
in N.0
(Watetbodyl (cltylfowb and/or county)
oThe applicant hiss described to me, as shown below, the development proposed at the above
locistl n,
I have no objection to this proposal
lw t have objections to this proposal.
WALVOR SEDUM
I understand that a pier, OCR, mooring pilings, boat ramp, breakwater, boathouse, Irft, or groin
do
must be set back a minimum distance of 15' from my area of riparian access unless waived by
} me. (If you wl h to waive the setback, you Mille tf%ol.the appropriate blank below.)
4li} dt5 7�do wish to waive the IV setback requirement.
14 of.
I do not wish to waive the I setback requirement. _
(Proprry :/
Owner IrNo°lion} _(Ad��°__nt PrgperycQw r formation)
Ril
//?�,,)� 2�7 MH N!g MW/tlys i 7
'V d-- _ o�ns daa.L .��-
r(O MS n, GOM
Telephone Number/®marl address
Le•
(RavisHd Aug. 2014)
ter signature*

IrijGal
Here on
one of ,
these
itles
I hereby certify that I awn property adjacent to
property located at %r' / G. v�r�r1 ..,•, o�
(Address Lot, Bloc , A Road etc.)
on Gt�ini2 l�aK m '(C(�NC
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
ocation
a I have no objection to this proposal
I have objections to this proposal
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(fncilvldual gropoalrtg development must llll in derecrlpffun below or atfech d BNO clAtwing)
J�Q ` v�k(Q C`fc�'n'
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
me (If you wish to waive the setback, you must initial the appropriate blank below )
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Pnnr or
Mailing
Telephone
I rare
Waik1 for one calendar year after sgnature'
(Adjacent Property Owner Information)
.5'I,�oeuhrt,'` J
Print TyrlANarne
Merl' A ess n ��
Citylstarelbp -,-
Telephone N { f M/ grna{! address
IS
Nnre•—��
iRevrsed Aug 20141

White Oak River
North
1
River Oaks Marina Dock
�................... .
Slip #13 i Slip #15 Slip #17
13'x13'
area for Lift
-- ----------
Proposed work:
Install a 4 pile boat lift in slip #15.
Extend 3' wide finger pier out an
additional 9'.
Property Address:
Boat Slip #15
156 Deepwater Dr
Stella, NC 28582
Prooertv Owner:
Stacy Reynolds
Drawing Prepared By: C3 Scott, Inc
Date: 6/9/21
Scale: 1 ": 10'

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