83908A_Midgette, Jody_20210915

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/CAMA / 7— DREDGE & FILL No 83908 D
C
GENERAL PERMIT Previouspermit 4
ANew Modification , - Complete Reissue = Partial Reissue Date previous permit issued
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 15A NCAC_7(jj-� . 1A00
%7- Rules attached.
Applicant Name_,,. �,1766— Project Location- County
Address -- Cb--)Z LaStreet Address/ State Road/ Lot #(s)__L;;A
City
State ZIP,215
Phone #
E-Mail Subdivision
Authorized Agent City
7 CW SAW V—"FTA ES E: PTS Phone# River Basin te
Affected
� 11 EA HHF :1 1H -USA Z—;WA
AEC(s)� 0 .
Pws� Adj. Wtr. man JunkAn
01RW: yes / Ch.) PNA yes / no Closest Mai, Wtr. Body Cett -74nL.C-ke
Type of Project/ Activity AI--(,)
101'XS' PLIr
(Scale:
P75
Pier (dock) length
Fixed Platform(s)
Vf
-w 14et S'
�o�
Floating Platform(s) _ __......_r
cingerpier(s)
[[�j
Groin length
number
Bulkhead/ Riprap kq0,
wg distance offshore ­
max distance offshore
Basin , channel
cubic yards
Boat ramp
l
Boathouselljg�'-Qxa-
lit /it
fkw�-ON-u/d los'J"s pot
Beach Bulldozing 4
114.
Other k
6-w
G re*
16
Shoreline Length
SAV: not sure Yes
Moratorium; a yes no
Photos: 4 no
Waiver Attached; e, no
e
6AW �r)
A building permit m.. required
by:
r;-�-,,x, k,
—See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
+
............
Ag Applicant Printed Name
&2ta�t
S`hgnatij e "Please read compliances e ent nbackofpermlt**
Application Fee(3) Check #
—Clm -6eif
_-
Permit Officer's Printed Name
Signature
Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Name of Propel "er Applying ermit:
e
Mailing Adder:
qb@-D k�w
'vi"t A 0(214c Ltql
I certify that I have authorized (agent) 0i. 1 I arm-e, to act on my
behalf, for the parpose of applying .for and obtaining all CAMA tPo�rmib useemary to j
install or construct ()
t
at (my Property located at) P
This certi5c ation it valid thm (data) � _a� _ .. �

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAfl , PPTI IPM Or-f-EE-11PEIT RQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner.
Address of Property:
Mailing Address of Owner,
Owner's email:
Agent's Name: Ns Marine
Agent's Email k al I etz np v-,%
Nc
Agent Phone#: --cif -5Q - 19to i - 3A, Q
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(
,A2ft2MJP-o0rfionq --t — ..
be completed by the Adjacent Property
I hereby certify that I own property adjacent to the above referenced property. The indiviCi,,ai applying
for this
permit has described to me, as shown on the attached drawing the dev
elopment they are proposing A
de cri drawl w' i n ions M st be rovTded with this letter I r�c
I DO NOT have objections to this proposal,
1 DO have objections to this proposal
if you have objections to what is being Proposed, YOU Must notify the N.C. �division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909. 0CM representatives can also be
contacted at [phone]. No response is considered the same as no objection if You have been
notified by Certified Mail,
WAIVER SECTION
I understand that any Proposed pier, dock, Mooring dings, 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
(this does not apply to bulkheads or riprap revetments), (Iff YOU Wish to waive the setback, you MyaLsiLn
the appropriate blank below )
I DO wish to waive some/ail of the 15' setback "ack
-OR- �gnatu nt �Ripenfian Riparian �CO*wnm,�,�
I do rwt wish to waive the 15' setback reQuirement (Inftl the blank)
Signature of Adjacent Riparian Proparty owner:
Typed/Printed name of ARPO:
--7 H
Mailing Address of ARPO:
ARPO's email:' Phonet: I -Ai Liz- 54 6 Z- 4 7
Date: 61- 1'
- 0 2- 1 —'waiver 18 vallid far up to On$ year from ARPO's Signatuw
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
QERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner
Address of Property:
Mailing Address of Owner:
Owner's email:
q , CC'C(LA; V)'1 J4Q b,VT-,v- NC
Owner's Phone# "�-;k "
Agent's name: NE (-T�nkc t t }e,_1�,
Agent's Email \� I r1P tYl CZ_1r" t r
.Agent Phone#. � ' t (0 J
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Prop2rtx Ownes?
I hereby certify that I own property adjacent to the above referenced property The individual applying for this
permit has described to me. as shown on the attached drawing, the development they are pro using. A .
description or drawing, +with dimensions. must be provided with this letter1' ti tt
I DO NOT have objections to this proposal I DO have objections to this proposal
if you have objections to what is being proposed, You must notify the s'*l.C. Division -of Coastai
Management (DCM) in writing within 10 :;lays of receipt of this notice, Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response i4 considered the same as no abjection ff You have been
notified by Certified Mail.
WAIVER SECTION
understand that any proposed pier, dock, mooring pilings. boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15' frorr my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments) Of you wish to waive the setback, you must sign
the appropriate blank below)
i DO wish to waive some/ail of the 15' setback..
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 95 setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO: Oz" L%
Mailing Address of ARPO: % 7 �'� <f � t "ey Ev
l
ARPO's email: f_b'ryr4k,! %bA ARPO's Phones#:
Cate: , � �- � *waiver is valid for up to one year from ARPO's Signature4
Revised ,'day 2021

tCr
CAMA / `DREDGE & FILL ACIENERAL PERMIT Previous permit #
IeNew . Modification -- Complete Reissue '- Partial Reissue Date previous permit issued
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 I SA NCAC I Inn)
f.44Aft attached.
Applicant Name
Project Lo
Addresscation. Cwvy'j��j'4&Ck'­­
Street AddreW State Road/ Lot
city, Stater,ZP
E-Mail--- Subdivision
Audwfted Agent
zip'A�Xc—
Affected,CW /TA IS PTS Phone #
Bao*A
ORA HHF ' iH U" WA
AEC(s): Adj. Wtr. Body..0 ,44C444'k '5
I PW& I Ih6wo
ORW: yes/ PHA yen f no Closest Maj. Wtr. Body
(070)
Type of Project] Axdvky At, r
Pier (dock) length- (Sca
fixed Platform($)
floating Pladwm(s)
Finserpier(s)—
Groin len.Z6,
number
�fistance Riprap length offshore
-ax distance offshore-. CL#
Basin, channel �Ls'xk'
cubic yard s
Boat rAMP 0'
Boathouse/ Boatlift
Reach Wkicaling,
Ottier—
OWN"
shorelk
SAV net sure Y"
MO ratorlurn:
Phoros� 4i no
WaivwAtcacha& - <� &i;�—&�L,
A building permit may be required by: rm11 See note on back regarcift River Basin rules.
(Note Local Pianirting Jurlsdiction't
Notesif Special Conditions I
+ axne'-A 4 to &N. ALI�
AWu2r Appkant Printed Name
ay1C/L'LA
Naw read compliance statiw,:Q!i _LtMt
600 . � C)
Application Fee(s) Cho&
Pt!2�*O&W Printed Nam
Signature
Issuing Date Expiration Data