86190A - Moore, Melvin & Caroline

,*LWXV E-CAMA ❑ DREDGE & FILL N° 86190 il- A. B C D
GPrevious permit
GENERAL PERMIT T
Date previous permit issued
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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.dgg.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
_ State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body Jf (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body I
ORW: yes/no PNA: yes/no
Type of Project/ Activity ram- h C o'c-, v ^N
(Scale: V )
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) r'
Age or Applicant PRINTED Name .;
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #/Money Order
Permit Officer's PRINTED Name
Signature
Issuing Date
Expiration Date
we

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit 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 from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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:
F1Tar - Pamlico River Basin Buffer Rules F] 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. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT .AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: (I"'O'gey-
Mailing Address:
hone Number:
Ernaii Address:
IF
(keiA) 7557 - 320 •18z(3 -75-1 57 0 3 (' (60"? r)
cer{ify that f have ai rthorize
Agent / Contractor
to act on my behalf; for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: _ C� d In IQ a �i
iP1Cu-"+i- -ioki
at my property located at
.. (_ h o i o-ri County.
furthermore certify that I am authorized to grant, and do in fact grant permission to
Divisicn of Coastal Management staff, the Locai Permit Officer and their agents to enter
or t�e aforementioned lands in connection .with evaluating information related to -" Jis
permit application.
roperty 0 r lArmation:
Signature
�-p,►/ film O
Print or Type Narne
rt;iefc��,r
i itie
q I/'� I- —t 1
Date
^is certification is vatic through /
con

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION JQRM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DE IV RED
I hereby certify that I own property adjacent to �e, �Lt ��ne4✓ 11,460 re- 's
(Name of Property Owner)
property located at
(Project Site: Address, Lot, Block, Road, etc.)
on CC j3�L a aCLL4 in Z�Yet' -kA N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #:
Mailing Address:
Agent's phone #: Emai
He/She has described to me as shown below the development he/she is proposing at that
location, and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual prpposiag dwelopmient must fi#1 irr description taw or attach a site drawing)
If you have objections to what is being proposed, you must notify the Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Gruen St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certiried Mail.
(Property O)0ner Information) (Adjacent Property Owner Information)
& � j 1j(4 - - I we
Signnatur1 gnature*
, I
Print or Type Name Print or Type Name
601
l�
Mailing Address
City/State ip
75"7 - 3 qv - (,F6(3
Telephone Number/Email Address
i-i/ - Jr
Date
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Mailing Address
�0. fir NC 732
City/State/Zip
616-- 7;,
Telephone Number/ Email Address
Cii(I Ya l
Date"
*Valid for one calendar year after signature"
Revised Jan. 2017

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