86189A_Mikinek, Dan & Judith_20210920

a�toasr,, ❑LAMA ❑ DREDGE & FILL N9 86189 A B C D
3°
o Previous permit
GENERALPERMIT Date previous permit issued
0 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.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County): V—
City State ZIP Street Address/State Road/Lot #(s)
Phone # (� )
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body i
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scaler )
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
I
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 „w ..._.._.
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:
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Feels) Check #/Money Order Issuing Date Expiration Date

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:
1-1 Tar - Pamlico River Basin Buffer Rules F-1 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

tame of Property oww Rig Permit A) � y ✓Vl L I A J.
Walft Adds: a I a rz r� �sl�a •� �z
Email Address:
1 cw* that 1 have 8l>t MFIZed �l Q �° r 1 Yam/' ri ti C -
AWt I Cmb imix
to act on my behalf, for the purpose of applying for and obt&ft aN CAMA permits
neCessffy for the fio�w ft proposed development SAC l s
-1
at my proty ioc�a at q l o `( 6Z'r.��/sho�E I2 n .
per
in !) -
I furthermore cwft that l am suf caked to grant; and do in fact grant permission to
Division of Coastal Management stall; the Local Pem* Officer and their agents to enter
on the motioned lands in connection with evalna ft information rated to this
pe►mt apphdation.
Sgnature
Pmjt or Type Name
Title
1 27
DOD
This coon is vald through / 1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
t hereby cw* that I own property adjacent to 6 / JN�f T k 6 y Pill Q N F !� 's
Owner)
property located at o ( o�2 y1 J Y
(Address, Lot etc-)
on !t vC , m �I.Z , 1`. c� , N C_
(Waterbody) (City/To*n andtor Cou dy)
The applicant has described to me, as shown below, the development proposed at the above
locatio
�Z_ ! have no objection to this proposal_
t have objections to this proposal.
DESCRIPTION ANMOR DRAWING OF PROPOSED DEVELOPHEKF
pnoiOosir�g dev� fafi i� �ieiorr or mach a Abe'_ Lr w
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WAIVER SECTION
i understand that a pier, dock, rrrooft pilings, boat ramp, breakwater, boathot>se; lift, or grain
must be set back a n**n m distance of IS from my area of riparian access rmless waived by
me. (if you wish to waive the setback, you must initial the appropriate blank below_)
I do wish to waive the 16 setback requirement
1 do not wish to waive the 15' setback requrement.
(P Owner Information) (Ad'V W..v w 7 W79 Unnafic
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Phirtt or Type Name , ype n
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T / sdr�ress lbkphone Akmt l ernad address
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ADJACENT RIPARIMI+1 PROPERTY OWNER STATEMENT
I hereby c ertr7y that I own property adjacent to fl/J b� i''j1 i-Mil K 's
Property Owner)
property locked at Q Q 9 61yel5kate rzI of
/ f (Address, Lot Bbxk arc.)
on in G1a . �. Li . N.C.
VVaberbody) (Cityrrovin andlor county)
The applicant has described to me, as shown below, the development proposed at the above
bowI have no objection to this proposal.
{ have objections to this proposal.
cc)vnS t�4 s f'L
V
L.,I'K fb' f:4&t&LqrJ I cc4 �a
WAVIER SECTION
I understand that a pier, dock, mooring pilings, boat ram, breakwater, boathouse;- lift, or groin
must be set back a minimum distance of 16 from my area of riparian access unless waived by
mw (If you wish to waive the sedmck, you must initial the appropriate blank below-)
I do wish to waive the IS k requirement.
I do not wish to waive the IS setback requirement
#(Property Owner Information) Property r information)
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Pasquotank County NC a I Rd-
September 20, 2021
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