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°`°"4P1CAMA ❑ DREDGE & FILL
111 N° 85663 A B C 'Q
Previous permit
GENERAL PERMIT
Date previous permit issued
1 New ❑Modification I I Complete Reissue n Partial Reissue
As authorized by the State of North Carolina,Department of Environmental Quality and the Costal Resources Commission in an area of environmental concern pursuant to:
I 5A NCAC O /j'1• j 0 C. n Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CA,MArules
Applicant Name .re'";Yi !t'&'4 i(A. Authorized Agent `/ - (1/, t/ t c(� (.�J t/j Li -Lr.
Address g O 0 EII1'i"} !"'i i'?A-4 L4/it Project Location(County): ,? ' .'i rf:.
City r>v I State N_C ZIP 2 7?5/ ' Street Address/State Road/Lot#(s)
Phone#(// / ) �'/1' /:53
Email }c"4/T 1 6- irlin if ` f ilt? i ,, M it, Subdivision f/=�
City 41t 4(k ZIP `=44').,
Affected ❑CW [EW n PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA ❑IHA n UW IT SPIMA n PWS Closest Maj.Wtr.Body ',6 GC;
ORW:yes/no IjPNA:yes/no
Type of Project/Activity /`'i1",'l^S,-, 1 / -Y CAL r%/I/6(Ct rr/ii/ a r, cl /j y 1G.- 11077? y
4/ (Scale: )
Shoreline Length
I Ill" I ; _ Er 11111MMEIMMIN _
Access Length -�6' ' '
, 11111116111111111111 IN 1 NO111111111111111111111
Pier(dock)length — I I [ I
Fixed Platform(s) i
ILI
j , :_ �
,, , ,
4
i
Floating Platform(s) Fr 1p(
.r.... 1111111111111111111111111111111111
Finger pier(s) — ... i
Total Platform area 71I e-X1SthL/
fin.{' ,.i ,` � J ` 1111111111111111111111111
Groin length/# a+r. _
Bulkhead/Riprap length .,.._ xi1,,w�}
i Hk• '.
isle✓_-Ft __
Avg distance offshore • I f --(- i ' 7-
Breakwater/Sill .. (Pjr *f
Max distance/length •- . —
Basin,channel
"---- 11.141M1
_. tall
Cubic yards `—"
Boat ramp 4's
Boathouse/Boatlift IIIIIIIII111111111111111111111111111111111111.1111
Beach Bulldozing
Other x
r
AM
SAV observed: yes no %; 171111111111
—p--_ 1 ;amilis ,
Moratorium: n/a yes no
Site Photos: yes no ' _ ____ _ '. { ......... .... ..- .
Riparian Waiver Attached: yes .
A building permit/zoning p mit m re.y be ired by: 7'h/(-✓I 1 IGf . -'�4,a
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions 4.4-' "'lea r r? , X 1
nSee note on back regarding River Basin rules
nSee 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
✓ i:2
Signature**Please read compliance statement on back of permit** Signature
hG 4 %_ :_
Application Fee(s) 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:
Tar - Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves:Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

f6w4, t) tS' r56�� A B C 6,
4CJ4l1il/$ Li DREDGE & FILL - •
GENERAL PERMIT Previous
o per issued:
53New [Modification 0Complete Reissue I i Partial Reissue
As at:thonzed by the Some of North Carolina.Department of Environmental Quality and the Coastal Rmuartes Commission 41 an area of env ro im nt l concern isurvU rit to
i SA NBC Ali_l?SU 0 -._—_ 0 Rules attached a`�''Gaie''al Pe.nut Rules ara:labk at the!plowing link hwv-•,,flog; ray. Atti'yA_
Applicant Name ,ft Yt! c. --- — . ..-
pp,,�t..ts���� AutFarued Agent_- /�� jf}?{- at-
Address_Aelo Mai Lc m6._ bule, Protect Location(County) j1/4'?A.fa=-.__-_...._ ----------
City Cill �State_. ?JP 2��_. Street A dress.5tare Roadlot#tsi _ . _
"hone#(9.4 ) deb f',3y ---
Enud• .htT�_y}� a D Subdivmon__�CCe�k� i!--�.a-'•'�^_---•-----------.- --
Cite .._I lI u.41 _ZUP-..oe ----
Affectedr_tc kEW { PTA -Es LPTS AI ytr Body__auc{a marti,rtkl
AC-Cis) DOM OM Ouw Dspauk i]PWS CtosestMaiWtr.Body 4'U4(J -------
r�n
ORW resit p PNA yese
Type of Project/Activity_%'` 'TT1 r C .r> ,P it,elie li fig,
ea (Scale IVIS )
Shoreline Length/46" �•-
Access Length edrt31'A'L't
Pier fdoct}length -
toted JJ
rieeo Platform(s) '--
Floating Madermis} TY t�
---
TotatPlatforma -- ,
rea e? ,6tt it / • _:
Groin lzng /g-. --...... _Mpi guLit. 1 S . •
Bulkhead/Rif:raptlt oFp s r'. distance offshore - - k
o p CJ `
•
Breakwater/Sig �f t:4^.f >!
Max distances length - ��
Balm channel -C..btc i1
;
yards
'
Boat ramp.--- -_ _ Se
Boathouse/froathft
Beach Bulidonng —_
Other -
i/
-- --
SAV observed yes fig ' Sr"m P}n
Moratorium n/a yes re0
Site Photos ves a. a 77'...:1Aa'013‘;
tuparian Waive,Attached yes
A building permiUtenmg mi[may fin re °red by _ 7E111_ r- _._-..-_..--
8 ❑ FAR1PAhUNEUSE'BUFfER(cede one)
Permit Condinors__1a. .. - ---- -
- T.._ _- 0 See rote on back regarding Rivet Basin rules
.. _. .-. ._ _.---_ _ __ i I See additional notes/conditions on back
i
I AM AWARE OF SSTATTUTf3,CRC RULES AND CONDITIONS THAT/ APPLY TO THIS PROJECT,AND REVIEWED COMPLIANCE STATEMENt*(Please land) �'.
f 6- / '- . ,- �j(j6/(y V /i'fytt4, ie(o
Agent or Appticav*P me Permit Dfh is PRl TED Name
Signature"Please rejti c lance merit on back of permit" Signature
.100 /l)04 __ 9/2s/ I 'as-/a�
Application Fee(s) Check ii/Money Order Issuing Date Expiration Cate

AGENT AUTHORIZATION FOR CAMA PERMIT APPUCATION
Name of Property Owner Requesting Permit: ("Ift.. Jor}m 1A642 !L
Mailing Address: 3(01 Secec ; 1 Y-
gclaem 2ec riN
Phone Number: q i'? [o- 142 - 133 E
Email Address: pr)N ( ,fo)-3,J (A.IER IEft...C)M
I certify that I have authorized H-5 (ni'c'tcioln. SQc:ntAs,
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: tvtt.) rt�F?S�'.i(� back,
ve-� by Sc.t....\ 13 u,►�vS
at my property located at Sty I S c�IN;1 1:>r-
in BfkAr aJACK 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.
Owner I rmation:
Sig
IL-
rt Print or Type Name
•
Title
Date
This certification is valid through / /

o w=ON OF COASTAL MANAMERER
ADJACENT FOP/JEAN PROPERTY OWNER NOIWWAT10N MAWBR FORM
Nwaa aPm,anfir Owner: 10.4 ``Ttm fn--
Addsaas of Rowdy: 34.1 .St an. lien \ Rfunsw,cle—
(Lot or OnetfCtliest or Road. 10
Aped*Nemo.* N5 faigAcidim $ -r Pis6m 249
-
A puI s .t — 3 1 ` '` ' ►1`t Ascf 234k
het*that t awn peopsetr sascess to the above atlJerioM wi uipF.The Imseidud
awl*"for Ns pun*has deeaihed b asses share on the inlueld si gjhudes iapirnt
T L_� any are Proposing.A daea)stion or crimes.with dimensions.ilaiminaktidthijog
jab.have no objections b ibis proving. Ihaicabjeatiossblibpsopoei.
ryes komallmasonfouistiebaspospamityamosatineffiblipmegeocoldwilmemisiit.Cleas
millapulaMiallealinpbli. i cfaee ooito Com poodos oskoatdi�..e7rla127Catot&hand,
r4eMeue snubs ou am lw►a cooieosdat t i 7Da•72l&N o e iipa isols
as so e1d eeeeramtee.Nee.-dAirCarallrfiiit
I twiawirad that a WAIVER SECTION
kooks Nnieenia i dock. Ping%bredoesisr' .Et main mat be set
hbrrsiwths my eves of Win acansesoiees valved by me.(if you
> ac4lrou 1hs appneprieM blankbebrc)
I detrain b versus the 1S setback requitement
-1-- I do notwlah to weirs tea 1S setback requirenu rt.
(Alum*Piamostf Omar fulmination)
•
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cicsastil
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� Chi) - tin - 7573
Telephone Niftier
Revised 60812012

comma)am.•RED/NI Raman SPRIESTED
DIVISION OF COMI ITAL RIANAOt'IIENT
ADJACENT RIPARIAN PROPlRTY OWND NOT1FICATIONANAI ER FORM
Nerds of Property Omer: .Se -1 IMQ.((12
Address of Properly. ski `w-ceni ) B'{UW f S tC
(!at or 8restA or Load,My Coiart»
Agent's Nana ilk W5 �E� � i�elr>eAci�rtec 1g>4 our P;56A*
Aprtpe pt]ons# QI<} "t-L p 4 ATV 2 Q 2 .
i hereby cart y that I own property adjsoernf to the above referenced property. The individual
appryinp for this permit has described to me as shown on the*ached dreektg ttte development
they are proposing.A art dr ydikCllyieraktis,newt be Provided taint this leper.
have no objecdons to this proposal. I haweobjectices to this proposal.
try hive objections tovaretis balmy propos you most amity es Min°Mess —nj- .rt CI1is
'widow olden so days of receipt of Ilda notice. Cone poodenc.aheaddhairoa<isd do 127'Cardin!&ve ea,
Mtbriogan,pity,aas111. DCN ropreeiraleffees an also be h anisoadat p10)T96.7215t Ne ragroase is
coerWaed the same seaoatdsc onifyorlavebeenaotridbyCrralirdiW
WAIVER SecnoN
i understand that a pier,dock,mooring pangs,breakwater,boatter:se,Ik or grout neat be set
back a minimum dkdiartte of 16'from my area of riparian accessories*wished by me.(if you
wish to waive the setback,you migitjellbd the appropriate blank Wow.)
rri4 _6-11-4) t do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback regiremor t
information) information)
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or Pipe Niters Print a 7ypeilarse
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Wing Adifrida
'e 2B462 a31-tip2
1338 gip- 2-El6S9
Teiaphone Number Ty Minter
Date
Revised&18/2012

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L Check
Date Received Date Deposited Check From(Name) Name d Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Column., Calumn2 Cuumn3 Column) Column5 Columns Column7 Cohtmn8 Columns
9/29/2021 Grice Construction Geoff and Linda Walker BB&T 14932 $ 400.00 GP#80237D BB rot.15547
9/2912021 Grlce construction Adam Nix 888T 14935 S 400.00_GP#856720 BB r_ct.15545
9/29/2021 Once Construction Betsy Upton BB&T 14933 $ 400.00 GP#85673D. BB rct.15546
9/29/2021 Grice Construction Anthony&Krista Harris BB&T 14934 $ 400.00 GP#856710 BB rct.15544
9/29/2021' Team React LLC OSNC,LLC Coastal Bank and Trust 2525 $ 200.00 GP#856200 _JD rct,15584
9/29/2021 Claude Rogers same Wells Fargo 1393 $__ 200.00 GP#856700 PA rct.15708
9/29/2021 Richard McCain same First Citizens Bank 12337 $ 200.00 GP#85661D PA rct 15713
9/29/2021 I H5 Construction,LLC John Harlin Truist 1001 $ 200.00 GP#856620 PA rct.15710
9/29/2021 H5 Construction,LLC John Werner Truist 1004 $ 200.00 GP#85663D PA rct.15711
9/29/2021 Aaron Perkins Duke Energy Progress _LGFCU 405 $ 200.00 GP#856640 PA rct.15712
9/29/2021 McPherson Marine Services,LLC Daen Evans First Citizens Bank 4491 $ 200.00 GP#803540 PA rct.15706
9/29/2021 Logan Marine,LLC Barbee Family Trust BB&T 7617 $ 200.00 GP#80355D PA rct.15707 _ _
9/29/2021 Logan Marine,LLC Albert J Brown Jr BB&T 7616 $ 200.00 GP#803600 PA rct.15715
929/2021 Ruth Rushing same Bank of America 2367 $ 200.00 GP#802360 BB rct.15541
9/29/2021' AMW Docks and Marine Construction LLC Patti Rubino BB&T 6496 $ 400.00 GP#80272D BB rct.15542 _ _
9/29/2021 AMW Docks and Marine Construction LLC Steven and Allen Williamson BB&T 6497 $ 200.00 GP#802710 BB rct.15543 _
9/29/2021 Donna Byrd Donna and Richard Byrd BB&T 1049 $ 200.00 GP#80281 D BB rct.15538
9/29/2021 McPherson Marine Services,LLC James Banko First Citizens Bank 4521 $ 400.00 GP#85669D PA rot.15714
9/29/2021 Allied Marine Contractors LLC Mark Long First Citizens Bank 10387 $ 400.00 GP#80208D PA rot.15701
929/2021 Allied Marine Contractors LLC Ronnie Hussey First Citizens Bank 10388 $ 400.00 GP#801970 PA rct.15702
9/29/2021 Drew Todd,Jr. Sandra Cochell Woodforest National Bank 1078. $.. 200.00 GP#801980 PA rot.15716
9/29/2021 Lighthouse Marine Construction Jose Gonzales Coastal Bank and Trust 3950 $ 400.00 I GP#85632D JD rot.16004