85659D - Medon

i3atg'sk ft. LAMA .. DREDGE & FILL No 85659 ABC D
GENERAL PERMIT PreviOuspermit_
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:
I 5A NCAC t 4 ' \2 J 'J I l .'- / '" T'—"- in Rules attached. General Permit Rules available at the following link:www.dea.nc.gov/CAMArules
Applicant Name 3 C �' + W 1G VrA60 V t4" ,, V l'C C1 O/1 _ Authorized Agent L t„).e CV.-
JC(r i" -Tk r1' I.K.V 1 S
Address 4-4,U G, ' 'C',j h( Dv `e. U ' I Project Location(County): -i ", ''„ ` VIOV Qi(/
City: 'j` ,4`1".\0C\ State ‘'..-IL-" ZIP a o�'t i 1 Street Address/State Road/Lot#(s)
Phone#(_) 1 - v ti'1 E
Email '41 YV1(d a- l ,owl Subdivision i (- I S VI0y'Q-
City ZIP
Adj.Wtr.Bodyi'T i S �Vs...
❑CW EW PTA I I ES PTS 1 I (nat/rtrardunk)
AEC(s): ❑DEA I I IHA UW n SPIMA pi PINS Closest Maj.Wtr.Body 1.+` a. (\,�` S oUV`G(^ /A ��'J vJ
ORW:yes/no.' PNA:yes/no
Type of Project/Activity'i (' a v f -1 04 a Y.0;l- r e""')v wl,°st"�\ ri-' - .,r F _t rr( C k/J 1 r_ , r,i,-J a t ( "S 3 Iv. c " y
i
sk,a cx k0 c-cc' 53 ! k- - IrC,v( r ! (Scale:' ;4))
Shoreline Length }/- t l v'V<,11 A......s el,,,
Access Length — #
Pier(dock)length -ti TS r f 1
I
Fixed Platforms) I-
L ' iIllik'
a
Floating Platform(s)
Finger pier(skiwk ) I
Total Platform area+(f 1 M + ? f
Groin length/# w¢41 ( __, i i_. _ it`J b V r
Bulkhead/Riprap length .... 1.........{ u_._ i _._._._. �.o { f a _.
Avg distance offshore
< — i
Breakwater/Sill 3 ' I i . E • 1 ) '
Max distance/length 1 ' .k.`v,,_
Basin,channel ; � �.} ���
/
Cubic yards 1 I f
Boat ramp ( a f I 't v
Boathouse/Boatlift
Beach Bulldozing 0'(6V-If_' C. o, ( 114 i 1 �,S „ , co
Other F 'Al h ��4" r' r G t t L 1 x. . I , , tat
di
v` - ,i v
SAV observed: yes no' i ;, ,r.._ • ) s-1- ,' e. _ i `F ,�, r'�#M i
Moratorium: n/a yes no ' P „ o111
Site Photos: no ,�..._� kk._\ �! v .. ,., : , _. , ._ t11 , l _ _
Riparian Waiver Attached: yes no? tsl'`� '� ':U�,r1 c1 c CO ; C yJ , V , i 1�•A + ' r 4
A building permit/zoning permit may be required by: NI C1 l •
. .. I 1 TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions 14 ,.i ) • ( 1,,.v j - r--_',`► ;y '} C w�C(� r�'1
k 1 (i..E' . ``•"'y-G, 1 S f�-1t i �_a(I 1\Cy\V ri See note on back regarding River Basin rules
��t‘,...)
n 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)
V • y -{ t
Agent or Applicant PRINTED Name Permit cer's PRINTED Name i. I ir
zse"
Signature**Please read compliance statement on back of permit** Signature
ia3J9-�at b'SIa(>a1,
Application Fee(s) Check#/Money Order Issuin 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

°t`*Ne rACAMA DI DREDGE & FILL N9 85659 A B C 0
GENERAL PERMIT
L-..:.
Previous permit
Date previous permit issued
New ❑Modification 0 Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina,Department of Environmental Quality and this Coastal Resources Commission m an area of enviromtentaf concern pursuant to:
ISA NCAC 14 •1204 1. l l Oo /. U4 O O Rum attached. 0 General Permit Rules available at the fofowing link:merjjeszESAill
Applicant Namo SC 044- +AAA wavy Wl a O/'1 Authorized Agent t>..CtC 4-D C Cik �1�I r c/01-1 b,.. ILfMY
Address 40 li 13iS fit/tit t)vWt
� Project Location(County): J ✓V4AKove
CityWl1WtlVtC�'Dvl State N` p
ZIP a 4 (J Street Address/State Road/Lot 0(s)
Phone 0(_) 11 ,/� S P}Vv1 e
Email $C 04 wildal a qw►u,I.Cawt Subdivision t�ri,,i$tioy't.
v City ZIP
Affected pm gEW PPTA [A Es • OPTS Adj.Wtr.Body R&S�C V� tom, (nat/mvVunk)
AEC(s) 0 OEA IHA UW 0SPIMA �PWS Closest Maj.Mr,Bodo i*Ad4V .^
l f,4 1 W V%
ORW:yes PN ye no
•
Type of Project/Activity kewtov. Auaka yloh-Cotrtotrk is dt. - YCptaUt. va I O. ',Wes' aCLeJJ It.. A ~ NC
pe.40 ACC(33 44‘l oa4-L +- le '(. tXt• 1.,j .Ftt •S•41161 t u. +fie•0.0 41 ima-3 0-4 (Scale: e ) •
Shoreline Length+/_ i )$1 W kiln VCGY- 1� ♦os.-1'�- hotr� DV+
Vavr^ Ov .{2,t,ywo'/t 44t. Watt CL.J ela .
Access Length 44 ' YOc,IL u•- -}Ina- sc.tA}-h.ewr lb"/4‘a. s•
Pier(dock)length a g/ w {
Fixed Platforms) 'v
Floating Platform(s) ��
// 1 • r--
fingerpier(sl� 1 t/O'( ly' r •
w
Total Platform``area 11a q.(t' tutrJ.]rU 0 4 k_- . L
Groin length/1 d,dftiS'li..,f-10A ' '•Vve.-For fw
Bulkhead/Riprap length'/- Ili e • ✓v:/ GR E bady NHS t'ele
Avg distance offshore Llv b '
Breakwater/Sill .
Max distance/length • �r M
Basin,channel `rlpp04 V.0
Cubic yards / L/�7i3�1l�5 dVGIL
Boat ramp (/ 0 ie Yt aP I'
Boathouse/Boatlik Beach Bulldozing to W�ilk aveo . I y'. IV
I • 5'*20'' totvw" }p VC/Mgtln
other2'Alf'p w, et., a 4 yq.,c,k• e ° a `� .p0 e %~ f
tiv-
lt•-• A.(„e 42_,... :16" \ ire v..- f'•;"
SAV observed: yes ®' Ve ,it, Ce- }
Moratorium: n/a es ®
SiteMoratorium:
Photos: �5 no s�//�j�,.I pQ/j V\'l�V e dt v'r f+V '�V/ i . 0Riparian Waiver Attached: yes r/` ps �tCtL [WA building permit/zooning permiitt may be required by:``a dii/ s _ r
Permit C dldons Ail' •12 W j • 11001 Cl 4 . 2.400 rw.t..4.-Cu►�CL I W�-r 0 TAR/PAM/NEUSE/BUFFER(circle one)
Ct_r M 1 .�'edt/ef-1 ( S'• .j-e i 1 O fit, YI g(V.t d-'�rd, See note on back regarding River Basin rules
-) •
14 e U See additional notes/condidons on back
•
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
` 71/16 6/ w/s C 44-1).n.befe.0 a>6,e5 V FitiWAV -t. G t 1Lr
Agententppiicant PRIN2ED Name Per .hcer' RINTED Name c s
42-
Si nazi a Please read Bence statement on back of permit•• Sienat re Cf/�`
o0 1230 1 t� 3 a- el 23 31 /l a- )941 -1 1 'zS I �a I
Application Fee(s) Check R/Money Order issuingDate Expiratioh Date

ADJACENT RIPARIAN PRQf'BRRTYWNERO STATEMENT
I hereby certify that I own property edgpet(g, kA ,,r i SGfT Ail 6 4 's
(Name of Property Owner)
Property located at 14749 6/5 () D2 10(N/a d,VU NC. ?4/ir
I (Address,Lot, Block,Road,etc.)
on PAS C.ar.,k.- , in ►'ilIc-MiNCi-AN NC- , N.C.
x (Waterbody) (City/Town and/or County)
i "rM'__°,0441 he iipii •: described to me,as shown below, the development proposed at the above location,
lJ I have no objection to this proposal.
I have objections to this proposal.
"/"/-
Ckc' DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
V \\ '1r %11� (Individual proposing development must fill In description below or attach a site drawing)
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WAIVER%ECTION
C:.virM 0/6(1)1 understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin m t be set back a
minimum distance ' from my area of riparian access unless waived by me. (If you wish to waive
the satin u must Int he appropriate blank below.)
I do wish to waive t e 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Owner information) (Adjacent Props nnation)
X
?)•/"%'4734--/11-----
ignalure Si lure
' MA-Q&+aef 15corac6 Ain (1 vp4 X
Print or T �� xe, Print.or Reps Name
LI( u�_Gv AR ' X
X Malay
014.A4,"f4i,p„) C 719ii. Melling Address X
x CO/State/Zip /`r l�t (,c�1 i U� �,�/
giii.��s--3.P7 ciry/sr�p�° 2 1-(p?.36 X
x Telephone Number Te ne Numbbr
7- /- 24 o41.-"'4,( X
Dale Dar.
(Revised 618/2012)

•
'1DJAGENT RIPARIAN PROPERTY OMER STATEMENT
I hereby certify that I own property awl(Q, U/I-gbiliert Scar 114)01 -a
(Name of Propernf Owner)
Property located al 2400 61 e a2 Vo 44 N 6M NC, //I
E �t`resa, Lot,Stock,Road,etc.)on p 5 G( ,e. , In Wic4t4/06r a0 NC. , N.C.
(Waterbody) (City/Town and/or County)
X/ ` zweL4c,one
applant hes described to me,as shown below, the development proposed at the above location,
71/S I have no objection to this proposal
I have objections to this proposal.
�- �(k DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
t ,1.Q ';1/0 (lndhddwlp►oposing development must lill in description below or attach a site drawing)
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WAIVER SECTION
CS.vr �k 0' I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin m st 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.)
" S I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjacent P ns cation)
Signature Si a e ,�
„caw- a 'o s /vr,Q,Qc,f efr kwf1�J 7-e S/`'o..--/- X
Print or Type Name Print or Type_Name
Meal, ad was A/Cq` Mailing -se,7 ,4.4, zosilx
x cny/stererzp 71 o-yes-40347 C 07 3.'4 Y.
Teleph
Telephone Number one Number
x 7_/_zi 7/z(7z/ X
Dale D .
(Revised 618/2012)

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- k : .•.: . .. i • . • - CAMA R IT . 'PLICATI•
Name of Property Owner •equesting Permit: (?con-- fit G.1.1�41t)
Mailing Address: L/O(a 0 i. at S11A M
Phone Number:
Email Address: .Sc.o rtriA6. Q C3MtifL, c a '
I certify that I have auth a -a A+k 441 k ( :)61iri k lf.Kj4
Agent/Contractor
to act on my behalf, for th- purpose of applying for and obtaining all CAMA permits
necessary for the follow' . proposed development: /CYL�, Rc r3r/'
at my property located at 1 '9 Pi f)A,
in .0 fv APClittik5A County.
I furthemrore certify that 1 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 formation:
..\' )/‘, ./117--------'411
Signature t
ic s..ir r fbc30A I
Print or Type Nanpe
X
Title
/ J
Date
This certification is valid through /0 I .r-P7 / -R N

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Check
Data Received Dada Deposited Check From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Ra/und/Reelloseted
Colored Column2 Column3 Column Column5 Column6 Column? Columns Column9
10/5/2021' Wilmington Marine Construction James Teachey Bank of America 1027 $ 400.00 GP#856180 BH rat.15636
10/5/2021 Scott Bowser same Bank of Amenca 6037 $ 200.00 GP#856460 _ BH rot.15641
10/5/2021 Land to Sea Construction,LLC Noon Family Trust First Citizens Bank 513 $ 600.00 GP#856600 _ KE rct.15750
10/5/2021 Brent Smith same Merrill 3768 $ 200.00 GP#856900 KB rct.15677
10/5/2021_ Jared Lipped _ _ same Bank of America 134 $ 400.00 GP#856470 BH rct 15642 _
10/5/2021 Signature Building Solutions,LLC Christy 8 John Mack 'First Citizens Bank 1426 $ 200.00 GP#856910 KE rct.15680
10/5/2021 Men Brown same ICresCom Bank_ _ _ .. 2179 $ 200.00 GP#802660 PA rct.12799 _
10/5/2021 Dock and Deck Dudes,LLC Scott&Margaret Medon 'PNC Bank 1230 $ 200.00 GP#856590 KE rct.15747
10/5/2021 Dock and Deck Dudes,LLC Scott&Margaret Medon PNC Bank 1231 $ 200.00 GP#85659D KE rot 15748
10/5/2021 Dock and Deck Dudes,LLC Scott&Margaret Marion PNC Bank 1232 $ 200 00 GP#856590 KE rct.15749