86110A_Albemarle Shores POA_20211014

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GENERAL PERMIT A 1) Previous permit
® New ❑ Modification ElComplete 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 NCAe Rules attained.EJ General Permit Rules availaak0W
a at the ioling Nnk: www, ft.rK JRM C4Ms � U'
Applicant Name _A. i bf� A L S k a t`P's {P G A Armed Age
Address
,+ 202, ostl r Q Dr. Project Location (County): �t LcA
city 954e•1l YN State New ZIP R-7 . StreetAddress/State Road/Lot #(s) 14 * z-
Pho„e#(ZL )'IIZ- 23 7 125b bTL"*,VnSc t�'rn dl-,
:' +
Email_ .QSt�t'Ci' 0 L cts7Y1 Subdivision AIbelhA,it tl�re-,
City zip �L7 9 3 Z
Affected CW ®E W PTA ® ES ®PTS Adj. WV. Body ,L/►1�manrunk)
AEC(s): OEA ❑ iHA ❑ UW SPIMA 0 PWS Closest Maj. Wtr. Body Ft be ar- to S
ORW: Yes PNA: ye no
Type of Project/ Activity 6a1.l e> <, i5 + X Zd %pC)t.�""—� (Ccrv(•i+c.Ge� �,.al t - S r,1X'j�
ShorelineLength}1- ($Cafe:IJ'%7"
Access Length ^' i i
Pier (dock) I*trtgth P -' - � � _i . t � _ jar-.
Faed Platform(:) ,
Lt
Floating Platform(s) , 1-+-=. l -
^+ i I
Ir
Finger pier(:)_ --I--•-- t _ --
Total Platform area t t �_., t
8t/ 1 r r ; , 1 ; {_ r- Y x.-r--'-i
Groin lea h # r v"'�. �. ._-_•+__t--t Lj �'1 --'•_ . ! _r
—rt1. _ - �--•;4�( r• ' � ir•-.)._...._: �. __ i i ' i i ' f i � i ; i i '!~ ( , r-�+
Bulkhead/ Riprap length " : _ _ i.._� - r i �ii-i� -� r- -�-j _ �- -r-y- ` .. r i
Avg distance offshore - _-i -1 j� _ r j j 'rL.. ( i .' �-• -,-..r
Breakwater/Sill4-4 +
V ' �`�� ` ! k' ' t
Max distance/ length
Basin, channel _ rllr----
Cubic yards i--F-^-�—}).. ' — —•r i �— f ' ` _ i. i i _...,. .f'"-� --r_^-1_.....--T--l—!
Boat ramp-�- • 1S' _]: ' r i r '-�� a + i
Boathouse/ Boattik i -- _ r_ , id + i
Beach Bulldozing._{_.a.
Other-�--
'-- i_+ l ~� • + � sue. � .-.,_._ r_ .'- -) '—;
SAV observed: yes �)-- 1' _.-+-.-. ` _, i
Moratorium: i' i ��-r+-_-
Site Photos: y s o -
Riparian Waiver Attached: -:.
A building permit/zoningit
Perm i may be required by:
Permit Conditions ❑ TAR/PANNEUSE/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 PROD
Agent o Ap nt PRI N
Signatu •• se read compliance ent on back of t � permit'
Application Fee(s) - Check #/Money Order
(Please Initial)
r-
Permit is RINTED Name
th
Signature
Issuing Date
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: / "i'7 ,�.L� 5 /�. ..fir f jayc-46
Address of Property: :',)�i i Aa.41b/:5 "y-r,41j, OE ,t1- A16 Z79:5 Z
Mailing Address of Owner: ;, t _'' 45 jr zj,Q%dAJ 1. /(f(' 27 Q3 Z
Owner's email: *01 Owner's Phone#:
Gc M
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner}
! 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 proposing. A
description or drawing, with dimensions must be provided with this letter.
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 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. DCM 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 pilings, 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). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback 9
-OR-
Signature of Adjabuvnt Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Printed name ofARPO: ��Aer—�Lj­ JG/AGC.Lf/"%A.th
Mailing Address of ARPO: _1� / //�C�1�) �`, , �A jAlt- 9; Z
ARPO's email: AdI&X,,67%,V6 6360K,RPO's Phone#: IX
Date: AG, 4 ZeZ / *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

It Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
Attach this card to the back of the mailpiece, B. Received by
or on the front if space permits.
Article Addressed to:
13.5-94? S,
OJ2N S-Okiti.
❑ Agent
C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery addnes&Wow: ❑ No
roN t)4 jai
3. Service Type ❑Priority Mail Express
II I II'III III I'I I II I I II I (I I I I I II II� III I II I I ( O Adult Signature ❑ Registered MailTM
❑ Adult Signature Restricted Delivery ❑Registered Mail Rest
❑ Certified Mail® Delivery
9590 9402 6413 0303 3792 30 Certified Mail Restricted Delivery ❑ Signature Confirmatl
❑ Collect on Delivery ❑ Signature Confirmatl
- 'r—& tram service labeO ElCollect on Delivery Restricted Delivery Restricted Delivery
7020 1290 0000 7853 7836n� Mall
Mail Restricted Delivery
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'S Form 3811, July 2020 PSN 7530-02-000-9053 Domestic Return Rea

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Dear Mr. and Mrs. Gursahaney,
The Albemarle Property Association is in the process of repairing the boat ramp on the community
property adjacent to your lot. The boat ramp will be situated in its present location approximately 55
feet from your property line. The plans for this project are attached.
To move forward with this project, we ask that you complete the lower portion of the attached N.C.
Division of Coastal Management Adjacent Riparian Property Owner Notification/Waiver Form that is
needed by the regulatory agency (CAMA) for construction activities on the Albemarle Sound. (A similar,
uncompleted form with "Tips" is also attached for your information.)
Hopefully, construction of this community amenity could take place in the near future and Albemarle
Sound Property Owners can have better access to the Sound for launching and retrieving their small
watercraft.
If you have any questions, please contact myself at (252-482-2337/[e-mail]) or Board
Member Bob Sciacchitano (757-613-7318/rsciacchitano@cox. net).
Thank you in advance for your prompt attention to this matter.
Sincerely,
Randy Jordan
ASPOA Board Treasurer

Albemarle Shores POA
Boat Ramp
6-27-21
Coffer Dam Installer Responsibilities
• Install coffer dam to result in a "dry" bottom suitable for the installation of
the concrete ramp.
• Dam shall extend a minimum of 5 feet beyond the limits of the concrete
slab.
• Excavate for the ramp and surrounding rip -rap to the depths indicated.
• Provide pumping equipment for the duration of the project to maintain
"dry" conditions until concrete is adequately cured.
• Install a 4"x6" stringer that is missing on the community bulkhead.
• Install a 2"x6" cross member that is missing on the community pier.
• Provide close coordination with the Concrete ramp installer.
Concrete Ramp Installer Responsibilities
• Provide any fine grading as necessary for the ramp and #57 stone.
• 6-inch concrete ramp shall be placed on an 8-inch layer of #57 stone.
• Ramp shall have a finished slope of between 120 and 150 and shall match
existing bottom at termination.
• Concrete shall be 4,000 PSI with 4% to 6% air entrainment and have a
slump of 3" to 4" at placement.
• Concrete shall be reinforced with #4 (1/2" dia.) rebar, Grade 60, placed
12" OC (On Center) lengthwise and 18" OC across. Rebar shall be
embedded in concrete 3" below top surface.
• Concrete shall have a rough finish to provide good traction and shall have
either 1" x 1" "V" grooves aligned at 60' to longitudinal axis or finished with
a garden rake with reverse tines to a depth of inch.
• Place rip rap 3 feet horizontally around the finished ramp on geotextile
fabric, at a depth of 24" to hold the #57 stone in place. Rip rap height
shall be no higher than the bottom of the concrete.
• Tie existing concrete slab to new slab (boat ramp) using 6 — 3/8" stainless
steel dowels equally spaced, inserted 6" into each slab. Fill annular space
around the rebar with concrete epoxy. Pour 6" of concrete between the
slabs to match the surface of the two slabs.
• Install a permanent sign at the end of the ramp that reads,
Caution!
End of Ramp
Shallow Draft
• Maintain dewatering pump provided by the Coffer Dam Installer.
• Provide close coordination with the Coffer Dam Installer.

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{ 5 Feet
Geotextiie Fabric }
- 3 Feet
Rip Rap
3 Feet }
3 Feet
NOT TO SCALE
6-27-21

. . . . . . . . . . . . ............. C.Mcreb
8' #t57 Stone
Transition to existing using smooth vertical curve.Dowel together.
Not To Scale
12% to 15% Slope
Geotextile Fabric
LWL
Match Existing
Bottom Elevation
12" Rip Rap

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