86151A_Perry, Bryan & Susie_20211025

di0tO1Sr41, �bAMA DREDGE & FILL {` 1v .``� �•) (40 � �' 1 � B C D l�
Previous permit
amG E N E RAL PERMIT Date previous permit issued
�Nevv ❑ 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 r t34"7 ❑ Rules attached. ® General Permit Rules available at the following link: wvwv.deq.nc.govLCAMArules
Applicant Name _ T7 1 Q_ In 'i- -� Gk,% .l r 0-r- Authorized Agent � P rF L�
Address SS. r 6 eX 49 Project Location (County):
City Erl A c.o State NC ZIP Street Address/State Road/Lot #(s) _-
Phone # 23 9 �'____f- �ri---
Email QSCo Subdivision --- -
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City 11 �X_h-n--- _ zIP
Affected ❑ eW I.EW N-PTA ®ES [AIPTS Adj. Wtr. Body
AEC(s): ❑ OEA ❑ IHA ❑ U W ❑ SPIMA ❑ PINS Closest Maj. Wtr. Body /lt A G o J a U\ c
ORW: yesll\o PNA: yes) / !
vt, �7 �'- I � (. I t C � t/� r "� �F. ✓ t /
Type of Project/ Activity G- a ` /1
N( c4- `r -k (A -v— �� �, � 4 '� 2f � s � � � � e r� Z s f W 0 ( (Scale: N T3 )
Shoreline Length 7 00
Access Length _
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Pier(dock)length
(e- n
Fixed Platformis)
Floating Platform(s)
Finger pier(s)
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Total Platform area �
Groin length/R
c"
ulkhead Riprap length 3J
Avg distance offshore _ % •
Breakwater/Sill
Max distance/ length
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channel
Basin, channel
fi
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing -
Other _
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SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
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A building permit/zoning permit may be required by: �� —
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Permit Conditions (np4 n)`p _.Dls 'ru Rlfd n1C C- L
L.it l 91-1 A Q 19 �_ F a s c.- a
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❑ 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. J+ (Please Initial)
r !Ce
Agent orApiAcant PRI/�ED Name Per it Officer's PRINTED Name
Signature •`Plea a read compliance statement on back of permit •' 5i 50fure
Application Feels) Check 11/Money Order Issuing Date Expiration Date

PAMLICO SOUND
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BUXTON, NC a
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BUXTON BACK ROAD
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NOT TO SCALE
CAMA GENERAL PERMIT PLAN FOR
BRYAN L. PERRY
SUSIE E. PERRY
48184 DECOY ROAD
BUXTON, NC 27920
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1.21I acres
52,7,,46.41 sq ft
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Scale Date
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EXISTING I
DWELLING I

Mailing Address:
P.O. BOX 25
Frisco, NC, 27936
Telephone Number:
252.473,8388
I certify that I have authorized Gary Price agent to act on my behalf,
for the purpose of applying and obtaining a CAMA Permit necessary for the
proposed development of: bulkhead construction.
My property is located at, 48184 Decoy Dr., Buxton, NC, 27920
I further certify that I am authorized to grant permission to the Division of Coastal
Management staff, the Local Permit Officer anf their agents to enter upon the
aforementioned lands in connection with evaluating information related to this
permit application.
This certification is valid through 12/30/21
(Property Owner Information)
Signature
Print, dr Type Name
Date
2.�? q7; q
Telephone Number

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Q' Certified Me# fee
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ESu1Y. Ua.. �.3�32- I

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:
Address of Property:
MYAA/ L. PCRRY
419 A8 q-1Y6QY Dk- 7 13uY11-A:.:1VLs 23925
Mailing Address of Owner: PD I3VX 25. FF. IS' P, NL 279 3 6
Owner's email: br'yan L2Fr,sccrrxlu, i 4eJn Owner's Phone#: 252`17-3* 83,99
Agent's Name: LEA Y FRILB Agent Phone#: 2! 2• �p5. *:?`f
Agent's Email h&4Adi ssijrrLYinctc� Lu4
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
I hereby c ify that I own property adjacent to the above referenced property. Th ividual applying for this
permit has cribed to me, as shown on the attached drawing, th�dment they are proposing. A
descri tion or win with dimensions must be rovided with this J
I DO NO ave objections to this proposal. I have objections to this proposal.
If you have objections what is being proposed, u must notify the N.C. Division of Coastal
Management (DCM) in ,rift within 10 days of r Kr of this notice. Correspondence should be
mailed to 401 S. Griffin St., S 300, Elizabet ity, NC, 27909. DCM representatives can also be
contacted at [phone]. No onse ' considered the same as no objection if you have been
notified by Certified Mail.
VER SECTION
I understand that any proposed er, dock, moors pilings, boat ramp, breakwater, boathouse, lift, or
groin must be setback a mi ' um distance of 1: fr my area of riparian access unless waived by me
(this does not apply to b.4Wheads or riprap revetments). you wish to waive the setback, you must sign
the appropriate blan elow.)
I DO wish toy4ive some/all of the 15' setback
Signature of Adjacent RipariaK Property
not wish to waive the 15' setback requirement (initial the blank)
.- Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
X141 Date:
ARPO's Phone#:
'''waiver is valid for up to one year from ARPO's Signature"
Revised May 2021

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