86199A_Gatierriez; Richardo & Maria_20211018

CUS ❑CAMA ❑ DREDGE & FILL N9 86199. ��L A:. B C D
R •G E N E RAL PERMIT Previous permit t
Date previous permit issued
9�levv ❑ 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: t
I SA NCAC Y t [ 12 j ❑ Rules attached. LZ General Permit Rules available at the following link: www.dgg.nc.gov/CAMAruies
Applicant Name i1.. - Y ; r c •. a rn ti :,
Address 7 L
City Statee' /- ZIP
Phone # ( �C� r .� `�
Email c
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP i
Ad' Wtr. Body nat/ an/unk
Affected ❑ CW EW ❑PTA ❑ ES ❑ PTS I• y � )
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtc Body lV ; i
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Skoreline Length.
Access Length
Pier(dock)length
Fixed Platform(s),
Fle~latform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill 6
Max distance/ length t
Basin, channel
i
Cubic yards
e
Boat ramp
Boathouse[Boatlift `.
Beach Bulldozing
Other
- -T
SAV observed: - yeso�
Moratorium: n/ y ss no `
Site Photos: yes' no `
Riparian Waiver Attached: yes no' t
A building permit/zoning permit may be required by: ti_
Permit Conditions ?i. Lk, ! _t;iis��,•�
_41 —c.tr^ 1, roc. (t( J)aj elf
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AM
RULES
(Scale::!' )
a
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1NDCONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agi�Kt-or pli ant PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) 0&ek #/Money Order
s
Permit Officer' PRINTED Name
/
Signature
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 17 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

A%NT AUTHORIZATION FOR LAMA PERMIT APPI,ICATMN
Narte. of Property Owner Requesting Permit to u� €GC`�•
Manikin Address: IS 3 01 Y-Aa N as n C.
1�1D *20%75
Phone NurrOer: ` 40 0 ( 4 H 134
Email address: C't C a.,Y O { tar
owtify that i have authwzed v K a 1xx Y 1 J
Nqy 1�
to act on my behalf, tcx the purposo of apWng for and ObtMnMg an CAMA pens is
necessary for the ioro+Nir•.g pro Osed deveiopffwnt: (k I Vier- , YV 4y,
at my PMpKty+«aiedan k0 � ��,�c.� 1�f� � l.n l40���,t�r�, ��� 77qq
tt� Cc xity „,,
t (tirthenTKYO certify that t am niAhonzed to Want *W do in fad g not pOnnas.aQ" tr>
DvfS'Cn of Coastei iMarra_-W)ent staff. the Lori Peen* 00ftw aW the,r'r ageirts to enter
On the afo► ww7tux)u l kinds in c:onnookwi with eretrishngr Intofma&W► rerfalod to thrs
pwft,it appf/Cawn.
a',p wq!!! \)
�ICAR,Jbo 6(jft '2!?�7
PMW or %e 1Msrr�s
0w ueY
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086
Tvs certification is valid throix0 31 ��� ,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i hereb� certify that 1 own property adjacent to Ric--Gkf'At✓ Z 's
(Narne of propert� located at I�2 (U8¢f}� RIU Rt ACld �A -T# J_SG ey
on _ L' iTsuC k 50 Lc n3 b (Address, Lot.Block, Road, etN
�y} , in UQQ►Ttticl4 11t� , N-C.
(City/Town and/or County}
The apoiicant has described to me, as shown below. the develop
loprnertt proposed at the shave
I I have no objection to this proposal.
I have objections to this proposal.
{
' DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
-Prgmsibg development mast fits in description belnr► oraffacira Alfa
Y 20a Ff ?tca wi� Tti 1(,Y'7_S it T
1 Z &-Az-9 b� S x 1(s LOw L ►2 Dec�
f'�NJ ti 00 L413 LC SET 1-.. P-r ,/�j :s
DI AJ �-
WAIVER SECTION.,
I und"tand that a pier, dock, mooring pilings, boat ramp breakwater, boathouse, lilt, or groin
must set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If twaive the setback, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement
1 do not wish to waive the 15, setback requirement.
Tekoio
/n - l
Date
�} (Ad1a Owner �nationj
i Type Name
��%eat y t L�-�
(.7 W
w4U 3 % tit . T c- 7-?5G
for one calendar year after sigr►ature
TeAephone Number/email address'
IC,-2.1
Date'
(Revised Aug- 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
jj
1 hereby certify that I own property adjacent to' RICtM-U0 's
(Name of Property Owner)
pr�erty Rotated at L0_E OT. RIUt<R t�EAc la Lm le . �T4f?VJSLA(4e(r Mk —
on Lot,Block, Road, etc.)
on ,iR(ZITUCk SC9C«3b in UUCI ITAcK, NO- , N.C.
(W��y) (CitylTown and/or County)
The cant has described to me, as shown below, the development proposed at the above
locati
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
P Sin9 ei�sva/opment must fi►[ hi.he1ou► o drowWo
f to X 20c FT rPI%a2 W]CM J(, y 2`b r-T D-SeK , �NCLut��ivC�
u4 Aj c-
WAIVER SECTION ,
I understand that a pier, dock, mooring pilings, boat rap7'breakwater, boathouse, lift, or groin
must 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_)
do wish to waive the 16 setback requirement
l do not wish to waive the 15' setback requirement
( Owner Information) (Adjacent Property OWM Information)
4 .Sig
i [urge
or Tie Name Pant Type
C tit ,,� J , I►ala�ngA15
CUTd.fl 514D/1Cs IUC-
l,� C' Sf N� • � cc -�
T Ntirnbert email address Tekptxm Nwnber/emad address'
e Dw,*
'Valid ibr one tsar yamaftr . (Revised Aug. 2014)

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FIRM UC# P-0733
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102 N River Beach Ln
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