86118A_Schriefer, Walter & Susan_20211022

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XCAMA El DREDGE& FILL N9 86118 B C D
Previous permit
GENERAL PERMIT Date previous permit issued
NONew []Modification [JComplete Reissue ❑ Partial Reissue
As authorized by the Stain of North Curolina, Department of ErMr=TwnW Quality and the coastal Resources Commission in an am ofenvircomentai corIcam wwAnt to:
I SA NCAC 114 Rules attihd. fo General Permit &An the jolbft k&.
Ap*antNwe U._)CL14r 1SV,-S0LY\ ZOnrAAC MthordAprit 5=,,j L\S%M& &A: 1 (4 ec'\
Address __IQ5_hL I I
_ gL�Mr Project Location (County):
city VmrA s. W,, zw 'aJ"Wit Str. A&Vew/Suft R..WLt IT #
RXXM # () -70 Z 0 jqq e _ftc,6
&nafl— LVk_Srj%Cjjff0_Cd244t. Subdivision A E-.}iljll
city _21p
Affected❑ ❑m 0 K pn A4• oar: \If.A�r,
El r%
AEq-* EJOEA DINA Eluw E]sP,MA F-1 Pyn a. Mai. w,,. Body ft. etg sais-Ij
OKw:VesA0 PK& yese
TV" of "ftV ACbVKV cinis hupA a 101 r xi,
e5 1 f - e±r_ 01'a worrv, x ao, b,
Shorelln
T ;t2ff,
Access Length
ra
Pier (dock) length 107' YV
Fixed PI., ua
Ar-J Y
4t
Floating Pkfform(s) L7L.V0
Finger pler(s)
T-
j_j
4
#
. . .......
Total Pladorm area LL L
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore . . . . . . . . . .
T
A
Breakwater/Sill
Max distance/ length
Basin, channel
Cublcyards_
Boat ramp _T I 4
'i 10 %
308toft X 2jr,61
Bea Ildozing
Other 1-4
SAV observed: yes
Moratorium:
yes no
Site Photos:
no
Riparian Waiver Attached.- yes
A building permK(zoning permit may be required by.
Permit Conditions
I AM AWARE OF STATUTES, CRC RULES AND CoNorium TKqT AppLy To THIS pRM
m(dide- btimoliDw
.4 Applicant PRINTE—D-V
��_�
eread compataVce statement n bark of permit"
a0b.a jq 5 (017 (0
Application Feels) Check #/Money Order
_J
;1V
4—
T
❑ TWA"8JSWWFFER(CWd.one)
❑ See note on back regarding River Basin rules
❑ See additional notes/condrdons on bade
(Please Initial)
Signature
jVj.Lj.ttj
Issuing Date Expiration Date

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address: 4 Mt
�Wa( tic P �P ug
Telephone Number: ' o ag � o
I certify that I have authorized ,� }�Jtir-4 #PMe- `$V` I '�-e-KS (agenticontractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of ��* �' �' S -ee.
at my property located at aee ch fO`'-H 96i f e. l.o�- 5 fl
This certification is valid through I b 0 / Z.0" - (date).
(Property Owner Information)
Signa
Print or Type Name
0 W/let,--
Title, co. owner or trustee for property
q(�C) �21
1t are
SR3- -703
Telephone Number
Email Address

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby cerfify that I own Property adjacent to
(Name of Properly Owner)
properly located at Bch 10 - • py-. — L. o 4- S A ge o ch P t-
(project Site: Address, Lot, Block, Road, etc.)
on apir� �►/22.K in r-i- ord��e,� �«nallS LrovltfY N.C.
(Waterbody) • , , . (City/Town andlor County)
Agents Name Ik- �'1 Mailing Address: j '� b '�- P t es-,-, t-1 -u -(
Agents phone#: Fib , ly C a -7 5
He/She has descn yy t6 me to c
f3ede as shown below the development hetshe is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(IndMdual proposing development must fill In description below or attach a site-drawirr)
t
If you have objeadas to what is being propose4 you must notify the Division of Ccsastal Management
(nCM) in writing w hbin to days of receipt of this notice. Comaspondence should be mailed to 40f S.
Grlflin Si,, St+e sloe, Elizabeth city, Ar, 27W9. DCM representwmscan also be costact+edat(M) 264-
3901. No response is considered the same as no ob%ection if you have been notified 4yCertlfied Mail
(PIcw0 er Information)
Signature
Print or Type Name
05 (f,'rG1e �Qs{-
Mailing Address
k,r --G,rd I �) c A '19 q �l
CitylStamop Telephre NumberlEmad Address
2�D 2o2
Date
"Vafid for one calendar year after signature"
(Adja owner Info 'on)
Sig ature`
}Ibemalle P1 o� f�.��c s�,y for-'
Prfni or Type Name C- -- cha�J
��a ea 5VIOkI L Alt/ .
Mailing Address
c�
04ysiaEaop /2
a 5d - (J &&,a 5 -.,,-f,Ykr pailb& z
Telephone N r/Email Address
%
Revised Jan.2017

! hereby car" that I ow property adoow t tO
W,ller ,5
(Nome of Pn*erw
praperfytocad�edat t 1 q ' D'' D S- Kk £feet A F'o:^ 4- -
(PmptSte: A�� es Lot Brock, Or-)
P, M C�� Yt � Al 4�" KcL y4CS jtil,lCi,t'1S Cqua `l . N.C-
r,- (We arbody) iCit�Rawn andfor Gorettj►} { _t , c t-� �1y .
Agars Name #� ---,3 ^ •. t:n., At3dres--
AgerWs prone
Cf
HQISha has desriU to measshown beicw the dasek*ff Ott hehsite to pr+opowig atthat won,
and I twa no objecdorm to the proposal.
DE,SCR*rrm mDIOR OMWM OF USED DEVELOPW+if
#n*Adad. g pyw**pxmWtAffb3 d oes hdbwara0 h aAift a hwftW
aul
(DES in wrMW wMij fddrya atreCW ofdds rrOOM Can*eloandar�as shaaW be rvaiJbd to 409 a
a*Wn st, 8030IR 0 1 a CjtK MC► VM DC�r � swrralsa i»c at } ai4
390t. Abe.wawaai�scor�gdbrtrdtl,.sa�easroafgediandy+arrlbsar.r�o�edt+r
t hvfb�)
(�liC+r Schr,'e
Prbt or Type Hama
kx-+tea f c a -7`4 y q
$A 3 -^70a -,Q?6o Wit 50w'i "'' oaf- ne
T Number -/lam Alas
Gt ,� z "52
Deb
*Vabd fior ester year a�
PY*rarType Name
Ak
TstApnans AkwxbertEmW Ad*ow
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I er uimans nc easement Imagery 2020 I
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perquimans_nc_misc perquimans_nc_dims Red: Red Imagery2016 INCRNorthEMENT USS�AsaleolNoMCarolnaDOT. Esri,IfRE.Oarr�li",
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