86113A_Arnett, Grant @_20211015

®CAMA A DREDGE & FILL � N9 86113 B D
fA 1) GENERAL PERMIT Dae pPrevious ionpermit
� Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and die Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 7N • I 100 Rules attached. ® General Permit Rules available at the folloWng link: wwwwMnc.Poy/CAMArvles
Applicant Name �9 rckyCA: S . flyne-Jk' Authorized Agent 'v''�
Address _ 3� i �C'kr2 C:�CLQ Project Location (County): �Lokw O.YI.S
city t k r f� ( K. State V0. ZIP X 35 (3 Street Address/State Raad/Lot #(s)
Phone # (22b- 14 -1(o 55 1 t ° 1 otd G.t p: s Lam
Email m4d 3� Cox , V�14 Subdivision --
city ZIP _ a'l4 4 l
Affected Adj. wtr Body i- l / tnardunk)
AEC(s): ❑ oEA ❑ lHA ❑ uW ❑ sPIMA �. PWs Closest Mai. wtr Body A 16e*I ale Aa!tl
ORW: yes no PNA: yes
Type of Project/ Activity i�kacQ_ j t' OP Well 24,
Shoreline Length — I t 1 / (ale: ! ••' )
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
1
Finger pier(s)
Total Platform area
Groin length/#
Bulkheadflength 1 l
Avg distance offshore % t
Breakwater/siN
Max distance/ length �or
Basin, channel
Cubic yards
Boat ramp
Boathouse/ BoatliR _
Beach Bulldozing
Other
SAV observed. yes
Moratorium: 4w yes no
Site Photos: (at no
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by. t iihnL1'Lr'3 (70•
Permit Conditions-
TAR/PAM/NEUSEjBUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONwom THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
a C.,a +f'�� 2o4"�c
Agent (cant Prl1TED tJ.- Permit s PR)IVTED Name r
Signature "NPlease read compliance statement on back of penWt—
A V(D. �' �139� �� 114 �lrSn
Application Fee(s) Chet* A/Money Order lssuing Date Expiration Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to a&9-1- 5• Jkbjc (r 's
(Name of Property
Owner)
property, located at
0©L-D C(PRE5$ L-AkibTi&-,
(Project Site: Add re s, Lot, Block, Road, etc.)
on � -Me &1fC'9 in FQTI'oQ-D I N(�C• a)194,+
N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #: Mailing Address:
Agent's phone #:
He/She has described to me as shown below the development he/she is proposing atthat
I location, and I have no objections to the proposal. �jPL-(�5r�1(t! [Tn� rJl� Kk,fLLJ�iZ�(�
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site
drawing)
If you have objections to what is being proposed, you must notify the 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.
(Property Owner Information) (Adjacent Property Owner Information)
JJ • (.W*-
Signature
Signature*
i')T c u A f L. (L f( 9 r-(

Print or Type Name
Name
Print or Type
l i I Deb W CUSS 1,1�1a16
Mailing Address
LTFVfj), At. )-icI44
City/State/Zip
(N) nl+- Ib55
Telephone Number/Email Address
7, // 7
Date
Valid for one
signature*
1 I q O L O C. YP rcFSS ZA i'D—t •v
Mailing Address
City/State/Zip
4 C- Z
Telephone Number/Email Address
l 1-I - ~
Date'
calendar year after
Revised Jan. 2017

Native trees and shrubs
ECM
1 (V) /
Filter fabric
Crushed stu
-Riprap stones
Z 00 •iseas000ess
Rove of large anchor
rocks in toe trench
M•

ram~

■ Complete items 1;`'Aand 3.
r.
■ 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,
or on the front if space permits.
Article Addressed to:
CAV4- w . -� Z�FeYe-4 SrECL-eJ
1 a 1 PttpbM,6 AtbCe PN.
ca-t N MLL!�� .44C 9 7A:>
IIIIIIIII I1I IIIII IIIIII IIII IN I IIII I I I
9590 9402 6712 1060 7864 68
2. Article Number (transfer from service label)
7019 2970 0000 7635 1830
3S Form 3811. Juiv 2020 PSN 7530-02-000-9053
A. Signature
((�
X / ,•,t/�� \"�
�1�
❑ Agent
❑ Addresse
B. R ived by (
ri fed Name)
C. Date of Deliver
D. Is delivery addess
different from item 11 ❑ Yes
If YES, enter delivery address below: ONo
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered Mail*"
Signature Restricted Delivery
El Registered Mail Restrict
,rdult
�J Certified Mail(ID
Delivery
❑ Certified Mail Restricted Delivery
❑ Signature Confirmation'
❑ Collect on Delivery
❑Signature Confirmation
❑ Collect on Delivery Restricted Delivery
Restricted Delivery
❑ Insured Mail
nsured Mail Restricted Delivery
over$500)
Domestic Return Recpin

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HerquImans C315 11-1 Otcl
9/3/2021, 3:16:27 PM
Address Points perquimans nc easement Imagery 2020 Blue: Blue
perquimans _nc_misc perquimans _nc_dims Red: Red Imagery2016
1:564
0 0 0.01 0.01 mi
0 0.01 0.01 0.02 km
State of North Carolina DOT, State of North Caro:ma DOT, Esn, HERE, Oartnm,
INCREMENT P, USOS, EPA
perquimans__nc_lot perquimans_nc_acres Green: Green
M, � S Vt� r �ej� perquimans map
let '\ _ c j�- 1 1 r For tax purposes only. Not a legal Document or survey. perquimans nor State of NC assume any liability resorting from use of this map.
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C,-4) l t~ t vc` Z35-(I

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117 Old Cypress Landing