86410A_Fulford Family Limited Partnership_20211112

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`°""v �CAMA 3 DREDGE & FILL �� NNI?86410
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Previous permit
3 GENERAL PERMIT Date DrevioUS Dermit issued
E New ❑ Modification L' 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 , [A - ( ! 4C3 E Rules attached. ® General Permit Rules available at the following link: www.dea nc&2&AMAru o
Applicant Name 1r'-kX Qrd 1`IQ.'(Y�tIU L...I'm t K6 Mrtne>r* Authorized Agent er- L
Address °� ���.t_� e� 1--V\ Project Location(County): WQ & c+tijylS Qj%-S r�J
City RVI C*ur&K Stare �c,. ZIP _�VYZ_ StyreeetAddress/State Road/�LLo7t#(s) � ��'t lQ 11/P_Ar� SieCZ�S I,
Phone#() 2GZ" 11CX°! T0."'�q #
Emall '^" ` Subdivision
City d zip a?aqq
Affected CW ® EW ® PTA ® ES PTS Adj. `/Vtr. Body 1.,-A414- Z,�VCPi`_ _--Q%+aiuunk)
AEC(s): OFA IHA UW SPIMA PWS Closest Maj. Wtr. Body A{ YlCLi- tz Sdu
ORW: yelm PNA: yeses
Type of Project/ Activity ►� (� �- 3�oi'c� R k2c�►
(Scat
u-
Shoreline Length
Access Length ;... •.(.
Pier (dock) length ._
Fixed Platform(s) ..............
Floating
Floating Platform(s}
A'.
'I f t Finger piers , , ;py,rI, (—._.1}.r;=
_
�_•-1_---a--•.r- {—'--i—....__.�__t s..�._._.e--3-...L _i. .L.—._ice _ .L J lZ.t ... _• � •_ S _ — 1 —�_ ,
Total Platform area
i r I
Groin length/# .,. .---r•--;--'-r t-w' �-•--: r � -r- � .— i•--. L.-w ^•--t_—. c _ ..-! ' _e_ rt
I ! r i4 _euhea Riprap length
'
to
1
Avg distance offshore 2
�,
Breakwater/Sill
Max distance/ length
h
>7
Basin, channel
Cubic yards
Boat ramp � . - -�'-
a � -. _.._- r•-...�"_„--�--.r!....
Boathouse/ Boatlift ;
71
Beach Bulldozing_,
Other
jj 1 T
SAV observed: yes i _ . _..j ._.: _. __ r
{� I
Moratorium: � yes
tkk
Site Photos: �'�+ ye no r
� 1 r... __ r_. .__ — — _._. .. ,_.i.. _.� _, .t--..
Riparian Waiver Attached: yes __� '.�___�.<
1 AM AWARE OF
ent or Applican
Signature`PI as
Application Fees)
TARMAM(NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on�T
CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE`SSTTA_TEMElNT (Please initial) _
Permit Offis PRINTED Name v
back of perm it'
1135 3/fz/zi
Check #/Money Order Issuing Date Expiration Date

DigiSign Verified: 58B 1,90FE-F56F-4DA6-8D6F-E7E232CBEOF5
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 09-23.2021
Name of Property Owner Applying for Permit:
Malting Address:
-71 3q La rn �, ) �j j
I certify that I have authorized (agent) 1Z I /UGG 0Z ��_%�'"'�J to iocoday
access the below property
t19 Ke`f U for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) n t.�: jf rIJ�M t�ur�lteuc
T'
at (my property located at) oS r" 72,f- /C, ve t/-SLio!,-,s ��,tets� ,
}?ef2 In,ur,;�s (ou �,7�� '�" n# , l� � `7 - OO (o -- c C, 6
48 Y A)( R�
Dee cC 5
This certification is valid thru (date)
09-23-2021
Property Owner Signature Date

■ 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,
or on the front if space permits.
1. Article Addressed to:
c1^1 CcIle-iKe—<<l
too 3 O' Ve'+G,k4r- 13IVs
prAWIC, �27a L4N
A. Signature
❑ Agent
Addresse
B. f3ec ved by (Pri ed lame) C. Date of Deliver
D. Is delivery address differentWorn item 19 ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered MailT"
I'll
II III
III
I I I
I
III"
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Il
I
I I I
❑ Adult Signature Restricted Delivery
El Registered Mail Restrict
❑ Certified Mai
9590 9402 6361 0296 8607 51
Certified Mail Restricted Delivery
El Signature ConfirmationT
❑ Collect on Delivery
❑ Signature Confirmation
2. Article Number (!ransfer from service label)
❑ Collect on Delivery Restricted Delivery
Restricted Delivery
3160 0001 2522 4485,
'd Mail
$5 ail Restricted Delivery
7020
nrm . h�lv 9n2n PSN 753n-n2-nnn-9n53
Domestic Return Receipl

n
0
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7
7
D
a
n
;ertified Mail Fee
13.75
�xtra Services & Fees (ctmkbox, addfw4p
❑ Return Receipt (hardcopy) $ F =' =
❑ Return Receipt (electronic) $
❑CenRed Mail Restricted Delivery $ r. -
❑ Adult Signature Required $ t,�_
❑ Aduh Signature Restricted Delivery $
bstage
'otal Postage and Fees -
Postmark
�\ Here
l
7 Sent To 11 II j
U h A G l-1 -
l------------
----------- - 1
� Street and �Pt. No., or P� Box No. 1 --
--J13 IYA-----------------------
c;ry -7 cI `1

D
Domestic Mail Only
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For
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O tFM S E
u
U
Certified Mail Fee
n
U
$
Extra Services & Fees (check box, add Tea )
❑ Retum Recelpt (hardcopY) $ a
❑ Retum Recelpt (electronic) $ t i ! !! I
Postmark
❑ Certified Mail Restricted Delivery $t tt� ^�
Here
❑Adult Signature Required $
❑Adult Signature Restricted Delivery $
AIS
:3
Postage
13
rl
- - - —
Total Postage a
_ 1. ...
Sent To ``
U 1�t ! Y e---------------------------
----------- rr.
7 $treat and Apt No., or PC7 Bo No.
--- ---- *S-a �/ Q_cA k.�^---- --- ht,J- ---- -- -------
City State, ZNP ,,+ 4 ,,J t .N C. I-1Q 7

( A
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 �ixlpRa Fur ��� �(f� �4`��
(Name of Property Owner)
property located at c fiP" J elz P1,-J Kam"
�[ (Project Site: Address, Lot, Block, Road, etc.)
on � i lf' l� c v : 2 y in Pe a I "h'A ,,-s tl c, � .�7� _, N.C.
(Waterbody) � �,v sty �J (City/Town and/or County)
G-.
Agent's Name #: &A,; 3 ► Q &t Q 1.4•0 D +-7A14ej'- Mailing Address: P (D ilo)Z
Agent's phone #: C) l o kp
He/She has described to me as shown below the development he/she is proposing at thatcation,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
()Individual proposing )development must till in description below or attach a site Q)
dra in,
1c �
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weStThyta+ej,als w, It AC
F K /V �u lk�«fire L>r
iai 1r* �(sc lac � . `j n
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i,e cc �r�Q Qeri dct M 4io L-1c 4 ! //u 5 424 tE; s 7 P3 S'!'o/Qe
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 (252) 264-
3901. No response Is considered the same as no objection if you have been notified by Certified Mail.
(Prop Owner Information) L
Signature
Print or Type Name
..��%e
Mailing Address
�7"Ik ("hurCti VA 2ci/z
City/State/Zip
�r,Gu15 Telephone Number / Email Addressj
Date
*Valid for one calendar year after signature*
(Adjacent Property Own)q Information)
Signature _.J �J
Print or Type Name
Mailing Address
City/State/Zip
,q-C3 �L- 4 56�-
Telephone Number / Email Address
�--%-a/
Date*
Revised Jan. 2017

Perquimans GIS
9/13/202 1, 1 1:42:19 AM
perquimans_nc_misc perquimans_nc_dims Imagery 2020 Blue: Blue
perquimans_nc_lot perquimans_nc_acres N Red: Red Imagery2016
perquimans_nc_easement IN
M Green: Green
1:2,257
0 0.01 0.03 0.061
0 0.02 0.04 0.09 km
State of North Carolina DOT. State of North Carolina DOT, Esn. HE!
INCREMENT P. USGS, EPA
Perq
For tax purposes only Not a leoal document of survey. Perquimans nor State of NC assume anv liability resullinq from use

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Perquimans GIS
• 11 /8/2021, 11:05:13 AM
Address Points perquimans_nc_lot perquimans_nc_acres
Centerlines perquimans_nc_easement Imagery 2020
perquimans_nc_mic perquimans_nc_dims Red: Red
Fulls C9.�, 1�0. 2Zoti Z.
1:4,514
0 0.03 0.06 0. 12 mi
Green: Green
0 0.05 0.1 0.2 km
state of North Carolina DOT, State of North Carolina DOT, Esn. HERE, Garmn.
Blue: Blue INCREMENT P. USGS. EPA
Imagery2016
Pergmmans GIS
f or tax putrxwses only Not a legal Ca:umont rx survey PerrImmans ax state of NC assume any tabdny resulting Ran use olthis rrep

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