Poole, Betty Sue & Scarboro, Peggy 80499C

I- AMA / L] DREDGE & FILL Na 80499 A B D
r. ENERAL PERMIT Previous permit #
ew I ]Modification DComplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality t f�
and the Coastal Resources Commission in an area of environment concern pursuant to 15A NCAC
^ I CiC ules ched.
Applicant Name '1 ) Project Location: County---
Address(�_��� n y Street Address/Sate Road/ Lot #(s) _
-
City_.. State UY ZIPs-
�1'1'`
j�Cj, Subdivision_- --_----
Phone #�_ - ail
Authorized Agent'----' _ _ City_ __ ZIP
❑ CW EW�PTA i1 ES ❑ PTS Phone # G 7�jJ7 Ri er Basin
Affected :7 IH ❑ UBA ❑ NIA 1
AEC(s): ❑ OEA ❑ HHF ,p � nat man unkn
Adj. Wtr. Body--%�,''�, �" __ __ _— i`'' �(----l—L: )
❑P U
Closest Maj. Wtr. Bod - - --
ORW: yes / So . PNA yes /
Type of Project/ Activity
Pier (dock) length _
Fixed Platform(s)a I
Floating Platform(s i '
Finger piers) _ __X .s/-
Groin length number---- -
Bulkhead/ Riprap length
avg distance offshore'—�
max distance offshore
Basin, channel
cubic yards __ I
CT.
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing --- -
Other_'-
Cur
Shoreline Lengthq_��_ J .
SAV: not sure yes
Moratorium: n/a yes no
Photos: yes no
Waiver Attached:
A building permit may be required by: '
( Note Local Planning jurisdiction) / .P
Notes/ Special Conditions71)i1 41f
Agent or licant Printe ame
oor
j ( Si nature Please read compliance statement n ack
644.A_ _- _ _ _ __
of pe mi
Application Fee(s)
heck
(Scale:
A
fA
�'! x"► I a
_ I
rid,�_
L] See no on back regarding River Basin rules.
Si toe r
r f
PLC-/�1
Issuin Date xpiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific 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 or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ 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. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AMA / ❑ DREDGE & FILL 9 80499 A B U D
ENERAL PERMIT' Previous permit #
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality j (�
and the Coastal Resources Commission in an area of environment concern pursuant to I SA NCAC 000
,'1L"� ules •ached.
Applicant NameL Project Location: County
Address j —M/) ►, , : M ✓%/ , _ I _ Street Address/ State Road/ Lot #(s)
City
Phoi
Authorized Agent- ------
Affected ❑ CW X EW
AEC(s): ❑ OEA ❑ HHF
❑P
ORW: yes / X0 PNA
Type of Project/ Activity
Pier (dock) length ILA
Fixed Platform(s)
Floating Platform si
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore '
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
PTA ❑ ES ❑ PTS
❑IH ❑UBA ❑N/A
yes /
Shoreline Lengthy %J
SAV: not sure yes o .-.....
a
Moratorium: n/a yes no
Photos: i yes o
Waiver Attached: yes` no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
A A ,-
Agent or Applicant PrinteTName P
ISinature e. ,lease read compliance statement n ackofpermit. S
Application Fee(s) heck l;
(Scale:
/, 30
❑ See note on back regarding River Basin rules.

AW tau} MAY p2 H'q c 0 Ulm 88?
AD, ACENT RIPARIAN PRC)PERTY OWNER STATEItiAf u
i hereby certify that I own property adjacent to ?ray S0 Qoo(.6 + r �C4'vcklo
property located at—�l lkx Ot-O OAAJ. CUAI (Name of property Owner)
°•Smut �' '�`2C t2u c -61 .
(Address, Lot, Block, Road, etc.)
on i� tn�4'cY �4\Jk� - — in mtsr . t�1C.� � 1: o.
(Waterbody) _ (Coityffown and/or County)
The applicant has' described to me, as shown below, the development proposed at the above
lacatioI.
!have no objection to this proposal.
i have objections to this proposal.
DESCRIPTION AND/OFF DRAWING OF PROPOSED DEVELOPMENT �.
(lndiaiafual.proposing development must fill in description below or attach a site drawing)
;"tI'; " ,IV!' I-;
.lJI -. -(h 20211
WAIVER SgCTtflN
I Urwierstand that a pier, (tack, mooring }pilings, boat ramp, -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.)
> It i do wish to waive the 15' setback requirement.
I do not wish to waive the -1 setback requirement,
(P arty Owr Infarmation) - - (Ad .acont Property Owner Information)
Stb>ra ! r•� Sigma tcr•e `
PKht or Type Name Print or T Namp
VIER
ivma
Mailing Address - - - — tVTa ii AOre
(��..�(,t�t���•-
�riryisearelzio cityistatelzip
Telephone NNuniber/ mail address Tetophorre Nurnberlamait vddress
Date Date{
(Revised Aug. 2014)
"Valid for one calendar year after signature'

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ov-, RECEIVED 05/18/2021 01:59PM
18-1116y-2021 14:59 User Two Z527262636
1111e, aO Causp-r,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 'i(5� n
(Name of Property Owner)
property located at (aa, OLD CAoscc,Ay 1,2
(Address, Lot, Block, Road, etc.)
on LW�o�T" t2"\rk� in %eAvyt2" or (Z N.C.
(Waterbody) (City/Town and/or County)
The applic t has described to me, as shown below, the development proposed at the above
locab .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(hidivldual proposing: development must fill M des.crlptlan:'below or attach,a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 Ish to waive the setback, you must initial the appropriate blank below,)
71 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
op rty Owner Info ati n (Adjacen Property wner InforrpAtion)
Si natu e Signahtre* ArtE
aORtsEZAO� AXw0 Ad
Print or Type Name ('�
�
?3E7ry Svc � fOOL'e a, 7cVo-
Mailin Address
city/state �At u T-s C.E ,
Telephone Number/email address
t)ate
*Valid for one calendar year after signature*
Prrnt or Type Name
Mailing Address
City/state2ip
Telephone Number/email address
Date*-------_--
RECEIVE!P
AL 15
DCM-MHD '1TY
(Revised Aug. 2014)

9?13y 641) Way M wq{t, o f-11LO
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to � / SIJ fodc.c -I- �6 r �r�30
_ (Name of Property Owner)
property located at _ 1 ads 01-4 -S>K
(Address, Lot, Block, Road, etc.)
on t4GV bz\ KNE-K , in B r.1c._ {'�' Co .
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
_ I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
HF("'r::IVFD
JUL. 15 ?021
D(W-WID CITY
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(p erty Ow r Information) acent Property Owner Information)
Sign t r (' Sigma ttr•e
`1 SrJ,06�t .kaeBoea I✓ C° .
Type Name/ Print or TvnA Narru'
Print or
#'%o�cZ,
Mailing Address Mar ing Address
City/State/Zip OWStatelZip
Ct (SIV%
Telephone Number / email address
--. Telephone Nu ber/ mail address p ���
__�------- - Date*
Date
(Revised Aug. 2014)
*Valid for one calendar year after signature

Ll
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 8cTV
iOF ?()0(
Mailing Address: 313 FA�t�V t�vd ��tvE
ErALS
Phone Number:
Email Address:
I certify that I have authorized
Agent! contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at�aa
in l County.
I furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
v 61 Signature
l9 LTr-/9oe FOOL-r Pe-lsGY 5c,2 Lev
Print or Type Name
?A,eP�
Title
1_T_1 -20�
Date
RECEIVED
This certification is valid through �2 /-3 �__l 0� JUL 15 2021
i:)CiVi-MFiD CITY

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4VES IS 0.6' INTO HWY R/W
RECEIVED
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Directions For Filling Out A CAMA MINOR Permit
Please fill out the application completely including applicant's signature on the second
page. De sure to complete the "statement of ownership" and the "adjacent property
owners". Your Local Permit Officer can assist you in preparing your application and project
drawings. Once the application and drawing(s) are complete, follow the instructions below:
SEND THE FOLLOWING ITEMS TO THE ADJOINING PROPERTY
OWNERS: CERTIFIED/RETURN RECIEPT_ MAIL IS RECOMMENDED
A letter stating you have applied for a CAMA permit and are required to notify them
of your intended project. (Attached please find an example of this letter)
2. A copy of the application drawing(s) showing your project.
3. A copy of the completed application.
BRING THE FOLLOWING ITEMS TO YOUR LOCAL CAMA PERMIT
OFFICER:
A $100.00 check payable to LOCAL GOVERNMENT
2. The completed, signed application.
3. The project drawing(s) showing your proposed development.
4. Copies of the letters mailed to the adjoining property owners.
5. The certified mail receipts from the post office showing that you have mailed the
letters to adjoining property owners.
6. A copy of the property survey (if applicable).
7. A copy of your Zoning Certificate and/or Improvements Permit, for installation of
your septic system (if applicable).
This process usually takes approximately two (2) weeks from the date that we receive your
complete application. A review period of 25 days is provided by law and an additional 25-
day period can be imposed when such time is necessary to complete the review of the
proposed project. Under those circumstances, you will be notified of the need for an
extended review period. if you have any questions about the Minor Permit application, your
project drawing(s), or any otherMPrograment Act 0ff ce(CAMA),
please contact the LOCAL GOVERNMENT CAMA Local Perm

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PROJECT DRAWINGS
1. All drawings should be drawn to scale (ie. 1"=20', 1"=30') and include the following information;
- Name, project address, date and drawing scale (title box).
- Property dimensions and names of adjacent property owners indicated
- Dimensions and location of all existing and proposed structures, driveways, and sewage
disposal system (attach Improvements Permit, if applicable). Decks labeled as covered or
uncovered and dimensions shown. or Normal Water Level (NWL)
- Adjacent water body labeled and Normal High Water, (NHW)
contour shown.
- Marsh and/or wetland areas labeled (wetland delineation documentation from USACOE
Army Corps of Engineers must be included with the application, if applicable).
- All areas of ground disturbance and/or landscaping shown.
2. If your project is in the Ocean Hazard Area, your application must include an AEC Hazard Notice,
signed by the property owner. Additional information for project drawings in the Qcean Hazard
Area AECs includes:
Show all dunes and dune system contours, labeling the dune crest and both the landward
and oceanward dune toes. Also, include spot elevations on the highest portion of the
dunes.
The first line of stable, natural vegetation as flagged by the LPO and the applicable setback
from the vegetation line. Contact the Local Permit Officer to stake the vegetation line for
you if necessary.
rawings showing
Cross-sectional/Elevation dwing the number of floors and the roof and deck
profiles of the proposed structure(s). Additional drawing(s) for each floor plan may be
necessary.
List the Total Enclosed Floor Area. Total Enclosed Floor Area is the combined
square -footage of all heated or air conditioned living space.
3. Additional information for project drawings in the Coastal Shoreline AECs:
Dimensions of the footprintiroof line of all structures (outside walls + roof
overhang extended to the ground).
Dimensions of all decks, labeled either covered or open (all elevated decks with
concrete below them at ground level are considered impervious).
Normal high water (NHW) or normal water level (NWL) contour.
Show the applicable Area of Environmental Concern (AEC); 75 feet landward of
normal high water (NHW) or normal water level (NWL) for Estuarine Shoreline
AEC (Coastal or Joint Waters); or 575 feet landward of normal high water (NHW)
or normal water level (NWL), if adjacent to Outstanding Resource Waters; or 30
feet landward of normal high water (NHW) or normal water level (NWL), if
adjacent to Public Trust Shoreline (Inland Waters).
List the total amount (sqft) of impervious surface that will be created from your
proposed development.
- Show the 30-ft. buffer landward of normal high water (NHW) or normal water
level (NWL)
JUI. 15 2021
[)GIVI-MVID CITY

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