Hodges, Scott 84111C

1-1\°``°"S'"1LN❑CAMA ❑ DREDGE & FILL 1 '� 84111 A B C D
i 3 Preous
GENERAL PERMIT D to previous permit
issued
EJ New ❑ 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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address" I ! Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body ". t 1✓• t.(nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity-
i 1 �
(Scale:
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s) ,. '�._.. �� .t _ .. ore
. 1 _.....^
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no t i�
Moratorium: n/a yes no
Site Photos: yes no - --
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
1/
: '�r" 'c; f1;
F.�..
14 �f
— .
❑ TAR/PAM/NEUSE/BUFFER (circle one)
�`'•
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or APP licant PRINTED Name Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit** Signature }
Application Fee(s) Check #/Money Order 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 1-1 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 Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

N\jOA`r"1 ❑CAMA ❑ DREDGE & FILL Na 84111 A B C D
Preous permit
y 2 GENERAL PERMIT D to previous permit issued
J
New ❑ 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:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: Www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other '
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no ' --- - - -
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
Subdivision
City ZIP
Adj. Wtr. Body (nat/man/unk)
Closest Maj. Wtr. Body
r�
(Scale:
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s) Check #/Money Order Issuing Date
Expiration

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:
F] Tar - Pamlico River Basin Buffer Rules F1 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 Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPAN
MAIRLI�RETRtJR REC OPERTY®PT REQ WNER®STEDTIFICATIONMAIVor HAND DEELIRFORM VERY
(Top portion
yto�be completed by owner or their agent)
Name of Property Owner: r
Sb Jew (�cc e Dr• ¢1y+1�or`f �NL 9 7C�
Address of Property:
►W�� dead Qu�'L C'4cic_ f�quo!'ina, � t�
Mailing Address of Owner: Q
Owner's email:
Cca4
4s \b es ® grA&i.L.^Owner's Phone#: l 03 7 ®7 70P
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that ► own property adjacent to the above referenced property. The individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
... .. - _ _..:.l...i . 3k Ohio 1oftnr
I DO NOT have objections to this proposal.
I DO have objections to this proposal.
if you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. 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.
WAIVER SECTION
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.) •�
DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:. _—
Typed/Printed name of ARPO: �-7
1
Mailing Address of ARPO: �) ' 4
ARPO's email: ARPO's Phone#:
Date: �� / *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

toy, T An 1 Asews WAAMM w 4
TANW- C
&.01TV e %hazy"
v -"A. OWN lot I XQMY
Rang gh 1 RIN

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIOWW►AIVER FORM
rE—RTIFiED F.4AII F ETURN L�ECI ,'PT I2E(2- fJ _ 'E,D_o 4- AA ;
I IJP pi)[Li(iiul! W Ub' k;Ulilpluiuu Uy Uvtiiiai UI
Name of Property Owner
Addr ss of Proper'3•
111'Cl
valtL r�tc
Mailing Address of Owner �_.___.- r /� _
cl
a{a"tT S lntt de pr G^ QNt+,�^ta -Y_.,�r+r _ ,?h !#rri "1 i C_i1 7 % D5"�
Agent's Name __._—_----.--______.__ _. __..- agent
Agent's Email
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
�f3attom portion to be completed by the Adiacent Property Owrier)
i 1Ili euy Ut;1 iiiy tryst I vvvl) pitij el—", ailiacerrr iC+tna aoove rorerenced pi oucri'y. i� c �n::iviuisa7 a}'r(iir+77y �v� ir'ia
permit has described to me, as shown on the attached drawing, the development they are prcpos7nq. "+
description or drawing with dimensions must b_e prgvided_with this tetier.
I DO NOT have objections to this proposal. 100 have objections to this p•oposai.
if you have ob%actions to what is being proposed, you muse notify the N.G. Divistnn of Coaatal
Management (DGM) in writing within 10 days of receipt of this notice. Correspondence should be
malted to d00 Commerce Ave., Morehead City, MC 29357. DCMrepresentativ©scan also be eantrrt.ted
at j[J.) 6V6-lvtlO. IVU ti33jTi7t;Jt i i �ur7aitfc rGU irsu Svarsr da tiu vfijc 2: fie !i vu iric: ucCt+ rsu:;:,c :,q
Certifled Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater. boatnouse, lift. or
groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments). (if you wish to waive the setback yoi: must siGn
the appropriate blank below.)
Signature of Ad%acent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property
1W
Mailing Address of ARPO:,,t CtLtn— "*
ARPO's email: • C� ase W t'';IYtt� '_'%RPO's Phone#: 3o �� 55
Date: � Zo "waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

w
w
� -Vay 9 S
Ott
Vol
it
c�

C V