Langley, Logan 84839C

fir) oa;ler f
/� eQ�/� Previous pm I I lil
t VENE■ Q■AL PG■71V1IT Date previous permit issued
PJew L_(Moclification L�(Cnl-nplete Reissue (.,,(Partial Reissue
As authorized by the State of N r i Carolina. Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC -) � yet - ED Rules attached, � orneral Permit Rules available at the followin link: ,-
_. 1._.._. g vlytiYdasltis$sYL+�fAruLos
Applicant Name (/�"
Authorized Agent,.-_.._.. _
1_ocation Coun
Pro ( tY)
/�
r s L' h State 1 : J
Address fl—R-
Phone'#��
ZIP...�
a /,. _1
iect
Street Ad<Ire s/S t Roadl t / (s)City
Emailr=
_.-.
Subdivision r
"''
7--Y-Y
City
--...LIP, !
Affected
L W PTA
L
(_� ES L l PTS
I-,ISPIMA L IPWS
/f t r S nat an/ink
Adj. Wtr. Body _� . - 1 ( )
AEC(,): ( IOEA
IIHA I ]UW
Closest Mal.Wtr.Btrly,._-_,.,_._:..�..
012W: ye;/ lcf�/
PN : yes/fk,
'Type of Project/ Activity
Shoreline Length
---
Access Length
Pier(dock)length l _-
Fixed Platform(s)
Floating- Platforms)
Finger pier(s) ,
Total Platfonn arc i , __
Groin Iongth/Il
Bulkhead/ Riprap length --
Avg distance offshore _
Breakwater/Sill.-_---_...:--..-__ .--
Max distance/ length
Basin,
Cubic yards .
Boat ramp.._, _•
Boat house'/ 'athh
lleacti Bullddttng
SAVuIy,vjvcd:
Moratorium: n/a
1
1)
yc•s
W". �IVd/
Site Photos:
yr.
Rilmrian W,iivl•I Anindwd:
yo" ( /
A buildinll permit/tTIIa
iniI m,iv l required by -
tint:
Permit t nnrlihnn•, /
.'
� / :(t.,
A
r ,
'fAR/PAM/NEUSE/BUFC=ER (circle one)
L� Stle note oil luck repardirig River Basin rules
See ,idditionJl notes/tondilion5 on back
I AM AWARE OF SIAtU ITS, CRC RULLS AND CONDITIONS TlIAT APPLY TO THIS PROIEC'f AND RFVIEW ) OMPI IA TAiEMFNT (Plvam- Milian '�
Altvn( or Applic,mi PR IJ I I U unr, Pr•nnit hre 131Nf.GU NJtrIC
Sign., a "'h tisr ro;ld c.olnpii'11m• .tau•uu•ni on back of pet I nl"
-(hv(k IllivioiloyOidoi fu.uui/;D•nle I ixpnalir Ir,,ie

pOpF COASr41 AMA ❑ DREDGE & FILL NQ 84839 A BC p
4
GENERAL PERMIT Previous permit
y Date previous permit issued
F--�PJew ❑ Modification ❑ Complete Reissue [:]Partial Reissue
As autho zed by the State of No Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC '! ❑ � Rules attached. eneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
-- '
Authorized Agent
Address
e.
Project Location (County)'
City
�'� State
ZIP
Street Addre s/S to Road/of (s) .
Phone # �)
Email
Subdivision
City ZIP
Affected
PTA
❑ ES ❑ PTS
Adj. Wtr. Body (nat an/unk)
AEC(s):
❑ IHA ❑ UW
❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body
/❑'.+/OEA
ORW: yesdfio %
PN : yes/)o
Type of Project/ Activity
Shoreline Length �—
Access Length
Pier (dock) length d
Fixed Platform(s)
Floating Platform(s)
Finger piers)
Total Platform area
Groin length/# �1
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ oath
Beach Bulld
Other
i
SAV observed: yes
Moratorium: n/a yes
Site Photos: yes f6l
Riparian Waiver Attached: yes
A building permit/ pe mit may required by.-
Permit Conditions
IF/���
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEW
r
Agent or Applicant PRINTED Name Permit .0
(`'
Signa ** lease read compliance statement on back of permit** Signat
Ap ication Feels) Check #/Money Order Issuing Date
MAM
EEMA A E
N
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial
ExpiratA 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 Manaeement 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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATIf�N.
Name of Property Owner Requesting Permit: i-oGAt-j
--
Mailing Address: a tU%-rre-rLb W A-%
(,+.s"-VT0r3 NC ATVA�
Phone Number:
Email Address: t (,Ate , LANG►-e4 J-PV46rO 70 M,.,.Lk),cam
I certify that I have authorized C3 Scott, Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the foliowing proposed development:
uta8i �C.
at my property located at Oix tjkrn� pAK ,3x.vr-f (Iura+l
In __-- a IN-�� &T_ County,
l furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staf, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating Information related to this
permit application.
prolwrty Owner Information:
" ure
print or type blame
Gw+ M IL
Tile
0:1 / ti / o .
Date
This certification is valid through .-b---1 oZ

tx)Vt-,f e- CaXgittf _f f 100
I hereby certify I . pmperty itifwant to
1 9
rm (.Zh,,-tt c.),a"iti0m of ProPorty Oviner)
property located at
(Addr"g, Lotrk,
Toad, aft.)
in N.C.
on bf
(fa terbody) (Ciiii—town andfor County)
litial The applicant has cla=fbed to me, as shown below, the development proposed at the above
ere on I
no of ', =1
I have no objection to this proposal.
tese
les
iore onA,
ne of
iese
le's
I have objections to this proposal.
DESCRI"ON ANDIOP. DRAWING OF PROPOSED DEVELOPMENT
00 -a
OW40,21 proposing�o yolopM ho!W, #jftqvb a site drawing)
�e P�icf.�c�
I understand that a pier, dock, moring pilings, boat romp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparlan access unless waived by
me. (f. you wish to waive the setback, you must inittafft appropriate blank below.)
'a
I do wish to waive thev IS' setback requirement
I do not wish to waive the I 5'setback requirement
(Pro Owner Inn, (AdjaceiM Property Owner Information)
Pdnt or Type Name Print of. MrAl,
(147, eAk 13WI--F AOAD__ mMaL
Mailing Address Arel"
A.1c
Citylswomp CHY11
ralophone Number/ eme# eaVrew a 0 U. C r, - N Telep Niumoerj email addrew
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

initial
Here ort -
one of
these
lines
Initial
Here on
one of
these
lines
ADJACENT 1311PARIAN.-PROPERTY.-OWNER STATEM
I hereby certify that I own property adjacent to
property looted at I ctQftite Oak Bluff Road (Name of Property Owner)
on Hadnot Creek (Addre", Lot Block, Road, 9W.) N.C.
(WoUnbody) (Citynown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
I have no objection to this proposal,
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(IhdiviOual proposing
Attached
WAM&-$ECDQR
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' firpip area of dparlan access unless waived by
me. (if you wish to waive the setback, yoco''
'J'a—he appropriate blank below,)
do wish to-walve the 16setback requirement
. W
I do not wish to, waive the IV setback requirement.
P . .. pe Ow"o atLon) (Adjacent Pro.mirty Owner Information)
MY
�rur
ture
Doom - K
Print or -rype Name Print or rype Name
8 H06old-Way- 190 White Oak Bluff Road
Uafling Address MAXOg Addr"g
Stellar, NC,
citylstatemp C0131atelzip
252.965.111,3. [e-mail] 252,20.0380, bonnieXim-3680amail.com
'akphona Number / ernall address Tolophone Number/ email address
29-Sep 29
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature'

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