Peaks, Mary S. 84727C

'paoFcourAr �❑CAMA ❑ DREDGE & FILL N9 84727 A B C D
4 Previous permit
GENERAL PERMIT
y Date previous permit issued
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 i I
l
Authorized Agent I +
Address
v ...� —
Project Location (County): ( •r
City
State
ZIP
Street Address/State Road/Lot #(s)
Phone#
1 1, 1 1r
Email •`��`-'"
Subdivision•
City ! .• �: �._-1 ZIP
Affected ❑ CW
❑ EW
❑ PTA ❑ ES ❑ PTS
Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA
❑ IHA
❑ UW ❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body L"".
ORW: yes/no' .
PNA; yes/no
Type of Project/ Activity
(Scale; / ).
Shoreline Length
Access Length 44
Pier (dock) length�"23
Fixed Platform(s)
Floating Platform(s)
�._t.........#l._
Finger pier(s)
._...........a__._--.
-.
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 Jno
Moratorium: n/a yes }no S -'
Site Photos: yes
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by
Permit Conditions
❑ 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"
Application Fee(s) Check #/Money Order
Signature
A 16
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:
F1Tar - Pamlico River Basin Buffer Rules F� 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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

ti 1°j`°"`r"1 ❑CAMA ❑ DREDGE & FILL N9 84727 A B C D
1 GENERAL PERMIT Previous permit
y Date previous permit issued
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
Address
City State
Phone # (_ )
Email "
ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s) _
Subdivision
City
Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/rib' PNq: yes/no
Type of Project/ Activity /
(Scaler
Shoreline Length
Access Length__ --
Pier (dock) length i' I
FixedPlattorm(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 } V"
Moratorium: n/a yes ; no ;J­
Site Photos: yes no, - �-
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
❑ 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 y Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" - Signa ure i/
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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

Styron, Heather M.
From: John Ammons <[e-mail]>
Sent: Tuesday, October 19, 2021 2:40 PM
To: Styron, Heather M.
Subject: [External] Permit Request - Mary Stuart Peaks, Newport NC
Attachments: CAMA Permit Request - Mary Stuart Peak - Newport NC.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hey Heather,
Please see attached permit request. Let me know if you have any question or concerns with the drawing or
paperwork. Customer decided did not want the plat form on the side, just straight out pier with boat lift.
Thank you!
John Ammons
Triangle Construction Services, Inc.
2103 Peach Grove Lane
Zebulon, NC 27597
0: 919-365-4800
F: 919-365-9155
M: 919-422-2000
Email: [e-mail]
1

Name of Property Owner Requesting Permit;
Mailing Address. �f?
Phone Number
OA
Email Address. y "
l certify that 1 have authorized
gent crntra�t
o act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed developments �
UA Aced 'ate.
at ray roperty located att
in A 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 eater
on the aforementioned lairds in connection with evaluating information related to this
permit application,
1
Date
This ce ification is valid through

t
(Top portion to be completed by owner or their agent)
i
PropertyName of
—N4r
Mailing
Address of Owner.>
• / Jr Owner's
Agents -mail: J-69F
NNW
hereby certify that I own property adjacent to the above referenced property The ,ndlvidual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing.
i�
'100 NOT have objections objections
ve objections to what being proposed, you must notity the N.C. Division o,
Management (DCM) in writing within 10 days of • a
mailed to 400 Commerce Ave., Morehead City, NC 28557DCM representatives can also be contacted
808-': No response is consWered the some as no objection"
ified by
certified mail.
,WAIVER SECTION
i understand that any proposed pier, dock, mooring pilings, moat ramp, breaKwater, boathouse lift. or
groin must be set back a minimum distance of ,i ' from my area of riparian access unless waived by nie
(this does not apply to bulkheads or ri rap r veti-nents t, of you wish to waive the setback, yow must s`
the appropriate blank ow,
100 wish to wawa some/all of the t °setback
ignalure # Adjaveri)t Rlat1Wn FF�rc�petty C�wraer'
-O .
! do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner_ X &me _ ,
Typed,Al rintei name of PO: � Ca >` � r�
Mailing Address of ARPO:
A;r.c•�' "
A 's email:n <+v I "` ,A O's hone#,. ` X
,Ijater valido p to one year fromPO

n
N
S WE
• ar ■ HN
certifyI hereby that
property adjacent to the above referenced property. The individual applying
•. �. _ e ♦« Proposing.
t
'i « I DO NOT have objections to thi's proposal. 100 have • w
objections 'to this Proi+►
I understand that any proposed pier, dock, mooring pilings.. boat ramp, breakwater, boathouse, lift, or
groin must be set bark e minimum distance of 1 ' from ray area of riparian access unless waiv8d by me
(this does not apply to bulkheads or riprap revetrnerita) (If you wish to waive the setback. you rrs s.
the appropriate blank below.)
I DO wish to waive somel ll of the 15'soteak , 1
sitteturf}e t('irlen rrrr% rror
-OR-
I do not wish
to waive the 151 setbackrequirement
ignatu-e of Adjacent Riparian Pro{" OwneC
Typed/Printed name of ARPO, . t ',_
MailingAddress f PO: `
ARP 's #sort
efe, � 1*wol er is valid f r p to one year from A PO's Signature*
Revised July 2021

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