Moore, Joseph 84819C

1ojcoasr41 ❑LAMA ❑ DREDGE & FILL N9 84819 A B C IL D
i 3 GENERAL PERMIT Date previous permit issued
a Previous permit
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 �( ( 1 t ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq,nc.gov/CAMArules
L ����
Applicant Name f�• � '�` �� . L�'U +
Address / + ./ # , f
City — State ZIP
Phone #
Email _
Authorized Agent >
Project Location (County):
Street Address/State Road/Lot #�s)
f
Subdivision 42
City ; ZIP:,.
r
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body `� "" L.�� ` i �nat/man/unk)
AEC s : OEA IHA UW SPIMA PWS .n
O ❑ ❑ ❑ ❑ ❑ Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale;
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
j
Max distance/ length
_
Basin, channel
Cubic yards
Boat ramp
i
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
t
!
t
Site Photos: yes no
Riparian Waiver Attached: yes no
m
A building permit/zoning permit may be required by:
^ t°
C
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)
PRINTED Name /,� �"` ;; Permit Officer's PRINTED Name
Agent or Applicant PIN� � �,,,, _... ..............
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:
F-1 Tar - 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

y\p1*1COW,1[ ❑LAMA ❑ DREDGE & FILL. N9 84819 A B. C. o
S
i mit
GENERAL PERMIT Date Pre io s 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:
Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
15A NCAC ❑
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone #
Email Subdivision
r
City ZIP
Affected ❑ CW ElEW ❑ PTA ❑ ES 1-1PTS Adj. Wtr. Body r (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
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
❑ TAR/PAM/NEUSE/BUFIFER (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.
Agent or Applicant PRINTED Name v . • Permit Officer's PRINTED Name
5 Y.
(Please Initial)
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:
F-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

Name of Property Owner Requesting Permit:
Mailing Address: J
Phone Number:
Email Address:
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 following proposed development. -
at my property located at
ire County.
/ furthermore certify that / 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 Inforrnation:
Title
Date
This certification is valid through

AQJ YERTY OWNER —ST—ATEMEK-
eqjj
Natne of Property Owner)
Plrf)pedy located at '"-'3—
'(Address� Lc tky
jjocK, Road, etc.)
(W . aterbody) pty!Town and/or County)
I 'd at tko abr,1116
haS defcnbe development propo&e
iitial d v. me, as shown te6w. tn�,
iere or, have no objection W t.'15 Prof,X)Sal
'"o o�
�'Iave objerUiUrIF, tQ thiS Pr";Posal
n s,
DESCRIPTION AND/OR DRAWING OF pROPOSED DEVELOPMENT
(individual proposing love-iopment must fill V, description below or attach a site drawing)
r
WAIVER. �EC
90 �INI-
I 'e,
r
i z0idiz�nitanrl ti)gi a pter� doci )re�j�.water, boathOLIS,
(r(jorinq piings, brt q,
riparian acce-SeS L-11MEMS
inds! be sot back Mininnurn distaflCr! Of 15, irorr t y a r3 a )f I . r I a e b la n k be 1
k-tosh to W@c,�eLl)ack� y0t; MU.St initial the -3ptb--q'J
i"';je. ", 've the -,,if -,1 1 1
rJ
I do wish towrtivC, the 15,
"ne of
i d o i i t 5 h t Q-
Sles
Information)
(Adjacent Property Ownev
/,Property Owner Informatioil) f (
/9 f.?
....... . .
po' al
Y
P1 r
ol vp V
10 1 1 Ai iN. S
A4 i!lr�r' A da
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2

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Initial
Here on
one of
these
lines
Initial
Here on
one of
these
lines
Aid JAC.eNT,RIPARIAN . PROPERTY OWNERSTATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on N.C.
in
(Waterbody) y (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
have no objection to this proposal.
I have objections to this proposal.
--i—
DESCRIPTION ANWOR DRAWING OF PROPOSED DEVELOPWk- I T
(individual proposing development must rill in description below or attach a site drawing)
0
WAIVER!9.9�TIN
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.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the '15' setback requirement.
(Property Owner Information) (Adjacent Property Owner lnformati(J.n)
alu;re
—!Yp— Name, Print or 7'ype 'el A
Telephone Numbed entail address
Mailing
r v'
T le h rte Number/ern rf addrass
(Revised Aug. 20 4)
*Valid for one calendar year after signature*

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Proposed New Work:
New 4 pole boat lift inside existing mooring poles