Gower, Jerry 84805C

CAMA (l DREDGE & FILL M 84805 A B(C D
Previous pe
GENERAL PERMIT Date previous Ipermit issued
�...� _
J New [_ 1 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 _�� 0 , - --- (-] Rules attached, ej General Permit Rules available at the following link: www dea nc rovtCAM rules
Applicant
Address
City _ (
Phone #
Email
State ZIP
Authorized Agent - .}r' ' --- ---- --
Project Location (County) "' : _ '�'✓
Street Address/St R ad/Lot #�s ---
l v C) A
Subdivision ----- -—
City l --_-7_IP
��Lr e' _ ----
Affected ❑ CW ❑ EW , ES ❑ PTS Adj. Wtc Body 1 ,C� u� ��'^. •' _. __ -- naVman/r
AEC s : IDEA IF�_'ATA IA UW SPIMA PWS Closest Maj. Wtr. Body
OR .yes/ PNA VI/no J.
tC: AY
y _
Type of Project/ Activity _ _ !A 1.4-
`30 (,� 7.•{, w �r�6 CA
Shoreline Length
Access length �. S Ls -- � 6 (,A I--
Pier (dock) length
Floating Platform(s)
r
Finger piers)
Total Platform area
Groin length/k
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ o0111) .
Beach Bulldozing
Other c
SAV observed: yes
Moratorium: n/a yes
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: -.—
Per �jonditions ]� p
!.AM AWARE OF STTAAT�U7 SCRC RULES AND CO
Agent otAyplica RINTFD Nato
APPLY TO THIS PROJECT
read compliance statement on back of permit'"
Feels) Check N/Money Order
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note an back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Permit Officer's PRINTED Name
Slgnatu
Issui g Date Expira n Pate

,jCOAW^1 CAMA ❑ DREDGE & FILL N9 84805 A BCC D
s T GPrevious permit
GENERAL PERMIT
Date previous permit issued
VNew ❑ 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:
7 d � ej 15A NCAC �' '�
❑Rules attached. .J�eneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _ iTr �✓�'I'
Address A �1-4—
City - C— State ZIP
c
Phone # ) ^
Email '"'��"���TTTT
Affected ❑ CW
AEC(s):_ ❑ OEA
EW
'EIIHA
Type of Project/ Activity
Access Length
Pier (dock) length
Fixed PI Ti(s)
to z
Floating Platform(s)
�TA
❑ UW
❑ ES ❑ PTS
❑ SPIMA ❑ PWS
Authorized Agent 00!1
Project Location (County):—'✓
Street Address/St Road/Lot #Is
l t--1 q fit i
Subdivision
City�� ' i •�" ZIP W y
A P
Adj. Wtr. Body
Closest Maj. Wtr. Body
`I jam. S V"—
Finger piers) ;r'
Total Platform area
Groin length/# _
Bulkhead/ Riprapler C��l
Avg distance offshorf
Breakwater/Sill _ ��
I
Max distance/ length key'/1 jL
Basin, channel
Cubic yards GL
Boat ramp(
Boathouse/ Boatti*ift
Beach Bulldozing_
Other
SAV observed:
Moratorium: ' n/a
v` v
Site Photos: ,... iw
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: �>
WILJ
Su LA�614
&�4
H 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)
M
Agent or Applicant PRINTED Name Permit Officer's PRINTED Namd
Sig **PleaN read compliance statement on back of permit** Signatu
P
a
Ap ' ation Feels) Check #/Money Order Issui g Date Expira n 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

%ta►
N. �; DIVISION OF COASTAL MANAGEMENT
ADJACENT IPA IAN PROPERTY OWNER P(OTIFICIATION/WAIVER FORM
CERTIFIE MAILRETURN RECEIPT RE ' ESTEQ or HAND DELIVERY
( op p rtion to be completed by oyvner or their agent)
I
Name of Property Owr or: ,,/f
O 06V t'� �QlZ O/ /U a$sg`f"
Address of Property: '
Mailing Address of O er:
lea ���� ����� h �-�-t���•
Owner's email: /l Owner's Phone#:
Mods Agent Phon : 7rQ Z�
Agent's Name:
Agent's Email flrlp r ns++,.�;Wj Set V i te,S . Cow
AOJACE4'T RIPARIAN PROPERTY OWNER'S s:`,.ERTIFICATION
(ottom 13caLon to be completed by the Adiace0i PropedY Owner)
I hereby certify that I o n pro er y adjacent to the above referenced property. The individual applying for this
permit has described o me, as shown on the attached drawing, thejdevelopment they are proposing. A
y descrl tion or drawl with llilensions, must be -r-ilie4arlwith this letter.
LL.Q I DO NOT Pave ok jtctions to this proposal. I DO have objections to this proposal.
If you have object/ ns to ,hat is being proposed, you must notify the N.G. Division of Coastal
Management (DCM) f,in wri 'r! within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce A, Fo., 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�Troposed pier, dock, mooring pilings, brat ramp, breakwater, boathouse, lift, or
groin must be set bac a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkh')ads or riprap revetments). (If you wish to waive the setback, you must sion
the appropriate blankbelow.
i
I DO wish to waive me/al of the 15' setback
5ignatu Adja ent R n Propert Owner
-OR-
I do not wish to waivie the 1 /setback requirement (initial the blank)
Signature of Adjacenj Ril
Typed/Printed name► of
Mailing Address of �kRI
ARPO's email:70
n Property Owner: r
O• V A U t D IIAO& �1eRR�
iQ64sZ Por4f N(Z
ARPO's Phone#: ZU IZ4 1?1/ 7
4 '
*waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

3�Qi,- 3o
ADJACE
Name of, Property O%
Address of Property:
Mailing Address of C
Owner's email:
Agent's Name:
1
Agent's Email:
N. P DIVISION OF COASTAL h
'AftlIAN PROPERTY OWNER N
op p rItion to be completed by of
1 + -
�al o/d
"Os e a Owner's Phone#:
:MENT
►TIONIWAIVER FORM
or HAND DELIVERY
their agent)��
i Alf 079 ,.Ts
t? Agent Phonc#:l_,
Q. QIAnq �Q Co>JS us.T1�J�i se-pstft - G+7tyl
RIPARIAN PROPERTY OWNER'S CERTIFICATION
I hereby certify that I own property adjacent to the above referenced pr perty. The individual applying for this
permit has described to me, ias shown on the attached drawing, the development they are proposing. A
description or drawing' with dimensions tter
must be provided with this le.
• 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) 'n wrif ng within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce A e., Morehead City, NC 28557. DCM representatives can also be contacted
at [phone]. No resp se is considered the same as no oWection if you have been notified by
Certified Mail.
11 WAIVER SECTION
I understand that anyroposed 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.)
Eai ✓ ��
I DO wish to waive some/all; of the 15' setiJac
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waivJ the 1 'setback requirement (initial the blank)
r
Signaturo of Adjacer
Typed/Printed nam
Mailing Address of
ARPO's email:
Date: X 5. _.
part io Property Owner: K 1/1 //^___r_ EAA&W
AR P6. J e Q- rz_ GO rl e- ✓C_.
t,J p�7 VKa1t' CbN� CI. 1427.72&T
Phone#: V
02 ( *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

Name of Property
Mailing Address:
Phone Number:
Email Address:
I certify that I ha
Requesting Permit:
authorized
to act on my behalf,
necessary for the foi
L 9i9 �'p q -; 5 3'<4
go Welt ea f-viv
�o i� ►� I� � �©��s_�'�K'«rnl��. ���{�+�� ,S"�'�`-ter
Agent / Cdntractor
for the purpose of applying for and obtaining all CAMA permits
proposed development: D. 0pl e
at my property located at x
in County.
l furthermore certify that i 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:
A
U Signature
P-) &V—
P int or Type Name
Title
Date
This certification is valid through I 1 I 1 ZZ

John Ammons
I

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