Lazzara, Michael 84806C

1*�F`°"S'41 AMA ❑ DREDGE & FILL Na 84806 A B/c. D
E N E RAL PERMIT D to previous Preous permit issued
s
J v Z
ew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As auth "kedby 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
Address
City
Phone #
Email
4a:
C a J "- La"U State C ZIP
0
Authorized Agent (C ,,Al
Project Location (County):.__
Street Address/State Road Lot #(s)
•21 � , ti
Subdivision
City
�; L-a e- 0-. 'A L,);r L
V
Affected ❑ CW TA ❑ ES ❑ PTS Adj. Wtr. Body a,— t' `�'/ (nat/man/unk)
i
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: ye no / PNA: yes/no�
Type of Project/ Activity 13 X 3 t icy
(Scale
Shoreline Length
Access Length �-��-• /V/
Pier (dock) length l \�
Fixed Platform(s)
Floating Platform(s) lJ
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/Voath'
Beach Bulld
Other
A
SAV observed: yes n
Moratorium: n/a yes
Site Photos: n
Riparian Waiver Attached: yes no
A building permit/zoning per 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 REVIEWE-PJOMPLIANCE r4TEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit
Si Ieation
re_ "Please read compliance statement on back of permit;* Sign r
ll 11 l f
A Feels) Check tt/Money Order Issui a e Expir 'on Dat

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 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Ll r (- 2 Z R R-Y1
Mailing Address: 2 t? W Ft
�c l�5 o,J U. lZ,YYY0
T--
Phone Number: to S'_ 32
Email Address: Ji» f1 L � �y� �� M.4 , -
I certify that I have authorized i�anr�0►h GOGhY 1� 1�{S�i h lye
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: ! nS+00 t ova-► Ova af
a new h_(pg+ 1 i ft_
at my property located at 2— ( 7 (A) /A- � _ S
in (0 t ,N 16 c�) County.
1 furthermore ceWy that l 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:
Signagu►e
Print or Type Name
�Waesz-
T.He
L 1 pa e 1 ( �?OU
�d
301
This cerUtication Is valid through r
AUG 3 0 2021
OCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1. hereby certify that i own property adjacent to n N < c-', , ::k —
property located at(Name of Properly Owner)
(Address, Lot, -Block, Road, eta) — on �.�r�,c a is c
in , .� �_; ,a :=� � � � c , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/Oil DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
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.)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information)
(Adjacent Property Owner Information)
Si pature
1 `� ✓ C
Signatur
Print or Type Name
Print or T e Name
Mailing Add ss
73
Mailing Address
City/5tate2ip
'
_ �
City/state'Zip (y fj(
Telephone Number/email address
Telephoneu ber/ mail addms _.
Date _ .. . —
�,i2 r�
Date*
*Valid for one calendar year after signature* (Revised Aug. 2014)
RECEIVED
AUG 3 0 202
DCM-MHD CITY

ADJACENT RIPARIAN PRQPERTY OWNER -STATEMENT
I hereby certify that I own property adjacent to N 1 c: � ot e- t LA Zz ,4,!�A Is
(Name of Property owner
Property located at 2 rs S 1
(Address, Lo� Brock, Road, etc.)
on I ► �'T f' Coe-i in V i o !'O , N.C.
(Waterbody) (CltyRown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
1 have objections to this proposal. 1
Lor=at+rtir r 1UN AI VIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing deveiopmeptmi sE rill In description below Oraftacti`a site drawing)
WAIVER SECTION
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 11910 Tthe appropriate Blank below.)
I do wish to waive the 1S setback requirement.
(Property
Signatur
C
Print or Tvo
I do not wish. to waive the 15' setback requirement.
information)
Name
O L P [ %-r)
G c�kS7/c)
(Adjacent
-7 -1 3 - s►5� �17t:�F--
Telephone Number/email address Tele hone�lVumber/8
-7 - Ls_ z
Date .
*Valid for one calendar year after signature*
Owner Information) ,(
t5c. FR. covl
(RevisedAug.2�41)V ED
pUG 3 0 'W1
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ADJACENT WARM PROPERLY OWNER STATEMM
I hereby certify that I'= property+ adjacent to Yh C �-A7ZR le -A 's
property for ed at 2 (7 �) F -Te (S S (Name of Propmw Omrer)
(Address, Lo� Block, Rold, etc.)
on �T rA coA ti In (-o N.C.
(Watarbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
WCOWer I rvro AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Indivldual PAP nfi d i�ilimast fill IFir desc*ffon b6.ibia or ai[w h a site drawing)
N R SECTION
1 understand that a pier, dock, mooring p Inge; boat tamp, breakwater, boathouse, rA or groin
must be set back a minirnurn distance of 15' from my: ' of r'W", an access unless waived by
me. of you wishbo weave the settdc, you must Ini0.01'.1 to 9ncptfal `b`b1w c behiW.)
Sap
I do wish to waive the 16, seffiadk requir?ernent,
I do not wish. to waive the IS setback requirement
(Property Owrt r Itd'orntpoon) (AdAwnt Pro" Owner information) ,t
SignaftirV
W.1 % C. A C L
PnWt or type Name
Icy i�OL4 c 1--01)
�Ad
ft-,. .,ilJ`' \t'? . 4G c6 C7
SZf r 3 r
Telephone Nun fier/erwD
"7 -
Dare
'vaffd for one calendar year after are•
(Revised Aug. 2014)
Ec. Re.COVY7

ADJACENT K PARIAN.PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to m t CA x pp-(- ,',Hz 2,A-2 A 's
property located at _ �_ i -7 S(Name of Property Owner)
may. (Address, Lot, lock, Road, ear
on N 1 �P�C (56�T �( in v,�j pr,-�S bar O
(fVaterbody) N.C.
(CityRown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
_ I have no objection to this proposal_
have objections to this proposal.
/J DESCRIPTION AND/OR DRA{MNG OE PROPOSED DEVELOPMENT
(il%Sli KldUa� iY% , r "i':C:hmtrt a.. .:�
c�
p s v"K A fw- O Cb. c'i Slt&.Lir8Wll7g)
I understand. that a;pier, dock moan WAEir<ER�oECZlON
must be'Set back a jpr b�neaiWZt�rx.�ioathouse, lift, or groin
crltnimum d `#o ,my era of npartart "access uhlfts wCahted by
me. (If you wish io waNe die
ri yoirm�usF�nafie blank Telow.)
I do wish to waive the 16 setback,rqqufrement. `
1 do natwish to•vaai R#R. W eft?adc requirement
..< <> -
(ProperO ct{ tl�eation) ..
�'w ter: :�—`�j• � � � +�
a• -
'Vaud for one calendar year8fw gYI'atue• (Revised Aug. 2014)

A