Johnson, Debra 84808C

,*` ARt, LAMA ❑ DREDGE & FILL 1�J� �480� A B C D
T1.
t Previous permit
s GENERAL PERMIT 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 " " It ❑Rules attached. General Permit Rules available at the following link: vaww.deq.nc.gov/CAMArules
Applicant Name
Address I , / 6 l: I c r)r
City i...^ "S * 1 ) S]y e A-1 ZIP
Phone #,({.' 16
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
i.. ZIP
'Body
Affected ❑ CW ❑ EW ❑PTA ❑ ES ❑ Adj. Wtr. PTS „••�,
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body p) _ %�( �. f ✓` k"
ORW: yes/no PNA: yes/no
Type of Project/ Activity _
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
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/.Boatlift r
Beach Bulldozing
Other
ire aU f P� �f
SAV observed: yes no
Moratorium: n/a yes no E
Site Photos: yes no
Riparian Waiver Attached: (yes no
A building permit/zoning permit may be required by:
Permit Conditions
(1,
(, ��'.'�' :.:,,•ems.' .1 Yt-J.\
(Scalewl,, )
�,r >✓� ❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
A....
( I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.
Sl J_ -
S Agent or Applicant PRINTED Name ' Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit** Signature
Application Feels) Check #/Money Order Issuing Date
(Please Initial)
5�
v ,
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

❑LAMA ❑ DREDGE & FILL N9 84808 A B ('C D
Previous permit
i 3 GENERAL PERMIT 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
Address f -••"% °
City State A.-� f ZIP
Phone #
Email
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
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
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes
Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: yes
A building permit/zoning permit m�
Permit Conditions
Authorized Agent
9
Project Location (County): U
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Adj. Wtr. Body &fZ nk)
Closest Maj. Wtr. Body 1, t
(Scale:
U TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
-19 t ❑See additional notes/conditions on back
�i �
t
r f
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicantf PRINTED Name{ Permit Officer's PRINTED Name
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to LQ,,j Fe-.\ ce�, GlCbrR Sd^&' #I "\ 's
11 {Name of Property Owner)
property located at t� d� l- �� I +� pr� +�2
(Address, qtlock, Road, e )
on G Lt,-� in `100%,erT n Srd+e/ Lrlvh7Y, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
lac 1
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must tfll in description below or attach a site drawing)
p �
�
�� lc(Ge- Yr R (er( C-
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,)
-XI do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Z
party O er nformation)
err r•..Q
ignature
��rerc�, �"v�ar►n
Prin
U pr T ype t ame �/ +
V _cs + e `tee
Ili g Address
e r T G c
6��g
T leph ne Number / email address
(0 1 -- ;z
Date
*Valid for one calendar year after signature*
Information)
Print me Y
-� r .er.
Mailiri ddr ss
Gtty/stat ip
Telephone Nu ber / email address
7—/6-- z (
Date*
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ra.s�f s?f1Ge `lcg)i'�'af��"►'S
I hereby certify that I own property adjacent to 1
(Name of Property Owner)
property located at (o (o L,C.?-�C'i � i�!"s
(Address, Lot �(City
.)
on l , in - , N.C.
(Waterbody) and/or County)
Theapplicant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must Oil 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
'ed�r� L(I-n
natu e Signature* l
Print or Type Nana Print or Typ Name
to U
M il'n Addr ss Mailin Address 74
City/State2ip City/State/Zip r�c3 j
Telephone Number / email address
Telhon� Num�e r /email address p
�. ir1-1 - L-z-
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*