Leedom, Thomas 80095C

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AMA / L DREDGE & FILL N0 80095 A B `� D
i�
GENERAL PERMIT Previous permit#
(]Modification C'Complete Reissue ❑Partial Reissue Date previous permit issued
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
,1Rules at hed.
Applicant Name �j > Project Location: County
Address Street Address/ State Road/ Lot #(s) rr t y
Cityl: --I StateZip,' J /
Phone # -ti7•:. i E-Mail ___._ Subdivision C1 Authorized Agent City__ weA L[!tLyr") ZIP qq//
Affected DCW DEW CPTA DES LiPTS Phone# ()_. River Basin /VC-111,C
:1 s OFA C HHF ❑ IH ❑ UBA C WA
AEC: _i PWS: Adj. Wtr. Body 2e— a man unkn
ORW: yes /f no j PNA ,yes)/ no Closest Maj. Wtr. Body
Type of Project( Activity
Pier (dock) length
Fixed Platform(s) f ln'"��t`z�' 3
Floating Platform(s)
Finger pier(s) iQ't% �{h f
Groin length
number
Bulkhead/ Rlprap length_
avg distance offshore _'��'���''''^^^®�� -
maxdistance offshore'
Basin, channel
cubic yards __ _� ) / ` ' �+ �•
Boat ramp
Boathous oad tif) s7 1V 44 _` - -
Itf1a
Beach Bylldozing _ {
j.. --- } l
Other �, f :TI-i .! -'r tl
Shoreline-
SAV: not sure yes ( !no
(f_-- -- -- ---- --
Moratorium: n!a yes no _
Photos: yes no_. -
Waiver Attached: yes nod!
A building permit may be required by:
( Note Local Planning jurisdiction) }
Notes/ Special Conditions .f� t i Wo f,
i
f,A
See note on back regarding River Basin rules.
i
;;c ,
r'f r . A- I
`�2fji
or cant Prini Name PermitOfficers Printgd Name ; •t - T - ---
i p
t I acute �easerea iancestatementonbackofp 't'""' Si nat re f
Application Fee(s) Check# Issuing Date 6piration Date

�. XCAMA / ❑ DREDGE & FILL 80095 A B C D
GENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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 0
t ] Rules atta hed.
Applicant Name ,� S Lea 0/0 Project Location: County 0
Address �'f/ Street Address/ State Road/ Lot #(s) Lt
City State ZIP l
Phone # ( E-Mail !6 Subdivision
Authorized Agent W�
g �!(► `�k�►/(�Q �j / GW(� �LU/1 �_ �City �-Y�S 1 ll'1. (�%' � ZIP o20���i
Affected �W ,, /EW A 'A 4S ❑ PTS Phone # ( ) River Basin N�Gf.�
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Bod � ji(/ a man /unkn
❑ PWS: D
ORW: yes //'no j PNA es)/ no Closest Maj. Wtr. Body � � `� ►^` e-T
Type of Project/ Activity
Pier (dock) length P7 /*- r,—
Fixed Platform(s),f
Floating Platform(s) ./
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_,
avg distance offshore
max distance offshore'
Basin, channel /
cubic yards
s
Boat ramp
Boathous B atlif) X
Beach B Ildozing
Other
_ s
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdictiono )
Notes/ Special Conditions
Applicant Printed Name
*�ease read compliance statement on backof permit"
4 %.1 /t
Permit Officer's
re
(Scale:
P( See note on back regarding River Basin rules.
f�
Fee(s)
Check #
ration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific 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 or certified mail return receipt has been obtained from the adjacent riparian
landowner(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:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
❑ 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. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead Cry Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

LGENT AUTHORIZATION FOR LAMA PERMITAPPLICATION
Name of Property Owner Req
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
C cl 1e� lt- �r.S6cd ► A, Ales
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in — County.
I furthermore certify 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.
r-i ri it ui , ype ivame
Title
Date
RECEIVED
This certification is valid through �i 3 % /_ AUG 3 0 2021
DCM-MHD CITY

ASKV.
E]

CERTIFIED MAIL - RETURN RECEIP r REQUESTED -
DIVISION OF COASTAL MANAGEMENT
_ ADJACENT RIPARIAN PROPERTY OWNER-NOTIFIGATI NMAIVER FORM -
Name of Property Owner: e,, t9> C C Cl
Address of Property 6700 -J O
(Lot or
street or Road, CiV & County)
ti i! ee CCv
Agent s Name %- Mailing Address. _
Agent's phone #:10 3A 7 `)- 5"_1(;)i"T a.
ZI3 .���G3C1� COI
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described tome as shown on the attached drawin the development
the are �q PW
Y proposing. ArsrtpttanQrSclrawnctihrnetartssirt b:e��.V>:e.. �fihrr. It`en.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 90 days of receipt of this notice. Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808-
2808. Alo response is considered the same as no objection if you have been notified by Certified Mail.
1II RIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
pry Owner f tm ion)
Cl,1i
Sig/nat re
Print or Type Name
-7oc -�r_-11)d . a,-) V1,_ lZea Alto
Mailing Ad& s
iz
(ify/State)Zip
._6,-/c' 7f�'
Telephone Number
-� L) /
Date
Print or Type Name
Address
Date
Revised 6 i-AWD CITY
RECEIVED
AUG 30 2.07.1

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Page# of pa(
Lawrence & Son
Marine Construction
153 Diamond City`
Flarkers Island, NC 28531
252-648.7781
�dAl VR It
PROPOSAL SUBMITTED TO: JOB NAME JOB #
ADDRESS JOB LOCATION
DATE DATE OF PLANS
FAX #
Ve hereby submit specifications and estimates for:
t,•
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x
go
rIle RECEIVE®_
AUG---1-0 2021
CM-I1 HD CITY
f_
19e propose hereby to furnish material and labor — complete in accordance with the above. specifications for the sum of:
Do
with payments to be made as follows: —
Any alteration or deviation from above specifications involving extra costs Respectfully
will be executed only upon written order, and will become an extra charge submitted
over and above the estimate. All agreements contingent upon strikes,
accidents, or delays beyond our control. Note — this proposal may be withdrawn by us If not accepted within day
'Acceptance of j3 opoml
The above prices, specifications and conditions are satisfactory and are
hereby accepted. You are authorized to do the work as specified. Signature
Payments will be made as outlined above.
Date of Acceptance Signature
A-NC3819 / T-3950 09-11

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USPS TRACKING #
First -Class Mail
1.17 Postage & Fees Paid
USPS
6 L _ Permit No. G-10
9590 9402 6509 0346 1519 98
United States
Postal Service
" Sender: Please print your name, address, and ZIP+4® in this box*
p C' JOM
r //.a/ rc[,A)k,
VA C9�11�11
I:.�iI1r1}tl11pfill 101111
■ Complete 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
O\j Qlz p
j�
9590 9402 6509 0346 1519 98
2. Article Number (transfer from service label)
PS Form 3811, July 2020 PSN 7530 02 000 9053
❑ Agent
/�- ❑ Addressee
C. Date of Delivery
D. Is delivery address d erent from item 1? ❑Yes
If YES, enter delive ad ress below: ,_ : ❑ NO
S,o...�,vti I
.V
3. Service Type
❑ Adult Signature
❑ Adult Signature Restricted Delivery
❑ Certified Mail®
❑ Certified Mail Restricted Delivery
I❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
❑ Insured Mail
❑ Insured Mail Restricted Delivery
❑ Priority Mail Express®
❑ Registered MaiIT^"
❑ Registered Mail Restricted
Delivery
❑ Signature Confirmation""'
❑ Signature Confirmation
Restricted Delivery
Domestic Return Receipt
I