Garner, Jeff 84137C

o1*gF(OA 4Z& ❑ CAMA ❑ DREDGE & FILL 9 841,37 A B C
,
y GENERAL PERMIT Previous 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 Authorized Agent
Address
City
Phone # (_ )
Email
Affected ❑ cW
AEC(s): ❑ OEA
ORW: yes/no
Project Location (County):
State ZIP Street Address/State Road/Lot #(s)
❑EW ❑PTA
❑ IHA ❑ UW
PNA: yes/no
ES ❑ PTS
❑ SPIMA ❑ PWS
Subdivision
City ZIP
Adj. Wtr. Body (nat/man/unk)
Closest Mal. Wtr. Body
Type of Project/ Activity
Shoreline Length t'
Access Length - -
Pier (dock) length
Fixed Platform(s) --._ —
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/# I
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing ii
Other ' Z
SAV observed: yes no
Moratorium: n/a yes
Site Photos: yes AL
Riparian Waiver Attached: yes no.,
A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
t r
# " r ❑ See note on back regarding River Basin rules
pN� ❑ 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)
At
Agent or Applicant PRINTED Name
Permit Officer'sPRINTED.Name �"'�A ��
** Signature Please rea
d ad compliance statement on back of permit** Signaturje �, R3
Application Fee(s) Check #/Money Order Issuing Date r 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:
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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

5 1*ojCOA r41& ❑ CAMA ElDREDGE & FILL N9 84137 A B C D
y =GENERAL PERMIT Previous 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 Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone #
Email
Affected ❑ CW
AEC(s): ❑ OEA
ORW: yes/no
DEW ❑PTA
❑ IHA ❑ UW
PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length t
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
i
Other
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 re
Permit Conditions
ES ❑ PTS
❑ SPIMA ❑ PWS
Subdivision
City ZIP
Adj. Wtr. Body (nat/man/unk)
Closest Mal. Wtr. Body
(Scale: )
U TAR/PAM/NtUSt/BUhFtK (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:lnitial)
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 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] 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 Jeffrev Alan Garner
(Name of Property Owner.
property located at 420 Madewood Lane Newport NC 28570 - (Lot 2 Chadwick Shores Plant.
(Address, Lot, Block, Road, etc.)
on Unidentified Tributary to Harlowe Creek, in Newport/Carteret County , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
vocation
I have no objection to this proposa.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEN E
(individual proposing development must fill in description below or attach a site drawing,
lee attached Drawina.
WAIVERSECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift. or aroin must be se
back a minimum distance of 15' from my area of riparian access unless waived by me. (IT M
wish to waive the setback, you must initial the appropriate blank beiov�,.
I do wish to waive the 15' setback reauiremert:,
do not wish to waive the 15' setback requirement.
(Property Owner In rmation)
I i ure
,)effrev Alan Garner
Print or Type Name
420 Madewood Lane
Mailing Address
Newport. NC 28570
City/State/Zip
i9101309-0244
Telephone Number
1,1712o2t
Dale,
(Adjace Property Owner Information)
Signature
GrayMor n
Print or Type Name
8627 Bull Rd
Mailing Address
Colfax. NC 27235
City/Sta tell--ip
[phone]
Telephone Number
Z 2-1
Date
(Revised 611812012)

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: JeffreV Alan Garner
Address of Property: 420 Madewood Lane, Newport NC 28570Carteret County- (Lot 2)
(Lot or Street #, Street or Road, City & County)
Agent's Name #: N/A Mailing Address:
Agent's phone #:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
�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 10 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. No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
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.
(Property Owner Information)
t ure
Jeffrey Alan Garner
Print or Type Name
420 Madewood Lane
Mailing Address
Newport, NC 28570
City/State/Zip
[phone]
Telephone Number
t l /177 /20 Zt
Date
(Adjacent Property Owner Information)
Signature
Donald Hawes
Print or Type Name
9231 Poor Valley Rd
Mailing Address
Ceres, VA 24318 _
City/State/Zip
[phone]
Telephone Number
a -
Date
Revised 611812012

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