Davenport, Lynn 84138C

N\°``°"RN [ICAMA ❑ DREDGE & FILL N9 84138 A B C D
0
y Previous permit
= GENERAL PERMIT Date
Date previous permit issued
n 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:
5A NCAC / \' ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City
Phone #
Email
Authorized Agent
—K _ Project Location (County):
ZIP y �' L� '/ Street Address/State Road/Lot #(s) _
Subdivision
City
Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body t j[''C� (nat/man/unk)
: s AEC UW SPIMA PWS
() ❑OEA ❑ IHA ❑ ❑ ❑ Closest Maj. Wtr. Body k
ORW: yes/no PNA: yes/no,
Type of Project/ Activity
(Scale/=
Shoreline Length i
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 -r
Breakwater/Sill ( v
Max distance/ length
Basin, channel_ s r
3
Cubic yards
Boat ramp ! ;
Boathouse/ Boatlift
Beach Bulldozing
Other '
SAV observed: yes no
Moratorium: n/a yes ! no µ 1
Site Photos: yes no .- 1._-.. ... ...... __.
-- - -
Riparian Waiver Attached: yes no r i
A building permit/zoning permit maybe required by i �^� 5�� (?fi i z
Permit Conditions 4A, �7i� (•' ` 1el
�.
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
C)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name',
Signature"Please read compliance statement on back of permit" Signature 1 i
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:
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

X\°jCOASIq ❑CAMA ❑ DREDGE & FILL N9 84138 A B C o
0
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.dgq.nc.gov/CAMArules
Applicant Name
Address
City
Phone # (_ )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA
❑ ES
❑ PTS
Adj. Wtr. Body
(nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW
❑ SPIMA
❑ PWS
Closest Maj. Wtr. Body
ORW: yes/no .` PNA: yes/no.
Type of Project/ Activity
'
Shoreline Length
K
-
Access Length
I -
Pier (dock) length 1. f j
...---
✓ `'
Fixed Platform(s) l f
I
Floating Platform(s)
l_ ._ _
_
__ _
,
Finger pier(s) --
..... . ..---
-
Total Platform area
Groin length/#
-+
-
-
Bulkhead/ Riprap length
Avg distance offshore
f
Breakwater/Sill
_
Max distance/ length
Basin,
-
`
7.
i
—�
channel
4aT
Cubic yards
i
l
s
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
... .-._
_
-.
_.._.._
1. __
.. _
..
.__.._
-
.T_....
_
.._.._
___-
.. ._.
1 . -
f
5
r
1
Other
3
!
?
I
SAV observed: yes no--
i
Moratorium: n/a yes no77
:
s
- = - - - - --
Site Photos: yes , no
_. —;
- i-
- --
I -
Riparian Waiver Attached: yes no
�� ..
�
A building permit/zoning permit may befequired by:
�;+'l •'
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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)
Agent or Applicant 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

,p,GEWAIT /,-k U,-(t�0RMATl102K FOR CAMA FERNii% AP UCA-1111"N
klame of Property Owner Requesting Permit: �-ytiarj
Mailing Address:
o 03-rR,5"-r R"vs
Phone Number: q62- �/
Entail Address:
%�ig2RCS �3/nW N:R�'_i!►/_�'
l certify that !have authorized -R�NK�c Agent Gontradtor
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 uoo3 T i,�T Q�S ���✓� ,
in CROVem County.
I furthennore 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 Informations
I
71 Signature V
� V ��
PType Name
rint or
Title
Date

.. �. - -- -�i �i , .. , F- y
.� :1 . . r
,_.. , , � ., il� .. i-� �.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _ IVn,-., �'`�`^Ie'•�_.'s
(Name of Property Owner)
property located at_ Otr 3 e�'r ,did 1z-,Ivc
(Address,'Lot, Block Road, etc.)
on , in (%Owird/f , N.C.
(Waterbody) (City/Town and/or County)
The app ant has described to rne, as shown below, the development proposed at the above
locatio .
1 have no objection to this proposal.
i have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing devetopment must fill in description below or attach a site drawing)
0
pv �v
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set bark 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)
.Si"'nat llre
Print or Type Name
Mailing Address
City/State2ip
(Adjacent Property Owner Information)
Sigurtayr(ul'c*�
Print ��Ty� e( me
Mailil�g✓
City/sta�te�IZ' / I
Teleohone Number/email address Tohnnhnno Abi nhnr /email

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 4-- /N Vyf's
(Name of Property Owner)
property located at 003 te,-g r p,vss bR(Ve
(Address, Lot, Block, Road, etc.)
on IRsN1r' )e''vsq in :: 226,ct 1^/00,bN.C.
(Watbrbody) (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.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing devollopment must fill in description below or attach a site drawing)
/32P LANoi 0 0
7
�sTinl� bowr
Re,-0f R�Ba��fl dLifo
bocSNovJN
�4s
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)
Signature
Print or Type Name
Mailing Address
CityJState/Zip
Felephono Number/email address
Date
Signature* Zaz/(,,�,,, Q%.!r
Print or Type Name
4�=c yC
Mailing Address /-
City/State/Zip
Telephone Number/email address
Date*
(Revised Aug. 2014)
"Valid for one calendar year after signature"

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