Ballou, D A 84365C

oCO S% CAMA4DLREDGE & FILL NO 84365 A B
Previous permit
E N E PERMIT Date previous permit issued
ew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the St to of North Carolina, Department of Environmental Quality and the Co as Resources Commission in an area of environmental concern pursuant to:
15A NCAC t 9 ❑ Rules attached. eneral Permit Rules available at the following link: www.dee nc.¢ovlCAMArules
City ( C
Phone #
Email
Affected ❑ CW NEW TA
AEC(s): ❑ OEA ffI`HA ❑ UW
ORW: yes/Mott PNA: yes
Type of Project/ Activity -Y/
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/ Ong,
asin> annel
Cubic yards
Boat ramp
Boathouse/ Boatlift'—
Beach Bulldozing �S
Other{
SAV observed: yes Lno
Moratorium: n/a yes Site Photos: yes
Riparian Waiver Attached: yes
A building permit/zonipg permit may be required by:
Authorized Agent. `? b
Project Location (County):
Street Mdress/Star Rpad/Lot #(s)
-iA''A 0 t>r--\ --.-:
Subdivision
City (Y
❑ ES ❑ PTS Adj. Wtr. Body --T
❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
R
THAT
Agent or Applicant PRINTED Ndme
iate�re'*Please read co lance statement on back of pgrfnit**
Feels)
`
_ 2-L_ �?
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A,A/Icr/l
� ❑ TAR/PAM/NEUSElBUFFER (circle one)
❑ See note on back regarding River Basin rules
+"��'See additional notes/conditions on back
r w
THIS PROJECT AND RkVJEWED CO P,.IANCE AgSEMFNT. lease Initial)
S*,,n,tlre
la /&A I —
ney 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:
Tar - Pamlico River Basin Buffer Rules 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

OQ COASTgT c CAMA DREDGE &FILL I, P e, Nd 84365 A B c
s 31,110
3 j{I Previous permit
Z i E N E R,AL PERMIT Date previous permit issued
ew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North gCarolina, Department of Environmental Quality and the Coas 1 Resources Commission in an area of environmental concern pursuant to:
15A NCAC� !��� i,�� ❑ Rules attached. eneral Permit Rules available at the following link: wvrw.deq.nc.gov/CAMArules
Appl
City i 4 IL-1A ! tate P V 1� ztf—=—
Phone # i
Email
Affected ❑ CW EW TA ❑ ES ❑ PTS
AEC(s): ❑(�OEA IHA ❑l UUW ❑ SPIMA ❑ PWS
ORW: yes/hod / PNA: yes/JS /
Type of Project/ Activity.
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s) `®
Floating Platform(s) -
Finger pier(s)
Total Platform area y
Groin length/# 1 ��
Bulkhead/ Riprap length
Avg distance offshore °
Breakwater/Sill k,_
Max distance/ I ngth���
asln, annel a
Cubic yards
Boat ramp
Boathouse/ Boat Iift"
Beach Bulldozing
Other QV, F
Uno
SAV observed: yes Moratorium: n/a yes Site Photos: yes
Riparian Waiver Attached: yes ,
A building permit/zon' g permit may be re�juired by:
Armit Con itions , %
r, lZ rj _ _Lj /-n� t► 1 .`
OF STATUTES, CRC RULES AND
Authorized Agent
Project Location (County):
Street Address/Statg Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
THAT APPLY TO THIS PROJECT AND RgVU4EWED COMPJAANCE
P
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
See additional notes/conditions on back
Initial)
Agent or Applicant PRTNTED Ndme Yer r me r YKIN I LU N me / jv
e
Var read compliance statement on back of p r it**Signat re / (s) Chec #/Money Order Issuing Date Expiration Date
fi

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 F-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://porta1.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

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AGENT AUTHORIZATION FOR C- A—PPLI—CATION
NarTie of Property Owner Roqi
Mailing Address,
Phone Number:
Email Address;
I certify that I have authorized
to act on my behalf, for the Purpose of applying (or and obtainin CA all MA permits
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necessary for the following proposed development- r
at my proerty lac ted at
in C(w "' ,,���County-
I furthermore certify that I air] auffrofized to grant. =grid in fact grant permission to
Division of Coastal Management stalf. the Local Peraid otficor and their agents to enter
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on the aforementioned lands in connection with avamating infor",ation rot, t0 d to this
pernid application,
Owner InformaHom
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Pfint ar Typo Mauro
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Date
This certification is valid through
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: \
Mailing Address:
Phone Number:
Email Address:
I certify that I have author
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
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at my property located at
in CG���.. Count .
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I furthermore certify that 1 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 evaluatina information related to this
permit application.
Property Owner Information:
Signature
Print or Type Name
aL(�r
Title
&.1 Iz�`��
Date

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