Holder, Boyde 84314C

;o1*q``°"Sr4eNT4CAMA ❑ DREDGE & FILL N° 84314 A B CC
Previous
GENERAL PERMIT p
Date previous
permit issued
@-'*New ❑ Modification [:]Complete Reissue ❑ Partial Reissue
As authorized by the Stat of 4North Carolina, Department of Environmental Quality and the�Castal Resources Commission in an area of environmental concern pursuant to:
15A NCAC _ T v ❑ Rules attached. General Permit Rules available at the following link: www.de .nc. ov CA rules
Applicant Name
Authorized Agent r ' v !s'
Addres
/
Project Location (County): (�
City ` State
ZIP
/
Street Address/S a Road/Lot #(s)
Phone (
Email !^
Su division
City J ZIP
\4EW
Affected ❑ CW XPTA
❑ ES
❑ PTS
Adj. Wtr. Body (nat/man/unk)
AEC(s): HA W
❑ SPIMA
❑ PWS
Closest Maj. Wtr. Body L
,(❑�OEA
o
ORW: yes,(rda / PNA: ye n
Type of Project/ Activity
Shoreline Length trlf
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 j
Boathouse Bo lift
Beach B Q
Otherr
SAV observed: yes no
Moratorium: n/a yes no
A building perm
I W AWARE OF STA UTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWE
Agent or Applicant PRINTED Name P6&i t
T�
Sign we "Ple a ad o ompliance statement 'ack f permit" Signat re
Application Fee(s) C-1CheX#/K46ney Order Issuin Date
C15, -
U I
0
(Scale. ', )
e�v-�jm .
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(PI
0- ) D
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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: (4W lJe
Mailing Address:
J
Phone Number: 'I 19 u5z O-Z2 j
Email Address:
I certify that I have authorizec �C
d ►� 3 € t 2G ti i w- - L.
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:'
1k ��
at my property located at �2� t �8 ���� �'� -�� ���h �•C,=
in
County.
l furthermore 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 Information:
Signature
A�> l�l i✓�
Print or Type Name
Title
/o I S l jc" ---)-/
Date
This certification is valid through /.

R ,%`E � � v}:' ?
,.� � . M � �

Oct 06 2021 4:46PM HP Fax page 1
nmT
I hereby cm th► that I Own property adjacent to 0 -{�o lok . /' $
propwv tocam at v e (Narree of Properly Oan mi
--..._ _
Oft r✓ (Ad '°sa, Road. etc.)
---S-i— In .� . c a. . N.C.
�) (CkWuwn andrar Ca iw)
The applicant has described to me, as shown below. the developmem propose d at ttm above
10""Oh. ,
-- 4 bf ecftn to this proposst.
I taw no o
I have ob)ec&m to Oft pr+oposai.
DESCRIMON ANWOR DRA AlING OF PROPOSIED DSVELOPIIE dT
AAPa� doVarbprner t mumt #W In ddse balaw or atekh it aft dr*wkjg)
ga
RAI11'ER OEM
w
rrxsstbe sst bade a m�ml � j �, breakwa ,r, t�oatttam ►, Ntt, or groin
my areo of rfparlan access unh ea: wainred
'ma- (If y�r wlsh m waive the setbeck, you must MttW the appropii� blank bekw .) by
-�: I do wlsh to waiv® the 15 setbaok requMarnerrL
I do not wish b wafvc tha 1 S sed ack requirement
!E'^oP ► Owner I bn) (Ad "nt property Owrrer trtl
t�TyAs Name
ALe-
�2p ,
r
NO;Rd Ibr aye casermar year eftr sowme (Raft d Aug. tom)

0

ADJACENT RIPAMN_ PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C(.-) ,P ���� i(J4 !"' 's
(Name of Property Owner)
Property located at l Z "-2 f 7 to L-( I,- i--
(Address, Lo Slock, Road, etc..)
on vi- j�- k,. g, 1 , in �l i ;,,+ `r % -� < c -G ") , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
`v I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill 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 rust initial the appropriate blank below.)
-0 e- I do wish to waive the 16 setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
SiWture
Print Name
c
,Mgifin/g Address )
clty/�p ! n
/Telephone Number/email add ss J
51
Da e
(Adjacent Property Owner Information)1�+.J�.+INfiG�
6 6. y C -32-
Signature *
Pit or Type Name
-J _7 ��GrL
Telephone Number/email address
2 S 2 - -77 3--2Z <2
Date* /0 _ 9 _ - j
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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