85060B - Sparrow, Terry

1-ICAMA ( I DREDGE & FILL No 85060 A 13 C D
a Previous GENERAL PERMIT ID 4- 03 Date prev ous permit
Date previous permit issued
ONew Modification I I Complete Reissue n 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:
I5A NCAC I I 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 Subdivision
City ZIP
Affected Il CW EW fl PTA ES PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): [-I OEA ❑IHA ❑UW SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:
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/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
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 required by:
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee 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 ogApplfcant kINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement en 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:
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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St.Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

000"4`4,.i4,I 1 CAMA L DREDGE & FILL N9 85060 ABC D
A' Previous permit
3 f GENERAL PERMIT I D it tQ 0 Date previous permit issued
n New Modification I 'Complete Reissue 7 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:
I5A NCAC Rules attached. I 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 Subdivision
City ZIP
Affected CW EW PTA ES PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): OEA ]IHA n UW n SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length __ _
Access Length r; 1 I, . - , - I L
Pier(dock)length I I I Alg
I I S • 1'
Fixed Platform(s)
II �. .
---_ 1
i
j r .
Floating Platform(s) •' .
Finger ier s j j !
i
Total Platform area I
f
Groin length/# j
Bulkhead/Riprap length i 1
Avg distance offshore I i -
Breakwater/Sill 1
Max distance/length .
Basin,channel •
—
Cubic yards ._ —
Boat ramp
Boathouse/Boatlift _
Beach Bulldozing j 1
Other i
i
SAV observed: yes no I
Moratorium: n/a yes no ' F I I
I
Site Photos: yes no — i a
,
Riparian Waiver Attached: yes no I
A building permit/zoning permit may be required by:
Permit Conditions I I TAR/PAM/NEUSE/BUFFER(circle one)
II 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:
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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie, Camden,Chowan,Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

Pungo River 17'0" Terry Van Sparrow Jr.
• L r n ? 625 Avon Ridge Lane
i / Grimesland, NC 27837
[phone]
o
Project Location:
Hose Bibs 1102 Old Mill Rd
d cr :3 Belhaven, NC 27810
Spring Creek
0 C
Pilings4post lift for
,
0 O
co
t
0
e1• Prepared by B F Warren &Son Inc.
•
c For permitting purposes only
NOT TO SCALE'
BFW20210084
ate: 12/8/2021
Owner Approval:
NWt. Hose Bib
Sparrow Property" Date:
E4sting Bulk NWL
heed
Shoreline+/-2000ft
Steele Porperty

ROY COOPER
Governor
MICHAEL S. REGAN
- secretary
CoastalManagement BRAXTON DAVIS
ENVIRONMENTAL QUALITY
Duector
BUFFER AUTHORIZATION CERTIFICATE •
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico&
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 02B.0233 & .0259.The
Division of Coastal Management(DCM),through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party(contractor) performing the •
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per day per violation.
1. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees)unless.otherwise approved by DCM.The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials:All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open-slatted wood or composite, mulch, or grass to meet.the intent of the rules to the
maximum extent practicable. •
3. Access Width:The width of the pier or docking facility access way shal I be limited to six(6) feet.
4. Project Drawing:The drawing on the CAMA General Permit is considered the project drawing of your
• property indicating the relative location of the pier or docking facility and any requested access way.This
drawing will be used to aid in compliance and monitoring efforts.• Pre-project site conditions: 474 7h ‘''rct 0/7 /9rr2ol4ci (L/
/e..1 14-4,Gi 7i /�� c' ,yLA
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
that all information provided is complete and accurate.
Agent orrApplplilicant Printed Name Permit Officer's Signatye
/J L„` • ///
Agen or Applicant Sig ure Issue Date
CAMA GENERAL PERMIT#: t529 7/d
State of North Carolina I Environmental QualIty I Coastal Management
Washington Office 1943 Washington Square Mall Washington NC 278891252-946-6481
• Wilmington Office 1127 Cardlnai Drive En.wihnington.NC 28405-38451 910-796-721S
Morehead City Office 1400 Commerce Avenue Morehead Qty.NC 28551 1252-808-2808

B. F. Warren & Son, Inc. •
180 Taylor Farm Road,Belhaven NC 27810
Office(252)9644628 Fax[phone]
Forrest cell(252)945-2492 Freddy cell(252)945-4240
NC General Contractor License 472600
www:ncpiers.com email:[e-mail]
•
Authorized Agent Consent Agreement
To:State of North Carolina Department or Local Government Department
from whom this permit is being applied for.
I,the undersigned property owner,do hereby authorize B.F.Warren&Sons INC.to act on my behalf in
obtaining the necessary permitls for the below listed projects.'have contracted their services to perform
the work permitted.This agreement is limited only to the specific activity of obtaining permits for the
below specified projects.
Projects:
Dock and boat lift pilings
Project location/address:
1102 Old Mill Rd
Belhaven,NC 27810
Body of Water:
Spring Creek/P.ungo River
Property Owner Mailing Address:
Terry Van Sparrow Jr.
625 Avon Ridge Lane
Grimesland,NC.27837
[phone]
Property Owner's Signature: Date: 1217,0121
Authorized Agent Signature: Date: f/Via-

•
N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN'PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL- RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner of their agent)
Name of Property Owner. Terry Van Sparrow Jr
Address of Property: 1102 Old Mill Rd, Belhaven, NC 27810
Mailing Address of Owner. 625 Avon Ridge Lane,Grimesland, NC 27837
Owners email: [e-mail] Owner's Phone#: [phone]
Agent's Name: B F Warren&Son Inc Agent Phone#:[phone]
Agents Email: bfwarrennson@rsnetorg
•
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
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.g
description or drawing,with dimensions.must be provided with this letter.
___ I DO NOT have objections to this proposal. I DO have objections to this proposal.
•
If you have objections to what Is being'proposed,you must notify the N.C;.Division of Coastal
Management(DCM)in writing within 10 days of receipt of this notice: Correspondence should be
mailed to.943 Washington Square Mall,Washington,NC 27889 DCM representatives_can also be
contacted et(252)946-8481.No response is considered the same as no objectionif you have been
notified by Certified Mall. .
WAIVER SECTION
I understand that any proposed pier,.dock,niooring'piings,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
(this does not apply to bulkheads or riprap revetments).(If you wish to waive the setback;you must sign
the appropriate blank below.)
I DO wish to Waive some/all of the 15'setback
Signature Adjacent Rroarian P p y Owned
OR-
I do not wish to waive the.15'setback requirement l(Ini//tial the blank) /
Signature of Adjacent Riparian Property Owner 1—he_Jae � /
Typed/Pdnted name ofARFO:�1 6U�II *Rv'Ydl^s re
�Mailing Address ofARPO: Fag o is'h7c.J Pa-
ARPO's email: ARPO's Phone#: G&? 9/3' '
Date: It I70/S i `waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
r

N.C.DIVISION OF COASTAL:MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONiVVAIVER FORM
CERTIFIED MAIL• RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. Terry Van Sparrow Jr
Address of Property: 1102 Old'Mill Rd, Belhaven, NC 27810
Mailing Address of Owner: 625 Avon Ridge Lane,Grimesland, NC 27837
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's.Name:.B F Warren & Son Inc Agent Phone#:[phone]
Agents Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
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 drawina,with dimensions,must be provided with this letter.
I DO NOT-have objections to this proposal., I DO have objections to this proposal.
if you have,ob)ectons,to what is being;proposed, you must notify, the N.C. Division.of Coastal
Management(DCM)In writing within 10 days of receipt of,this notice. Correspondence should be.
mailed to 943 Washington Square Mail,Washington,NC 27889,DCM representatives can also be
contacted at(252)94648481.No response Is considered the same as no objection if you have been
notified by Certified Mail.,
WAIVER SECTION
I understand that any proposed pier,dock,mooring pilings,boat ramp,breakwater,boathouse,lift;or
groin must be set back a minimum distance of 15'from my area of iiparianriparian access unless waived by me
'(this does not apply to bulkheads or riprap revetments).(if you wish to walye the setback,you must skin
the appropriate Manic below.)
1 DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the bllaalnk) j
Signature of Adjacent Riparian Property Owner. 112 t�1 .G
Typed/Printed name of ARPO: -DeN •'1 C ebec��
Mailing Address of ARPO: 19)3 Viriskilorckain6 TDr•,V c
ARPO's email:
1dtheelerDi ALICeSL4•je'r'lARPO's Phone#: qi9. r-f 2Th 3, 6$
Date: 124)`il`yi 'waiver Is valid for up to one year from ARPO's Signatue
Revised July 2021