Sherron, Jeffery 84164C

oloFcats,,lr, XCAMA ❑ DREDGE & FILL A B OC,, D
S ��
Previous permit
RGENERAL PERMIT
Date previous permit issued
(New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by theStateof%North Carolina, Depart en%t of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I5A NCAC� + 0Z /C)❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City 1
Phone #
Email
ZIP
Authorized Agent / n .I C, 1�
Project Location (County): J
Street Address/State Road/Lot #(s)
Subdivision
City �G'rt !� (,6�ZIP
Affected CW Wiik —ES ❑ PTS Adj. Wtc Body �'f 1` �+^ �'/iFrar�rnan/unk)
AEC(s): OEA IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body /�%Lr
ORW: y?s/no PNA: yes
Type of Project/ Activity
Shoreline Length'C
Access Length
`y
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) i F�
Finger pier(s)
Total Platform area >'
Groin length/# r
Bulkhead pra ngth
Avg distance offshore
Breakwater/Sill "
Max distance/ length
Basin, channel Y
Cubic yards
Boat ramp
Boathouse/ oa`tirW�
Beach Bulldozing
Other(
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached
A building permit/z ning
Permit Conditions fir,
i r,,
AWARE OF
yes rno
o�yes
yes ,o
Yes no /
nit may be required by:
-I
/
ILES AND CONDITIONS THAT
:%f'iVi{i L�frl
r AK', •'9
TO THIS PROJECT AND
gent or Applicant PRINTED Nn Permit Officer's
ea
Si gat rey. Ple��e rd c tatement on back of perkt" Si na ure j
r� com Plian7' �/i
Ap'lllication Feels) Check #/Money 6rder Issbing Date
�r
(Scats . jC) )
I X I TAR/PA NEUS /� FFER (circle one)
' See note on back regarding River Basin rules
R
❑ See additional notes/conditions on back

&��ZfCAMA ❑ DREDGE & FILL N9 84164 A B O D
GENERAL PERMIT Previous permit
� Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the Sta a of North Carolina, Deeparrtpent of
Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC �5 � 0 � ©/ T ► ,/2� / ❑ Rules attached. � General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Authorized Agent_(
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected CW _ ❑ PTS Adj. Wtr. Body I'!-[,U & L GY:_6 r man/unk)
AEC(s): OEA IHA ❑ UW 1:1SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: y /no PNA: yes
Type of Project/ Activity
Shoreline Length b
Access Length 'go
Fixed Pier (dock) length $o
Fixed Platform(s) _I1)4or
�Ir7
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead rap gth
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ atr
Beach 6 Idozing
Other ' S �/
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit /z ing permit may be required by: _
Permit Conditions
i
0
I AM AWARE OF
y y Ap ication Feels) Check #/Mone6rder
CWXw�1oP
'5he�t;'Ori
fl 7
(Scale /)�)
TARP EUS /B FFER (circle one)
See note on back regarding River Basin rules
❑ See additional notes/conditions on back

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: J-6 GI54Y 5colt 5 HW-0*
Mailing Address: a a9
Phone Number: 11 Gl -7 01Jay
Email Address: s iiLLA, c IV -7 Cf� E- c©"
I certify that I have authorized 'i6 ;A-��Mv� �j t'�r4m
Agent / Contractor 20-- s1W.,! 5'32
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Vie, d-e-4K
at my property located at
in UUyaA,1 County.
1 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
"�;►-.rroki, _ ebb V�
Print or Type Name
w 51
Title
Date
RECEIVE®
This certification is valid through S 1 3o / o: JAN 18 2022
0 .,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to
property located at _ 404 Vicksburg Court
on Club Foot Creek (Adc
(Waterbody)
Jeffery Scott Sherron
(Name of Property Owner)
ress, Lot, Block, Road, etc.)
in Havelock
(City/Town and/or County)
's
The applicant has described to me, as shown below, the development proposed at the above
__-location.._
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fr/I in description below or attach a site drawing)
Adding a seawall, dock and boat lift to our property.
-`I�- o-P-
WAIVER SECTION
1 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 Ownerration) (Adjacent Property Owner Informatkm)--
Signature Si azure*
M' c k,-,, I F 5 w Jeffery Scott Sherron
Print o Ty�q$ ,gym c.°i 4, � .z...�,h 12 Y� Print
stType a Court
falling A d 5 .;,►¢� t'11� g 7� Hav�lockd N 28532
r% _
City/StatelZ/p City/Stafe/Zip
252-617-0254 / [e-mail]
Telephone Number/email address Telephone Number/email address
dL-I
Date Date* / RECEIVED
(RevisQ�u�. lA4�4�;
'`Valid for one calendar year after signature' JJ II'V�
0CM-NIHO CWITY

W�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to e_f V 5 o 6rnU� 's
. , , , , A _ A ame of Property Owner)
property located at
on ('� ��� �� _� (Addregn , Lot, Block, Road, etc.)
1 �,'N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
/� ti
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)
�%l Sias fL
WAIVER SECTION
1 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.
I 1 do not wish to waive the 15' setback requirement.
Telephone Number email address
Date
(Adjacent Property Owner Informatiorrr-
c;tiy S arelzip
I i - 6�`f Sn,Ke ,� y6) .(urn
Telephone Number/email address
Date* RECEIVEr
(Revised Ajpka4 20?1
*Valid for one calendar year after signature* DCM-MHO CITY

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