86231A_Taylor, A.D._20220121

1*0coas41 ❑LAMA El DREDGE & FILL N° 86231 A B C D
3°
Previous permit 1
D
GENERAL 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.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
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
(Scale:
Shoreline Length
Access Length
Pier (dock) length
Fixed Platforms)
Floating Platform(s)
Finger pier(s)
1
Total Platform area
Groin length/#
Bulkhead/IRipraeJength
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)
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)
ai
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

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property: Coln Mt a, e J-7
Mailing Address of Owner: /;52� leLLJ- /�/L /PcQT�LI v�i 4-ttA<.
Owner's email:
Agent's Name:
Agent's Email:
Owner's Phone#: ( '�L 3 :33 Z-3180
Agent Phone#:
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. A
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. 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 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' etbac
ture of Adjacent FMarfan Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: Z -(/ LOL-VrA
Typed/Printed name of ARPO del _X7 • rO tt
/�0�
• !'ram �v�,�
Mailing Address of ARPO:&1VVLL K e,0on /S 3 CvHr a Sc- Curb" fW p/c /lie
iw�.n.cra-t(�L�m�vkGoti., n`. � Z'��fT 9
ARPO's email: A O's Fhone#: v2 S Z - 2 3 Z - Zc 7�'
Date: , l-Z- *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: L`t I"
Address of Property: � �-�Li n_ cLs t� �� : (.�L/�6 �7"L� ('.��. /t/� L�`/ 7,9
Mailing Address of Owner: /mays/lri�s(.�� �U�- t'� /✓L� �°%CJZg
Owner's email:
Agent's Name:
Agent's Email:
Owner's Phone#: C4 S.ZI 2-3 2- 31 Sr0
Agent Pho
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. A
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. 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 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 )_ /j , /// ' 77r, /j,. - o-_
/dig �ture of Affjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.,
Typed/Printed name of ARPO:
Mailing Address of ARPO: 1�4,:
ARPO's email: �QL JARPO's Phone#:
Date: Tah "waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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Currituck County GIS Data Viewer
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Currituck County GIS
Phone: [phone]
E-mail: [e-mail]
Addresses
Communities
Aydiett
Barco
Coinjock
Corolla
Currituck
Gibbs Woods
Grandy
Harbinger
Jarvisburg
Knotts Island
Maple
Moyock
Point Harbor
Poplar Branch
Polls Point
Shawboro
Sligo
Waterlily,
County Boundary
-- state
County
Streets
Wright Memorial Bridge
Major Streets
—Arterial_Principal
- - Arterial_Major
— Conxtor_Mapr
Parcel Land Hooks
Parcels
El
Currituck County
Aerial Photography (202(
NRad: Band_1
Green: Bantl 2
■Blue: Band_3

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