86250A - Edenton Bay Homeowners Association

"""``\XCAMA R DREDGE & FILL N9 86250 a B c D
GENERAL PERMIT Previous pe"T'"
Dales previous permit rswwed
New
❑ Modification ❑ Complete Reissue ❑ Partial Reissue
Aa auQ rIzod by the Store of North C_&-,a, DWVW_ t a(6wwMMnd Quality and the Coastal Resoums Canrrlisdon in an area of wMronnarloi concern Parson[ to:
1 SA NCAC '714 ' it W R Rui. at ,&.d. ® Cwn.ral %"'* Rides availllbia at dN following kk
Awk.nt Name Aadwrtted Agant --INC +'Li l G QAn j oceaAS i Pl` cGh
Address O $
Pto)ett loction (Coetnay):
City E&VA*_ � State iUc ZIP Z SV. Address/5tacs Rwcylvt 0) LO+' *
Planer (Z�, 2-} "- 'I q? (.— l01 E}c�(t� t S W
r s tkv,�►71 Q lei sllbdivkston __� r\ IBat.
�q city Eolex\�r mP 21ML
AThcted ❑ cw tqt Ew ® M ®ES ®PTS A• Wtr. Body SINrsun/trlk)
AIEK(z� ❑ OEA EIIHA ❑ uw ❑ SPIMA
O Pw: Cl,,,t Ma,. Wtr Body
of(w: y"Aw PN&- yeso
Type of Projei V ActlhW h3kaw a��i' C &�tK� d .Z' 0�.4 �,. eXa�
Shord ine Length Alf- 14V7 ' (Scale- �
A"A!&s Length
Pier (dock) lengthi i 1' _i ---�- 1 _ r _ _ i _ r.T _I--
Fland Platform(s) r '.� - Qe�►4�--r-t . -+-= f --r--+-!^-��--�--^- ! ! 1 ;
r
Floating Platform(s)
oily Dlel{
f) 3)
1 i , t �:.--�_.. _TTr'"•.._
Vr
Total PWarm area
Groin length/R
Bulkhea Ripraplength Al —LLJ- ? '
Avg distance offshore 1' r} - -� t , = 1 _ti. ' _i ; , '_� _L. • _:
Breakwater/Sill
Max distance/ Wngdl
Basin, channel
't �--i , yJ._.. .__1 .... T.rt 1._Ir'.�. "�--s-1••�--r-� • I.
Cubic yards 1. { iv
-
Boat tame - - - - — :-1
Bwthouse/ BoatdR
Beach Bulldozing f- -� 1 1 1 �;
Other LJ ..J Y-i--'
71-
SAVobserved: yea
Moratorium: yes - ; r-r r-i-t 1_r l t 1 t 1 t t r•1�
Site Photos: ® I t 1 l
Riparian WalvesrAttaclted: yes ' n '- i-J_ i __- _i .l t
A budding permit/MIT19 Permit "W be require by.
TAJt1PAf'yNEtJSFlBUFFfR (drela oela)
Permit Condfdcm
El See note on bade regarding River Basin rules
See additional notas/owdltlons on back
I AM AWARE OF STATUTES CRC RUBS AND CONDMONS TWIT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
ASeM IIUnt P Na Permit O is RINTED Name
Sign, "Please read compliance statement on back of Permit- Signature 64 5
APPll,caflon Fee(s)
puck #/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: f'61f41fQY1 140*1eo YVdS Atc5c ion
Mailing Address: 2M ftoldee_ Ar;ie-
eolwto✓1 A?G
Phone Number: 2523374846
1 certify that I have authorized JA
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: coot y4c* ='5 LP or-
54 hi&yil1wiI 124tk. )w
Y
at my property located at 101 Har ,4 i'tEcle i o✓1 tJc_ wiot31. .
in C�10k4n 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:
sl; we 15'1/GLI ///
Simon B Rch III Dec 27, 2021 _712 ES')
Signature
Simon B Rich III
Print or Type Name
President
Title
Dec 27/2021 /
Date
This certification is valid through i /

N.G. DM31QN OF GOA3TAL MANAOCMCNT
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)
Nwm of Property Owner
Address of ••: I . ♦ !mil•
• Owners Phone#:3,:3
i
ADJACENT RIPARIAN PROPERTY OWNER'S CER MrICATION
Betfom Ad!a —rtt Pronortx 12WMr
I hereby certify that I own property adjacent to the above referenced property, The indtviduai applying forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. a
0@ "mon or tlrawinA, wttn olmenslons mum w arDwaaa wnn ants lager.
DO NOT have objections to this proposal. I DO have objections to this proposal.
if you have objections to wfiat /s being proposed, you must nobly the N.C. Division of Coastal
Management (DCAI) 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 qu) 26+F390t. No nmponse is considered Me same as no objwvon it you trove beer►
notified by Certified Mail.
WAIVER sEc'no I
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). Of you wish to waive the setback, you must Sim
Ina appropriate 0lanK below,)
I DO wish to waive somelali of the 15' setback
JZfZ1U-_ --�
Signature of cent Riparian Properly Owner
I do not men io waive the 10' =DOCK requirement (Inlual the 0lanK)
Sipnahire of Adjanant Riparian Property Owner_
Typed/Prirftd name of A RPO: T-e (CG Me Ll t fyit r
Moiling A0111vos yr ARP41 = HarJ4s H t 1( I -a ne GJ6e\tpn M(, 21g32 -L{(,e3p
ARPO's amall: ARPO's Phone#:
"waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

L-1
61
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
t. Article Addressed to:
c7 e 0 tr—
021 f Y6;1'E v*O'ceeexkP
-2-1 iir as r 300
,' IIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIII
9590 9402 7054 1225 5507 12
2. Article Number (Transfer from service label)
7020 1290 0000 7857 5197
PS Form 3811, July 2020 PSN 7530-02-000-9053
3. Service Type
O Priority Mau Expro"O
O Adult Signature
O Registered Mall -
El Adult Signature Restricted Delivery
❑ Registered Mail RosMctad
Certltled Mall®
Delivery
Cartltied Mail Restricted Delivery
O Signature ConfimtstlonTM
O Collect on Delivery
O Signature Confimutlon
O Collect on Delivery Restricted Delivery
Restricted Osilvery
n Insured Mall
Insured Mall Restricted Delivery
(over $5W)
/
Domestic Return Receipt
ao
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F,

VIM MA.

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