85566D - Roy

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i. d 3�`°et� �AMA ( � DREDGE S FILL Previous permit KZ)�'�
` . GENERAL PERMIT pate previous permit issue sci 1
r
g
t New ❑Modification D Complete Reissue [1 Partial Reissue
M luthoneed by�the
�Su`it o North
hCar en&Department of Enoronn ereai Qua,.ty and the
/Caatt t Rctorecrt Commoner,rn in area Of enneonmend concern punatnt to
1 SA NCAC ( a t L j�12-l L�' — ❑Rule,atuthcd Y1 I General Permit Rake arable at the toiltrenng Pelt.ky. .dttIPL�
Apple:me Nan.e�tr117 e r t T ( . taci.8 �Aostsoozed Item p....Z V,r l•'C
Mews s 4'1 I A L ('� Project location(County). ,l ••'‘t.,...t.IC
AS
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Clef ASAb•+*n --ZIP J 4 F strut AddrroJState RoaMot Po) �51 c] $tN—�--
Pttona r/ _) /r i.. �i
Fossil ey. 3iiGS.Cn.a11'•scPllr+el..,M•J. .a (ntiti1,_.._ Subdhrnion
City SJSSrI Ticrhi ZIP 2�ttc ----
Allaned DON )�.
PTA DES Dm Adj.Wtr Body '�c -heat! )
AEC(a).. DOM III IPA tm 0SPIMA 0PWS Closest Mai Wtr.Body St^VS Ce4.j--I'
ORW;re!y11Lo? PNA ye ` /'� y,
Type of Project/Activity CoASCr - r ( /1 c.r...3 AD'It-1_�_ Fes c i t ,t h ? Ci...,1 .,e-i c1.0
Y (Scale:tJ r . )
SAorefirte length U
Acres Length (1 r2`J ,
Pier Mock)ength (PIS \l`IIt Ni' 4, r
Sit C `..�
Fiwed Pietkewn)S) J g v I b ria.ig e) S�.Q
u ,
Floating Platforms) (p a'{a• 114
cwp ec Piero) S t t e .
1
TotalPlatlorrnarea 321fI"-
Groin iength/e
Buff ead/Ripraplength
Avg distance offshore G
Bieakwater/Sifl , ie---.*-----______!„—\\4 Max ddtance/length 4 `
basin,channel `
.xbcyardz — /-�
doatrams) t v IT IJo fa.3(.twcl( .-&s
Baatho Boatl. W 7,01
L. t L �
Beach Bulieozine • t0),•� '
CF:htr . /
- 1
IS1to IC°I KJ.Sturt.0 ISt 12
SAV observed- yes o ��� \ Q
Moratorium. Oa yea L C.4' �O l( J� , j
Ill.P ocos yes .J J
P�parlan Waiver Attached. s' o �J/�(\
A bw'd't g perrnit/tanin permit y be required by AS(� f`L IX 6{ i A I- ._�QO-ift C o{. n TAAIPAMVNEUSEBUFFER(welt one)
Pr►mit tAaidrabona lb ".l;,ft,,,!*, t r
k.,I 16, j, " Vie:^ f . t,.. C ' l'4r (•- it ,) See note on back regarding River Basin rule
-.)...t.LL— �- -rl--- C See additional moles/conditions on back
h
AND CONDITIONS THAT APPLY TO THIS PROJECT AND REV)EWED COMPLIANCE STA ENT. (Please Initial) e�.`t
/AMAWAR��ATUTEPS}CR�tRy�U}kE...S.T.� w,.� •,
____A› 6d i ce____..-.. .(.. t:.r". f J c\C._ Z-1 4• 2 L
Agent PRINt(D Na Prtnd Ofrlc is Al E Name—
,..... li \ ') J) (--- 611-((-(--zz
S+L t ••Pleas r read tomplia e statement an bat of permit'• Signature
20° : 26,11''411 1L ? -}1-20'2- (0. 1kt •2o'z2_.
• reefs) Check P/Money Order Issuing Dale Eapuahon Date

�30�°�`°"'"� CAMA f I DREDGE & FILL No. 85566 z A B
1 GENERAL PERMIT Previous permit _/ 1� z r�
Date previous permit issued a��i
k New n Modification n Complete Reissue I I 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 Cl 1*� `L.00 j Rules attached. \\\ General •
Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name?ab4, \ T.A,.., .i(A - Authorized Agent •- ...-• �` L • --
Address `I I I D T A b4-e l,n0ll t f 1. Project Location(County): \'z d^S- c•ICd..
City A'��,\ ),,It State y P ZIP '20I4 ' Street Address/State Road/Lot#(s) /Qf It /6// Ai-
Phone#( ) 1 ✓L /. kiaff
Email it, _,a elf,C+"..r' ;., j{.-,, 1 U^.0 cj..)6..I. .o ((.7.,4) Subdivision
/ City , n fi
l te.-1'1 ZIP Z ttl�.r V
..
Affected n CW El EW PTA n ES n PTS Adj.Wtr.Body -'c- /^ (nat/ unk;
AEC(s): n OEA rn IHA to UW SPIMA PWS Closest Maj.Wtr.Body \(" S 1 ✓4c.e-('C.-
ORW:yesl9 PNA:yey/fi-o/
Type of Project/Activity 0/:•4 4/., C t i1 r 4--> AA:IC t _, r,.• .( . 2. L..,-,I , 7 S \ Cr‘•n
(Scale:?J-r'S )
Shoreline Length - 4.)Q
Access Length (c'Fl i r _"__ �.,.f " (• •4 l/-"I `'� i
`I NO J
Pier(dock)length � 7 s Ir
G
Fixed Platform(s) $ b Ze ` 1
I 1
Floating Platform(s) 10 x'1Q „4} r _ .
.r . ..
Finger pier(s) �' Q, r
Total Platform area 329 fk j '"'�
Groin length/# { - - i -
Bulkhead Riprap length r !
Avg distance offshore i
Breakwater/Sill ! - .-
Maxis "` ��
I
distance/length
Basin,channel
Cubic yards ._� ... ` _.._
Boat ramp ^ _ - 4 _ joy ti.> . „AnF^tr. _ I "
"1
Boathou /Boatli8 J �11 y 4 L 1 •
Beach Bulldozing I •
r.
Other 1 '
t
15c2SAV observed: es t ' I lam_ ____
y ,�_ v i
Moratorium: n/a yes 4y[1 _ t,t� `f 9
Photos: yes ._-. ,....._._ _ p.._.__ . j._ __...-
Site
Riparian Waiver Attached: es o f - ' , j - i
A building permit/zoning permit may be required by: �jAst r Q B4+.0 ill
(,, n TAR/PAM/NEUSE/BUFFER(circle one)
Permit Condition 0?tic,i -'- �&t•`' L.,Ak .- , P c nt.via I'JnJ/ i '; G
i-`,,,,, ,S�'V r,r,,cx roil, r �f( p• i- tc[e L; (U,i.c(w s-i,,1r, n See note on back regarding River Basin rule!
��$1,1 ,3,% t S ` i gto `../ ' )“ L , ° Z 67 % i J.ci S(p n See additional notes/conditions on back
q
'1- 1.1•r.if,- Y
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()Mors PRLINITEI Name VVV• 1

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:
'lease ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
)roject area and disposed of in an appropriate upland location.
)ivision of Coastal Management Offices
Vlorehead City Headquarters Washington District
l00 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
?52-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
:ounties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
G01 S.Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
t52-264-3901 Fax:[phone]
Serves: Bertie,Camden, Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)

ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FUKM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. rW Raj
Address of Property: $7y A' SA.p, e ..S&c,t Se/ & c
Mailing Address of Owner. Jc✓rJ e
Owner's email: Owner's Phone#'
Agent's Name: bad s'0/ dgy c t- Agent Phone#: 50, 9A / S
Agent's Email: ail&612A:e ConSAANChb4 t am )
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by th&Adlacent 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. ,
1,./j'af
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
(252)mailed to 400 Commerce Ave esentatives can also be
at
808-2808.No response I considered the sarehead City,NC me as noCM objection ectiion ff you a e been notified dby
ertified Mall.
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 accessunless waived by me
(this does not apply to bulkheads or riprap revetments).(If you wish to waive th9,setback, you must stun
the appropriate blank below.)
I DO wish to waive some/all of the 15'setback /4--
SeDt-' Signature of Adjacent Rip Pro Owner
-0R- ✓
I do not wish to waive the 15 setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Printed name of ARPO: '^ 1—A114 6.8
Mailing Address of ARPO: 7 'U 6 W IPArbO l v gArtisia3fric ZZ'I. 5
ARPO's email:t au" 1►Q (.av ►.NG{' ARPO's Phone#: (11::k (021 Citt
Date: "S/,ss1 '(2,v7.j *waiver Is valid for up to one year from ARPO's Signature*
Revised May 2021

DocuSign Envelope ID: 11A2FB5B-0368-4AA3-8CC6-3A6BC09361 D8
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIgp MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: P pOti Rp cr
Address of Property: IS)y A,/ gA0A. S4/1.Se,gee;
Mailing Address of Owner: .$41..9) •
Owner's email: Owner's Phone#:
Agent's Name: 04au/a/rcto Agent Phone#: 90 9/8",S”
Agent's Email: Nod e,c.e FL C� �'�h,l• &in
..�,. . . ..—�.�...r
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.
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 400 Commerce Ave Morehead City,NC 28557.DCM representatives can also be contacted at
[phone] No response is considered the same as no objection if you have been notified by
. Certified Mall.
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 riprep revetments).(If you wish to waive the setback,you must stun
the appropriate blank below.)
OocuSigned by:
I DO wish to waive some/all of the 15'setbe "
6' earlAgkent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
--nocuSigned by:
lJ
Signature of Adjacent Riparian Property Owner:
-BOF B 1A4 3
Typed/Printed name of ARPO: )n V t C 'r Il // ,,II
MailingAddress of ARPO: (Q('� r r •i'5(� _ 1�t7 P. ?7.I I
t�� f of 1� lv
ARPO's email: ARPO's Phone#. "��`��������
Date: *waiver*waiver Is valid for up to one year from ARPO's Signature*
Revised May 2021

N.C. D1VBSiON OF COASTAL NAM/AGED/TENT
AGENT AUTHI.IALe: kni*N FORM
/ -,
Date ,4 ---.Z- - ,2 .3
iklgoli.e of Property Owner Applyi,ig for Permit:
QC k PW Li
Mailing Address:
./Li SAC R e.
g co. cA A/C..,
11 cer6:ify thAt N have authorized(agent) az 01 cl 6Ri'cr to act ot nay
behallf, Tor the purpose ,,T spilAyl rg for and obtaining P RR CANA Penni.. necn,gary to
. •'.) iL
fantail CoT construct(activaty) L i,t_o, P-N sr a 0/ c i / clor
sC,( y property locat•.I' at) 1C-1/ ,'' / -CAC ke, ,5i97_C-e/ g ee:=‘,'., vi‘(,C
Thia nerdifiegtfton Ls va three ( ate) /),- •?0 - .2-,p2 .
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ISSUE:DV
12114/20
• REVISION D•
01N4/20
• 16' -. 24.r—. - - _ 40' -- -
PROPOSED DOCK CALCULATIONS 0 SIDE ELEVATION
BOW:311E••1'.G• `
50 LN FT BULKHEAD X 8 = 400 SF FT ALLOWED JJl/
/
265 SQ FT PROPOSED
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Check
ad Date Deposited Cheek From(Name) Name of Permit Nobler Vendor Cheek number amount PermitNumber/Comments Receipt or Refund/Reallocated
•
Column Column3 Column) Column5 Column° Column? Column8 Column9
22 David Grice Money Order Robert Roy USPS 2.64E+10 $400.00 1GP#85579D BB rct.16986
22 David Grice Money Order Robert Roy USPS 2.64E+10 $200.00 GP#85566D 'BB rct.16990
22 Alexander Torello Jr. same BB&T 5923 $400.00 GP#85598D KE rct.16590
02 Jerry Ennett Edna Lockamy Coastal Bank and Trust 4489 $200.00 GP#85591D JD rct.16565
22 Carolina Bluewater Construction,Inc.David Aucello BB&T 24517 $200.00 GP#85568D BB rct.16991
22 Carolina Bluewater Construction,Inc.Ashley&Jackson Trent BB&T 24516 $200.00 GP#85567D BB rct.16992
22 r South Cape Maritime,LLC Marsh Harbour HOA Wells Fargo 1148 $400.00 GP#85571D KE rct 16588
22 Richard Penny Construction,LLC Eagle Point HOA Navy Federal CU 2658 $200.00 GP#85570D KE rct.16587
221 bennett Boys,LLC Matt Bennett First Citizens Bank 1128 $200.00 GP#85559D JD rct.16811 _
22' Sea Dog Marine Construction Edgar Garber II First Bank ! 1629 $200.00 GP#85373D 'BB rct.16989
22 Meadowbrook Investments LLC Debell BB&T 1396 $200.00 GP#85581D BB rct.16988
22! Rhonda McCall Tony Alexander - Bank of America 1131 $200.00 GP#80195D PA rct.16541
221 Roy Smart Same Wells Fargo 5783 $400.00 GP#85450D PA rct.16502
221 South Cape Maritime,LLC Daniel Bowman Wells Fargo 1358 $200 00 GP#85406D BH rct.16260