86202A_Innes, James & Amy_20220221

"joUtf, XI C.4MA ❑ DRE®GE & FILL NO 86202 (Z) B C D
G E N E R L PERMIT Previous sous it permit s issued IC
�i/'°1 B"" Date previous permit issued j(~`1'1U•a—`
❑ New ❑ Modification V 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�{ - C al{'J�� Rules attached. General Permit Rules available at the following link: www.deq.nc-govlCAMArules
Applicant Name (rA' T1 G� Authorized Agent 4ac4 ,'r e
Address 13 Project Location (County): �iGerr.'{ tti(ir�
city r�iyifY Y State �U_ ZIP Z qS Street Address/State Road/Lot #(s) 11 O� Ui pi o ,,.0
Phone #
Email IGw 6 oAna: .Gan• Subdivision? Mor.. 0 of tK P(j l COS :5- k � W S t�
City 4�af CC-,) ZIP a-7-9 1
Affected CW EW ©PTA QES PTS Adj. Wtr. Body �y j/�(nor Wunk)
AEC(s): nOEA D IHA ❑ UW OSPIMA DPWS Closest Maj. Wtr. Body Gwf r: 4-L. c, f ctA
ORW: VesA DO PNA: yes/e)
Type of Project/ Activity Nat a t" '>e 3V' Pc W,93
c PC I,,. y-Z'- 1 -pr a`I i1or, se i 5w' ,c
Shoreline Length %�Sls f /
Access Length 2/ x 6 r W
Pier (dock) length -V0 r X 4_
Fixed Platforms) _e 1c ' F t GG�3 S
Floating Platforms)
Finger pier(s) _:>,�
Total R ofWarea :5 2m -r-t—
Groin length/N
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boat ous Boatlift 30 ioZt
Beach Bulldozing
Other :4
�Y
> AaeEss
y
Ztit�CS Dot
V
� p'x fa.' r �'7 Grnnec-WA bV p, (Scale: —IS
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Ve d) , r _
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At�,�llorizzc( �i'xb'Qar�, i I _. .
aF C,,6,'c> to.'x tor' .uec %ow
!l '�oaSi�1 LL
SAV observed: yes ® 7,
/�
Moratorium: no
Site Photos: no
Riparian Waiver Attached:
A building permit/zoning permit may be required by: _ (SLrr " i'(-C' k— (Df 4-y
Permit Conditions___
11---- 30 --- -
�i 7
TAR/PAMlNEUSE/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)
Agent or plica , ame rmit Officer's PRINlFtlName
Signature " se read compliance statement on back of permit" Signature
2-21
Application Feels) Check N/Money Order Issuing Date Expiration Date

DECEIVED DIVISION OF COASTAL MANAGEMENT
0 C T o 2 2021 AGENCY FORM FOR PERTNUT APPLICATIONS
��,,^n ! _ n s vNmer of tl�.e property located at:
i —A
(proper{v owner)
7C
do herebv authorize
. aam-e _ _ .c ,ng as agent;
to act as my agent for the purpose of obtairinq =— - v -. t � ' . oa :_.aI Area Management Act and/or
Dredge and Fill Act permits, that may be n e :-mused development at the above -
indicated property, which entails:
J
(describe proposed developmenr,,cr •.wzich permits are being sought)
Tanis agency authorization is limited to the specific activities described above, and will expire on:
(date on which agenc, authorization expires)
—� signa j
f,/prin name Of owner)
!dare)
!title, if officer of corp. owner or trustee for properryj

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 or their agent)
Name of Property Owner. James & AZY Ianes
Address of Property: 105 Fkvie Dr, Barco NC 27917
Mailing Address of Owner. 1371 Caratoke Hwy, M'oyock NC 27958
owner's$maih [e-mail] Owner's Phone#: [phone]
Agents Name:
Agents Email:
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 drawina. wjtii 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 nbtify 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 repiasentatives 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 minimutn 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 somelall of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR
I do not wish to waive the 16 setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
g
TypediPrinted name of ARPO: Brian P Innee, Trustee of Brian & Patricia Inns Trust
Mailing Address of ARPO: PO Bog 116, Barco NC 27917
ARPO's email: biianpinnes@yahoo'com ARPO's Phone#: [phone]
Date:
.*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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: James & Amg Inne's
Address of Property: 105 Fvvie Dr, Barco Nd 27917
Mailing Address of Owner: 1371 Caratoke Hwy, Moyock NC 27938
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name:
Agents Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
1 hereby certify that I own property adjacent to the above referenced property. The individual applying forthis
permit has gescribed to me, as shown on the attached drawing, the development they are proposing. A
I DO NOT have objections to this proposal. — 1 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
malled 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
-OR-
Signa lac R/pafi n Property O n
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
I
Typed/Printed name of ARPO: Laura A. P
Mailing Address of ARPO• 3861 Caratokp"Hwy, Haroo NC 27917
ARPO'semail:[e-mail] ARPO'sPhone#: 252-202-4075
Date:
*waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

97c �4 0-ld A-v9.0
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