86273A - Fallon, William & Denise

, "W IOCAMA ❑ DREDGE & FJU r� NY 86273 3 B C C)
IN,GENERAL PERMIT `` Date prePrevious vious permit issued
® New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the StateofNorth Carolina. Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 714 - l°�f�� Rules attached. ® Generai Permit Rules available at the following link- wwwdaq.nc,yyKAMArales
f� ���+�_ a �^ _
Appllcant Name W t CLM=1& Dee'.% 'e- 1 CLvoin Authorized Agent
Address �•� Sol V1 Project Location (County): 61-
City State e' ZIP -P l3Ci Street AddresVState Road/Lot #(s) 0 �-
Phone # $0+54 553 U-'tffl�lot.� W
Email 01PCOCn C-11CAA', / ' � it 9 VK Subdivision /�►��.Lm ltl� $�1C r CS G
city "4-1r4V1-d ZIP a1 r1
Affect ❑ ❑ed CW ® EW ® PTA Es ❑ PTS AclBody}
i• Wtr-
y ex79 Fi_u _I�v.ri 1�$ Z -ee- (a./unk)
AEC(s): 0 OEA ❑ IHA UW SPIMA PWS Closest Mai. Wtr. Body n 1 [K.�r'a'tQ- S0
ORW: yes/1!4 PNA: yesttto]
Type of Project/ Activity i�..h i'MI�F X
100t x f.r a e r•
4x- d
(Scale: 1" =60
�t
Shoreline Length--r-r-T-+----
1
Access Length
i __� IT t r E.-r- I
�--t-* I ! 1 F- r---� - I
1
y
I
, I
"X-
Pier (dock) length I
i
_r..
I
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
1
I
Total Platform area
I
I-+--�-- -. �.-4
Groin length/#
Bulkhead/ Riprap length
t
Avg distance offshore
t 1 i
Breakwater/Sill
Marc distance/ length
Basin, channel _
;-Tt
5
Cubicyards
�T--
i I
-_�_-T-•1
+ i„ r I
Boat ramp
Boathouse/ Boatlift
' ;
Beach Bulldozing r.
1 I _
1 • I
t Y
Other
SAV observed: yes �,f 1 F 1 T 1 )'
Moratorium: yes o `''i , f R • kts e I I I 1 'i" J__'1--r-
Site Photos: n0
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by: (j�lIv'&r,
Permit Conditions
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT
�IVIVLV=
or
Signature "Please read &fftp lance statement on back of permit"
uccl. C& ilq (o
Application Feels) Check #/Money Order
Folk
❑ TAR/PAM/NEUSE/BUFFER (cwde one)
See note on back regarding River Basin rules
See additional notes/conditions on back
ID REVIEWED COMPUANCE STATEMENT. (Please
(Please Initial)
l-�iC>t &,-r'h 04
Permit Offi PR q.lame - /
Signatu
i2�22. -712122
Issuing Date Expiration Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: -/,) t ( �"GLrrm oL► o� tee, ��� l
Address of Property: �S 3 tAJ I D �� ✓rC� if ai )`� f L�
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
�- Mailing Address:
�w� t
F E 8 1 7 2022
QNX50001
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 p
V I have no objections to this proposal. I have objections to this
proposal.
if you have objections to what is being proposed, you must notify the 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 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 sign the appropriate blank below.)
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Pro erty Ow r I mation)
Signature * ,"
Print or Type Name
,vs, t
Mailing Address

City/State/Zip
City/State/Zip
7S'7 5X i �?7S 9 t ism eq-
Telephone Number/ Email Address Telephone Number/ Email Address C yp 4 X,) C
Date
Date*
*Valid for one calendar year after signature" Revised 2017
mDIVED
FEB 17 Y022
ACM -EC

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: by k ( ("a-� yii-� :; ( ton
Address of Property:
►-�5 3 � i ems) o�J � �'1� r-�—�a r-d NC oZ7`7
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
FEB 1 7 2022
DCM-EC
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 drawin the develo ment
they are proposing.
C,i nave no objections to this proposal. I have objections to this
proposal.
If you have objections to what is being proposed, you must notify the 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 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 sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
to waive the 15' setback requirement.
(Property Owner Information) (AAacenAt PropprI j Owner )nformation)
Signature
Print or Type Name
Mailing Address
Si ature * ((rrff
Print or Type Name
511� 91 (�qu-
M ifing � ess c

City/State/Zip
Telephone Number/ Email Address
Date
"Valid for one calendar year after signature`
City/State/Zip
Telephone Number / Email Address
Date*
Revised 2017
RECEIVED
FEB 1 7 2022
DPvj C

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Perq uimans GIS
2/21 /2022, 10:59:18 AM
Address Points perquimans nc lot perquimans nc acres
Centerlines perquimans—nc—easement Imagery 2020
perquimans_nc_misc perquimans—nc—dims Red: Red
Q.O. (3c%riJ`1
1:1,128
0 0.01 0.01 0.03 M
j Green: Green
0 0.01 0.02 0.04 km
State of North Carolina DOT, State of North Carolina DOT. Esri, HERE, Garntin,
Blue: Blue GeuTechnolcgles. Inc. USOS, EPA
Imagery2016
Perqurbans CIS
F"cx lax purpcnes nn ly Nd a legal ticx;crtnent cx scrvey Perqulrnans mu Slate nt NC assume any liability resulting frcm use cA thrs map

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553 Winslow Rd
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