Gull Harbor Yacht Club Inc. 76686C

r
AMA / ❑ DREDGE & FILL N9 76686 A B
ENERAL PERMIT Previous permit#
New ❑Modification [-]Complete Reissue ❑Partial Reissue Dat rev' us permit is d
As autho ized by the State of North Carolina, Department of Environmental Quality
and the oastal Resources Com is ion in n area of qnviro m ntal nc n pursuant to I SA NCAC
u s ached.
Applicant Name /C L` Project Location: County V/t/rJ
Address St%re t dress/ S a/te oad Lot #(s)
City Stat ZIP /� ��!� t
Phone # ail Subdis slon
Authorized Agent City ZIP
Affected El CVO/ JEW PTA 'ElEs ❑FITS hone# ( Riv rBasin
AEC(s): 710 Lv HHF ❑ 1 ❑ UBA ❑ N/A (t�*Ado. Wtr. Bod net man unkn
❑ PWS:
ORW: yes / PNA yes / Closest Maj. Wtr. Body /
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Piprap length_
avg distance offshore
max distance offshore
Basin, channel i
cubic
Boat ramp
Beach
Other
I
Shoreline Length7yes
SAV: not sMoratorium: Photos: Waiver Attached:
A building permit may be required by:
( Note Local Planning Jurisdiction)
Note{/ Special Conditions
on
(Scale:
rules.
Signature 'r lease read compliance stateme ton back of permi,'""
pplication Fee(s) Check #

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Philip Wesley Adams Jr
Mailing Address:
Phone Number:
Email Address:
148 Camp Morehead Drive
Morehead City, NC 28557
919.801.2434
[e-mail]
I certify that I have authorized JOG lm `a^ l
Agent ! Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: adding a 4 piling 10,000 Ito boat
lift to an existing slip
at my property located at 104 Gull Harbor Or - Slip 34,
in Carteret County.
I fudff6-F rore 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:
M
ignature
�jc'SC`/) S-OIul)C,'j
Print or Type Name
Title
Date
This certification is valid through

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _T�A 11 i
property located at
(Name
C
I
�q IMUUress, Lot, IOCK, Koaa, etc.)
on riill }}aV�llY tvtAV lr`a in /IrUVC+ (kl+V , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
,— I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
NSW 4- �i1'nq Io)060 1 to Tide ►amev- -boeif- I' �r
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 initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Owner
'I„n'
City? tatelLip r
Telephone pumber/ email ddress
Date"
(Revised Aug. 2014)
'Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to (H j b I r Wo 4 71 �&' Gib s
(Name of Pr perty Owner)
property located at 104 Gu U. �tA r &o r-. -1:�JL r SL I P 3 4-
(Address, Lot, Block, Road, etc.)
on G-qw. HpYQ&Iy 6M411UA , in ( A4-Te2er C0u_N i�V N.C.
(Waterbody) (City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above
location.
X I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
I_ f)UU(r )pdp L(3 j Ine �fimlh (sv�ri LIB—i
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 Initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Proper w ter Information)
Si iahtre*
Josh Lyle
Print or Type Name
129 Gull Harbor Drive
Mailing Address
Newport, NC 28570
City/State2ip
LAW 252-646-9590
Telephone Number/email address
6/16/20
Date"
(Revised Aug. 2014)
'Valid for one calendar year after signature'