85600D - Burstein

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✓LAMA /DREDGE & FILL g5(oOb
"ENERAL PERMIT
VNe'A Modification Complete Reissue Partial Russue
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t°"R",&❑CAMA ❑DREDGE & FILL
GENERAL PERMIT
N9 85600
Previous permit
Date previous permit issued
A B C
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by theStateof North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC d7 +,, i J DO &:7 14. U16 J) ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deg.nc.gov/CAMAru
Applicant Name Mk &40e l -n
Address
City i4h Wn?)4 aek State ZIP A
Phone # (IN)
Email «ties ��a lea yAota/Ytbai/_Com
Authorized Agent " In 4� r z(' J// 1M JT V OLE(j f L
Project Location (County): &nSWI-/C_
Street Address/State Road/Lot #(s) _Sa44[.,.'
Subdivision
City ZIP
Affected ❑ cW
+ EW '.' PTA
YES
�PTS Adj. Wtr. Body Z L' (nat/�t
AEC(s): ❑ OEA
❑ IHA ❑ UW
❑ SPIMA
❑ PWS Closest Maj. Wtr. Body
ORW: yes o'?
PNA: yes ' o
Type of Project/ Activity
Total Platform area
GroiLLJeggth/#
Bulk head;'ftiprap length thvg distance offshore
Breakwater/Sill
Max distance/ lengt
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing �-
other MtA ]1 —>
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zonyin
Permit Conditions d1-b
I AM AWARE OF STATUTES
yes'^
yes
yes �..:...... .
yes f4keJ
nit may be required by:
(Scale:
e
❑ TAR/PAM/NEUSE/BUFFER (circle one)
//l�Y ]c / 1, ❑ See note on back regarding River Basin n
❑ See additional notes/conditions on back
RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.,,'' (Please Initial)
pi T l c—�- I "Cc
Agent or Appli Permit cer's P INT Name

itement of Compliance and Consistency
is permit is subject to compliance with this application and permit conditions. Any violation of these terms may
eject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
is permit must be on the project site and accessible to the permit officer when the project is inspected for
-npliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
rmit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
al land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
s been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
e State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
ormation and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
Fer Basin Rules Applicable To Your Project:
1-1 Tar - Pamlico River Basin Buffer Rules 1-1 Neuse River Basin Buffer Rules
indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
r the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Iashington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
otes/Additional Permit Conditions:
ase ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
ject area and disposed of in an appropriate upland location.
ision of Coastal Management Offices
rehead City Headquarters
i Commerce Ave Morehead City, NC 28557
-808-2808/ 1-888-4RCOAST Fax: [phone]
'ves: Carteret, Craven — south of the Neuse River, Onslow
inties)
abeth City District
S. Griffin St. Ste. 300
abeth City, NC 27909
-264-3901
-ves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)

AGENT AUTNORlZATION FOR LAMA PERMIT APPLICATION
Name of property Owner Requesting Permit M ✓ A (,�
Mailing Address: _ ,� 7 j Cj G1am Dx
Ni/-28.�10
Phone Number: 7 p 1
L_ 7, :z 3 55
Email Address: 6
�irkfi nt�a Cia:/;��.vA L .�,✓Go,yJ r
I certify that I have authorized H .
Agent i Contractor '
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development _ A zP i�irinc O
1
Joe
at my property located at i O V L3 g
in fufl SW-CK County.
I furthermore certify that / 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 permit application. with evaluating information related to this
Property Owner Information:
nn 4g=21-ure
Print or Type Name
2h , (/
Title _
Date
This certification is valid through /V i as
1;2-1)-

D1 vWH OF COASTAL AMANAIi)#N7
ADJACENT AlPAU Mi PRO Mtff OWNER NO nWA110W WAVIER FORM
Nsne of ProQertar OWW. L+z,; r►
pat4rMwMMb@War'Rm4 CgrsDour*]
1 ' ' ' 1 bf cWft Ut ! O1 PMPiy I lb the abatis s+eRerenoad . The wovwtw
hw ds@mWlo, now shown on lm atledm d dma vftv_Me dvm4msrd
d�jee�e■sisiisrepei. I heriecArjealiam to thispcuposat
s6o iW 4GdWWatPlG) terns No
D3AtiR1l RSBCif K
In tlrata pier, do&, mombig plkW brodualm. boaVbn . Bk arordn must be set
brut a mfiinurm distance of 96 cram my area of dead m accm udm wanted by me. (it you
wieft�o thesetbedc,You In althesppraprialeb�nitbWow)
t do wish to waive the 16 seas�c n�
do not wish to wi*m to IS soft* regvlm nwk
vvepvrtyo*
Prtid'or Type Name
0270 L4ttiam Pf
AtaftAddiml-
Gk,A!(ot& , M, 212- t o
7011 71 � - 35 50
DIM
ropar4y lrtiornmiion) S� �
Arlbtar !llama
Haft
W 2� 2
7 se.xQMW
PAWsed narg
eNSM12
57e- Ccw\
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=ice It ii_ �.�` gib$ �i�CiAtT
Addri,.S of—
(i of or atrEet -, at= or l md� cY & C,OMV)
ksrit:s parr e EQsOO—c . dj con w"mno mdren
&- - lc.! �ie\✓✓ ��"8 �1
113ereka- car* that i aunt property adjscsr� re -►rts above re�'seterrceti psap8rty. the ir�ff ual
a�iying rar this parmit has described to me as shower on the abehed drawing the development
they errs proposing. A dirt ar efr&tn►in , vAth rfirrrarrsians m Coro • %%Mh!his le tr3r.
j � aio oiojectsorts fibs Rossi a have abicctionsto tea proposaL
ii understand ttrat a pier, deck, mooring pilings, breaioiMer. boaftuse, Off, or groin must be set
beck a rninimtrm dt3tmw of 16 from my area of riparian eCmsurdess vmMd by me. (it you
I'Ash to waive the setbacKyoas'mAJirritiaC the approp7ia#s a180%, b-,.loss.)
- lh i do uuish to vsahre the ` G' saftcic requirement
l do not wish to welve the i W sstback requirerxcmt•
(Peope> y € wear r-
SEgnatsu e
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PrWorType Nam
-�' 71 t! L,f fhNM D /
1t�a�ingAddrsss '
Telephone Number
Signahwe
Print or lypeNarme
IwaAtng Addmu
,YI
��- 22 - `72-4c)
Telephony Mrftr
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Date Date
Revised MaQ012
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Date Recelved
Date
Check Fran Name
!fame or Pwmk HOkfar
Vendor
check number
Check
.mount
Permh NumboNComm rite
wRdunddR-H-st,
—n1
Column2
Column2
Cdumn4
Columns
Column➢
Column?
Column➢
DokYI1nD
3/7/2022
H5 Construction Services (1 of 2)
Lail
Truist
1009
$ 200.00
GP #85599D
JD rct. 16512
3/7/2022
H5 Construction Services (2 of 2)
Lail
Truist
10055
$ 400.00
GP #85599D
IJD rct. 16512
377/2022
H5 Construction Services
Camden
Truist
10054
$ 200.00
GP #8547_8D
PA rct. 16514
3/7/2022
H5 Construction Services
Burtsein
Truist
10053
$- 600.00
GP #85600D
PA rct. 16513
3/7/2022
Overbeck Marine Construction, Inc.
Goldenberg
Suntrust
5532
$ 800.00
GP #85572D
KE rct. 16596 _
3/7/2022
Carolina Bluewaler Construction, Inc.
Perkins
BUT
24567
$ 200.00
GP #86025D
BB rcl. 16910
377/2022
Grice Construction
Laden
Truist
10964
400.00
GP #85353D
1
B8 rct. 6909