86021D - Baldwin

VCAMA ElDREDGE & FILL NO 86021 A B CliT
fA I)/ GPrevious permit
GENERAL PERMIT
Date previous permit issued �
New ❑ Modification D Complete Reissue ❑ Partial Reissue
As authorized by the Scat of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC [ • �Z"Q� �_ Rules attached. General Permit Rules available at the following link: wwwdeq.nc.gov1CAMArulees
Applicant.Narne W
t� Pt .At DWt't..%
Address �� k4—J "'o
kp
City _ ` _�Staa+tte �ZIP
Phone # ) � ' OQ (.A
Email
Authorized Agent _
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected CW EW PTA ES OPTS
Adj. Wtr. Body i� (natlman/unk;
AEC(s): FI OEA D IHA D uW D SPIMA EIPWS Closest Maj. Wtr. Body---
ORW: ye&.) PNA: ye n
Type of �P.rorject/ Activity 9e40N'P1"K E�( DOC& 4' 1 IV !;r?tPA=
�•' __.P/--47J D ' _ _ (Scale:/'�*
Shoreline Length :j1—
Access Length A)
Pier (dock) length
Fixed Platform(s)
Flo a 'ng Piatform(i) I
Fingerpier(s)�' !
Total Pia rm area
Groin lengt
Bulkhead/ \offshe
Avg distancBreakwater
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatiift
Beach Bulldozing -
Other
N?AA)
New JA4
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no 4�
A building permit/zoning permit may be required by:
Permit Conditions
I AM AWARE OF STATUTEEXRC/RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND
rtor atame
z
Si)Wture:"- 1 ase read compliance statement on back of permit"
V
r 1%b
1/1
TAR/PAM/NEUSEIBUFFER (circle one)
See note on back regarding River Basin rule
See additional notes/conditions on back
0 IANCE STATEMENT. {Please
PRINTED Name
�j7" 11}•IIZ �

3o'dcoasrk ❑CAMA ❑ DREDGE & FILL N° 86021 A B C
GENERAL PERMIT Previous permit
Date previous permit issued
New ❑ Modification ❑ 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 " G ❑Rules attached. ❑ General Permit Rules available at the following link: www.dgq.nc.gov/CAMAruI
Applicant Name_` g t k.'
Address
city ' >'E1 t (=j= State N(�. ZIP
Phone#(` ���) �r��i� ��� Z
Email
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
Authorized Agent
Project Location (County): �r
Street Address/State Road/Lot #(s)
Subdivision
City
P
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin n
❑ 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)`
J( -+
or Applicant PRINTED Name
PRINTED Name

itement of Compliance and Consistency
is permit is subject to compliance with this application and permit conditions. Any violation of these terms may
oject 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
mpliance. 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.
ter Basin Rules Applicable To Your Project:
F-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
it the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
C Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
(ashington 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
eject area and disposed of in an appropriate upland location.
,ision of Coastal Management Offices
irehead City Headquarters
) Commerce Ave Morehead City, NC 28557
?-808-2808/ 1-888-4RCOAST Fax: [phone]
rves: Carteret, Craven — south of the Neuse River, Onslow
inties)
:abeth City District
L S. Griffin St. Ste. 300
:abeth City, NC 27909
?-264-3901
rves: 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 Fender Counties)

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 1 AO,\ f- ty- �a-1 (\Y,� n
Address of Property:
N
Mailing Address of Owner:
/�
„-„ 1a A +-Y'oo�S • C orYl
Owners email: y�OI,�LI.� Win 00 _Owner's Phone#: q a' U Z Z & _0 Z
Agent's Name: if �Z0 J . W, n Agent Phone#:
Agent's Email:
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 drawing with dimensions must be provided with this letter.
_I_ 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 127 Cardinal Drive EXT, Wilmington, NC 28405. DCM representatives can also be contactedat
[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
Signature of Adjacent Riparian Property Owner (ARPO)
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner V�Q, 1:- CyrI �V�I + n
Address of Property:
Mailing Address of Owner:
rt ian-� -roJ5.c,0m Owner's email: 1WUt\ _U--bQk\W\nn^�Owner's Phone#: `1 l O - G 2 7_ - L02 &Z
Agent's Name: W a.1K-+(,K 1(��4�1 ti (1 Agent Phone#:
Agent's Email:
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 descrintion or drawina_ with dimencinns mutt hp nrnviriarl with thk lattar
I DO NOT have objections to this proposal.
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 127 Cardinal Drive EXT, Wilmington, NC 28405. 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-
Sknatare of Adjacent Riparian Property Owner (ARPO)
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: C "L•
ARPO's email:8' rb< ,O—ARPO's Phone#: VV� �l�v c)d J9
Date: Ll (>Q Q *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

5

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d Date Deposited
Check From Nam.
Named Permk Nokl.r
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Check numher
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Pormh Numoer/Comments
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22
South Cape Maritime, LLC
Goudarzi
same
same _ _ _
Chris Baile
Wells Fargo
Bank of America
First Citizens Bank _
Wells Faro
1364
$ 200.00
GP #66084D
KE rot. 16953
22
_ -
W Phillip Loughlin _
Amy Baldwin
181
$ 200.00
GP #86022D
JD rot. 16303 _
JD rat. 16302
_ _
22
1150
1363
$ 200.00
GP #86021 D _ _
_
22
South Cave Maritime LLC
$ 400.00
GP #86029D
KE rot. 16598