86233A_Innes, James & Amy_20220307

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CAMA DRE®GE & FILL � N9 86233 aB c D
asi d
Previous permit `dG
G E N E �►1�, PERMIT 2��Pr
Date previous permit issued a-,Z1-.-LD--
[�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 7'pl • aloo ..___ Rules attached. t� General Permit Rules available at the following link: www.dgq.nc.gov/CAMArules
Applicant Name •, Aix^%, Mcm-nS Authorized Agent Address I , ?- ( '-�r r c'Fo K.,o- I k111- I I Z /� Project Location (County): L.G. re : 4Lesc K-
City M,-, \ (-, (J( State /U G ZIP f% % Street Address/State Road/Lot #(s) 1 O S F y v I e 19t •,i/,-
Phone # ( ark.)--1.&--- q2 $ _ L,o+ q t`'Sc• /q
Email : A-(,- sIr-Q, .- t .Cori.... Subdivision &C,8A n.�e,.9 r,- ft)T Ae-r&9jj � i'7 J;ws %ors
City I'JCn �- ZIP-a79
Affected ❑ CW dW [g/pTA ES PTS Adj. Wtr. Body Col tioo (' e- q lX (a�t nan/unk)
AEC(s): 7 OEA IHA UW SPIMA PWS Closest Mal. Wtr. Bodyfr
ORW: yes/ PPNA: yes/ io
Type of Project/ Activity Map, r P' l2
(scale: /UTS )
Shoreline Length
Access Length , d `Y ra.�n•�r � fps �. ty �' t~�%i E�� �. I
Pier (dock) length
Fixed Platform(s) J
FloatingPlatform(s) V/ C71? 4 g6209-A
Finger piers)
Total Pfetfca 4ea 7p(-) �-o
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatrift
Beach Bulldozing _,._ _
Other _Mott," P:1e
//r let
iir �W ter/ iir ale
4 . �4
NC'- cc�a.34- t
W elI't-^-A S
SAV observed: yes no `!
Moratorium: G1 &Lees no �Y '2f
Site Photos: CyB3 no iJ`Gr- ��r CS �fC�
Riparian Waiver Attached: et y�Is� Cf..Jo ;I.e d
A building permit/zoning Perrin may berequiredby: �L Ir i L. G f� f✓ol w /
Permit Conditions _A{- -y 41
r" Moor �S _ �: ►g
TAR/PAM/NEUSE/BUFFER (drde one)
See note on back regarding River Basin rules
5ee additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT, (Please Initial) 444f'r
5, k,&S f_MC S - ILC�J�r��f by
Agent or Appli an TED Name P it fficer�sINTED yarne
Signatu `Please read compliance statement on back of permit" Si nature
Application Feels) Check #/Money Order Issuing Date Expiration Date
S

RECEIVED
MAR 0 7 2022
N.C. DW11SION OF COASTAL. MANAGEMENT D C M- E C
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONUAWER FORM
CERTiFiED PML • RETURN RECEIPT REQUESTED or HMD DEU4VERY
(Top- portion to be completed by owner or their agent)
Name of Property Owner James_ & Amy des
Address of Property: 1(15 Xa ie Dr Barco NC 27917
Mailing Address of Owner.' 1371 Carat:oke Hy7, ; yock NC 27988
Owner's email: TOKBuilder@gmajl,.com Owner's Phone#: 252-202--R82
Agents Name: Agent Phones
Agent's Email.
ADJACENT RiPARiAN PROPERTY OWNER'S CERMRCATION
Bottom portion to be eo!gpleted by the Adiacerd Praperiv Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying forthis;
permit has Oescribed to me, as shown do the attached drawing, the, development they are proposing,.A
de . Imensions must be provided wfth Wm Wfler
I DO NOT have objections to this proposal _ . — I DO have objections to this proposal.
It you have objections to what is betas proposed, you must nv , the N. Dfvfslvn of Coastal
Management (DCAd) in writing wAUn 10 days of receipt of this notice. Correspondepce should be
mailed to 401 S. GrMn St, Ste, 30% E1rzabeth CFiy, NC, 279a9. Dowrepre*Vntaffves can also be
confacfed at (252) 2644M. No resFonse is considered the mme'as no oltje ion if you ha
tre beennotfffed by CertffPed Mail
WAMER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater,boathouse, lilt; Cr
groin must be set back a minimum distance of fV 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 si n
the appropriate blank below.)
1 DO wish to waive some/all of the 16 setback g
-OR-Signature of r>fRlparian p r
1 do not wish to waive the 9S setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
TypedlPrinied name of ARPO: Laura A. Palmer
Mailing Address of ARPO: 3861 Caratoke Hwy, Sarao NC 27917
ARPd'semail; [e-mail] ARPWsPhonet 252-202-4075.
Date: `waiver is valid for up to one year from ARPWs; SignatLW
Revised July 2021

RECEIVED
MAR 0 7 2022
N.C. DIVISION OF COASTAL ADJACENT RI ARIAN PROPERTY OWNER NOT F16AVONIWAIVER FORM D C M - E C
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: James & Amy ine's
Address of Property: _ 105 Ftvie Dr, Barco NC _ 27917
Mailing Address of Owner: 1371 Carat6ke Hwy, Nfoyock NC 27988
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Agent Phone#>::
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be comeleted,by_the Adjacent Property Ownerl
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.
Y 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 (DC" in writing within 90 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, M09. DCM representatives can also -be
contacted at [phone]. No response Is considered the same -as no objection If you have been
noffed by Ceri frred 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 somelall of the 15' setback
Signature of A acent Rip ran Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner. g
TypedfPrinted name of ARPO. Brian P Inns, Trustee of Brian & Patricia Innes Trust
Mailing Address ofARPO: PO Box 116, Barco NC 27917
ARPO's email: [e-mail] ARPO's Phone#:[phone]
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

ECE
MAR 0 1 2022
105 Fpvie Dr, .Barco NC- 27917 DC/�-EC
-- - • - - --- — _ _ _. _.i Mooring Poleqpv-
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105 Fgvie Dr,.Barco NC 27917
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