85520D - Parks

,30� COur"`+ ❑CAMA ❑ DREDGE & FILL N9 85520 A B
GENERAL PERMIT Previous permit
Date previous permit issued
0 New ❑ Modification ❑ Complete Reissue [--]Partial Reissue
As authorized
�b}y- the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant
15A NCAC u 00 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.dgq.nc.gov/CAMi
Applicant Name AchadAuthorized Agent N
Address ✓ Project Location (County): I
City W State AIG,ZIP R Street Address/State Road/Lot #(s) R h
Phone # () (-
Email bT� �/�5� (►/i f w0 � I! S C-60 Subdivision
City t3C 4 141 A
` ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body �- �G�G lit/nU/L j/L�ima
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
f ' viva 0ck fy) ��/ , '� Si,
IScale:N l
Shoreline Length.
Access Length
Pier (dock) length
Fixed Platform(s),
.hq
Floating Platform(s):So3(/
Finger pier(s)
Total Platform area 01bb S
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other ; 4+w P
SAV observed: yes 6& a;
Moratorium: n/a yes �f oz ¢ t..
Site Photos: yes Ae i
Riparian Waiver Attached: yes Rio �s y
A building permit/zoning permit may be required by:
Permit Conditions -'`[,' _f1' &f 'r L ?i'-I
❑ TAR/PAM/NEUSE/BUFFER (circle one
❑ See note on back regarding River Bash
❑ See additional notes/conditions on ba
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Mich
Agent or Applicant PRINTED Name
PeMc R,I��TIE,D Name p�
/L�lN

ement of Compliance and Consistency
permit is subject to compliance with this application and permit conditions. Any violation of these terms may
ect the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
permit must be on the project site and accessible to the permit officer when the project is inspected for
pliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
nit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
I land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
peen obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
*mation and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
r Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules F-1 Neuse River Basin Buffer Rules
dicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
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
shington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
;es/Additional Permit Conditions:
e ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
ct area and disposed of in an appropriate upland location.
on of Coastal Management Offices
head City Headquarters
ommerce Ave Morehead City, NC 28557
108-2808/ 1-888-4RCOAST Fax: [phone]
?s: Carteret, Craven — south of the Neuse River, Onslow
ties)
ieth City District
. Griffin St. Ste. 300
ieth City, NC 27909
'.64-3901
�s: 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)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Ir►Gb,f= a, /LJ'r
/(5-
Mailing Address: ZAb e�ar"Ya- Jr
Phone Number: -
Email Address: !'r),Oo/^ &10e_Gt-/�{;/©rh-X4o�IC//h- a GOIy
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
f
necessary for the following proposed development:
at my property located at
r
in County.
I furthermore certify that 1 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:
A4 r kk -
Print or Type Name
Title
Date
This certification is valid through /,

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 •rf uel d- &,45
Address of Property:
Mailing Address of Owner: L/;7,9'7%`G7 r,aryq- o4r.
Owner's emailD�lRS�c%ri�yir��fGDnf�wne0r/s*Phone#: �'3��'ao D7410
Agent's Name: SGt/Y1 Q�I DWI;CC Agent Phone#: J�amC 46 OSTi//�C�
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 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 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
Signature of Adjacent Riparian Property Owner (ARPO)
-OR-
I do not wish to waive the 15' setback requirement (initial
Signature of Adjacent Riparian Property
Typed/Printed name of ARPO: L5
Mailing Address of ARPO: 665 W ►�`� r �V C ��
ARPO's email: �PlSctt,osale?(mC.nt ARPO's Phone#:
Date: I 1 '�' a*--), *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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Permit Number/Comments
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22 -
Jon Williams
same Civis Bank
3701
$-200.00
GP #85481D
PA rat. 16521
22
Sea Dog Marine Construction
_
Gonzales First Bank
1656
$ 600.00
GP #86072D
PA rct. 16518
22
Anna Clark
Anna and Frank Clark First Citizens Bank
1261
$ 2-6"0
GP #85482D
PA rat. 16520
22
22
Michael Parks Cashiers Check
Randall Mosley
same First National Bank
Kim Barringer First Citizens Bank
1.04E+08
2757
$ 200.00
- $ 200.00
GP #85520D
GP #85480D
PA rct. 16130
PA rct. 16129
22
22
Randall Mosley
Rodney Clark
Richard Benson First Citizens Bank
same Wells Fargo
_ _ 2756
8683
$ 200.00
GP #85479D _ _ -
GP #85533D
- -
PA rct. 16128 _
PA net. 16517
$ 200.00
-
1062
$ 200.00
22
Holden the Line
RodneyDabbondanza Wells Faro
GP #85532D
PA rat. 16516