Epic Holdings LLC 84559C

° IACAMA ❑DREDGE & FILL N9 84559 A a Oc D
GENERAL PERMIT Date 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 NCACy +D Rules attached. FA General Permit Furst; available at the following link: vnvvvdea.nc.¢oy( Arules
Applicant Name _—Mr �t RaLb�_ Ly, �t Authorized Agent EN1vV�
Project Location (Countyr�1�L0W City......... /4Q ..._State N�zip _%LLt_' __.... ... Street Addressl5tate Road/Lot
Phone # (_)
Email
Subdivision
City stvom ZIP 2&J00
Affected CW EW
AEC(s): rJOEA IHA
,PTA
ES PTS
�
Adj. Wtr.Body-4"��t,1�___..4EC�E--..-__.._
at tan/unk)
uW
SPIMA PWS
Closest Mal. War. Body (�W ( U &
ORW: yes/no PNA6?/no
Type of Project/ Activity AX
1
U '(
1 1
l (
` F5 X
4ND /51
13 x nnT
Ir
(Scale:2/1 ,
)11,
Shoreline Length_,
Access Length�.�Q�._.��rr�,
Pier (dock) length & I Y 7.7
Fixed Platform(s) iDV I
(I' piPt +wlLSv,i1J
V'( v
rf 6 x�`rrG J W v
No`"
I
Floating Platforms) / _
VJ00
Finger piers) _/
Total Platform
Groin length/# /
Bulkhead/Riprap length i
Avg distance offshore i
Breakwater/Sill
Max distance/length /
Basin, channel _f
Cubic yards
Boat ramp
Boathouse
Beach Bull/
Other_
SAV observed: yes 't$
Moratorium: nja yes r-6
Site Photos: yes ap
Riparian Waiver Attached: (!9
no
A building permit/zoning permit may be required by:
Permit Conditions ANTS_ Pl-'It 4t- A)
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pun
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TAWFAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AC 1�ii11 OF STATUTES, CRC R LES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT, (Please initial) - v
YT.Xt _.. ._ _ ..
k
Agent orApplicaut PRINTE ame
Signafure**Please reatrfomPliance statement on back o(permiN' Signatue
200. 00 �ISN j 3 l5
Application Feels) eck # Money Order Issuing Date
Date

❑DREDGE & FILL CU1al N° 84559 A B �) D
a GENERAL �`�""`""; Previous permit
PERMIT
Date previous permit issued
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized bytheState of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC �f M. 17AI) ❑ Rules attached. [�J General Permit Rules available at the following link: wwwdeq.nc.gov/CAMArules
Applicant(Naame �(L HOLD146S Li.Ci1�/1
Address ^^CAJ(�WN6weyi 12A.l2
('Q ,�,yyrryb aJl�.
City i.�lC. State IVYL ZIP X1�3
Authorized Agent l l*rl/,�tV ,^1 MiYI�I�L' W�Srr
Project Location (County): OW
Street Address/State Road/Lot#(s) ?J(D �NW"ylN�
Phone # (_ )
i
Email Subdivision r f ^
City SNl'��S r yYGIU� ;_1 ZIP 2&L(400
Affected CW W IPTA ES ❑PTS Adj. Wtr. Body WLAA,�Tf�,���t�1' 1�� �/� zI_' �nan/unk)
AEC(s): ❑MOEA �IHA ❑ uW KSPIMA ❑ PWS Closest Maj. Wtr. Body' 04- M1 iW1(1 L G Lie
ORW: yes/no PNAP/no
Total Platform area I CIO .TF
Bulkhead/ Riprap length
Avg distance offshore
Basin, channel
fuhir vardc
SAV observed: yes 'tt I�Xp,.e� i
Moratorium: n/a yes ra QV' (-
Site Photos: yes r5E%P
Riparian Waiver Attached: ® no ^
A building permit/zoning permit may be required
Permit Conditions IF{(
S PenA-�-J
k
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit** �6��
Application Feels) eck# Money Order
(JUop
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Per tOfficer's PRI ED ame
J K?�aft
Signatu e
81 16/22 Z/ /22
Issuing Da et Expira 'on Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: (, I r 15 � l G' Ud
Mailing Address: c� 1(p Aiv h 8r b?
Phone Number:
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: � i X I �' C�OC k I K I71eelt
at my property located at �C
in L County.
I furthermore 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:
Signature
Print or Type Ndma
( nrx
Title
sn
Date
This certification is valid through

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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
Address of Property:
Mailing Address of Owner:
�" �'
Owner's email: �'. rl ti 0(jP1i71( 2h� f - wner'ts Phone#: !r I !I lc I
f I I
Agent's Name: �t�Rj-1 LI (/� ,D/75f7"Cl6I 1�Agent Phone#:_-'116- 027-34115
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom R2rtlon to be completed by the Adjacent Pr -o ,Owner)
\I hereby certify that I own property adjacent to the above referenced property. The individual applying forthis
Permit has described to me, as shown on the attached drawing, the development they are proposing. A
�[l1 cri r dr in io s mu t be 2roviged with this letter.
O NOT have objections to this proposal. I DO have objections to this proposal.
if you have obiectlons to what is being proposed, you must notify the N.C. Dlvlslon of Coastal
Management (DCM) In writing within 10 days of recelpt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead Chy, NC 28557. DCM representatives can also be contacted
at [phone]. No response is considered the some as no objection If you have been notNled 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
O� 5 i Ct the appropriate blank below.) A`
J I DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the i5' setback requirement (initial th an
Signature of Adjacent Riparian Property Owner:
C01'5 Typed/Printed name of ARPO: . C h a A /�L Sfita
Mailing Address of ARPO: __M
ARPO's email: ARPO's Phone#: %1� �/1 y99 Zi'
Date: 2 ' D - waiver is t/alld for up to one year from ARPO's Signature'
Revised Jury 2021

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