Tootle, Jennifer 84186C

�r,R(A ' KCAMA ❑ DREDGE & FILL N° 84186 A B
ua. permit
GENERAL PERMIT D reveiprevious p
p permit Issued
�6ew [-]Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the stare ofNo�INy Department of EnNrantnentei Quality and the Cons/W 3asources Commisslon In an area of environmental concern pursuant to:
I SA NCAC —"mil--a+ r'-t-1-b"' ❑ Rubs ituachad. ,,General Permit (tales avdlable at tho following Onk: d e nt tov/UMAnilez
Appikant a ,
Add-
Ciry t State
Phone # ^
Email T
Affected ❑CW ❑EW ❑PTA
AFC(s): OEA ❑INA ❑UW
ORW: yea no PNA a no
Type of Project/ Activity S^0
Shoreline Length N-- ,-
Access Length
er
Fixed Platform(tl�
Fixed Platforms)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groan lenuthAll�_____t i.
Avg disteaeCoffshore
Breakwater/sill_
Mail distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift _
Beach Bulldozing _
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zonfn(q{
Permit Conditions _nLP
Es ❑PTS
SPIMA ❑PWs
Authorized Agent
Project Location (County)' .1
Street Address/state itoad/loc #(s) tlAuta
subdivision
City
Adj. Win Body_
Closest Mal. Wtr. Body
I1A-rAR/PAM/aE 1SE/BUFFER(circle one)
Y�Senote on back regarding River Basin rules
❑ See additional notes/conditions on back
Fee(s)

"�`°"'" idLCAMA ElDREDGE & FILL N9 84186 A B
JPrevious
GENERAL PERMIT Date prei uslpermitissued
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:
I SA NCAC ® 7!9 0 � w ❑ Rules attached. eneral Permit Rules available at the following link: wwwdet nc gov/CAMArules
Applicant a Authorized Agent
Address ^V Project Location (County):
City • State ZIP Street Address/State Road/Lot #(s)
Phone # ( J
Email r' Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ES ❑ PTS Adj. Wtr. Body na an/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. War. Body Nei(14
ORW: ye no PNA a no
Type of Project/ Activity QCO G 1p 1]&12
11 tJ*.GICr r'
Shoreline LengthN l
Access Length , •��
Pier (dock)length
Fixed Platform(s)
Floating
Finger pier(s)
Total Platform area
Groin lennb&L�
Avg dist"etroffshore
Breakwater/Sill _
Max distance/ length
Basin, channel_
Cubic yards
Boat ramp
Boathouse/ Boatlif[ _
Beach Bulldozing
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zonrgi
Permit Conditions � yr
by:
ly i TAR/PAM/PBUFFER (circle one)
V, ee note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED CWPLIANCEySTATEMENT. I rlease lniti
Agent or ppli nt PRINTED Name Permit Omcer's P D Na
�SiIi **Ple read compliance statement on back of permit" „vy, )/ Sign
WW
A lication Feels) Check #/Money Order Issuin6 D e

1�00
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT - V' 6
I hereby certify that I own property adjacent to Jennifer Tootle 's
(Name of Property Owner)
property located at 406 Dewey Rd
(Address, Lot, Block, Road, etc.)
on Clubfoot Creek in Havelock N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
K_ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Install riprap along shore line.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
4 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
rL
or Tvoe Name
4-�"A0,, '�r1� n�. Z453Z
7Gg1/--15 11- 0,7W0
Tele hon Num er
Z7zl zoL,Z
Dare
(Adjacent Property Owner Information)
JI �1-�1PJ1
Signature
Print or
phone Number
RECEIVED
(Revised Wik022
DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Jennifer Tootle s
(Name of Property Owner)
property located at 406 Dewey Rd
(Address, Lot, Block, Road, etc.)
on Clubfoot Creek in Havelock N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
t/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Install ripr�n olnnn ehnr. lino
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
_4� 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sign re
nmt or Type Na e
e r2n ^ ct ) 1 3 �G
`� At rin na- z865
sZ'pSZ 1-
Telepho a Nu/pber
/ 9/ o ,
Dare ZZ. 7
(Adjacent Property Owner Information)
ow'f L��
SlJ nature y/
l -11 1 9-
Print or Type Name
ECEIVED
;// 7/ G Z_ �i i`t l 2022
(Revised 6/1
DCM-MHD CITY