Dennis, William 84642C

at0" kCAMA ❑ DREDGE & FILL 1'+�a $4642 A B MD
Previous permit
NERAL PERMIT Date previous permit issued
0New ❑Modification El Complete Reissue ❑Partial Reissue
As authorized by the State of NonhC%arr'olliinna, Department of Environmental Quality and the Coastal. Resources Commission in an area of environmental concern pursuant to:
15A NCAC _ A .�0) I �a --- ❑ Rules attached. 0 General Permit Rules available at the following link: w ny dea nc gov/CAMArule
Address
City —
Phone #
Email
j C��Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s) F A s")
Subdivision
City --
Affected 7JhT:W W. TA 991f OPTS Adj. Wte Body �'\.��' ` O'Kanjunk)
AEC(s): •ram 1OEA ❑IHA ❑UW ❑SPIMA ❑PWs Closest Mal. Wtr. Body_._�_�(,t—
ORW: yes nq PNA: ye no
Type of Project/ Activity
Shoreline Length I;,."
Access Length _
/ �y
Pier (dock) length J /�_,L fzf; �_�
Fixed Platform(s)
dQ fr�7.
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/N
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length ^
Basin, channel
Cubic yards
Boat ramp
Boath'us oat, _
Beach Bu o n i "C7
Other eV
Lk t- -'111� �r
SAV observed: yes (no
Moratorium: n/a yesSite Photos: yesno
Riparian Waiver Attached: yesnog
A building permit/toni%permit mby4e
4
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I
❑ TARlPAM/NEUSE/BUFFER (circle one)
❑.See note on back regarding River Basin rules
❑ See additional notes/conditions on back

❑DREDGE & FILL N9 84642 A B C)D
GENERAL PERMIT Previous permit
3 Date previous permit issued
�y New ❑ Modifiication [:]Complete Reissue ❑ Partial Reissue
As authorized by these State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC cz_/ �r r' ❑ Rules attached. � General Permit Rules available at the following link: wwwdeq.nc.gov/CAMArules
Applicant Name
F C
Authorized Agent
Address
Project Location (County):
City
r
StateCL ZIP
Street Address/State Road/Lot #(s)
Phone #)-
Email
Subdivision
City ZIP
Affectedr
� TA Ngr ❑PTS
Adj.Wtr.Body � / ( nan/unk)
AEC(s): ❑ OEA
❑ IHA ❑ UW ❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body
ORW: yeso
PNA: ye no
Type of Project/ Activity
Shoreline Length /' I I
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) r i�
Finger pier(s)
Total Platform area _
Groin length/M
Bulkhead/ Riprap lent
Avg distance offshore
Breakwater/Sill _
M distance/I n h
ax agt
Basin, channel �'� .,�•
Cubic yards
Boat ramp \ C.v �• ,mac/, AC•
BoathoUs oat i ` ��, ' `• s
Beach Bu on
Other
SAV observed: yes fnoll
Moratorium: n/a yes Ino
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning,permit m e required by:
I AM AWARE OF
Agent ph nt—PRINTED Name Permit
SlpatLtte"Please read compliance statement on back of per i•*_/�_©� Signa
Y({ij(LJl/-ll (7�/ 5�iL7 3
A licatior Fee(s) Check H/Money Order Issu g
r
C
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
Initial)

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RECEIVED
MAR 10 2022
DCM-MHD CITY

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: W S' 'k Cr4foA 1XnrLtS
Address of Property: in ifl'_raccas alItiye 16,e . Cbrli we ai,16110
Mailing Address of Owner: 3RMF_ PkS Sgov6
Owner's email: `OSMCL4,CCOGIMAIt-, CUM Owner's Phone#: a5d a41 b9(oa
Agent's Name: DENNIS & SONS MARINE CONSTRUCTION, LLC
Agent Phone: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed kthe Adjacent Property Owner)
I hereby certify that 1 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 proposes, you must nomy the n.t;. urvision or L oastai
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. 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
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) U ffS RECEIVED
Signature of Adjacent Riparian Property Owner: PEAR 10 2022
Typed/Printed name of ARPO: rr �41` 1�: c« H S 45 S er r DCM-MHL) CITY
Mailing Address ofARPO: l �l�trrn � Lc,-%4—
ARPO's email: f«k • SO45tA (°-�YU64 ARPO's Phone#: sip- i ?8 --3 ?OD
Date: ! I / r7 1LD ZI *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: l 1') I I I Lr (AL x.c ZSt U'l I J r 1. ► )rt.
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
Mailing Address:
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 have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
/ I do wish to waive the 15' setback requirement. RECEIVED
I do not wish to waive the 15' setback requirement. MAR 10 2022
operty Owner Information)
'gn ure
Print or Type Name
III 1nb-ornasf l Dr.
Mailing Address
zea,u� r+. rs)C aea (o
City/State/Zip
ate- au I - tgoa
Telephone Number/Email Address
� 3 a �aa
Date
DCM I�1HD CITY
(Rip rian Property Owner lnformation
gnature
r—r Aank.
Print or Tye N�me
�17 t GrA� �i✓.
Matting Address
C•
City/Stat ip
Telephone Number/Email Address
35aa
Date
(Revised Aug. 2014)