84643C - Marsh, George

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�GENERAL PERMIT
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PERMIT Previous permit
Date previous permit issued
al)�(�,New
❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of fu`lorth Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 0 � 'f f + I ❑ Rules attached. JNJ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant
ClryJiJJe.njJ0lJLWVJFate A10. ZIP ;14V4nL
Phone #
Email
Affected ❑ CW _. TA ❑ ES ❑ PTs
AEC(,): ❑OEA ❑IHA UW ❑SPIMA ❑PWS
ORW: ye no PNA: ye no
Type of Project/ Activity D 6
Shoreline Length
Access Length
Pier(dock) length0
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length
Bulkhead/ Ripriprap length �\
Avg distance offshore mil
Max distance/ length
Basin, channel
I. -
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Ildozin
(JsV
Othe
4�
SAV observed:
yes 0
Moratorium: n/a
yesG•
nn..
Site Photos:
yes
Riparian Waiver Attached: yes
A building permit/zoning permit may be require
I AM AWARE OF
Name
Authorized Agent V
Project Location (County)'
Street Address/State Road/Lot #(s) o
Subdivision
City ZIP
Adj. Wtr. Body
Closest Maj. Wtr. Body
Cfa�
Permit Officer's
7\m
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Sign ure *'Please r ad compliance statement on back of permit"
�I o`7
Applieation Feels) Chec k/Money Order

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules El Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven —south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bartle, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

APPLICATION: LOCALITY: PERMIT ISSUED USING
STATIC LINE EXCEPTION?
YES 0 NO
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOAM
Name of Property Owner:
r L
Address of Property: Eva (
(Lot or Street #, Street or Road, City & County)
Agent's Name #: 41rcy /1.Mailing Address:
// ?D GI/r'
Agent's phone #: � � ���� >/'ia�YHrC, ge,. " r Pie 57ON,
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
7I are p oposing. A description or drawing with dimensions must be provided with this letter.
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 http://www.nccoastaimanaaement.net(web/cm/staff-listing orby calling 1-888-4RCOAST.
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. JkhEIVED
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. MAR i) 8 2022
I do not wish to waive the 15' setback requirement. IXi1h-MHD CITY
(Property Owner Information)
Signature
Print or Ty ame
,Zgb
Mailing Address
(Riparian Property nerl�on)
fd1'
Signai% re
rr�
Print or Type Name
a y
Mailing Address
00 /a,,� -e.5 W. c, -
1y/State/Zip �/)Cz City/Statelzip
Telephone Number/Email Address Telephone Number/Email Address
Date
Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street tr Road, City 8 County)
Agent's Name #: A c A4W l/i,, '6 Mailing Address: J6
Agent's phone #:�, '37,;1," �o� b 5 �/���-,fG✓� l' G /�e�C�,
I hereby certi at I own property adjacent to the above referenced property. The individual
applying for .s permit has described to me as shown on the attached drawing the development
they are p posing. 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 http•//www.nccoastaimanagement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
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 waivet�e setback, you must initial the appropriate blank below.) RECEIVE®
I do wish to waive the 15' setback requirement.
MAR (l 8 ?pl
I do not wish to waive the 15' setback requirement.
_-:m,o CITE
(Property Owner Information)
Signature
Print or Ty Name
Mailing Address
,.il /,'/yin
ity/slatelzip
Telephone Number/Email Address
(Riparia Foperty O format' n)
Signature
Z0:7� eI p,,n-e47a11"540res
Print or Type Name
Igo rnan e- :.>'J�vl z; r
Mailing Address
,s'l� i ✓e - / /'
(-/�`o l / yror GS
!ty/state/Zip
aS_�- 9V 7
Telephone Number/Email Address
Date
Date
(Revised Aug. 2014)

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