86336A - Cerreny, Kimberly

,oACAMA ® DREDGE & FILL N° 86336 B C D
GENERAL PERMIT Previous permit
Date previous permit issued
® New ❑ Modification [-]Complete Reissue [:]Partial Reissue
As authorized by doe State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of envkonmend concern pursuant to:
I SA NCAC r7H - 1 100 Rules attached. ® General Permit Rules avallable at the foikNft link www tiPgJ�ttovICAMArules
• ,•r•••• 1. •.a.• c US AUthOrtzed Agent V {. 99 f
Address 94011 �► 4 - Project Location (County): _
Ctcy C�1 r j.-State tJ ZIP t�q Street Address/State Rood/Lot # (s) 0
Phone # (2s) -� ' 9 tt8 _Q
Emall Kimja a v- \m C e-ry a n. 1 al t Caw. Subdivision %r —
City f_:&Y�� ZIP ! a1`t 32
Affected OW ®EW ®PTA ®ES PTS Adj. Wtr. Body A ! be ty -e-
AEC(s): ❑ IDEA IHA UW SPIMA ❑ PWS CIV
ORW: yesl0 PNA yes/Q
Type of Project/ Activity r�wt {08` X New ��1k�- d of f 01.�1- Qn,
Shoreline Length VUr
Access Length!7
Pier (dock) length r-t-►-+-'- _ _' i-v-� I {{yy�� ' ' '-_ �. _ .i'- 1 1 �" i I o t I i Fixed Platform(s) 1 1 I t"r-t-1--�--`--�� ; • t �"' +-=_ _ ......�+�r..t_y,...�..�._t-.. •i_ _ ,--r--r
1 i ! r—
Floating Platform(s)-r-r-•-- +--^--L--t- -. lr -a- +---t . ! .. i 1 t i��__ s - •'-- s t > i _ r t + 1 t t ;
(— —l... J i 1 • 1 I I I + t i t rat•--�— r 1 ; i t , R j"1 y _.i_"^_'�'—.L j" ±
J_.
Finger pier(s) t
, I ! t ! � I + t i ! + , i I i_ `"'+"!"i _ + I , _I_--t- t E r , -. -t t i + ;-•.
Total Platform area ! ! ; i + I + I i t
_. .I .,. t-+-_.�..1 .._. r + '�•.i�:._.t I . I t r t 1 t r
Groin length/# ».._+ i r 1 ! I
ulkhead 1prap length 100,- _t_4 __1_ ' 11 ' ` t • ,_ t r + ' i iIV
Avg distance offshore t� __! ..�_ _L t 1 + t 7+��/
'Y—--� �--{- + 1 t 'r�._.w. ^+t .....r...—�i_..�._.
Breakwater/Sill --,--a--1--�--L-t , t t�s " • t I t t , r
Max distance/ le �r L_1 + ' 1 , ' I •�= i 1 t / `_...;_.t r , , r :
rlgt}I l tl--+----t-�--; 11-,—• + �..t. :---a-s »__!- t._ W0.
Basin, channel ^ , tt m ��-r�_._--*--+-,-- +- lJ -i _'t"'a.__- -;• _.� ,._.•.__ irCubic yards ,?tF--+-'.-__1..r�.__,._..a_..� _� 1._T-y_ i i r € t E 6 i t 'I_-r--+"r
r �e .: t i f 1 1 t + •1 t r 1 ".Y ;_- r ' � + _—.-- t + -,, _ �
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other !.. _II`
�... k
SAVobserved: yes
Moratorium: yes no i 1,€ � I r
Site Photos: 49 no-i--•'--' r-�-_ _fit L
Riparian Waiver Attached: yes �� _ _ . ,,,_•,� •_,__• _ ,{{
A building permit/zoning permit may be required by: 0-WAIr A.) Clt.in CpLiY�%tcl
Permit Conditions
OF STATUTES. CRC
THAT APPLY TO THIS PROJECT
Agent or Appll rat D Narhe
Signature+��1"y"P_Ie a ead compliance statement on back of permit**
V" T loo. C-" I I 1 aZ O
Application Fee(s) Check #/Money Order
'" r -•r
TAR/PAM/NEUSEBUFFER (cirde one)
See note on back regarding River Basin rules
See additional notes/conditions on back
COMPLIANCE STATEMENT. (Please Initial)
Permit OflfVk,k
''INTED Nam /�' -
.
Signature
_ 3 /; ,Z AZ 7iz 2. i2 Z___
Issuing Date Expiration Date _

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: m be r C Ce r'
Mailing Address: 20a.6-
�
Phone Number: 095 a 331 — 9 l l P-)
Email Address:
I certify that I have authorized i
/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: !OO L.:P cl- V(n ka)
ou 1 IL hg
at my property located at 111 H-e-r)4'aa? Foi/i+ !`�. ' &J&-rl 0110 NL. -.1
in ChoyAn 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:
Ly� - avev-oz��
kimberly carter erveoy (;ab 12, 202207 47 ;7STi
Signature
kimberly carter cerveny
Print or Type Name
Title
Feb 12, 2022
/ -
Date
This certification is valid through / /

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: K i nube,/-L� Cf'> "S4
Address of Property; Dr„ 8_ � �er� tort 1�L ��g
Mailing Address of Owner:
eI
Owner's email: %abe
Owner's Phone#: a5.�"'JJ�!—�{ 11 �
Agent's Name: Agent Phone#: a 5a ' 31 a `1
Agent's Email: OC eQn7, de • �'� } t•DtGtF�, �u'>�t ++ �„t
01-J N( ■
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ADJACENT RiPARiAN PROPER T Y OWNEi
(Eottom portion to be comaleted by the Adim
I hereby certify that I own property adjacent to the above reference
permit has described to me, as shown on the attached drawing
description or drawing with dimensions must be provided with tt
I DO NOT have objections to this proposal. I C
If you have objections to what is being proposed, you mu
Management (DCM) in writing within 10 days of receipt of th
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 276
contacted at [phone]. No response is considered the
noted by Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat
groin must be set back a minimum distance of 15' from my area
(this does not apply to bulkheads or riprap revetments). (if you w
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature ofAdjacent R
0
1 do not wish to waive the 15' setback requirement (initial the bla
Signature of Adjacent Ripanan Property Owner:
Typed/Printed name of ARPO: R 01er + Pa V,!>
Mailing Address of ARPO: PO 8,U X 91- Ka/ski ( i
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ARPO's email: �'y1 24. 1-t� 3 4J\S 4ARPO's Phone#:
Date: C7 L(-L�*waiver is valid for up to one year from ARPO's Signature*
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Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FrIRM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVIEM-Y
(Top portion to be completed by owner or their agent) 4
Name of Property Owner: K � JYl bei, l C e V- 1(1 sti
Address of Property: (11 H Sri �a!4e Or _ rde4f-&" N(, J-191 -2PtJ
,
Mailing Address of Owner: QLi0`5S R;6wlc,l— F-LI , ell -fah CJI'l MC ,9-lciocl
Owner's email:Owner's Phone*
Agent's Name: `I kM o cu) /cceell),;► e Agent Phone#:
Agent's Email:
C
A0JA0CN T MPAMAN 1311OPCATii C CR T IMC:A T iON
(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 forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
I DO NOT have objections to this proposal. I DO have ob ectlons tc this proposal.
ff 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
.,.vi/vw 4-- 401 S. vi:. r: S:., vtv. 30v, r/iiPNVN`I iwafi I vYtviiifuv Lvviy, iw, fwawway. .--g Um
contacted at (252) 28¢3901. 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 tow ive the setback, you must sign
the appropriate blank below.)
r"
i DO wish to waive/all of the 15' setback
Z7 Fcf3 ZOZL
Srgnatu# of Adjacent)?l4pdAn Property Owner
i do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: VOL,, eto, a'
- J ' � [•' t M2l
Mailing Addreas of ARPO; IOLHO U� ��/i' CYY� i_��-
ARPO's email:
Date:
MAR 6 V
ARPO's Phone#:
*waiver is valid for up to one year from ARPO's Signature`
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAID • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: �; M hP r' (�,, (i e r 1M H
Address of Property: III Hein -up iol- Or��t�► NG a1�f32
Mailing Address of Owner: QLIQS R;dd,cl- F-A Oilabetk Ci}u M(——ICjQci
Owner's email: k- /Vil5pe Iti c:e(vCl Owner's Phone#:
i ll. wnJ
Agent's Name: -)C ll,c�un ICkeany-,�de Agent Phor
C o,l�,tc�,�
v
Agent's Email: ecl/\5,'(,le . cC/1+ C(C_+' ye, ACV C
o
ADiAUNT RiPARiAN PROPER i Y OWNE j
(Bottom portion to be completed by the Adi; -1
L
I hereby certify that I own property adjacent to the above reference o
permit has described to me, as shown on the attached drawing
description or drawing, with dimensions, must be provided with tl c"nO
V
1 DO NOT have objections to this proposal. I r o
If you have objections to what is being proposed, you mL rl
Management (DCM) in writing within 10 days of receipt of d o
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 271 W
contacted at [phone]. No response is considered the
noted by Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat
groin must be set back a minimum distance of 15from my area
(this does not apply to bulkheads or riprap revetments). (If you w
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent F
-OR-
I do not wish to waive the 15' setback requirement (initial the ble
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
ie#:
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Mailing Address of ARPO. io�0 DhVt? -,J i�rI ve-
ARPO's email: ARPO's Phone#:
Date: *waiver is valid for up to one yearfrom ARPO's Signature*
Revised July 2021
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Untitled Map
Write a description for your map.
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Legend
111 Heritage Point Dr

SITUS ADDR 111 HERITAGE POINT
DR
PROP_DESC
LOT21, EDENTON BAY
PLANTATION
ORES
0.72
TtiM1 P-NArVE
EDENTON
SUBDIVISION
EDENTON BAY
PLANTATION
ZONING ODE
R15
TAXCDE
G0111F01
AC CCT N U N4
49799
Zoom to •••
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