84547C - Donnahoe, Shannon

❑DREDGE & FILL N9 84541 A B Q D
.GENERAL. PERMIT Previous permit`
Date previous permit issued _
Modification . Complete Reissue ::]Partial Reissue
As authorized Jby the State of North Carolina. Department of Environmental Quality and the Coastal REHOUMas Commission In an area of environmental concern pursuant to:
I $A NCAC-L1Rules attached. [Geiterai---"'—_---- ❑ Permit Rules available at the following link: wvw.deo.nc eov/CAM
_-___Ar.uIS3
Applicant Name
Address _� �I,�El+ s ,�A,b jA �... ��.1g(Z,�
City 51_C w,k�-.,..-,f�taj"�yLs{State—M ..czip
Phone #
Email
Affected iyy CW fj'EW Ly-j FTA{5 PTS
C
AECisF ;_jOEA ❑IHA PTA
❑SPIMA--PWS
ORW: yes PNA: veger t
Type of Project/ Activity
7
Shoreine Length. —
Access Length _
Pier f dackj length-5
Fixed Platforms) 1L
Floating Platform(s)!:
Finger piers)
Tote; PaHorm area
Groin length/u.,_
Bulkhead/ Riprap;ength=
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel!" _
Cubic yards -_
Boat ramp
Boathouse/Boatlift
Reach Bulldozing
Other
SAV observed: yes no
Moratorium: nia yps
Site Photos- yes,. o
Riparian Waiver Attached : s nn
A building oermit/zoning permit may be required by
Project Location (County): _............. __-__._.__
Street Addrestsuue Road/Lot #(a) _
V-j.—__.._-
Subdivision,
}--� y
City _--i"E-��-1-�y—s —Zlp --- _
Adj. Won Body _ i(—P:P�.` 'ic..—..__(J_lrman/unk)
Closest Mal, Wtr. Body (Jl(,2(. GA-J �Cl`
J
51 l�
(Scale:'jl, )
Permit ConditiotnsgUr` ct{jyL ({j,�j�j(N(tt t/{n�j _ .' (71{j�y t�Us �' r'�s,lv�ttVA� ❑ TARIPA"NEUSEIBUFFER(circle one)
n`q( J __K t3drlt�r�^i'-,cJ�urY See note on back regarding River Basin rules
0-5 �?HM'L Nth A{Li'.-y (�4 ffyr �i(%,G Fy (7E OF�*'! j'—1 See additional notes/ccnditionson back
I AM AWARE Of ST�ATAUTES,,C1RC RULES A D CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.
FX;Please Ininaq e
+115 f tY l n'tJ - -- l',.,� -� U 1,�.Ji,u tr, r — --
.-vptinease ret dance statement on back of permit"
w
Permit R
ffic_
Signaturje((/—/
Order I uaug ati tP
Date

�courk�L.AMA ❑DREDGE & FILL
GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
No 84547 A B © D
Previous permit —
Date previous permit issued
As authorizedbythe State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC! 11 T IZQ� ❑ Rules attached. GLr'ireneral Permit Rules available at the following link: wwwdeq nc.gov/CAMArules
Applicant Name
Authorized Agent
Address iy Vw[Gli A,,t,/i�y�A��LY- �myalns K-�y�'I Project Location (County): �5I �V
City SPOtA CaR State A) C ZIP Kam/ 60 Street Address/State Road/Lot # s A A/
Phone#( b) Zol (953j 6�
Email Subdivision WLa M nt G
City , Ai lQ" 1' tom'""—,A77Jn� .�rt ZIP ^ AHyCJ
Affected KTcW �EW PTA �f5 ❑ PTS Adj. Wtr. Body C`I%u. /`W (u� (man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body (/"tl�w(OL %
ORW:
PNA: yesyEro 7
Type of Project/Activity (AMSTIZVO 4' r7'A IC b'lW-- ` &IJ1 VL�lG' M02-V1,A)1-4VM LL)(V riN4Gy�f G
r
AAM C� X)3� 134'tTUr-( (Scale:Iif 1
1
Shoreline Length Y
Access Length I I r
Pier (dock)length � �'� �tlL�(J �t s�
Fixed Plattorm(s) �% etc 1i.� 1 I,�� 'i°
Floating Platform(s)!
Finger piers) YX %LI
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill �
Max distance/length
Basin, channel
Cubic yards
Boat ramp i
Boathouse/Boatlift J3t1t(?1r ;ll
Beach Bulldozing i
Other
A
SAV observed: yes no
Moratorium: n/a yes \1
Site Photos: y o �7•
Riparian Waiver Attached: /NEs ) no
A building permit/zoning permit may be required b
Agent or Applicant PRINTED Name
4
�( ` ���
\ AY aM t
Y
IV
S 41
IV
►��(" �Cyi � � SKP
THAT APPLY TO
Signature **Please read compliance statement on back of permit**
Application Fee(s) eck # oney Order
CA
❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please
Permit RINmz&�
Signatur // (� ^/l/�
Issuinr%e/ / Exx lrati Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: � Ymnm Dbne- o c
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Agent!
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 ai CYOGK; 5`'X 14Lpie r
X �a' naernie I QK n��f Li �i5Cl�aninaS�ct�i�t�
at my property located at t i Q l i C k Jm rc6 11r
in 0I1: � 16 t L1 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
)6u Ahae
Print or Type Name
Title
J I / I �Z
Date
This certification is valid through 1.

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED AhAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: S halQ DQnah t) 6
Property:Address of ILr1=wILl�1'4.1C9:lr7Il+7[►Z!!L_al[/1GL71L/1L7n
Mailing Address of Owner:
1'
Owner's email: _____.,......_..___._.
Owner's Phone#: [phone]S l
Agent'sName:AlitPkIyIC[I'Il1L',&.D 6I6�6gAgentPhone#:6116-00-8!4I5
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion tote comb pled W the A agW1RMRJ&kMW
ii 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
descriAtipn or drawing wilb dimensions. must be orovided with this letter.
1� I DO NOT have objections to this proposal. _ ,. _. ,_--- I DO have objections to this proposal,
N you nave objections to wnar is neing proposecr, you musx nowry we mt;. vtvision or voasxas
Management {IDCMI) in writing within 10 days of receipt o6 this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 20557. DCH representatIves can also be contacted
at [phone]. No response is considered the same as no objection it' you have been notilled by
CoWfled Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set backs minimum distance of 16 from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments). (If you wish to ive the ack, you nauat slran
i 6f the appropriate blank below.)
100 wish to waive some/ail of the I & setback
tat
I do not wish to waive the I& setback requirement (initial the
signature of Adjacent Riparian Property Owner: /
Typed/Printed name of ARPO:
Nalling Address of ARPO:
66 ARPO'semail, ,,� O k-Lc �.%6PO'sPhoned:_ %1/% 7�I 7
Deters T G f � 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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: S hant D l7 Bonah /) e
Address of Property: 7b5 CACICOuJ;d' S m-2S Dl- 5APLiL�I I`�C
Mailing Address of Owner: 5cun e
Owner'semail:t Owfner'sPhone#: q64—�D%-QrjpI
Agent's Name: G n() e-4 M(I Y i ii e CUl) Li L7 QJ Agent Phone#: ,i I D' U rI 34 g 5
Agent's Email: ennPi�()K1rll�i✓LO/7S'i7UC�nh�ma��.cai�
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(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 for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
�rt description or drawing, with dimensions, must be provided with this letter.
�ln JptI DO NOT have objections to this proposal, i DO have objections to this proposal.
If you have objections to what Is being proposed, you must notlty the N.C. Division or Coastal
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 N you have been notified by
Certified Mail.
WAIVER SECTION
1 I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
(R groin must be set back a minimum distance of I F 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
5 t the appropriate blank below,)
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 IV setback requirement (initial the blank)
(P
5�C
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 5q M
Mailing Address of ARPO: -Rol Shores Di21Cc-
ARPO's email:
ARPO's Phone#: qto - SR1-221 �'>
Date: 3- 5 ZZ *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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