84655C - Bland, Tom

"" II CAMA I OREOGE & FILL N� �':�1SS J, u (E5i V
P GENERAL PERMIT
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❑DREDGE & FILL a� N° 84655 A B �CO D
T� Previous permit
�; 3 GENERAL PERMIT Date previous permit issued
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State
off�`�1grth Carolina, De artment of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC ©(� r / ❑ Rules attached. General Permit Rules available at the following link: www.c1eq,nc:.goy/CAMArulqs
Applicant Name
City ,,// State ZIP
Phone# 1�i1 Tr ^"�I_ —
Email
Authorized Agent r
Project Location (County):
Street Address/State Road/Lot#(s)
Subdivision
City z4
Affected ❑CW EW 'PTA" ❑ES ❑PTS Adj. Wtr. Body n �--/� n /rnar/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr, Body_ C se— 1 �
ORW: yes/� PNA: y no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
F'xeJ Pla m(s) On�
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap lengt
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
CRC RULES
PRINTED
Permit Officer's
7
(circle one)
See note on back regarding River Basin rules
ElSee additional notes/conditions on back
Initial)
Signature **Pleaded compliance statement on back of permit**
w 207,
A plication Feels) Check A/Money Order

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
-- ADJACENT -RIPARIAN PROPERTY OWNER-NOTIFICATION[WAIVER-FORM
Name of Property Owner: TU m j �Sv� 3\ ►�`�
Address ofProp":fib \ ��w` N; hW aOC.� !✓r�yz �.
(Lot or Street #, Street or Road, City &County)
Agent's Name #:o iL Mailing Address:'��
Agent's phone #: `1\b `S" D A �'Y a�
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 devel nt
they are proposing. I' tiesipfiot�dCait�rwh ttrra �70� usbe pfrrgthhs)e . _ -
v""I have no objections to this proposal. Ibave objections to this proposal.
If you have objections to what is being proposed, you must notifythe Division of 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 (252) 808-
2808. No resoonse is considered the same as no objection if youhave been notlfied by Certffled Mail.
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.)
I do wish to waive the 1 setback requirement.
/ I do not wish to waive the 15' setback requirement.
:r)+y Owner tnforr4tiol, r I n (A�cent Property Owner Information)
1 (\omtks �`P t4y
Print or Type Name
lo\ -i�,%N rN*k C:�-
Mailing Address
Wk4tADLk 01g532
City/state/Zip
g1a,��"1—►1��
Telephone Number
A �-61aoas
Dat—tet I
Print or Type Name
k 0 7-
Mailing Address
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City/statezp
Telephone Number RECEIVED
LlI 13I I. 2u;L �- 10 13 2022
Date'
Revised 6/18/2 1
DCM-Idl b CITY

CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
-- - ADJACENT RIPARIAN PROPERTY OWNER-NOTIFICATION)WAIVER'FORM
—
Nal^te of °roperty Owner: Tto <`'�
+ Jul ,
Ad:rass of Prooarty: �� � -- ----
;Lot or Street #, Street or Road. �iiy &County)
z . ?daiLn .Ad:rass:
4gant s bane #: ��`uc``��� - LL� 9
Agen spone#: lO ' �s�w t_ v r-i 1Z�r�.�Atv�•i 1J C�—��7�
�, at I v Droperty ad,acent to the a c -
c r ;i';idt.al
a o ^ s ernii has described to me as sho yr or, ne at ached dra`rnn he +evAlopment
av, no objections to th:3 ntoposal. i eve objections to this proposal.9x
if you have objections to what is being proposed, you must notif7the Division of Coasts! IYtanagement
DU in writing within f 0 days of receipt of this notice. Correspondence should be mailed to 400
Commerce Ave., 1Ylorehead City. NC, 28557. DGVI representativesan also be contacted at(252) 803-
2808. No response is considered the sane as no objection if yos �a re been notified by Certifled,Nail.
WAIVER SECTION
,ndarsti R_". chat a oler. dock, _.oa .--
:.'Sr itus. inila!
t"e 17 cc',`.1li;r.
do not Trish to'ara'Ve :e 1 se:
Property Owner I
��(W'MAS �1Aav'D
1 �•t w�. rv:��
�,tailir.c .4d_ress
�57D2_
I (A jacent r Owneylnfortn�.�11�' -i
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,l'C:Ii1T'� 1LJ'ei
°_U
p Z RECEIVED
L pMPO CITY

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\0 N-� e�Z
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RECEIVED
APR 13 Z022