86502A_Halsey, Craig_20220428

iff-NCAMA D DREDGE & FILL W 86502 El C D
GENERAL PERMIT Previous perm—
New flModifimion E] Complete Reissue IJ Partial Reissue Date previous permit issued
As ajthced by the State a
llorth CaroLffta, Department of Environmental Qv*Wwd the CoVtal Resources comme,� in,, �,,of�ryTonmeatal concern Pursuant to:
I SA NCA(- 1200 Rules attached Celtcx;el pernlit ItItes aVaibbfe at d te fallowing fink: www
Applicant None ..
Address
PK— #
Email
Affected OCW �y Elk [9 PTA DES E]m
Ads): F1 OEA L] 1HA 1❑IUW SPIMA [] PWS
ORW: yes/40 PNA: yes/Q
Type Of Project/ Ac"
Shoreline Length
Autfiori;-d Agent
Protetzt Loa#4on fCary): I
a
Str— Addr-s/Statn Ro"Latjg(,)
brn
C i10
city J
—ZIP
Adj. Wtr. Body 1
Qosmt Mal, YV)r
Access Length
Pier (dock) langth
F -7-7—
mecl Platformls)
T
Fleeting P(ItfUrM(SJ
Finger pier(s)
i )c h— 1 1"
(Scabe-
Total of3tfixm, area
4-
-a-a!L. - �r-
Grain length/# �t7
Bulkhead/ RipraP length
Avg distance offshore
BiakwatL,/sal
T t---t --I
L—J
Max distance/ I if. f -4-4
Basin, charnei
Cubic yards f
17
Boat ramp T
J
Boathouse/ Boatlift A) -
Beach WfdczMg
Other A
_L4
2
i --T '71-1
H
SAV ObSe,-A,& T
yes )F
L
Moratorium; _2
(0 yes no
Site Photos:
no
F
Riparian waiver Attached:
4-
A building permtr/zoning pe,,A W
be mquiret!
Permit Conditions
TARIPAWNEUSMUfTR {circle 0,a)
See note on back regarding kiver b"n rules
Of STA
. Ict I
Agent or
M THIS
Signature "Pease 729 P Ce S"tatern an back of pemtiN+
t g6n. "em
APDXaflon FOe(�) I I I a — Check #/Morwy order
11 See additional notes/oDndrdons on back
(Piewx tratiall
Permit Of tefs PRINTED
Signature
4 /ar /. 2 a
Issuing Rate
fxpiratitttt Date

fie
iCERTIFIED.MAIL RETURN HIZUtIHI NtzQUtbitijr-trHAijijlJr--LlVr-rM%L:L.J
I I - A /r
Name of Property Owner
Addr-a-es of Property
A ent's Name
Agent's phone
fS-) 11
(Lot or Street #, Street or Road, City & County)
To,) A) ( 2 7 ?� ?
Mallirm Address,. 6-4
7o,,) NC -2
)CM -
1 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 drawingthe development
they are proposing, A description or drawing,, with dimensions, must be provided with this 1etter.
I have no objections to this proposal. have objections to this proposal.
ffyou 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. Correspondence should be mailed to 401 S.
Gliffin St, Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
,3901. Noresponse is considered the same as no objection ifZou have been notified bX Certified Mail,
WAIVER SECTION
understand that a pier. dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
ru
st be set back a minimum distance of 15'frcm my area of riparian access unless waived by
me. (If You 'wish to waive the setback, You n2y§A sign the appropriate blank below,)
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
,11'7T0PGrtY Owner Information)
7�,
Tyo e Na ame � L�
actress
L-��2-- �12 ,?? tv',2
Telephone Num b er / EM a # A dd-r-e �ss
*Valid for one Calendar year a7ter signature*
,'Adjacent Property Owner Information)
�.at re
Print or Type Name
7 / L( r'�-stN
Mailing Address
-ILCI (V
C 'it,
itylstatelzip
Telephone�Nu�4er /�,EM
ail Address
Dat
Revised 2017

DIVISION OF COASTAL MANAGEMENT
OWNER NOTIFICATION IWAIVER FORM
RETU
ADJACENT RIPARIAN PROPERTY I PT E UE T D r HAND DELIV RED
I
CE_RTIFI
Name of Property owner: e11V 74/J A) C ' 2
Addf6ts Of Property: (Lot or Street k Street or Road, City & county)
Mailing Address: ------
Agent's Name #:
Agent's Phone
referenced property. The individual
I
i hereby certify that own property adjacent to the above
has on the attached
permit has described to me as shown on the attached drawing the development
Te 8�q0w�l r,
applying for this
they are proposing.
—I have no objections to this proposal. —1 have objections to this proposal.
agement
if you have objections to what is being PMPOsed� you must notify the Division of Coastal Management 4(), S.
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed
Griffin St., Ste 300, Elizabeth City, NC, 27909, DCM representatives can also be contacted at (252) 264-
3901. No response Is considered the same as no ob'ection if ou have, been notified by Certified Mail.
WAIVER SECTION breakwater, boathouse, lift, Or groin
I understand that a pier, dock, mooring pilings, boat ramp, ;)adn cess unless waived by
MMAIlig
must be set back a minimum distance of 15' from my area of 6
me. (If you wish to waive the setback, you n the appropriaate abclank below.)
7 -1
aE41L� c, - I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property owner Inform ion)
Signature
Print t or Type I V a me jC
Malling Address
r,
75
.r-
(Adjacent Property Owner information)
na Sigture
na
Print or Type Name
C4�lstatelzlp I
hc! 16-1
Telephone Number /Email Address
'? I A '? 6; (/ 2
-, Li�-Z
bate -Valid for one calendar year after signature*
Mailing Address
citylstatelzip
Telephone Number Email Address
Date'
Revised 2017

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