Williams, Steve 78860C

feAMA /XO'REOGE & FILL
GENERAL PERMIT �`� ;t' A B D
Previous permit #
ew ' .Modification ..:;Complete Reissue '.Partial Reissue Date previous permit issued _
As authorized by the State of North Carolina, Department of Environmental Quality ,.•��
and the Coastal Resources Commissioninan area of environmental concern pursuant to 15A NCAC� �i.�t,J _
Applicant Name eyl)e Sv'V}_) f �kGkirf Project Location: County�f Rnlesatmfrhed _.
Addre i / C , t_4 � j ve Street Addre-%4 State Road/ Lot #(s) 93 Al o,r (ti leie-
,^' f�-�{i<
City ;ejiq _._ .... ...State t.`++,,2lPX (i,7)
Phone # 6 ) {�j J E-Mail
Authorized Agent
-' cW H9" + PTA . ES =PTS
Affected
AEC(s): -OEA ''. HHF `tH " , UBA '.. KA
PWS
ORW. yes / PNA yes R. }
Type of Project/ Activity
liter(dock) length ✓ _..
Fixed Platforms)
Floating Platf aur(st
Finger aer(sj
Groot length _..
number +
Sulkheatil Riprap length
avg distance offshore
nl: dI5t:4Kis Offshore _{
ssin" annot 4
Cubic M&
Boat ramp
Boathouse/ BoatUt
Beach Bulldozing
Ocher
Shoreline Length
SAV, not sure yes
� s
Moratorium. rya yes,j. no
Photos. Y i n.
Waiver Attached
Subdivision
City 1 i�..��.,.-t -'1r,Ir :.7�-,u":i ZIP
Phone # ( I )j� River Basin
Adj. Wtr. Body $4 I _ nat a unkn)
Closest Maj. Wtr. Body , ' , '-l."
t.
rr t
(Scale: C i )
�- tt
t �
A budding perrtut may be required by j'�'_ ,7 - See note on back regarding River Basin rules.
( Noce Local Planning )urisdction�) 75,L=-- c j #(
Notes_i Special ConditionsI.NiO
'A-
.
-----------------
pp /
J'�
n m Af p t Pndcud Nuin
5i a4,e *' Please read compliance statement otatement on back of permit**
L!
A pli<anon (ee{s) Ch"k#
Pcrrl.eSM.esr's Name y' q
Sigrvet re -.� - ,, •- t
ass ug 4uan n Date

CAMA /.P9 DREDGE &FILL � V" N9 78860 A B C) D
GENERAL PERMIT Previous permit #
ew ❑Modification [-]Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC L?7 N •'✓W
Rules attached.
Applicant Name! I eiVL f 1 1 j�j S Project Location: County
Addre& 95O5 ( a; I I pC) V6- Street Address/ State Road/ Lot #(s)
Phone # C71LI ) -0/!7
Authorized Agent
Affected El�El "rA ES ;El PTS
A
Affecte El OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs:
ORW: yes / PNA yes
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) l
Finger pier(s)
Groin length ^
number r
Bulkhead/ r iprap length
avg distance offshore
cubic yards
Boat ramp
Boathouse/ Boatlift _
Beach Bulldozing —. ..
Other '.
i
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Subdivision
City n Is Pv ZIP o Q r'
Phone # (_) River Basin 4**
Adj. Wtr. Body (nat man unkn
Closest Mal. Wtr. Body
(Scale: 1 I © )
V C1)A t--,11D I ) /7 k Q-W,& ❑ See note on back regarding River Basin rules.
e or Applicant Pri ted Name
§i nature ** Please read compliance statement on back of permit **
21t lo95
Application Fee(s) Check #

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �i�\i E IN t LL i Arn 5
Mailing Address:
AL�1 N , hl Z-7(p I S
Phone Number:
Email Address: Stvr10CS �c iC Gong
I certify that I have authorizedy ��u C � FW—'Nu
Agent I contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: t&EDUIC M.0 0 N Q
nT 1y.1 F'l
at my property located at s P �0 9__V \mac T;PPtL5 w C
in C AUeQ ET County.
1 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:
LZ Ck�ayg5
Signature
Print or Type Name
#� it QVYAef
Title RECEIVED
Date FEB 2 4 2021
DCM-MHD CITY
This certification is valid through

hW T�u Ukt T, D:� R `1 WZ01E, s
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to =FV F W ) L L I Q h'1 S 's
_ _ - __ _ (Name of Property Owner)
property located at
on �. R1� AL (Addresn, LotalNe 1�tl6L L 5" OV-6 -5 , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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.)
v e, I do wish to waive the 15' setback requirement.
I do not wish to waive the 16 setback requirement.
Signature
Print or Type Name
M Address iliMMD5 �1'Q VA1 t-L '02
City/Sttae"Nte/Lip
, N2-76Pl;__
Telephone Number
"-)15-?,15--70-1-7
Dale
9A I zozo
(Adjacent Property Owner Information)
U 1 l't C �a
sigrpgtur. K .i ('. C P I
Print or Type Name
M rfling Address
" D AIc)rvttoe, Dr•.
crnlrftnoll Shores, C 2ss62
Te ephone umber
�I52 ' qI-3c1g2
Date, / t{ / 0
/ (Revised 6/18/2012)

ADJACENT RIPARIAN PROPERTY OWNER\ST1ATEMENT
I hereby certify that I own property adjacent to >Ti11 E
INILLIAm s 's
(Name of Property Owner)
property located at iz�0 �N 1 TA
(Address, Lot, Block, Road, etc.)
on CAN p l in 21Nt lt\1DL.L SOOQ N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc do .
I have no objection to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill In description below or attach a site drawing)
DrLC-Drc- {w-ovN0 "�;OpcT L-1g1
J3�y��3 �Ig12;27 Crell
b
WAIVER SECTION --
I understand that a pier, dock, mooring pilings, breakwater, boathouse, l ift, 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.)
)iA__ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop rty caner In brmation)
Date
(Adjacent ?To /eI mdUV1II
Si ature 01
Print o— r Type i3ame
(Revised 6/18/2012)