Blackmore, Maureen 80001C

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CAMA/r11DREDGEAFILL }tl }�I)I)(lI A Bj D
GENERAL PERMIT Prevlouspermltu _F
X'New I IModtlkatlon I )Complete flolssue L 1Pm-tlal Reissue Date previous permit issued
As aulhonud by the, State of North Carolina, Department of Envlmnmontal Quality
and the Casual Resources ComMssbn In an area of onvlmnmental concern purwant to I SA NCAC_0,78JJ A 02&J iaN _ 1— r-71,,AP
yRu!es ,;Cvt.rJ
Applicant Name P1 eLp.rikA q n6,m Project Location: County
Atld,css I I SAI j 1 i'CA --h6 Ve'— /� J(� Street Address/ State RoW Lot u(s) .,,(
City i1 - �Of i �—_ Sate A/C ZIPt!'/ !2, 7 - -
Phone N jD) 7J2 S13 _ E•Mail ___ Subdivisions/ (�
—Q FO I City / t CV✓ [JL/�i i 1 zip
Authorized Agent Q v
I I CW �/
W 6MA des , I-IPTS Phone q ( ) Wver Bavn /V E't! {' _ -
Affected 1-1OFA LIHHF U lH I]URA nNIA, /U.f C / train prrsnr
AEC(s): Adj. Wtr. Body /Vi
Closest Maj. Wv. Body -
ORW: yes /14o) PNA yes lC?n
1 a r J
Type of Project/ ActJviry C' . / Y r
(Scale: �
Pier ldocs) length
rimedPtadorm(s) JV-11/—i dip
F losung Pbtfonn(s)
Finger pen(s)_
Gran length (---
A
-�-s+t\
'6u� MWprap kngth_J__�
avg durance onshore_
rtua distance offshore _
Baun• Channel I
J
wblc yards
Dom rmv --y -/
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n �oh ysaid-Iodd,
ya
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SAY:Morluw� ova Yet no
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be required by t C nslvt ( null l� �I
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ice now on beck mprdK K-W Basin rules.

CAMA /DREDGE &FILL Jl§� N9 80001 A B 0 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 15A NCAC� 0%/.�r.� . !-,L 02yAeb
KRules attached.
Applicant Name at,PeQ-1 LckyvlaSe. Project Location: County<01?J) P,
Address I I� I �j� �I (%Pi _ e Street Address/ State Road/ Lot #(s) bp,
Phone # ( );,5 Y' 7/ S7 E-Mail
Authorized Agent
Affected OCW id-EW ;k,#TA _RES / OPTS
AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ WA
❑ PWS:
ORW: yes //po� PNA yes /(.�V
Type of Project/ Activity
Pier (dock) length
Fined Platform(s)
�7t t
Floating Platform(s)
Finger pier(s)
Groin length
tuber
ulkhea Riprap length
avg distance offshore
max distance offshore 19,
Basin, channel r-
cubic yards
i
Boat ramp q �j
Boathou e $oatlif JI x�7
Beach Bulldozing 'r
Other
Subdivision
City— ZIP 425J20 _
Phone # ( ) River Basin /V !39
Adj. Wtr. Body A)J?A,(,S , R ; IV� 10 (n t man./u�ojkknn)
Closest Mal. Wt Body 1'1 �fi
a 80 � �—
�1=
Shoreline Length ✓ - I I I
SAV: not sure yes no
Moratorium: n/a yes UnPhotos: yesWaiver Attached: yes �—(,
A building permit maybe required by: G� CCut?-O i Q t.L/� 1 V
( Note Local Planning jurisdiction) j f (�
Notes/ Special Conditions NO �- 1 1 D \ ex 6, yrl t 04
�,a or Applicant Printed Name
Sig re •■ Please read compliance statementon backof permit'[*
Application Feels) Check #
(Scale: i O )
note on back regarding River Basin rules.
Name
Date

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ur>rkret®rd that a brow• Jock• avw" par9a. bteok& 4m. boau+wse, wl or groin muA Ln xet
tx a trtirura+or QpiatYoe o/ W kron my area o4 riparian eoceaas urira lowmd try me (H You
wish to warwe the aetbaoK you mu41, 'tint the app NmWo bla* bobow.)
t do wish to naive dm 15' setbaCk repureowA
t do not wash 1v wawa tf» t S letbetic tequrarrwt
mmpww owrwt h*omftn)
Sixnahre
PtW er r► w Ai me
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https://mail.google.wm/maiVu/O/#inbox/FMfcgmLswRTgVLpRgGLVnbKxPTDQvCS?projector--1 &messagePartld=0.l
RECEIVED
MAR 2 4 2021
DCM-MHD CITY
,n

3/22/2021
IMG_20210322_103435.jpg
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IN# 10rmoftw rlaa 64ok~ W rt1a, is Y19gfl Wduw. WW** E wr feovs
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b AaYe 1'✓l. brgs em- b eYa "TWO"
it
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f rendereGwrd that a }1rer, duck., nWorxfg pinpa, breelarNter, boalnwae.. ttr. a'pta'n mint Era wet
dick a ffw*r um distance of 15' *" MY aroa Of rpmr W aorsmt trim "S' w i by "w (M you
with to w71Me the Setback. You WNW hdtiwtl ow a0 ** balk WOW)
1 do wish to waive the 15' setback foouwem$rK
I do net v4%h to wrwe the 15' wbsck "x w*rnwrt
(Properly ok"Wink"""")
RECEIVED
MAR 2 4 2021
DCM—MHD CITY
https:llmail.google.00m/maiVu/0/#inbox/FMfcgxwLswRTgVLpRgGLVnbKxPTDQvCS?projector-1&messagePartld=0.l 1/1

3/22/2021 IMG_20210322_103444.jpg
r ;= Photo (3 of 3)
1
f cettify that [ have authotiml'stQYC.f'fljr,Y..
to act tat my behalf, fix the purpow of ajq lyutf; and oNahtmg all C'AMA pctmit% nect;SSOY
fear the lwTosecl development of r
' X my property located at:
�.5 NRx�tiytr.
h'.
DECEIVED
MAR 24 2021
CCM-MHD CITY
hops://mail.google.com/mail/u/0/#inbox/FMfcgxwLswRTgVLpRgGLVnbKxPTDQvCS?projector--1&messagePartld=0.3 1/1

LRECEIVED
APR 01 2021
41v�
. DCM-MHD CITY
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l
NC Division of Coastal Management 14415 A B©D
Cashier's Official Receipt
-gr4 Date: y /I 2o!L
IItv�IAKeWDrAA•D" 000 Received From: W1
Permit No.: C7p bu. 1 k In eaj Check No.: q I n
Applicant's Name: AML County: 6� io
Project Address: IVr, S vE IV%ye c Dr-.
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant:
Signature of Field Representative: Date: SM12