Blythe, Charles 88402C

�o+"(car YCAMA ❑ DREDGE & FILL N9 88402 A B OC D
3 GENERAL PERMIT Previous permit
Date previous permit issued
[New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by theStateof North Carolina, Department of Environmental Quality and the Coastal rces Commission In an area of environmental concern pursuant to:
ISA NCAC Q� T� .Z.Ub i) ❑ Rules attached. General Permh Rules available at the following link: v�nv�q nc ggv/CAMArulgs
Applicant �me q(L.AA. LA!I J Y. Ui.e ,___ Authorized Agent U n ::)Co I l L
Address LVr�.S� "�I l�( Project Location (County): 1"T"e-rCail
City-E-M �S,fdL4. e__State 1JL 7IP_jEg5 _ Street Address/State Road/Lot#(a)AA,�,�sailrlQ.-
Phone#(2624_U_,1 I %�ijp r't7 OlA`l) Qa ('Q.SS
Email i t<; C', SrtrV4hiC`� am L� i COLVI Subdivision
City YfytRVJJA [S[P ZIP Z90��4
Affected ❑CW EW PTA ❑ES ❑PTS Ad(. Wtc Body_rBOICALW_ (IC' na tan/unk)
AEC($)/: �'❑OEA ❑IHA ❑UW ❑❑ $PIMA PINS Closest Ma). Wtr. Body SS�esLt4_ 5t>OnA
OR* 4m, PNA: ves no
Type of Project/
Shoreline Length 'C�'
Access Length !�
Pier (dock) length
Fixed Platform(s)
_ '� .7
Floating Platform(sl
Finger pier(s) /
Total Platform area_T_
Groin length/g
Bulkhead/Riprap length /
Avg distance offshore
Breakwater/Sill /
Max distance/length i
Basln,channel
Cubic yards
Boat ramp
Boathouse o/[ a) t-smat
Reach Bulldozing 1�
--y A
`t
4
Zv
Other
SAV observed:
Moratorium: n/a yes CCfCCffffpgpppppp,'''1(11(((' ��?1Xik tsar_ Pry t�s-
Site Photos: ='s [ ulJ 1
Riparian Waiver Attached,
`hed: e no� C14- vie, i4e, _
A building permit/zoning pL•rmit maybe required by; f
or
txatm.. t > /
'Repletclnn��;Ni'siiM�-.
512,e Vlo,03
P L2hne�`:ej
l�K�aved)
_a ❑ TAWPAM/NEUSE/BUFFER (circle one)
]n� See note on back regarding River Basin rules
.. ❑ See additional notes/conditions on back
(Please Initial)
Signature "`Please read cornbBance statement on back of permit-" Signa ure
`` 2-M,0v 1532- 5,1a�2y �flii �2L
Application Fee(s) Check II/Money Order Issuifig Date Ex lratfod Date

MCAMA ❑ DREDGE & FILL N9 88402 A B 0D
GENERAL PERMIT Previous permit
' Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal esources Commission in an area of environmental concern pursuant to:
15A NCAC o 1 TI t 'XV0 b ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.eQy/CAMAruIes
Applicant, �m7e'�yy �^ , 'C I f Authorized Agent l: 0 ZZC-O t
Address 12_0e .mil Uml` �L p�r/7 Project Location(County): 1.cC"+e_re*
City emy'ytt l CA IS1P state fv (_ ZIP 7A Street Address/State Road/Lot #(s) n
Phone
t#(q�,,,,t,,_, L p'l I ` 4(�09 hS QVM er 6- N I;$
Email S��yckWfl4tS 1, 3 SCi� I(1 a LI` t CW Subdivision
J City 5 mpxbJ J l-,�.(to ziP Z&i 9f [
yEW PTES PTSAdI• Wtr. Body UAffected ❑CW 1JQ- � na an/unk)
AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS Closest Maj. Wtr. Body LLO_ SC�Jf1�1
OR . ye no PNA: yes n)Jo
Type of Project/
Shoreline Length
Access Length
Pier (dock) length /
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) /
Total Platform area %
Groin length/q
Bulkhead/ Riprap length /
Avg distance offshore
Breakwater/Sill /
Max distance/ length 11
Basin, channel /
Boat ramp
(ScaleW S )
ff
q `�'epluc)npj w'sCil^�{-
7V4�0 S1z-e I"�X03 l %4
tXkb'hNG
S-MMUO-e
Boathoziouse oat i t�J Lk ai Y �/ ti V
Beach Bulldozing
Other le
SAV observed: yes p
Moratorium: n/a yes
Site Photos: s n�
Riparian Waiver Attached: tf) no 1 U t1{' Wp %it d v�
A building/z (' permit/zoning permit may required by:
Permit Conditions 0 i-kC.i'1LA(1C1P__ ir) 612Utl-(-L vi-nQP o-f- I>rZ
AWARE OF
Agent or Applicant PRINTED Name
Signature **Please read compliance statement on back of permit**
$.i 2-00too 1532—
Application Feels) Check tf/Money Order
PIt- behnel ff ?er-N
(uAved )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
No REVIEWED COMPLIANCE STATEMENT. (Please Initial)
TOra Mq+Lljn
Per t�Of�ficer�spPRINTD Name
Signature
511 D 12-2-
Issuing Date Ex iratio Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

Drawing Prepared By: C3 Scott, Inc property_Addres_s.
Date: 4/13122 7208 Sowed Drive
Scale: 1 ": 40' Emerald Isle, NC 28594
ergpgrty_0_wner_
- - Charles Blythe
N
INTRACOASTAL WATERWAY
7210 Sound Drive
117'_; far
7206 Sound Drive

ADJACENT RIPARIAN PROpEgTy OWNER STATEMENT
I hereby certify that I own property adjacent to C 4644 L& S )"z
Name of Property Owner)
Property located at _ �% 2 0 Ff '3 c) vn ,> ' 1 v(�
(Address, Lot, Block, Road, etc.)
(Waterbody) (City/Town and or County)
Initial The applicant has described to me, as shown below, the development proposed at the above
Here on locatjon.
One Of __(_� I have no objection to this proposal.
these lines 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)
e
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
Initial me. (If you wish to waive the setback, you must Initial the appropriate blank below.)
Hereon � I do wish to waive the 15' setback requirement.
one of
these I do not wish to waive the 15' setback requirement.
lines
(Pr O ner Information) -
n
Unle
(Adjacent Property
rt
12
Signnnve"
Pdnt , Type Name
% _U(. Sort, l✓L
Mailing Address
�_ e A n Sce Wit. 7b'S�>Y
Cily/stafelLip
'1- 2- t v,P' 171 i Kde.,n 2 r7"C>Yrnn,e
Telephone Number/email address C<.r..1
Y- 1y-72
Dwe-
(Revised Aug. 2014)
'Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPE
R
TY
OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at „,_ J r� me of Pr arty Owner)
%Zllg cXJ
Y//� (Address,t�qt, Block, ''�� ��
on in 1 L%)PI?J �f�Jt17'fiJ , N.C.
(Waterbody)r (Cityfrown ndnd/orr County)
Initial The applicant has described to me, as shown below, the development proposed at the above
Here on 10 10a
one of I have no objection to this proposal.
these lines I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a sire drawing)
Ll Y��c, l r o AXIS I l �C1Oi f i ��
See ilf
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
Initial me. (If you wish to waive the setback, you must Initial the appropriate blank below.)
Here on I do wish to waive the 15' setback requirement.
one of
these 1 do not wish to waive the 15' setback requirement.
lines
(Revised Aug. 2014)
'Valid for one calendar year after signature'

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: avL(�a �!•�r"t/t
Mailing Address: % Z e
r
Phone Number: 2 S 2 -
Email Address: AL4V , �
I certify that I have authorized C3 Scott, Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at
jy property located at -jZ off ' t ti� %1 I rvG' S `�
in at'�'7 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:
Signat
Print or Type Name
Date
This certification is valid through 0A t t 1 t dP3