86507A_Crouse, Troy_20220512

dCOAft �jCAMA ❑ DREDGE & FILL
GENERAL PERMIT
N9 86507
Pneviow pmink
Date pre'vkxn permit issmd
(25 B C 6
® New ❑ Modification []Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Deparartent of Emrironrnenal Quality and the Coaxal Resources Corivnission in an area of environmental concnm pursuant to:
t5A NCAC 7 14 " i a0o ❑ Rules attadhed. © General Permit Riche available at the billowing link: mmjkq.ncZM&6wla Oes
Applicant Name _ TV0 - - C rnugg
Address 204 &i" Nh� bi^
city E stabs tvC ZJP _ al'790q
Pirrone # ( � 3� 0 - O
Email
Affected ❑ CW
ems)-. ❑0E►
ORW: yees/@)
NEW PTA
❑ iHA ❑ uw
PNA: yeses
Type of Project/ Activity
[:]ES ❑pTs
❑SPIMA ❑PWS
G' Clke mod red S/1S
Authorised Agent i� r
Nviem motion (County)
street Address/State RoadA of #(s)
Subdivision
1 L
�- .
Shoreline Length 17- 7 Y 1
Access Length
� fry-+- � _-... •� � - i..t:_r-rr-r^--�__._�r".t---r-��_
f�-�_ _ 1_ n I
EV
G �
Pier (dock) length Aip i _I `
Feted Platform(s)
Floating Platforms)
Finger pier(s)
Total Platform area
'
V
Groin length/# -
Bulkhead/ Riprap length
;—
Avg distance offshore
i—
Breakwater/Sill
F
Max distance/ length
i
r
Basin, channel
i—
f
Cubic yards
Boat ramp:—
Boathouse/ Boatkft
ar
Beach Bulldozing
Other "
I
SAY observed: yes
Moratorium: yes--
Site Photos: no
Riparian Waiver Attached: V. i !
A building pennit/zoning permit maybe required by:
Permit Conditions
(Scaler z- )
❑ TAR/PAM/NEUSE/BUFFElt (d.W one)
❑ See note on back regarding River Basin nidet
❑ See additional notes/condidons on bad
I AM AWARE OF STAnRB CRC RULES AND CONDmONS THAT APPLYTO THIS PROJECT AND REVIEWED CDWLIANCE STATEMENT. (Please Initial)
i-ri A 0 _ _ L :7 E 17
Signature —Please read compliance statement on back of permit"
Application Fee(s) Check is/Money Order
Signature
�A Zt.Z2 9//U.Z:L
Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property: �4 ' Si S hare , Q
Mailing Address of Owner: Z04 l�� s kor& c+ 2
Owner's email: r ou — Owner's Phone#: [phone] - 5 7 v q
Agent's Name: ( �c.� POUri JTr-e-e— Agent Phone#: Z SZ- Z (o44 --�9 O(
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawing, with dimensions, must be provided with this letter.
1* I DO NOT have objections to this proposal. I DO have objections to this proposal.
if you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Gruen St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed 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 me
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
ISTa
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email: 6 Ll XX aL4 Jya.1 Lt jQVu-RPO's Phone#:.,� SQ -
Date: �� t *waiver is valid for up to one year from ARPO's Signature*
4� 1
MAY 3 - 2022
DCVO -EC
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: t r04 C 0 Q)QS4L
Address of Property: Z 04 r3ku S �,o✓e- C
Mailing Address of Owner: ZOi4 Raw ,- nrC (L
Owner's email:Oram r L Owner's Phone#: Z 5L- 3 -Ll o -- 5 7 0q
Agent's Name:CY.-i Mi 2ou tct n Agent Phone#: Z5Z- ZCoq - 3 Oio
Agent's Email: LT�1 rci rnL)&,_J � , -cz (�/ {°U eC, e n r 4 0
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom portion to be completed by the Adjacent Property Owner)
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 development they are proposing. A
x � I DO NOT have objections to this proposal. I DO have objections to this proposal.
ff you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DChQ in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Gruen St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed 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 me
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback rn r- y q•
..
Signature of Adjacent Riparian Property Owner
-OR-
MAY 3 - 2022
I do not wish to waive the 15' setback requirement (initial the blank) X
Signature of Adjacent Riparian Property Owner: 1k-- or v`e_
Typed/Printed name of ARPO: AV1 Y"le- X o
Mailing Address of ARPO: a O b Q,l.l 41 D 2Q
k ARPO's email: 0kA et I A, Ul e. 5 e, ((S �P rAPL. ARPO's Phone#: .2 S 2- - cot I- Z o t ( X
k Date: L4 - 3 0 - Zo 2 Z *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

- ----- -----
!Wq,
SP-T 014Z:)Ti
U� :21 ;LX't>t. W-,L
&A-7
in
-Z Z�tC^- ANO
b-
ji,
jo
FIGURE 1: FIXED PIER WALKWAY SECTION
�o F0 S� as
t
5,e-l- bctc1c. (f
t 4kevq rr--o ps-7
�) I CK w 1 11 E, t"t RECEIVEE. D
MAY 3 - 2O22
DCM-EC

r 14, r.
t .
Yl y!rt t
J!. nl f • •
_
qq*��
r
}r � s ...- ,ty .�;.. •fir + ),�'�c 5f " K�

1 Y--C I C rope.
Wc-e�

Y
�A
4 "Bayshore Dr..;
k
M
�":� god ft:.