Buckhold, Keith 77372C

0leAMA / ❑ DREDGE & FILL A BOC
DENERAL PERMIT Previouspermit#
w ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / J / ��✓
and the Coastal Resources Commission in an area6L4
enviro ntal concern pursuant to 15A NCAC
I l ! ❑ Rattached.
Applicant Name `�6� 1 C � U `� Project Location: County 01A)ur; �
Address r
City )) Cr> State ZIP
WVV
Phone # nt v) I '- 0V E-Mail
Authorized Agent
Affected
s
AEC s : OEA LJ HHF ❑ IH
() ❑ PwS:
ORW: yes //%cl PNA yes
❑ ES ❑ PTS
❑ UBA ❑ N/A
Type of Project/ Activity I A d' ) t f
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) _
Finger pier(s)
Groin length
number -- -
4.
Bulkhead/ Riprap length ---
avg distance offshore
max distance offshore
Basin, channel
Street Address/ State Ro Lot #(s)
a 1� Ur I-
Subdivision
City tl C"`/ �u•.. ZIP )©-�
C-- ;:7r
Phone # ( )_ r► Rivor.13asin
Adj. Wtr. Body ­�> eS dnal man unkn
Closest Maj. Wtr. Body
cubic yards
j
Boat ramp
Boathouse/ oatlift
i
__......_..._.._.— _......_._.-_
_ -__-
--
_--
--
�.--__ _---------..__T_
Beach Bulldozing
-.-----....... ... _-
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Other—
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Shoreline Length
SAV: not sure yes no....
--
j
— - ---
-
Moratorium: n/a yes no
Photos: yes no
i
i
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)
/
Notes/ Special Conditions
(� `
Agent or Applicant Printed Name
Permit
(Scale: ^ j-V )
T.
❑ See note on back regarding River Basin rules.
Sig ure�** Please read compliance statement on back of permit Sig�na�tuu
typIicationFee(s) 6heck# Issuing
2 2.61t.
xpirati n Date

I hereby certify that I own property adjacent to I
(Name of Property Owner)
property located at
Address, Lot, Block, Road etc)
on ' In L, c� �2 g','� i'y N.C.
"aterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
A, w
Signature
Print or Type Name
Telephone Number
41 20
Date
RECEIVED
OCT 16 2020
DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
hereby certify that I own property adjacent to I(le-i� `) �'cl14 �� s
j% { / (Name of Property Owner)
property located at l ✓e el-�s` rr-1 1<� ,
Address, Lot Block, Road, etc.)
on .TC-in 'ti R S41, N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Sicfnqfure
I K) P tA 0"'
Print or Type Name
q)l9-l4l/-v3:38
Telephone Number
Dat
RECCIVED
OCT 16 2020
DCM-MHD CITY

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IVED
SEMI 0.2020
DCM-MHD CITY

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ate ./ a
Adjacent Property Owner / / el
Mailing Address I6 /} d/ e
9
City, State, Zip Code EG a es �y
Dear Adjacent Property:
This letter is to inform you that I,
Permit on my property at
Receipts for
Certified Mail
(Staple Here)
(�(70 ( s9H.o f8 /ILt
�Nc Zt3 7
have applied for a CAMA
Property Owner
Property Address
in
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at .. % ��'� or by mail at the address listed below. If you wish o
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely, /
Property 0 er
Mailing Address 4/
City, State, Zip Code
RECEIVED
SEP 3 0 2020
DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to !K 7� 4V
property located at
(Waterbody)
(Name of Property Owner)
0 (- G/- � Sly �•� t _
Address, Lot Block, Road, etc.)
In 7 4L -a 54 , � N.C.
(Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the devejopment
he is proposing at that location, and, I have no objections to his proposal.

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ate we
Adjacent Property Owner
Mailing Address �--
City, State, Zip Code J
Receipts for
Certified Mail
(Staple Here)
Dear Adjacent Property:
This letter is to inform you that I,
have applied for a LAMA Minor
Prope Owner
,.. � o \,
Permit on my property at 'L��" yS l� � J -� in COU�V �i�5e-0.`�
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact meat 10 j81 60)-y or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
Property Owner
)/9 .�6_ P,- _AIC.�1/'40_01
Mailing Address , /
City, State, Zip Code 9J 9/x

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to
�2 /0 &e� (Nameof Property Owner)
property located at G
on ,ra L j Address, Lot, `Block, Road . etc.)
� inS.c' f=� N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)i
Signature
Print or Type Name
telephone Number
Date

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