Strange, Danny 84632C

ti 1*ZIWAS'.V ❑CAMA ❑ DREDGE & FILL 9 84632 A B C D
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 Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier(dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes nc
Riparian Waiver Attached: yes nc
A building permit/zoning permit may be ieyuueu uy.
Permit Conditions
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s) Check #/Money Order Issuing Date
Expiration Date

0 1°F`°"R41 ❑CAMA ❑ DREDGE & FILL N9 84632 A B c D
y = GPrevious permit
GENERAL PERMIT T
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 Resources Commission in an area of environmental concern pursuant to:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be mqu-u may.
Permit Conditions
(Scalef )
TAR/PAM/NEUSE/BUFFER (circle one)
ElSee note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Feels)
Check #/Money Order
Issuing Date
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER MOTIF'ICATI4 NIWAIVER FORM
CERECEIPT REQUESTED or HANQ DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. K . I -±r,
Address of Property -
Mailing Address of Owner:
ae
AX
Owner's email: ��-1L�} rPhone#:
Agents Name: 'Dantiq Agent Phone#:�t�2__.2�
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portions to he cornpleted by the Adjacent Properly 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
description or drawing with dimensions. must be Drovided with this letter.
%i I DO NOT have objections to this proposal.---- I t DO have objections to this proposal.
3i ys�u bane o#�jectic�ns t rvhaf is being proposed, you must notify* �e N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
,-nailed to 943 !Washington Square ,Mall, Washington, NC 27889. DCM representatives can also .be
contacted at [phone]. No response is considered the same as no objection if ;you have been
notified by Certified Mali,
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 goes 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 Properly Owner
_OR_
I do not wish to waive the 15 setback requirement (initial the blank) �
Signature of Adjacent Riparian Property Owner:
Typed/Prisnted name of ARPO:
Mailing :Address of Aiizpo: 2306— Rr'-fCeR5 C4C-
5
�r 3
ARPO's email: _ k i dF' L 1 �- t-`'-,4-ARPO's Phone#:
Dai:e: _ l � Z *waiver is valid for up to one year from ARPO's Signature`
Revised tLiay 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
A
Name of Property Owner: (�_�?�
Address of Property:
Mailing Address of Owner:
Owner's email:
Agent's Name: 114
Agent's Email_
Agent Phone# -
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiaeent 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
description or drawing with dimensions must be provided with this letter.
�� 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 943 Vlashington Square Mall, Washington, /A'C 27889. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mall.
WAIVER SECTION
! 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/ail of the 15' setback
Signature of Adjace t Riparian Vropdrty Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:'-, _YV1144
Typed/Printed name of ARPO:
Mailing Address of ARPO: L.700
ARPO's email:
Phone#: Ci �2) 3-qq Sk LO I
..r
Date: I' *waiver is valid for up to one year from ARPO's Signature
Revised May 2021

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Edge of Water
50' Rlparlan Buffer
75' CAAIA Line