86395A - Norge, Jason & Frances

N[ZCAMA ❑ DREDGE & FILL
GENERAL PERMIT
No 86395 ® B C D
Previous permit 39coi.4
Date previous permit issued '.1- a Ai - 21
❑✓r�Nevv ❑ 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 ? H • 1 ACC ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name t
Address lorj /V\,C-, ooS iD r:yG
City MCGfiG State_ A1C,. ZIP
Phone # 6,3a - G QL3 C
Authorized Agent
Project Location (County): e . C r,'+L _f1 GC
Street Address/State Road/Lot #(s) IGt^� /1^ ,'=!S Dr %(4-9
Email Sti�r�(�, cox tiO `ice Subdivision ) (S ' JC.y /EGG' r S
City nnt4�0_C ;C ZIP �1-91S b
Affected ❑ CW gEW [g4TA ❑ ES ❑ PTS Adj. Wtr. Body naS^ f an/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ /
PWS Closest Maj. Wtr. Body l� Pn! r 4-C k- CE>1M 4—V
ORW: yesco PNA• yes o
Type of Project/ Activity. A_, G 14 . S X 24 2or l aQtfr e? w Cr -E 0 d' AV-.CJ
(2' SO4- 2 kt 0..,4 (Scale:/)-'S )
Shoreline Length t I g
Access Length
Pier (dock) length
Fixed Platform(s) _
Floating Platform(s)
Finger pier(s)
Total PaEdiArea Uc� a t_F_
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp 111
Boathouse oatlift, y Ix 1�
rx
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: no
sl,
A building permit/zoning permrt may be required by:
Permit Conditions /vNG,J( -it- of tai'ev1:
Cr_k�S J_""C c( .
13e 1Qe" ved)
)G
T
1
sr,' Cx P ks
•
j('�NG r-r-) T
C?
/// I \ ///
16. S,
1 y� A Avk at;aed D-WA.S
aoc;k- CM-, r 6.1,
AvjI r; tcd
S I , �► tv �-
r3a
❑ 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) >C
r IZp,�e�r -!-
Agent or Applican a e Per O 'cer's PR N ED N e
x
Signature Please rea mpliance statement on back of permit" Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

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: Jasen Norge
Address of Property: 100 Meiggs Drive, Moyock, NC
Mailing Address of Owner: 2262 Shillelagh Road, Chesapeake, Va, 23323
Owner's email: [e-mail] Owner's Phone#:
Agent's Name:
Agent's Email:
Agent Phone#:
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
description or drawing with dimensions must be provided with this letter.
SJT for NCDOT 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. Griffin 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 wa waive the setback —you must sign
the appropriate blank below.) /I-
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-O R-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: NC Dept. of Transportation
Mailing Address of ARPO: 113 Airport Drive Suite 100, Edenton, North Carolina 27932
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: May 25, 2022 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

SICIN
ADJACENT RIPA RIAN PROPER" �OWNER MOTIFIC AZ OWOVAIVElt VOKM
RLC IPT ncnL Ir I IM rx h u n
(Top P WtWr compWod by ownor or M' r jagant)
Address or pt-=F*,-p
Mae ^p Address oe owner ZZ L r.� d q IiL t , �+ ,
AQarnts fa++►*
AVJAC9Ni KIPARIAN PRalt+liAM OWNILK'a CL.RIIt404TICK
0%,&-f�a1�1 *0 tae b5r i1112AS f11 PjRJY �
Mr1t* *W* VW I a wn property aa1l~t to It* awv* it%fenow 0!cMtj Tha e4NWAW alpP+yM 1tt th-a
pw"vt hats Rowe" to .she, at►I► u%g-rKn cc the atsMNed dr&W", t1M 9%" ue WJPa%dV A
100 IYOT I1`116 p090ag11. I :"aD have .;c4m. try lc, ,% ;KI
dr M YCW hotly 0b,4X-rtart.r fa whatJi 2%Y� Ty1Jst n�tJfjtihi r t sty
mow). ,,L7Cj a'1 ;r wr-$VW wthtiin 10 dWx of ricelpf of this ngrka. C'on+1lsporx$ K, a shoedd bo
Mts~ ru 4dOY .S Grff'rrt 5t, $rn. JA EXrsboM Cam. NC. 271;r009. DC,J♦A r+Rpt'2-34rt(4rli rnt e:yln alAO bQ
r" ontocred at (262) 2I14,320t. No resposise fs C*Alh ir*d M, # ;arna SS rro UbjiX rr'*ri r+ )'EM haa•.•e t)+rQr
r.06,70d by Cer bf od MAO.
WAjV1ER SECTION
I Undmt-ind ;I:jti Jny F,-QPc:s,ec pW. dog, trkKy+V p rQs. roat rafnp. bmakwe..er, b0MPQUW- A or
gru-.1 mulA be wt harA :1 rWnIrfri m distante rN 151! Om rry areas of r5pWan acfjt5-'F ur' a-.s war ir:d trr T^
th+s does riot apply La Dul0wbc.s yr rpra;0 ravetrTW ts) I.,r Vou , tq *ar.ve ttw 4t'�ar� , YoL must -4ly!
rqe ap"prWv bla.rik txliGW
I DO M16,11 to cr ane sonhe all 0, the 15- t
J
►;t+14r� � �t�a►cartt F�;G=lart,r:t rfi,}��r#ja -r�7,r �.
I deg n of wish td **a'VC 'he--
`y'� rate. of Adam en t P'P&Um Property 'ncr:
-'yp@d'Prf name of AR PO: �. ---
Ma114rip Address of ARPCI: —
ARiP0'8VatsIJ: ARPO'S Phon69 _
D irfir . `wglyer Is valid for up to on* year from A6RPO's Bignatu s'
Revised Jui v ? 021

�}��.�`�±�V'�eaNPM�+r+�AW��NS�'pfM�iflMkt.�.' . .'�•..
r .l-

Currituck County GIS Data Viewer
Currituck County GIS
Phone: [phone]
E-mail: [e-mail]
Addresses
Communities
Ay(Nett
sarco
Cotyock
Corona
Currituck
Gibbs Woods
Grarxty
Harbinger
Jarvlsbwg
Krotts Istantl
Maple
kAoyac),
Pont Harbor
Poplar Wanr:h
Poweft Pont
stwwboro
watsr*
County Boundary
—state
—county
Streets
Major Streets
—Arter�ai_Prmcpat
--Arteriai_Wta�or
— Cosector_I„lapor
Parcel Land Hooks
Parcels
Currituck County
Aerial Photography (2011
EReo: satw_1
❑Green: 8uwf_2
�skx: sand_3
This map should be used for general reference purposes only. Currituck County assumes no legal liability for the information
shown on this map.

I
0 1, - - �