86566A_Edwards, Chris_20220531

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V4CAMA U DREDGE & FILL
���v N9 86566 CA) B C D
GENERAL PERMIT
-eviPt permit
11[34New
Date
Date previous permit issued
❑ 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.
S '
I SA NCAC �r�
L ZJ �� Rules attached.
J?qGeneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules
/_.
Applicant Name _ 4 IS r tS_ _
Authorized Agent / `] a
Address ar i7oY__/3 ZS
Project Location (County). I`�
City Q_ b state N ` -zip
Street Address/State Road/Lot #(s) - S K 4 � q(e
Phone#(V— X%8 2-
1 CJ-ho-
Email n,16 K L2 /Ke. v3 C.a /$-,_ _
subdivision 0.+M
City Nl a/7 4.5 Y-a rd o r zip 27 qs�
-----------------------------
Affected CW ® EW XPTA ES PTS
/j
Adj. Wtr. Body _ rte a(nat/ aNunk)
AEC(s): 11 OEA IHA DUW SPIMA PWS
Closest Maj. Wtr. Body
ORW- ye no PNA. yes/(to
Type of Project/ Activity �4 1
d, n o2 O C �Jr Q
i
Shoreline Length
Access Length _
Pier(dock)length �0 a
Fixed Platform(s) 2 0 r 2- aZ
cF-- e.Y_is 4-7 ^-C) O r A-r W r
/1ev�
--- --- — - (Scale:
Floating Platform(s) _
tr 1 Rc.rr
Finger pier(s) D yC ZD P A0.'/- j(li,
Total Platform area Y a O ^^ L /f y�
Groin length/#
Bulkhead/ Riprap length _
Avg distance offshore
Breakwater/Sill
Max distance/ length -
Basin, channel
/E Cubic yards -_ eW
Boathouse/ Boatlift�
Boat ramp - ---- ro.M!% �j� R p�V
_ i
Beach Bulldozing --- - - j \ , ?v ti+ • s `� ' c,'��' �K
Other
SAV observed: yes
Moratorium: n/a yes
Site Photos ye no ,
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: <L/ 0.�t w u n
Permit Conditions
ILES AND CONDITIONS THAT APPLY TO THE
Jt or Applicant PRINTED Name
Sia re **Please read compliance statement o �backpermit"
3 a
Application Fee(s) Check If/Money Order
C] TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
nSee additional notes/conditions on back
VD REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Yy e n t_ [ tl 2t!
Permit Officer's PRINTED Name
Sigi a
Issuing Date Expiration Date

RECEIVED
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date IQ
Name of Property Owner Applying for Permit:
Mailing Address:
Pa P-�x ►3a�
tea, 11\;C� a7 g5Lf
MAY 1 5 1011
DCM-EC
I certify that I have authorized (agent) �, Yl -�' , to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) (p C) \t 5 1 e y - -V,) i c--)C) -� 2 D r,-A 0-4trn�
at (my property located at) t D (r]} 1r( �[ i 1 iCa i�iQY�►� `1-x �bO r
This certification is valid thru (date)
Property Owner Signature
Date

c ; k, � A ',A t� S " 'i Z,
RECEIVED. .-
Y- 2 --5-.20
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MAP
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.13.336 So.
=-ILL
11. .3.
PROPOSED
DWE"LiNc. e 9 1
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PROP ORK
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LEGENC— AVE DATA
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CCMCAETr- MIMUMFIT
I, 1iAN30N Rh[ MAINS CERTIFY raAr
UNDER MY DIRECTION AND SUPERVISION
THIS PLAT WAS DRAW!? !ROM AN kCTUAL
FIELD LAJ4D SURVEY. THAT THE UTIO OF
PREC! S I og AS CALCULATED IS : , , o: . --
WI MSS MY Pi-"D AND SEAL
a`. -. t, Dwcr or zr
CARO
REGISTERED LAND SURVEYOR
L--kwk�* `/,
SURVEY FOR
JOHN AR--NOLD WH lTE
ANC N 7z.
ANNE WHITE

eeA1�.-- N.C. DIVISION OF COASTAL MANAGEMENT MAY 2 5 2022
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONANAIVER 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:
Mailing Address of Owner:
Owner's email: riA blue In CV - � Owners Phone#: ca �a -�� � '-� 2— cc_ tj
a-i1C() r � r-n
Agent's Name: t-1 �1 1 C_ Agent Phone#:
Agent's Email:
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
crition or dramna, with dimensions must be orovided with this letter.
r,c a pro't-- ei0.A-�Ov +rn
I DO NOT h2e objections to this proposal. I DO Rave 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 Ceded 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
-OR-
I do not wish to waive the 15` setback requirement (initial the blank)
Signature of Adjacent Riparian Property Uwner.
Z
Typed/Printed name of ARPO: ✓+ I S/ e r`'
Mailing Address of ARPO: / �C X / S(���li/I�
ARPO's email-�/+ igee ry �' t' f f I ARPO's hone#: 5^, '.:a - ; 7 V
Date; S -;_- e - AF;-- "waiver is valid for up to one year from ARPO's Signature`
c�Y�o�W ► n
Revised May 2021

�cc
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: N-Y 1 5
Address of Property:
Mailing Address of Owne
�L-G-EIVED
MAY 2 5 2022
DCM-EC
Owner's email: Owner's Phone#: ,r� to
' � c..c� r �,
Agent's Name: t 1 _ i CLY, If) e Agent Phone#: �Q--Q 10
Agent's Email:
n
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adjacent Property Owner}
rr
I hereby certify that (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 ing. with dimensions must be provided with this letter. calf
��
q� -,ri f aWt-uy- (pC` * ') re.r' t� � �Z-tD Pl-corr,n Calr��) n
1 DO NOT a objections to this proposal. 1 DO ha a 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 Maii.
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
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property``Owr �/�'.���1
Typed/Printed name of ARPO: (JR��i"t1 � Ae-A-4S"
Mailing Addreo otARPO: s%o / �',E�-l�Tt7i✓ �`�"¢
ARPO's email: bA—KC' f'�(C;cl� ARPO's Phone#:
Date: s /Z �Z*waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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