84638C - Dennee, Richard

1*°``OUT4,1&EICAMA ❑ DREDGE & FILL 9 4638 A B c D
y
Previous permit
y =GENERAL PERMIT
J 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 State
Phone # ( )
Email
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 t/
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 r
Permit Conditions
(Scale: )
w, ❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
ElSee 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"
Check #/Money Order
Application Fee(s)
Signature.
Issuing Date Expiration Date

1*q``0AST41 c❑CAMA ❑ DREDGE & FILL Na 84638 A B C D
y = 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:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City State
Phone # ( )
Email
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 r-Wuii— . y.
Permit Conditions
(Scale:- r )
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
Signature "Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
Application Fee(s)
Check #/Money Order Issuing Date
Expiration Date

AGEN ► AUT40RIZATION FOR
Name of Property Owner Requesting Permit: {21cN�R3> ��►� ��L
Mailing Address:
tiF-LJ ER 1J , �J c_.. 2 4S 56 2
Phone Number: _ -93J 5 6�
Email Address:
1 certify that I have authorized x � �l r;
Agent ! Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at (BIZ ij%L(jAASo.J DR 7JEvJ 6E�" OC
in CR A\JE O County.
1 fudherrnore certify that I am authorized to grant, and do rr) fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands it) connection with evaluating infoirnation related to this
pern7it application.
Property Owner Information,
C
1�� --
5rt�natrae
T l c at .i bCIJAJ C
Print or Type Name
Title
Date
This certification is valid through _ l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to f?ICA-AiZ6 L�clJtl ^ 's
(Name of Property Owner)
property located at J`K iZ- 0(t.UAM50-0 On NEW Be.rz-0, AlC.. 2��6Z
(Address, Lot, Block, Road, otc.)
on �uT '_ �.1 CR in 13 �Jc�P-VEIJ ►J 7' N.C.
(Waterbody) (Cit§fTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatiQ
Imo, r—. 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(hidividttal proposing development rnitst till iti description below or attach a site drawing)
WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.)
c. I do wish to waive the 15' setback requirement.
_ I do not wish to waive the 15' setback requirement.
(Property Owner Information)
�j
Si, natlwe
Print or Type Name
/8r)2 441441AMIQnJ 40_
Mailing Address
A/EaJ 4219711n1 NG 2 g 3'6 -.
city State2'ip
9 O- S t V
Telephone Number / email address
Dan,
(Adjacent Property Owner Information)
z '
(Revised Aug. 2014)
'Valid for one calendar year after signature'