85965D - Lazorik

(ifAMA ❑DREDGE & FILL N° 85965 A B 0` ,
Previous permit
GENERAL PERMIT Date previous permit issued
t ] 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 W r"_ + [ 'Cy ❑ Rules attached. ,❑ General Permit Rules available a the fo)lowing link www deq nc.eov/CAMArules
Applicant Name ff1V -r ,kf j G_r / f, Authorized Agent / / " /1( flO '�, („{'r -- •.
Address109" A Ota / Project Location (County):
City !/ c,rt. F ,! 12 ppce fw: ZIP X Street Address/State Road/[Llp�t /j(s),
Phone# L/ ) 3'a' - 1r77- Lit
Email Subdivision
city�7 ZIP
Affected ❑ cW ,MEW., [9 PTA: ❑ Es ❑ PTS Adj. Wt, Body 4.p1 LS��' �G h;G unk)
AEC(s): ❑IDEA ❑IHA ❑UW SPIMA¢,,, ❑PWS Closest Maj. Wtr. Body
ORW: yes/nu'. PNA: yes ^�
Tyne of Project/ Activity (,bl
(Scale:;
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
y
Floating Platform(s) '
r /
t
Finger pier(s) 2 LO - O10
Total Platform area
Groin length/# r
j d
Bulkhead/Riprap len` h (- - I - - t f---{ I • - - I - ,
Avg distance offshore-t-
•..,
Breakwater/Sill _
a +
Max distance/ length f->
Basin, channelCubic yards 3,,'i't ,•' �.. �'. lw �� - -�
Boat ramp a-w+a. °..
1 >*
Boathouse/ BoatUft�J 6' 12 K I L� —
Beach Bulldozing W .i
Other - ! '. •'
SAV observed: yes I--(fT-
Moratorium: n/a yes
Site Photos: yes o Riparian Waiver Attached: yes o ''
A building permit/zoning permit may be required by: �e7V11 � ( ��
TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
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. (Pleaselnitia)y
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please rea pliance statement on back of permit•* , ' Sign re
7�
Application Feels) Check #/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/1-888-4RCOASTFax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender Counties)
Revised 6/01/2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property • ally'
oi AI ♦/
Phone Number,
/ eti
ContractorI certify Mat I have authorized r, S frwjj lot,
Agent /
to act on my behalf, for the purpose of applying for and obtaining all CAM�A permits
necessary for the following proposed development: l 20/� -F 1 2
at my roperty located at
in r courtly.
No
t furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management stall, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit apptication-
Property nforniation:
Signature
RDVXYt 1, VVYi 1�--
Pnnt or Type Name
QcuN62
rwe
Date
This certification is valid through

a
s
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Ez�tra�9rvices B Fees(cMcxba¢ r W egprypete
es
LyAstum flecaiPt(MNmpp
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❑ Return fleceigt(ee lc) E
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❑C ffl tlMelt ReaNc oen E
Mere �
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❑Mutl Signature Re Uiu S
❑nun SlgreWm fleN WoelNerVE
PR
Postage �Q
28 2U22
Ra

.ercurev man service prvveves one svnvwing Mminems:
�Aprompt Pis portion of the CeMfled Mall label).
for an electronic return receipt, see a retail
A unique identifier for your mailpiece.
associate for assistance. To receive a duplicate
Electronic verification of delivery or attempted
return receipt for no addilional fee, present this
delivery.
USPSO-post marked Certified Mail receipt to the
A retard of delivery(including the recipients
retail associate.
signature)that is retained by the Postal Service"
- Restricted delivery service, which provides
for a specified period.
delivery to the addressee specified by name, or
to the addressee's authorized agent.
repprtantfierourders:
- Adult signature service, which requires the
You may purchase Certified Mail service with
signee to be at least 21 years of age (not
First -Class Mail-, First -Class Package Servicee,
available at retai).
or Priority Mal* service.
-Adult signature remitted delivery service, which
Certified Mail service is notavailable for
requires the signee to be at least 21 years of alp
intematlonal mail.
and provides delivery to the addressee specified
Insurance coverage is notavailable for purchase
byname, or to the addressee's authorized agent
with Certified Mail service. However, the purchase
(not avalable at recall).
of Certified Mail service does not change the
• To ensure that your Certified Mail receipt is
Insurance coverage automatically Included with
accepted as legal proof of mailing, R should beam
certain Priority Mail hems.
USPS postmark. If you would like a postmark on
For an adddional fee, and with a proper
this Certified Mall receipt, please present your
endorsement on the mailpiece, you may request
Certified Mail Rem at a Postfmce-for
the fallawing services:
postmarking. it you don't need a postmark on this
- Return receipt service, which provides a record
Certified Mail receipt, detach the barcoded portion
of delivery (including the recipient's signature).
of this latl, affix it to the mailpiece, apply
You can request a hardcopy return receipt er an
appropriate postage, and deposit the mallplece.
electronic version. For a hardcopy return receipt,
complete PS Form 3811, Domestic; Refum
Receipt,' attach PS Farm 3811 to your mailpiece;
IMPORTANT: Save this recelpl for your record&
c c,,,m 3Rm_ e.wr onrc I.—, co. ---

CEgT1Ftepj#AI .- RETURN -RECEIPT REQUESTED
DtVfS(ON OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOT(FICATIONIWAIVER FORM
Name of Property Owner:
Address of Property -
Agents Name
I MailingAddrew.
Agent's phone
I hereby certify that I own property adjacent to the a bove" r4ferenced, oroperly. The individual
applying for this permit has described to me as shown on the attached drawfagJfte development
they are proposing. A crescriation or drawfnci with dimensions, must be provided with this letter.
f have no objections to this proposal. I have objections to this proposaL
ffyoahaVe ofilerffofisto Whatisbelft qproposed 'yoUln stnofftythe of
If Division Coasiatganagainent(MMJin
WK1611ar within fdrdays of receipt of this notice, Carrgspandeiieeshoatcffie mafteldtaf27CatTinalDrive Ext,
Wilmih9tall, AfC, 29405.2846, DCU representatives can also be contacted at (Wj 796-72M Afo response is
�qgqsf#'gredme same as no ghfoado ifYqu have beenJlofiriedpy cergled fibil.
WAIVER SECTION
F understand that a pier, crock, mooring pirmgs, breakwater, boathouse, lift, or groin must be set
back a minimum distance of IT from my area of riparian access unless waived by me. (ff you
wish to waive the setback, you mustV"ifia the appropriate blank below.)
I do wish to waive the f 5! setback requirement
I d'a not wish to waive the f5setback requirement
(Prop7e Info (AdJac t Pr
roperty Owner tnfbrrnatidnj
&,7attar)
signdiuki .signature Print or rype, Name Pf JnCer Type Name
Mailing Address
\5 11,14 O�
CitylStafelZip
2-
2 _heafeppLhone AN�22Q�er �T
Date
/11L_
I& -Ahl wn'l
MaangXddress,
4q
QtylSfate,Vp
Z2 %- -,7 z - ..z- z
Telephone Number
- 1;I'�Jrell.2 Z
Date
Revfged 61MIM2

ADJACENT Rt'PARIAN PF f3PERTY OWNER STATEMENT
I hereby certify that l own property adjacent to Y1
`s
Property located at �`
(Name:.df Property owner)
h on 0 ddres c ctt
A.Lin
(IN'aterbody N.C.
(�►`Ey/To�rr arrcUor C6untYj "
The applicant has described to me, as shown below, the devaloprrrent proposed at the above lccatiart.
l have no objection to this proposal.
l have objections to this proposal.
DESCRIPTION aNlSfOt tSFEAtItf[NG OF PROPOSED DEVELOPMENT
(1ndiWd1zf01 proitcssing► development rest fiif it.y descriiriiarx hetow-or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, MOOrfng pilings, breakwater, boathouse, lift;or groin must be set back a
rnirioum, distance of 15" from my area of riparian access unless waived by me. (if you wish to waive
the setback, you must inifrat the appropriate blank below:)
CIO wish to waive the IT sefback requirement -
I do not wish to waive the 15` setback requirement.
C /Sf te/Zi
Telephone lVumbe� —
Date
(Adjacent Property Owner Inforrrration)
7O�Xfv-�/OC-U3Ss
Telephone Number
Date
(Revised f/f8`120t2)

I hereby certify that I own property adjacent to I y1(1 rl"S VA zVV I Imo"
property located at �I �©�/ (Name of Property Owner)
on I (� (� (� (Address. L�t Block, R d etc.) (�
in t i.Y{' ;m puld er . N.C.
T (Waterbody) (City/Town andlor Countv)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Mailing Address Mailing Address
City/state/Zip
Telephone Number
Dare
City/State/Zip
Telephone Number
Dare
(Revised 611 a(2012)

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JrLUV<37i5 %�JJ62

Data Recol-d
Date Deposited
Check From (Name)
Name of Permit Holder
Venda,
Check number
Check
amount
Permit NumberlComments
Recelot or Re/undlReelleoeted
Columnl
Column2
Cdumn3
Co1umn4
Coh mn5
Columns
Column?
Columns
Co/umn9
5/19/2022
John McClure
Dale Ramey III
United Bank
1128
$ 200.00
GP #85904D
BB rct. 17598
5/19/2022
S&ME
New Hanover County
Bank of America
503482
$ 200.00
GP #86043D
BH rct. 17570
5/19/2022
Moose Construction
Krzemien
Truist
2240
$ 200.00
GP #87710D
JD rct. 17669
5/19/2022
Richard Penny Construction LLC
Channel Bent HOA
NAVY Federal CU
2663
$ 200.00
GP #85901 D
JD rot. 17660
5/19/2022
_
Moose Construction
Lazorik
Truist
2241
$ 200.00
GP #85965D
JD rct. 17657
5/19/2022
Pamela Howze
same
State Em to ees CU
1123
$ 200.00
GP #85902D
JD rct. 17664
5/19/2022
Logan Marine, LLC
Andrews
BB&T
7923
$ 200.00
GP #85702D
JD rct. 17666
5/19/2022
Steven Farmer
Byrd
Truist
5481
$ 200.00
GP #85928D
BB rct. 17590
5/19/2022
Backwater Marine of NC LLC
Goldsmith
BB&T
1482
$ 200.00
GP #85968D
BB rct. 17588
5/19/2022
Backwater Marine of NC LLC
Woodcock
BB&T
1466
$ 200.00
GP #85907D
BB rct. 17596
5/19/2022
Sea Dog Marine Construction
McAnulty
First Bank
1741
$ 200.00
GP #85727D
BB rct. 17594
5/19/2022
Backwater Marine of NC LLC
Scott
BB&T
1481
$ 200.00
GP #85969D
BB rct. 17595
5/19/2022
Town of Ocean Isle Beach
NCWRC
First Bank
9332
$ 200.00
GP #85971 D .
BB rct. 17593
5/19/2022
Dominion Land Corporation
SH Village Green, LLC
SunTrust
990753
$ 200.00
GP #85978D
BB rct. 17591
5/19/2022
Vance Morgan Money Order
L kins Rev Liv Trust
USPS Money Order
2.78E+10
$ 200.00
GP #85970D
BB rct. 17592
5/19/2022
Oster Bay HOA
same
First Bank
1153
$ 200.00
GP #85418D
BH rct. 17567
5/19/2022
_ _
East Coast Sports
Doug Medlin
Coastal Bank and Trust
4904
$ 100.00
Minor Fee, 411 Roland Ave, Surf City PnCo
JD rct. 17667
5/19/2022
_
B&J Construction of NC, LLC
Silva
BB&T
2497
$ 200.00
GP #85973D
PA rct. 17634
5/19/2022
B&K Marine Construction
Ries
BB&T
1723
$ 200.00
GP #86081 D
PA rct. 17636
5/19/2022
Sea Do Marine Construction
Howell
First Bank
1745
$ 200.00
GP #87718D
PA rct. 17637
5/19/2022
_ _
Sea Dog Marine Construction
Swan
McFaul
First Bank
1722
$ 400.00
GP #86073D
PA rct. 17628
5/19/2022
Red Rock Builders
Fideli ty Bank
1661
$ 100.00
minor fee, 102 Waterfront Cir (Lot 41) Hampstead
PnCo
JD rot. 17671