Moore, Linda 88558C

AMA
Previous DREDGE & FILL NY 88,5-
Cl Previous permit
. . . . . . . . . . . ENE,1z L PERMIT Date previous permit issued
I INevu DModificapion n Complete Reissue OPartialReissue
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, w�tA-md c&o_yLC_AMAruies
Applicant Name ) Author -ized Agent
V—
Addre L
. ..... Project Location
City State ZIP StreetA� res tat Road/Lot#(s)
... ........ T,
Phone # A9 A A J; .. . . . ..... .......................... . ..
Email 'fill g 0 Subdivi i
City-WIM
4)
Affected 'CW **rA El ES E] pTS Adj. Wtr. Body. (na aniun
itif/
EW
W S P I MA AEC(s). �,OEA 31HA El PWS Closest Maj. Wtr, Body 14
ORW-. yp-,M& PNA: yes/
X�
Type of Project/ Activity I x\l- k"VC11-11t "U f/
(Scale:
Shoreline Length
Access Length
Piet (dock) length---
Fixed Platform(s) --------
Floating Platform(s)
Finger pier(s)
Total Platform area.,
Groin length/it
Bulkhead/ Riprap length
Avg distance offshore
Brea kwater/Sill_
Max distance/ length
n4v
el
Cubic yards
Boat ramp
Boathouse/ Boatlift K
Beach Bulldozing
Other cell, ')J Yi
...........
SAV observed; yes 0
Moratorium: n/a yes no
Site photos. yes 110
Riparian Waiver Attached. yes no
0 A building permit/toning permit mav
y required by. -f
J 4 fAR/PAM/NEUSE/B1JFFER (circle one)
Permit Condition_)pvy'
Basin rules
CD,
d" --�ry AateSee note on back regarding Rivei
42 d, it.V-
I E]See additional notes/conditi6ns on back
. .............................. .......... . ..... . ........
I AlVhAWARE _OF SJATVTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND WED CO LIANC S MEIN
hg nt or Ap lic, n P INTED Name .4 er T I E am
-A
RJ5
signa tire **Pleas adcoi-nplianc-estateryientoiibacirofperri-jit**. I
L
---------- -- . . ...... )—Ilaf ............ ..................
Application Fpp(s) Check It/Money Order Is Expiration Date

`°"S'"1 CAMA DREDGE & FILL A B )D
Previous permit ``�----�--
T ENE L PERMIT s � Date previous permit issued Y— -
'�*New ❑ Modification [-]Complete Reissue [-]Partial Reissue
As authorized by the State �ofjNorth Carolina, Department of Environmental Quality and th Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC , . ?C1 ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
City State /(a t) "1 7jD
Phone # A19)
Email
c�\ 'k
�W
Affected ❑ CW EW PTA
AEC(s): OEA ❑ IHA W
ORW: yes/CP PNA: yes/t
Type of Project/ Activity
Authorized Agent "'
Project Location (County):
itreet Address/State Road/Lot #(s) d
-.,est Maj. Wtr. Body
Shoreline Length 14
Access Length —
Pier (dock) lengtfi'��`�R_ ��•�,��, , j���
Fixed Platform(s) /X' �X1
• _sew ..
Floating Platform(s) *"
Finger pier(s) 6
Total Platform areaasr-
Groin length/#
Bulkhead/ Riprap length ----
Avg distance offshore
Breakwater/Sill — - —
Max distance/ length -
B in hannel
Cubic yards 1
Boat ramp -�
Boathouse/ Boatlift`— "
Beach Bulldozing -----
Other
SAV observed: yes1/1) 'Y)�
o
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit onrng permit may required by: S
Permit Condition
—)A 1. t- IT -�4) 0 i
f
I AIV%AWA OF S TES, CRC R
Agent or Ap is n ANTED Name
AND CONDITIONS THAT APPLY TO THIS PROJECT AND
Per
D
�•'
(Scale: �)
b
c
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Signa ure **Pleas ad compliance statement on back of permit**„ C,
/ ,
Application Fee(s) Check #/Money Order
Sig atu
O,-,
Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to Z. (
d d,i xv G'r`c__ I
�Narpe of Property Owner)
property located at
t'- ^ a
C_
(Address, Lot,, Block Road, etc.)
on 0 6 ex -0(1.i , in A arT'c) i?_. q r A , N.C.
(Waterbody) J (City/Town and/or County)
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, 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
i nature Signature
Lid /<7 M V-Drf_ 6- "? , /64
Print or ype Name Print or Type Name
b cR 1 -, r t
ailin Address Mailing Address
ity/ tate ip, Ci y/Stat ip �100
telephone Number / email address Te ep one Number / email address
Lag- q_ eg u '" RECEIVEr,
Date IDate
*Valid for one calendar year after signature*
(Revised Aug. 2WW)1 h 2022
CM-MH CITY

I
7<�
IQ
CNIJ
LU
>
C=)
LLJ
C)
cr
ZD

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to 'S
(Name of Property Owner)
property located at —IL govv '
(Address, Lot,, Block, Road etc.)
on qY)4 fiq in rik / c- P� F�a , N.C.
(Waterbody) (City/Town and/or County)
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 roust fill in description below or attach a site drawing)
V
WAIVER SECTION
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.)
RECEIVED
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement. JUN 16 202?-
(Property Owner Information) (Adjacent Property Owner InforiW&&PHD CITY
It AJAZ�� k
��-
S'ig atu. Sa 9r1r E`
nature
Print or ype Name Print or Type Name
-7.i n,l I; i L Fr) 'l dl 17 r) r- f b h I" 1)
Address
"�-,-�V-P--�I/X
Telephone Number/email address
Date
Wailin 'Address
e ' ► -. 0 d
t State/Zip
Telephone Number e
%G J t
Date *
. � �h /
address
*Valid for one calendar year after signature*
(Revised Aug. 2014)

0)
c®1
U.,
ZD
(r
.Pza
77,