87716D - Ellis

.O"10'i CAMA DREDGE & FILL N� g!71Ct A B C@
®e GENERAL PERMIT v, Date previouvious s --
hate previous permit issued
�New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorbed by the State W North Card.. nt of EmAronmrntal ale and the Coastal Itmources
ars /� Deparerrse W ry Comrisslon le an area of emironmenul concern Pursuant to:
ISA NCAC �Q f 12 OO ❑ Rules attached. W Cenral Permit Rules a cobble a the following Ink: v�yv clew nc,p�v(UMMhs
APWiona Name V 1 ^ CC C. //f S Authorized Agent b t e ale
Addr C. /� J dy_�l Project Location (County) I u..gvz a 1G
City JYOSa_ �" <IsG some N C LP '2YUK Street AddressfState Ro xvtet I(s)
Phone"(RMSly?. oNoZ
Email-.(��SN; AaA�/ frz� subdivision
ctY nv
Affecod EACW �EW It:
❑( Ef❑ORW. Yes/19PHA: ye PTs Adj. Wtr. Body r<e. L .�, tYk..aa/ (n�nk)
AEC($): ❑oU WA ❑SPIMA ❑PWS CbscttNai.Wer.Cl�jld— _
Type of Project/ Activity
Iscale: �/'rs)
Shorebne Length
Access Length _& If I Z
Pier(dock)knph /o ar/�. _
r/. z
Fixetl P"rtormisl /2Y/y, (17P 1 P
Floating Pletbrmis) Ir/ 10
Finger pferfs)
fr
TOUI P4fform area —Lie___
Groin length/#
Bulkhead/ Maras length
AYg diShMe, offshore
ereakwater/Sill
Max distance/ length
Basin, channel
Cubic YaNa
Boat qmp
Boathou tfift / at/
g
Beach Bu
Other
yes
Mcnatc i ,
Moratorium n/a
Site Photos: �F•�
Rlparian Waver Attached:
IpY�4 1
gew
/{�ef/�no /�lvsi
A building perm%/mnina,plrmh may be rewired bv: St.�'
statement on back of
Go
'L Lwa. I.rlt. wJI n
ov,sh-5 Vra_ T f to /tt �..n
„� pIGC6 �
1p'l--utd L l La, tG8'
❑ TAR/PAMINEUSE/BUFFER (dmle one)
EIS" we on bah regarding River Basin rules
❑ see additional notes/conditions on back
Issuing Date EaPllatidfl Date
Scanned with CamScanner

AA ❑DREDGE & FILL N° 87716 A B C
GENERAL PERMIT Previous permit
Date previous permit issued
f 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 ') 0
u
FO 15A NCAC r % G ❑ Rules attached. / General Permk Rules available a the following link: www.deq.nc.gov/CAMArules
aj
Applicant Name V pI
Address /< n
City
81
State Al C ZIP
Phone # (� f�J '6'7 L '— 10 3
Email "11, V, ir99
1
M A, /. "./
Authorized
Project Location (County): 6 . — S -- . s. I, -
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected ©CW EW PTA ES ❑Pr5 Adj. War. Body -< i�... CG. (nattmal unk)
AEC(s): ❑OEA �IHA ❑UW ❑SPIMA ❑PWS Ckeest Maj. Wtr. Body
ORW: yes/no PNA: ye no
Type of Project/ Activity
(Scaler/ .S )
Access Length _ (.'
Pier(dock)length t,
-
—
P
Fixed Platform(s) / =- - ----
Floating Platform(s)
----
�t---'
Finger pier(s)
Total Platform area 32
Groin length/q
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel—
Cubic Yards
Boat ramp
Boathouse/ Boatlift / P x/?
_
Beach B6Uclmlq- -
Other
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I
4AA
.
4
L
t
q
.,p
;
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a
,
J,
r
n
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_,
_'
SAV observed: yes L' n '
Moratorium: n/a yes
Site Photos:
Riparian Waiver Attached: /yesJ_ ., no
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A building permit/zoningpern
Permit Conditions
Agent or Applicant PRINTED Name
be required by:
Signature "Please read compliance statement on back of perrmit_•* _-�
It L�
Application Feels) Check q/Money Order
❑ TAR/PAWNEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
VD REVIEWED COMPLIANCE STATEMENT. (Please Initial)
i
)-U�1<._
Permit Officer's"RINTE9 Namg j
Signature
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:
ElTar - 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 Manaeement Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(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)
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 Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 4�Le
Meltig Addrews:
09,
Phone Number: ,�> % lJ ` (�1 f Q Zf Q 3
Email Address:
I certify that t have authorized /,U� �// M2
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: eg�'! Z.,
���i �C��� �ic:r'zeh � a•u,O o ate/ �
at my property located at ,6lile4cig4�{ ZQw
in 41WV�.i// County.
/ furthermore certify that i am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
� ���� Signature
Print or Type Name
Title
/r/
Date
This certification is valid through

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed;by owner or their agent)
Name of Property Owner: \!, AC-eA l i I IS
Address of Property: 0cl_ ;n C F14cz-� eS
Mailing Address of Owner. - I ybo. g 1y erS
Owners email: 1° H 1 S V 1 P q fit' r ` COO, Owner's Phone#: SyD ?q2 " 0 y� 3
Agent's Name: B i R "f'6mr<5 Agent Phone#:
Agent's Email: 1 I ^tart �'� "�Q Cu �CoAs �w Cron CO M
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom bortion to be completed_ by the Adiacent Prooeln 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 drawido. with dimensions must be provided with this letter.
�m
tht• v� I DO NOT have objections to this proposal. I DO have objections to this proposal.
�« W you have objections to what is being proposed, you must nobly the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted
at:[phone]. No response is considered the same as no objection Ifyou have been notified by
Certified Mail.
U
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 sometall of the 16'setbAk
9hatdMofAdiskentRipadan PrropertyOwner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Own C.
Typed/Printed name of ARPO: 1_10fwil k aF j L- Wt 1 'l A1o� L-AAt' AAq,
Mailing Address of ARPO:.SJ
ARPO's email: 1-t'h0u1410 a WAA , tARPO's Phone#: 70'i
Date:1l:Ib- 2D2 Z *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIEDMAIL- RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by bivner or their agent)
Name of Property Owne
r.
Address of Property: 1,400 94%ierr,,j-# 0 Aerah , AJC
M ng
sill Address of Owner, _q, -is cl-
Owner's email: owneesphonet
Agents Name. Agent Phonet—a Let - 9 Z-1-
Agenfs; Email: mctf'(�'-tc(oas4ck( ro,1�4(ON.Colh
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(ft-ttm Poirtlon to bfr canoleted by IftjAdIjIc;wA Property Owne
I hereby cwft that I own property acUacent to the above referenced property. The Individual applying for this
permit has described tome, as shown an the attached drawing, the development they am proposipg-6
doserintlan o1r d no. -with dintensl led wfth thil letter.
4 1 DO NOT have objections to this proposal., I'DO,have objections to this pro;iosal.
MWnagamiud (DCAQ In wdft within 10 days ofrweIpt of this notice. Correspondence should be
nudkd to 4W Commerce Ave., Morehead M NC 2&W. DCM mpreambW~ can also be contacted
W052 , ) 80&2808. No-responseb mo0"ealtbesame as no oA*tba Nyou have been nofflkdby
Car~ U&IL
WAIVER SECTION
I understand that any proposed pler. dock. mooring pilings, boat ramp, breakwater, boathouse, fit or
groin must be ad back a minimum distance of I S'ftm my am -of riparian access unless waived by me
(this,does not apply to bulkheads or dprap rivelmertts). (11 you wish to valve the utback, You must shin
the appropriate blank below.)',
I 6O �wlshlo waive isomiliff6fthe I&Selback
SlgbetaredA�jacentA
-OX,,
I•do not with to Volvo, the
RPO:_
•
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Date Recelvad
Date D-Ited
Check From!Name
Name of Pe It Holder
Vendor
Check number
Cheek
amount
Penult Number/Comments
Reeel t or Retund/Reallaeated
Column!
Column2
Cdumn3
Cdl 4
Column5
Columns
Column7
Columns
Column9
6/16/2022
Jerry Ennett
Schnell-
Coastal Bank and Trust
4778
$ 200.00
GP #87758D
JD rct. 17989
6/16/2022
Island Time Construction Money Ord e
Braxton
First Citizens Bank
3E+08
$ 600.00
GP #87759D
JD rct. 17990
_
6/16/2022
_
Pippin Marine Construction LLC
Jamieson
Wells Faro
6073
$ 200.00
GP #87757D
JD rct. 17988
6116/ 0022
_
Lighthouse Marine Construction Inc
Calcott
Coastal Bank and Trust
4300
$ 800.00
GP #85642D
JD rct. 17683
6/16/2022
_
Patriot Boat Lift & Dock Maint, LLC
Jacobs
A uesta Bank
1211
$ 200.00
GP #85645D
JD rct. 17682
6/16/2022
_
Maritime Coastal Construction LLC
Ellis
CresCom Bank
3474
$ 200.00
GP #87716D
BB ret. 18006
6/16/2022
_
AMW Docks & Marine Construction
Watson
Truist
7248
$ 200.00
GP #85926D
BB rct. 18008
6/16/2022
AMW Docks & Marine Construction
Beveriv
Truist
7258
$ 400.00
GP #85925D
BB rct. 18010