86537A_Brothers, John & Holly_20220616

-� ®CAMA v DREDGE & FILL
^ f" GENERAL PERMIT
N9 86537 (3 B C D
Previous permit
Date previous permit issued --�
,® New ZModification []Complete Reissue 1.] Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Coxrxnission in an area of environmental concem pursuant to:
.� 15A NCAC .._.w _ B `..-I a (P __ ❑ Rules attached. Germ -A Permit Rules available at the following link: --
Applicant Name ,.146D 4 W Ili i r An�� _ Authafted Agent M--+ •••
_ 1 -- - -- -
Address �..`C'yi� Project Location (County):---._.PASI_iLOf�._._ --
City F--fiifi o=ASt. _ _.. _Nc— __. ZIP s 7 7 G 0 l�} Street AddrewState Road L- #(s)
Phone # Oil A) ICI 7 4ULLL_?1N N
Email— 6f t1A�` Subdivision + �'— �c Q
City Aoekh �1.� ZlP -790l
Affected 0 CW ENt [NM on L; PTS Adj. Wtn e� /} L &\t �i"` t �)
AEC(s): ❑ QEA �] IHA �] UW SPiMA �] PWS Closest Maj. Mr. Body Al brltKa. to S�rioi�[ . '(
onW: yes/t0 PNA: yes, O X C 1� �/z $ i
Type of Project/ Activity f k i ` ~ 0+� % X Al M f 4
Q5I X/Z! b0Ltj i- 'OvA(t W-7- ' 1 t
Shoreline length af! _ M
Access Length
Pier (dock) length
Fixed Platiorm(s)7�-a-
-rr
., i
Floating Platform(s)
Finger pter(s)
Total Platform area 2y
Groin length o
Bulkhead/ Rlprap length
i
Avg distance offshore _ -
,
Breakwater/Shc
Max distance/ length
t
Basin, channel
Cubic yards.
Boat ram
Boathouse/
Beach Build
Other.e..,—
i ,
SAV observed: yes '
Moratortum: yes no -s
Site Photos a no
Riparian Waiver Attached: yes 64
A building permit/zoning permit may be required by:
Permit Conditions
c't�•.4t -
TAR/PA"ELISEJeL*KR, (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
I AWN AWARE OF STATUTES RUBS INENT. (Please Initial) �_ t
r Applicant TE0 Name
Sign *Please read compliance statement on back of permit""
Application Fee(s) Check #/Money Order
Permit Oifiir* siPRfNTED Name
S--yN
ignatpre
Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAiL RETURN RECEIPT REQUESTED or HAND DELIVERY RECEIVED
(Top portion to be completed by owner or their agent)
J U N 0 8 2022
Name of Property Owner: John P. and HollV L. Brothers
Address of Property: 1004 Rivershore Road, Elizabeth City, NC 27909 ®' CM -EC
Mailing Address of owner: 1004 Rivershore Road Elizabeth City, NC 27909
Owner's email: [e-mail]'s Phone#: [phone] '
Agent's Name:
Agent's Email:
Agent Phone#:
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
description or drawing, with dimensions must be provided with this letter.
I ( + f I DO NOT have objections to this proposal. I DO have objections to this proposal.
1 if you have objections to what is being r
Y I g proposed, you must notify the A 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 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
Alt -lam lC.
-OR-
Sigifature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: _Theresa//L. Hartsell
Mailing Address of ARPO: /L IV )UL,
ARPO's email: _rll )a-l1:�'e 6, tt6 �IC ARPO's Phone#:
Date: 7/ova *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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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. John P. and Holly L. Brothers J U N 0 9 2022
Address of Property: 1004 Rivershore Road, Elizabeth City, NC 27909 P,
Mailing Address of Owner. J-04 Rivershore Road, Elizabeth .City. NC 27909
Owner's email: brothersjohn@hotmail COmowners Phone#: [phone]
Agent's Name:
Agent's Email:
Agent Phone#.
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I herebycertify that i own property adjacentto the above referenced property. The individual applying forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
_ description or drawing with dimensions must be provided with this letter.
1 DO NOT have objections to this proposal. i DO have objections to this proposal
If you have objections to what is being proposed, you must notify the A! C. Division of Coastal
hTanagement (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 Mail
WAIVER SECTION
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 15' setback
-0R-
Signatu f A od a e t Riparian Property Owner
1 do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Printed name of P RPO: Russell M. Hull, Jr. and Kay B. Hull
Mailing Address of ARPO:1000 Rivershore Road, Elizabeth City, NC 27909
ARPO's email:
ARPO's Phone#:
Date: '1,% ,' = *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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1004 Rivershore Rd
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Google Earth:.. ► 4
100 ft
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