88437C - Debinski, Eva

' y Ef ArVIA ❑ DREDGE & FILL Nd 88437 A B (D D
(GENERAL Previous permit.
/ PERMIT evio
I;?dgw ❑Modification ❑Complete:Reissue ElPartiialReissue oafs previous permit issued
As avthotized by the State of NortrhryCarobn% Department of Emironmencu tluaky and the Resources Commission in an area of enviropm ntal concern pursuant to:
ISANCAC Q� %KJ� .u-nrte Ie�
E] Rules attached. . ...General Permit Rules available at the fofkrmng
A¢plirant `Ift'1 s t .
ame
Authorized Agent
F��s o •
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d.. a
Ci CW C c -
EIOEA
sJ
■Wu
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01HA MUW
OSPIMA E]pWS
Closestmg.mr.80
ORIN �►
Access. Length
Pier (dock)let
Floating
Total Platform are
Groihlengthl#_
Bulkhead/ Riprap
Avg distance offs)
Basin, channel
Other
SAV observed:
Moratorium: n(a
site Photos:
Riparian Waiver Alt
i
( ,
.w ♦.�,
W r
E
ma Q
rm,tmaybere utted by:..�CJ. r LIi,_�I DASfIJI✓
t \ p /� / j TAWPANINEUSMUFFER(cirde one).
p a ` C iFiSm note on back regarding Rivet Basin rules
I

dtmr4 yv1A#.A tZO 4Vr �jo 88437 A s 0 D
30+ & ❑rCAMA ❑ DREDGE & FILL Si�►10.$U C� previous permit /
I GENERAL PERMIT Date previous permit issued_/
EgIleew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the StateofNorth�Ca(ro�lin(a�Department of Environmental Quality and the Co I Resources Commission in an area of environmental concern pursuant to:
15A NCAC 0 1 1 ` 1 1 �"—`-' `� ❑ Rules attached. General Permit Rules available at the following link: www.dm.nc.gov/CAM/vines
Applicam Name Authorized Agent e,:X / / 1:P.
Address I Project Location (County):
City6po,116S Sace L ZIP Street Address/State Road/Lot #(s)
Phone #
Email F
Subdivision
n
City
Affected CW [RCW gkA ©ES ❑ PTS Adj. Wtr. Body (n .Vunk)
AEC(s): �❑ OEA ❑ INA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body a[_ILQ
ORW: yesfno 7 PN 2 /no 1� 1r f ,
Tvae of Project/ Activirirr t' P� T �J �L—� L1 T t'LSh
Shoreline Length
Access Length
Pier (dock)length
Fixed Platform(s)
41LIz,unr,f.n.d
Floating Platform(s)
Finger piers) 2) )Ii,� 3%% 1
Total Platform area
Groin length/ri /
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ram
Boathous Boatlift %
Beach Bulldozing .�
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zoning F
Permit Conditions L_A
yes r.O �fy/
yes
`1/
s n
no `(
ni may be required by: —
Agent or Applicant PRINTED Name
(Scale: N V )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature "Please read compliance statement on back of permit" Signa4tuTe T
Application Feels) eck r#/ oney Order Issuing Date

AGENT AUTHORIZATION FbR CAMA PERMIT APPLICATION
Name of Property Owner Req
Mailing Address:
Phone Number:
Email Address:
I certify that 1 have authorized
Agent/
to 'act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: E IX 75, N er I,9X 1 a' Gave nee
41
Cte c.hf tl`qj 5-ICA I %un
at my propefty located at
in. (L M I A LI) County.
I furthermore certify that l 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 lnia nnation:
0 wy)e r
Title.
�11 2 , A _
Date
This certification is valid through l

H'C. DIVISION OF COASTAL
ADJACENT RIPARIAN PROPERTY 0111MOR
FORM
.(Top portion to be completed by owner or their agent)
Plana of Property Owner: r) w C I D) e b
L` !� /Il
Address of Property: 1 n u v Y L c iP �i 1 fic) FJ ► t�i /� G
Mailing Address of Owner:
Owner's small: eV 2f 11 i1.cl r� i 115 k�1i Owner's P one#: _ M� 2- 4-/ 1 ` 5- S&S
Agents Name: EnQdf M(Ii'1 n C( 1��7T u6f 4gAgent Phane#
Agent's Email: C'11f�Ci�7Y1G11 G6o4roc° ,),45,CYYLQi CaYYj
v
ADJACENT i'.IP,ARIAN PROPERTY OWNER'S CEPTIFICAYION
(Bottom oortion to be computed h r the Aaktigg Progprtrr Otvriar)
I hereby car* that I own property adjacenf to the above referenced property. The individual applying for this
pannit has described'to me, as shown an the _descriotian o drawlna Adih dimensions must be provided redv wing, the development they ere prapcsing, e
h this letter.
CP I DO NOT have objections to this proposal. t DO have objections to this proposal.
if you have objections to wrhat is being pvopased, you nrusf notify the Iv DDtvlston of Coastal
Management (DW In vatting within 90 days of rece7pt of this notice, Copnasp;;Zance should be
malled to 400 CommerveAve., Morehead City, HC 28587. DCM representatives can also be conlacted
at 052).808-2808. NO response is considered the some as no objection Pr you have been notiRed by
Cartitied Mall.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
ss waivby me
ka groin must be set back a minimum distance of 16' from my area of riarian access
pad unle
�tlt (finis does not apply to bulkheads or dpmp revetments). (if you wish to waive the setlsack, you m s n
the approprlate blank below.)
J I DO wish to waive somelall of the 15 setback
-OR- Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (Initial the blank)
Signature of Adjacent Riparian Property Owner: —y c 7 !✓ ..L--
�j)mT )� lypedlPrinted name of ARPO: Y''1. v.i"�,' `T)a 4w--v- , cL
k� o� Mailing Address of Ap": i v 5
5e ARPO'ssmall: n:atr:-e,3=.��4 :%zc. ,�.-,
Date: c i 2 7 r a � 'Waiver Is valid for up to one your from A ftpo,s aigmature*
Revised July 2021