Sloan, Larry 88628C

(JIE
AMA ❑DREDGE & FILL N° 88628 A B( D
PrevNERAL PERMIT Date uevious t
Date previous permit issued
ew ❑Modification []Complete Reissue []Partial Reissue
As authorized byy/ the
l!State North Car�olin/a,�r'� p(Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC � ctiz ❑ Rules attached. General Permit Rules available at the following link: wwvvdeq.nc.gov/CAMArules
Applicant
Phone #
Email
Authorized Agent I_
Project Location (County)'
Street Address/State Road/Lot #(s)
City
Affected ❑CW _A&W PTA ❑ES ❑PTS Adj. Wtr. Body (n��ia unk)
AEC(s); OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. Wtr Body iC
ORW:ye� PNA: ye to
Type of Project/ Activity
Access Length
Pier (dock) length
Fixed Platforms)
Total Platform are
Groin length/#_
Bulkhead/ Riprap
Avg distance offsl
Max distance/ length
Boat ramp f
Boathou /Boatli
Beach o
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zonil
Permit Conditions AID
1
yes no
Sin
YL, cblA
❑ TARIPAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
notes/conditions on back

°`°"'" CAMA ❑DREDGE & FILLQG NO 88628 A B�D
GENERAL PERMIT Previous permit
Date previous permit issued
New ❑ Modification []Complete Reissue ❑ Partial Reissue
As authorized by the State f North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC L �` , ❑ Rules attached. General Permit Rules available at the following link: wwwdeq nc eov/CAMArules
Phone #
Email
Street Address/State Road/Lot
Subdivision
City ZIP
Affected ❑ CW �'E* PTA ❑ ES ❑ PTS Adj. Wtr. Body __ k
AEC(s): ❑OEA ❑IHA ❑UW ❑$PIMA ❑PWS Closest Mal. Wtr. Body
ORW: yeo PNA: ye6p
Type of Project/ Activity
Shoreline Length U
Access Length
Pier (dock) length
Fixed Platform(s) �
•J `+ �- ��'� 1
N
r'
Floating Platform(s)
Finger pier(s)
Total Platform and
Groin length/k
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathou / Boatli
Beach
other
SAV observed:
yes no
Moratorium: n/a
yes
Site Photos:
'm�'
Riparian Waiver Attached:
�jres')
A building permit/zoningper may be required
by: _
Permit Conditions
Q) 4L —P—)(n
�M /
VIt�,S1V�
It
D, )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back

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/ 1-888-4RCOAST 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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT AUTHORIZATION FOR T MIT
• t
Name of Property Owner Requesting Permit: (iL',rrN S (0'0+ lsv—
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
U r 1'n, � `C �P ee G-
-C
19-U���3
Agent /
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: j e)�"U nGJ
at my property located at 0��—
in 0r-rFOr(l- County.
1 furthermore certify that 1 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
1 Z?I ZZ
Date
This certification is valid through 1 2 i /_ a :5
RECEIVED
JUL 112022
DCM-MHD CITY

141
l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Zer. r � to-4— 's
;� �✓� � � (Name of Property Owner)
property located at �� 3 I�
Address, Lot ,��B��Ippck, Roa etc.
on �/� 5ci ( in tii�-1 Z74,& b ee-e� _, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to 'on.
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)
rO,. ,de eF
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.
(Property Owner
Lc� Sf0a1-\ Sr
Print or Type Name
(y `'�) l7v✓ el"
-27-Z
Date
-a3� 3
(Adjacent Property Owner Information)
1LI-)�2
M
19
ED
JUL 112022
(Revised 611812012)
DCM-MHD CITY

�i
r

r+`
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:
Address of Property:
I,0 3 -j�) t, „ c it t- I c h r , c O t 2'2!SI y
Mailing Address of Owner:
v I Owner's email: jI -+ t-� �t �� /ny� Owner's Phone#: l� `� t1
Agent's Name: rM;P_ 2GM-1 Agent Phone#: 2 S
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 forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
I 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 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 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' setbac
Signature of Adjac45 HIParign Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: IVNIv
Mailing Address of AR\\PO: u
ARPO's email: 1l CJC \C`y y- L' Z Z ARPO's Phone#:
C�- c '-- vA .c , � I .-
Date: �= -� l z2 *wai sr is valid for up to one year from ARPO's Signature*
Revisftww D
JUL 11 2022
DCM-MHD C{Ty

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