86686A_Hall, David & Christie_20220802

IS*WAS r"Z MCAMA ❑ DREDGE & FILL N° 86686 (A) B C D
GENERAL PERMIT Previous permit i
f Date previous permit issued .0 h
❑ 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:
15A NCAC ❑ Rules attached. 0 General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City State ZIP
Phone # (_ )
Email
Authorized Agent
Project Location (County): K
Street Address/State Road/Lot #(s) t: 2'!�* ? f d cl 0 3 16Q� cD
Subdivision t
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (pat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/rio
Type of Project/ Activity
Shoreline Length
Access Length
Pierjdock)length
Fixed-Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length I
Basin, channel t
Cubic yards i~
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other i
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
(Scale:: )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
i
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL YI1NACiENT
AGENT AUTHORIZATION FO1W
RECEIVED
Date r� ©� a o 1 U L 2 6 2022
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beMK for the parpow of appip" for asd ebftmin s!t CO" Peralit seoemry to
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■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article A_d/dressed to:
Bio
pC). BC)x Say
V,toj l l- jcc e, Op `15 7 97
111111111111111111111111111111111111111111111
9590 9402 4582 8278 8025 12
2. Article Number (Transfer from service label)
A. Signa
❑ Agent
❑ Addressee
B. Re ei by (P ted e) C. Date of Deliver
- -- 1 - - h ,
D. Is delivery address diffefent from item 11 U Yes
If YES, enter delivery address below: ❑ No
RECEIVED
JUL
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered MailTM
❑ Adult Signatur�R ery�
❑ Certified Ma lC i
egistered Mail Restrict
livery
+
❑ Certified Mail Restnc�stl a ry"'
etum Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
❑ Signature ConfirmationT
❑ Insured Mail
❑ Signature Confirmation
❑ Insured Mail Restricted Delivery
Restricted Delivery
PS Form 3811. July 2015 PSN 7530-02-000-9053
Domestic Return Receipt

N C. DIIASION tt� Ca4S7�. �
ADJACENT RPARL40 PROPERTY 0VWM R C^TtONAMArA R FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be c mVlefed by owner or their agent)
Narne of Property Owner
Address of Property.
,r,i 1,, c- ( • &I i
t # 94) -3q
j;//10 If 2OAV
kla" Address of Omm.. 519tw e
OAS e
Agents fine[ t.� l /,n e- XP7 C Agm t Pborret: sd - 33
AmWsEmat t,/t'r,L�r�/�!a / j�jy1�1/. 42ni
MMACBff MPA MM PROPERTY OWNER'S CERTIFICATION
{Bottom portion to be completed by the AdWSMA Property Off)
I hm by cw* brat i own property ajacertto the above rebmvmd prop uiy- The m vrdual' 9 for this
perms has described to rue, as shown on the attached drawing, the deveWpTmt they are preposh9- A
objectlons W NS prolr 4 F -
►f you have objections to what is [ham Prapoad ItW mmt the AM Division of Coastal
(DCN) In WX10g Of I Is t"s of -ev*t ofth nctk*. oe shorid be
wed to 401 S. &Wm St, SJ& 304 aftmWa City, lam, 2911 : DCU --IF — can also be
corrtac'rrdat (25a 264.3M. Illo response is considered the same as no action Kyou have been
notified by Car~ MIM&
t Undrastand that any proposed pier, dock, rrmoring PW09s• boat raffnP. breakwater, boathouse, K or
grain rust be set bade a n**marr disbinee of IS! fnxn rrry area of riparian access uniess waived by me
(this does not apply to bulkheads or nprap (if you wish to waive ,you must sign
the appropriate blank below.)
1 DO wish tip waive somelall ai the 1 S setback
S0relure of A*smnt Ro PmpaW Ow
x-OR- RECEIVED
1 do not wish to waive the 1S setback requirement (� the �
Sigtrabune of Adjacent Rsparian Properly Owner_
J U L 2 6 2022
TypedlPrkvW d name of AM): "CM -EC
litaikM Address of ARPO:
AIU2&t W -,-- ARPM Ph--mW&
Dabs: 'lraiver is valid tow ups to one ysarFrom ARPD's Sew
eu 6Z bn► - -4v L urn G"lP.� f??(.l�: �t e' a Jrdy 2(iz'
D. BOY 11 v15
rl;z. e k� 1, C_ a r? �D�

RECEIVED
JUL 2 6 2022
DCM-EC
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