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1COW41 CAMA F-1 DREDGE & FILL NO 84463 A B c D
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3 GENERAL PERMIT Previous permit
2
Date previous permit issued
[New F-]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. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name �� � ' -� < LU w4A 15
Address 40& INC 596,e,
City WEN ,S'�6u /V�S State � ZIP
JV
Phone # (`�} Q
Email
Authorized Agent ( S -q(o f (
Project Location (County): �Ttktf
r
Street Address/State Road/Lot #(s) /J 19
Subdivision ,.------
City 5S(kk ZIP
Affected gcw FVEW IV PTA ES PTS Adj. Wtr. Body I A 04LL C w�' at man/unk)
❑
AEC(s): F-] OEA F]11HA 1:1 UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/ o PNA• a no
e of Project/ ` C
T
Yp Activity.
(Scale:
Shoreline Length
Access Length
g
Pier (dock) length x
Fixed PlatformsIhIKI-b-9 ❑ &
00
Floating C
Platform(s) � � W
Finger pier(s)%
Tota I I
Groin
Bulkhi
Avg di
Break,
Max d
Basin,
Cubic
Boat r
Boath
Beach
Other
SAV of
Morat
Site PI
RinAri
A building permit/zoning permit may be required by: (&A)
Permit ConditionsA�� t �%� SZ MA Q 574t MlbAM�
(50TOM br g150e [1\) (4 ff 0 j6CbS
[:] TAR/PAM/NEUSE/BUFFER (circle one)
F-1 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 R VIEWED COMP ANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signatur **Please read compliance statement on back of permit**
Z(�D(o 16 ot� - 1 56Z,
Application Fee(s) C ec /Money Order
Permit cerIs PRINTED ame
Signa
2
Issuing bate I WiratiA Date
Drawing Prepared By: C3 Scott, Inc
Date: 7/13/22
Scale: 1 ": 20'
Property Address
114 Bridgeview Lane
Stella, NC 28582
Property Owner:
Larry Williams
Proposed Work:
-Construct a new 41x70'
walkway with a 16'x16'
platform made with treated
lumber
-Install a new 3'x16' lower
kayak platform
Docky.
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AGENT AUTHO
RIZATION FOR CAMA PERMIT APPLICATION
Name of ProperlLy Owner Requesting Permit: / I fj
Mailing Address,
ti
+......-.��wn�widse.M�.cw.�,fiR 1 !*�TS .� .n �.f �sr:-.w�-.w. m�sa�u
Phone Number:
es . . .WR'M�A�4nVfY��l�Y4. 'CY.itfiiM M"ih�T�'siyN/ lbN.
Email Address,:
I certify that I have authorized C3 Scott. Inek.";
Agent / C
ontrac or
to act on my behalf, for the purpose of applying for ania' obiaining of GAViA permits
necessary fo-1, the flollowing proposed development:
at my prope .,r y located
in -.-4::2/11kj����.Countty,
furtheri-n7ofe certify. teal i ain authorized to grant, and do in fact gnanf perrnissiotj to
Division of Goasta/ Vianagement staff, the Local Permit C)fficer'9ndff7effage f 71'Sto enter
On the eforementioned lan(Lq in kconnection with evaluating information reiated to this
permit application.
Properly Owne-16- Information-,
Signa t t i re
-or Type Name
900
Title
�z � 1 *!2- RECEIVE D
Date
I
JUL 2 2- ?O?F-)
1) C M M H D
This certificaflon is valid through '9(3 -
ADJACENT RIPARIAN PROPERTY 01"E"—TALE..MENT
I hereby certify that I own property adjacent to A/
of Pro perty Owner)
property located at V
on !((AA dress, Lot, Block, Road, etc.)
ire 1 N.0
(C
Aial The applicant has described to me, as shown below, the development proposed at the above,
n i location.
...re on
le, of -,w� ..,L�Z— I have no o�jecfion to, this proposal,
ese I have objections to this proposal.
es
DESCRIPTION AND/OR DRAWWN G OF PROPOSED DEVELOPMENT
(IndividuaJ PrOPOSing development M"St rill In descriptior? b9low of attach a '
site drawing)
See �C�(A &Po-
WAIVER SECTION
I understand I t' iat a Pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set Dack a minimum distance of 15' from MY area of riparian access. unfess waived-1 by
tile. Ot YOu wisih to waive the setback
You must.initial the appropriate blank below.)
Sre on
I do wish tO waive the 15'c%etback re uirer,nent
)e of ?
ese
les.
I ------------------ do not wish to waive the, 15, setback '*Pquirernent
(Propel Owner of anti
(Adjacent P!?R" Owner for at
4F
si, a t it
ZAzi A/
.Print or YPe- lVame
Print o'yName
A n a A ddr, Aor"q•
' —
4ifiss Waiina-
A/
Address
� � RRECEI�— _ s
VED
llepfione Nurnt%er .1
rn il address
elenh one Number e. mai/ a- ddress
2,
tie * JUL 22 L
DLCM-MHV
ADJACENT RIPARLIAN PROPg.RTY
E N T
hereby certify that I own property 4jacent to
L
I nor
Narne of POw )
PrOPelrty located at //V roperty
(Address, Lot, Block, Road, etc.)
On
N, C
Materbody) (city/Town' and/or County)
The aplAcant has described to me, as shown below, the development proposed at the above,
tial
re on locatiDn.
to of I have no o4jection to this propc)saL
pese I have objo
ections to this posal,
es Pr
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEN T-
(individual prpposing developmenj must fill in desc 4
ription below or attach a site drawing)
St 4006t 44 XfOL
ALAIVER §g.CTION
I understand that a pier, dock, moorinq ifings, boat ramp, breaK'water, boathouse, lift, or groin
P
must be set, back a minimurn distance of 15, from
my a rea of riparian access unless waiv'--
i ti ai rne... (if yot,i wish to waive the coetback., You Must initia'l the aMropriate blank below, ed b.�,.!
are on I do wish to w1alve the 15'set1-.)ac*
le of requirement.
ese I do not wish to waive tile 151 setback
requirement,
(P Owner 19formation)
(Adjacent Property Owner Information)
.Ve n t�wv
Print or i 1�ne Name
1 10-
Print or TMe. tvarnp.
kctylsta�d,4affing Adress
iT�--o
Mi1i7i' t rp nA (eId- e,r
: ,mow-1s2sIc
VC—
CIAIIStatShip M VeD
C
Tefer)hone, Number email acldress
Te, ienhone Number/ email address
Date
U L 2 2 0 2 2
DC M-M H 01 IT,
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