87805_Theodore Wells_20220809

°`°"rk 11CAMA I I DREDGE & FILL No. 87805 A O C D
GENERAL PERMIT �1) 4 29 Previous permit
Date previous permit issued •
n New n Modification n Complete Reissue n 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:
I5A NCAC n Rules attached. General Permit Rules available at the following link:www.dea.nc.gov/CAMArules
Applicant Name Authorized Agent '
Address '!/vi Project Location(County):
City --g.. State ZIP Street Address/State Road/Lot#(s)
Phone#( 1)
Email • Subdivision
City ZIP
Affected n CW ❑EW n PTA ❑ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): ❑OEA n IHA n UW n SPIMA PWS Closest Maj.Wtr.Body •
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:
Shoreline Length .
Access Length
Pier(dock)length
Fixed Platform(s) I
Floating Platform(s)
Finger pier(s)
Total Platform area ;
Groin length/# •
Bulkhead/Riprap length I •
Avg distance offshore
Breakwater/Sill t —
Max distance/length
Basin,channel
Cubic yards
Boat ramp r
Boathouse/Boatlift • '
Beach Bulldozing
Other •
SAV observed: yes no
Moratorium: nla yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee 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
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie,Camden,Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

�oe°`C0�`kc I CAMA DREDGE & FILL �-� ` N9 87805 A B c D
3 ID �12c7
GENERAL PERMIT Previous permit
Date previous permit issued
New Li Modification Complete Reissue n 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:
I SA NCAC Rules attached. General Permit Rules available at the following link:www.deci.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#( )
Email Subdivision
City ZIP
Affected CW EW PTA n ES I I PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): I I OEA IHA UW ❑SPIMA PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length
Access Length
Pier(dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/St
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
Other
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 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
Application Feels) Check ft/Money Order Issuing Date Expiration Date

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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie,Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: T#n try atn ,e j oi'^ W e I IC
Mailing Address: Schooner (u yr#-
e H/ g en., Al c
Phone Number: ( 01— 3 -) 4 — 17 d 2
Email Address: Bud d n M e j i ( oft, [ cf s f, ii et
I certify that I have authorized Rive r R 4+ M urt nt
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: (o PI !tr s P 1 erg
9 /
Deck r-
at my property located at M O E c o c n e✓ (our+
in CrAVe n County.
i I furthermore certify that I 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 wnerrAned Information:
i/j/J
rc
Signature
leoJure BWeal MegA , CWeEC
Print or Type Name
Title
(a i 3 0 / Zoz%
Date
This certification is valid through I I

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. NJ; -ko[a S G-In r l Mel kW-4
Address of Property: (OI 0- Srinnn.n rr C nIQ..VJ—E€Yt\ N C2,8500
Mailing Address of Owner. (ptt2 Sckop,i'vzf CA-'N 2WB.evn ,N C 98dc0
Owner's email: (�I10. 5E'ja. o•CornOwnersPhone#:?52'"(o3l- 5(0I
Agent's Name: 1 Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adlacent 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`pt or drawing.with dimensions.must be provided with this letter.
X.
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. Con'espondence should be
mailed to 943 Washington Square Mall, Washington,NC 27889. DCM representatives can also be
contacted at(252)946-6481.No response is considered the same as no objection if you have been
notified by Certified Mall.
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
Signature of Adjacent Riparian Pm rty Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank))�j�� $p
Signature of Adjacent Riparian Property Owner: � j-intrav, i��J
Typed/Printed name of ARPO: Ntc)i1D\aS atcyst.eiv2sow
Melling Address of ARPO: (LA t. Sa^oonc.( Ck 1 v2W 9e YeN(VI C. ABS co
ARPO's email: P'ta 5 €k/Oko.(oMARPO'sPhone.e. (o31-S(oB
Date: (ol t"1`2.0 22_ "waiver Is valid for up to one year from ARPO's Signature
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL• RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top /portion� to be completed by owner or their agent)
Name of Property Owner. (�2 a .,-J F_ yo n der J J D t2 'f h l 114—
Address of Property: e i O$ Sc Ann n.0 r f 7r' 1i j,a�w+:1-1 )vim�S 4
P rtY� (
Mailing Address of Owner. (,Z00 Tr //� r C r rr �� { a Pl., Ate 17 1004,
cricket-hif@dovtttif, i2 bvz 3r �( z
Owners email: Owners Phone#: r(( �f
Agent's Name: Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adlacent 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.
y on 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 N.C. Division of Coastal
Management(DCM)in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be
contacted at(252)946-8481.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
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank) C
Signature of Adjacent Riparian Property Owner. C44 t.(4a- r
Typed/Printed name of ARPO: ell a r let"; E .P n u -f A l f
MallingAddress ofARPO: ( ic 2OD Tn- �/ ,rn Cl/ C I-a. Pa/eigl AI 6
C 2 7 O
cdorl-thi+cac/0'44- ,im b
ARPO's email: 'RPosPhone#: 01/ 6Uc2J 3 yZ
Date: (p l//2 2— 'waiver Is valid for up to one year from ARPO's Signature
Revised May 2021
,x