Hale, William 84491C

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14CAMA ❑ DREDGE & FILL � �__
GENERAL PERMIT Previous permit
Date previous permit issued
j9.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:
I SA NCAC �� , (�C� ❑ Rules attached. 5. General Permit Rules available at the following link: www.deg.nc.gov/CAMArules
I m lLLftU� Authorized Agent
Applicant Name ti g / "� `' ---� ------ -- _----
Address BAUi 9 ug6r Project Location (County): (�" ►��J
City 5Aq IjIF' State. ZIP Street Address/State Road/Lot #(s
Phone # ( ) � �} _
Email «' A)�" -Iv { Subdivision
City ZIP
Affected u CW MEW PTA ES PTS Adj. Wtr. Body f 1( t`, L—Ce
CM 9°u � (�a�}r'man/unk)
AEC(s):: OEA IHA UW EISPIMA PWS Closest Maj. Wtr. Body , SO
ORW:(yes o PNA: yes. o
Type of Project/ Activity (Cmsf vc 'C YIP- C>Ow O P ArF62-q r 600 �?;QATLIFr
(Scale:��� �
? ,w r
Shoreline Length ���J
Access length �'xl
r
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#- -- .... --- -- `` J✓`� _ - ,--''
Bulkhead/ Riprap length .-'�J1� V
Avg distance offshore ...-''- �-
Breakwater/Sill
Max distance/ length-1-1
Basin, channel
PCubic yards
Boat ramp
BoathouseOozing
E ��3 �% ,/
Beach Bull% �YES��
Other��
j NE C% r
SAV observed: t. e
Moratorium: n/a yes n
Site Photos: s n
Riparian Waiver Attached: b
no
A building permit/zoning permit may be required by: ��' "-'� ( Cl✓v t
y t ,/ 1 o!p r7,t,{ C.�,� � �7_�'-tA.;'& TAR/PAM/NEUSE/BUFFER (circle one)
Permit Con 'bons Lam` '� "° G.-'-' - l�L> I' �' �`
5L-W See note on back regarding River Basin ruses
...... ------------ ---- -- --- --- -- See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT_ (Please Initial)
nt er Atilant PRINTT N
SigNfature **M} asei-eaTcor%pliance statement on back of permit"
2�'qt 0 .
Application Fee(s) �ck # Money Order
Perrni i-icer'� PRINTW Nara—
Signatur
V/
Issuing to Exprratio Date

\1*°ECOAST41 V;CAMA ❑ DREDGE & FILL N9 84491 A B I/DC D
3 Previous permit'
s I G E N E RAL PERMIT Date previous permit issued _ -
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 IWV ❑Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name W U-1 AM HAU� Authorized Agent Ol"��o t� �-•��`6��
Address n Project Location (County): (I V" ►`-C�J Ir
City �(-[ State NC ZIP Street Address/State Road/Lot #(s
Phone # ( )
Email NV, Subdivision
City ZIP [A5'T`'/
Affected ❑ CW MEW PTA ❑ ES ❑ PTS Adj. Wtr. Body 1 �1[�Y� �i� %,v �' (�ta 'man/unl<)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
OR Dyes o PNA: yesAo
Type of Project/ Activity (QMSf &C7t �CerVR�k4 ..St f-P- C>VW N P lA rF6 4 �AWO SARI Fr
� (Scale:�.�s )
Shoreline Length 710
�
Access Length 5
1
x1b pVFb9V k,-A—� �,•n/ l } �v r
Pier (dock) length \
e �
Fixed Platform(s),1' �� ✓�'" \ f,� *` r
a
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length VJ
Avg distance offshore /
Breakwater/Sill ---- �
Max distance/ length T y
Basin, channel � �
Cubic yards ` ��J�� �
Boat ramp
~�
p ,(�/ ♦b
Boathouse oatli C7)1 3 „\ rL 4
Beach Bulldozing
Other
DIE
SAV observed: yeJ
Moratorium: n/a yes
Site Photos: ves Riparian Waiver Attached: es ` no %�, Q
A building permit/zoning permit may be required by: WV
' /.nnr, %D ��t� i C T4-��-.S ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Con 'tions D �'"/�IfUL 7 Gs�p
14v Z / 1 S P6 t� l/���e� (�L%1 ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND gONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
24( 0 - 00 Jw2
Application Fee(s) eck 9
Money Order
Per='ffiPRINT Na —
Signatur
Z
Issuing to Expiratioi4 Date

EIN/

N.C. DIVISION OF COASTAL MANAGENT
ADJACENT RIPARIAN PROPERTY OWNED OTIFICA ONIWAIVER FORM
ERT'IFIED Vl REIURN RECEIP`I R-QQUE8TED or HA D DLaL\ffiB
(Top portion to be completed by owner or their agent)
Name of Property owner: William C. Male
Address of Property: 175 Backshore Lane Smyrna, NC 28579
Mailing Address of Owner. 175 Backshore Lane Smyrna, NC 28579
Owner's email:
Agent's Name:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bolftm portion to be completed by the Ad"aeent 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.
I DC NOT have objections to this proposal. I DO have objections to this proposal.
if you have objections to what is bung proposed, you must notify the N.C. Division of Coastal
Management MCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., forehead City, NC 28557. DCM representatives can also be contacted
at [phone]. No response is considered the same as no objection if you have been noted by
Cerdfied 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 16 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 slam
the appropriate blank below.)
# wish to waive _ e
Signature of Adjacent Riparian Property Owner
.# not wish to waive the 15' setback requirement (initial the blank)
Adjacent"'ignature of Propertylm,/13
DeNi-Mil-ID CITY

AUG 3 12022
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