Danyel, Demsin 88690C

e��`°"'"❑CAMA ❑ DREDGE & FILL NY 88690 A B= C D
GENERAL PERMIT Previous permit
Date previous permit issuedIz
----
❑ 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 I❑ Rules attached. d General Permit Rules available at the following link: www.deq.nc coy/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
Authorized Agent ,� Ir i I L(i ' i. { -
IP iT
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected `I, CW ❑ EW ❑ PTA 4 ES ❑ FITS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length'T"
Access Length--
Pier (dock)length;
Fixed Platforms) e
y
tJ—
-.
- -
i
_
I.
-j
_._
__
_
��
r
-
(
-
-
_'._
Floating Platform(s) �'�--
Finger Piers)
I
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill -
Maxdistance/length "�'�"-
Basin, channel
�.
Cubic yards
Boat rampLA
- -
_�.
-r
T
I
_+—
I
I
�(jj}�
1—
f
I!
f�
i
I
—
-
—
i
-
-
r --.
_
j
- -
- -
v
I/^
-
1—
_
.1`-j-
-
----i-
-
Boathouse/ Boatlift
Beach Bulldozing
Other
'
I
(
-
TaYI�
�-
I
I
I
I
f
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
RiparianWaiverAttached: yes no
-
i
1
/
-
---
-
A building permit/zoning permit may be required by:
Permit Conditions
❑ TARTAM/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)
t
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit'*
Feels) Check #/Money Order
Signature
Issuing Date Expiration Date'

oad'Ce"r"'%❑CAMA ❑ DREDGE & FILL N° 88690 A B C C
1 I GENERAL PERMIT Previous 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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City State ZIP
Phone # (� )
Email
Affected t CW 4 EW '�D PTA ES ❑ PTs
AEC(s): ❑OEA ❑IHA ❑UW MSPIMA ❑PWS
ORW:,yes/no PNA:yes/�o' :
Type of Project/ Activity
Authorized Agent
i
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Mal. Wtr. Body
i
Jcr.ln• 1 _._
Shoreline Lengthr
Access L
47:-�i
I_
A
Length
z
}
_
`
_k
✓
/T
Pier (dock) length f \ i,��
4` I r
-
I
�
—
-
i
i
i
i �
�
—"
3 "
....-
i
I
I
Fixed Platform(s) I
y
`�
`5
F--
...a.-
—i—
Floating Platform(s)
�_
r
—
Finger piers)
�1
Total Platform area
Groin length/#
Bulkhead/ Riprap length
I-
I—
Avg distance offshore -�--
—---
-
--
—
-
-
-j-�-—
—
—�
—
—
Breakwater/Sill�F—
Maxdistance/length
Basin, channel
Cubic yards
Boat ramp -Il-
Boathouse/ Boatlift
I
I
Beach Bulldozing i
Other
SAV observed:
`
L_
{
yes no �
Moratorium: n/a yes no
Site Photos: no 1
Dyes
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 Fee(s) Check#/Money Order Issuing Date Expiration Date

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:
Mailing Address of • - ..</r 1. / LIL.'
'�' y� ir•.� %.Agent Phone#:.' ..
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that 1 own property adjacentto 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 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
1 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 wai a the setback, you must sign
the appropriate blank below.) . /�
100 wish to waive some/all of the 15' setback��CL
'Siure ofAdjaceipe an PnaertyOwner
-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: (YI tB 11~S<
Mailing Address of ARPO:) P,O , Pxl k ! 11C r'�Zlii r•k,�+' (�' r�+ L }7,r 7
ARPO'semail:%U✓I�-/r1�T2'�ir'i,.,�N�ii�t<rs.I�ARPO's Phone#:
Date: J'r 3!', 9-0,4'u — 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

DIVISION OF ••
R ♦! iR iL i i !�
Name of Priumny Owner
Z -
PROPERTYADJACENT RIPARIAN OWNER'S
♦ . ♦ a x
- - ♦ - a♦ a � f f. y
' 't. At. 4 ♦♦ AA ff ♦�: �ti
f � ! } f fa x i 4 ♦ f x f.
i x r fx i s e 3 f k ♦, f
♦ t f of t f _ •.f
WAIVER 8ECTION
f ♦ # ., 1 4 _
i i R. � Y
t f•
S gndfure of Adpacen(Mparfarr owner
•iaA-
I do not )man to w" the W sedwk mque'ermnt (m"t the t tank)
Sign#tute of Raiamit Rt andn Pmpan Owners / tag. �,c Vrg , ttv -4 I OA- pecs,tt04
Typ•dlPrint•d nomo of ARPO. 1Nmp 7% ,lam cc — r txjF`C fJa
Malltng Address of ARM .2yY s -7 t, '....
aRP91s •mmtll n��<t 4A� b�g. c, . ARPO's Pnono#;9/
Oats; v 1n20 _'walyr Is mild for UP to on• year from ARPO's &lgn#tur•*
Revised My 202 1