86652A - Askew, Lynn

,J O"rk RCAMA ❑ DREDGE & FILL N° 86652 A B C D
a Previous permit
GENERAL 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
Phone # (_ )
Email
State
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS 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
Access Length
Pier (dock) 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
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
(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
Application Feels) 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:
1-1 Tar - Pamlico River Basin Buffer Rules 1-1 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
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

DIVISION OF COASTAL MANAGEMENT
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND
I hereby certify that I own property adjacent to L S k a,
(Name of Property Owner)
property located
(project Site: Address, Lot Block, Road, etc-)
-A 7
on �', in 7
N.C.
(Waterbody)
Agent's Name #:
Agents phone #:
(Cityfrown and/or County)
Mailing
at
Address:
He/She has described to me as shown below the development he/she is proposing at that
location, and I have no objections to the proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(7ndh4dusl proposing development must rill In description below Or attach 8 site drawing
tf you have obj
ections to what is being proposed, you must notifythe Division of Coastal
Management (DCAQ in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Grdrin St_, Ste 300, Elizabeth City, NC, 27909. 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
(Pr?pyty own Information)
Signa
Z L<
Rint or Type Name
5_id 6
ka—ifirig Address
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A/
(Ad' cent Property Owner Info tion)
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Print or Type Name
Mailing Xd'dress
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Telephone Number/ Email Address
Telephone lvumberlErnadAddress -5 ate
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Date *Valid for one calendar year after signature' Rt:w%_&.1EiVED Revised Jan.
2017 J U L 2 0 202Z
DCM-EC

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to
property located at___,
on
(Waterbody)
Agent's Name #:
Agent's phone #:
% /� (Name of Property Owner)
o S / 0./C /Q 4� .f /�D/JGG► lL�/ //d i�/lP Cfi, A �i��/ A � / o�
(Project Site: Address, Lot, Block, Road, etc.)
in
(City/Town and/or County)
Mailing Address:
N.C.
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
---------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
J,<aC-7- A ff",x 'W
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252)
264-3901. No response is considered the same as no objection if you have been notified by Certified
Mail.
(Property Owner Information)
Sign,6ture
/_ X,,Al /'✓ �c e, ac�
Print or Type Name
Mailing Address
City/State2ip
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Telephone Number/Email Address
(Adjacent Property Owner Information)
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Signature*
Print or Type Name
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Mailing Address
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Telephone Number / Email Address
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