87463D DODSON

ES PTS
❑ SPIMA ❑ PWS
°``°AMr"`� ❑ CAMA ❑ DREDGE & FILLG N9 87463 A e C ;'o
GENERAL PERMIT
)tr apt 1. 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.dgq.nc.gov/CAMArules
Applicant Name
Address
CityV il jil f State ZIP
O
Phone # (1� 1 `i ° I
Email
Affected ❑ CW
AEC(s): ❑ OEA
ORW: yes/no'
UEW PTA
❑ IHA ❑ UW
PNA: yes,('!'io
Type of Project/ Activity T
Shoreline Length Q f
Access Length-f,k,ST1r)
Pier (dock) length
Fixed Platform(s) h 4rt r
Floating Platform(s) FA)-1 `11,11 '{
A
Finger pier(s)
Total Platform area}41
uiu
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill ---
Max distance/ length
Basin, channel
Cubic yards -�
Boat ramp
Boathouse/ B6atlif( 11
Beach Bulldozing
Other
SAV observed: yes /{p
Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: yes no
A huildine nermit/7n6ine nermit may ha renuired by
Authorized Agent i,dl'C..�q
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City I ZIPlir
Adj. Wtr. Body / (halt(man/unk)
Closest Maj. Wtr. Body "'t'r�
(Scale jq'M )
❑ 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 Per fficer's PRINTED Name
/f/f�/%}y
lam`!';,
Signature "Please read compliance statement on back of permit" Signature
'1 1 (lid
Application FeelsCheck #/Money Order Issuing Dane 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:
F-1 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
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 Pender 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:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: of
at my property located at
in RCounty.
I furthermore certify that 1 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.
Prope y Owner Information:
O
Signature
I Print or Type Name
Title
Y I /'0 19
Date
This certification is valid through 1 1 0 I 23

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- RETM- U RECEIPT REQUESTED
DIVISION OF COAST_ L1ANAGEME�IT
ADdACY T RIP_AI AN PROPERTY OWNER MATE -MEN i
Name of Property 0%vner:
Address of Property: `,3 l e4ci h
Applicant's phone n:
(Lot or Street #, Street or Road; City & County)
Mailing Address:
�—
0-nx�,OLYY. c� a 7asA
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 of drawing
with dimensions must be provided with this letter.
I I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCIYf)
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Est.
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no ohiection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distance of
15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the
appropriate blank below.)
I do wish to waive the 15' setback requirement. � p� ©�1 y JV✓ S "qv
I do not wish to waive the 15' set back re uiremn. �, S 2f-AR-L (�
q � h �1�,4-
-7 3-- 7

•
~. Postage e &Fees Paid
USPS
5 L
Permit No. G-10
?8 0125 8682 65
• Sender: Please print your name, address, and ZIP+4® in this
w0ibg'- l'/k'7(—b"�p" c�
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT _ r -
1 hereby certify that 1 own property adjacent to
's
Property located at � (Name of Property Owner)
on (Address, Lot, k, Ind, a c.)
in ° C V h S
(Waterbody) -
N. G.
(CRWTown an or County)
The applic has described to me, as shown below, the development proposed at the above location.
1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAINING OF PROPOSED DEVELOPMENT
(individual proposing development must fiii in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish *to waive
the setback, you -must -initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. -
I do not wish to waive the 15' setback requirement.
(Pr erEy Owner I
Signature
- V
Print or Ty a Name
C_
Telephone Number
0 _
Date
Q
Y1\
(Adjacent Property Owner Information)
Sie
-01
PAW or typ ae me
Mailing Addr ss � � � h Try i l
YA
City/State/Zip
Telephone Number
ff
-2Z
Date
(Revised 611812012)

Date ReceNed
Data Deposited
Check From Nerve
Name of Permk Holder
Vendor
Check number
Cheek
emounf
Permk Numbedcomments
Receipt Refund/Realloceted
Columnl
Column2
column3
Column6
Column5
Columns
Co1umn7
Columns
Column9
9/9/2022
Richard Penny Construction, LLC
Cooling 1 of 2
NAVY FCU
5218
$ 200.00
GP #87640D
BH rct. 17717
9/9/2022
Richard Penny Construction, LLC
Cooling 2 of 2
NAVY FCU
5217
$ 400.00
GP #87640D
BH rct. 17717
9/9/2022
Kyle Dixon
same
Truist
5027
$ 200.00
GP #87681 D
PA rct. 17729
9/9/2022
Gregory Holden
Dodson
United Bank
5650
$ 200.00
1 GP #87463D
PA rct. 17730
9/9/20221
Jeffrey Maynard
same
State Employees CU
8254
$ 200.00
GP #87464D
PA rct. 17733
9/9/2022
Allied Marine Contractors, LLC
Bard
First Citizens Bank
11390
$ 400.00
GP #87726D
PA rct. 17731
9/9/20221
John McClure
Alexander.
United Bank
1151
$ 200.00
GP #87690D
PA rct. 17732
9/9/20221
Town of Wrightsville Beach
Isame
First Citizens Bank
121825
$ 200.00
GP #87465D
RM rct. 15508