87787D - BISTARKEY

'3oNd,cauV DCAMA ❑ DREDGE & FILL Qom" A:r,�9 87787 A B C: D.
Previous permit
GENERAL PERMIT f
a-F-1 i ap� ap� 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:
I SA NCAC %' ` �-1 Rules attached. a General Permit Rules available at the following link: www.dgg.nc.gov/CAMArules
Applicant Name (= r, '' S ` i t ° r ', Ct Authorized Agent
Address �! e` ` ) ` J ^ �� Project Location (County):
Citp State <. zip �' U Street Address/State Road/Lot #(s)
Phone#(�)`1 Z `l�3
Email
Subdivision
City
Affected CW EW PTA ES pTS Ad!. Wtr. Body (nattman/unk)
AEC(s): ❑ OEA IHA UW SPIMA PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:0 'r s )
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
Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: yes
A building permit/zoning permit ma,
Permit Conditions
C `
❑ 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. _,lease 1 itial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature /
IZ- fI J-LZ
Application Feels) Check #/Money Order Issuing Date Expiration Datle

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms riiay
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:
F1Tar - Pamlico River Basin Buffer Rules F-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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

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Tracking Number. 70180680000146604979
Your item was forwarded to a different address at 1 1,25;anj on July 5, 2022 in ALSEMARLE, NC.
This was because of fo"arding instructions or because the address or ZIP Code on the label was
Incorrect.
USPS Tracking Plus6 Available N/
Forwarded
July 5, 2W2 at 41-25 am
ALBEMARLE, NG
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Subloct: '33 Faifmonl Str"t CIS eoaowl apFfoval
Date, J%jly 8, 2022 at 1036 AM
TO: diannoiluds-rdl'aatY.n-1
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Dime fhb is Pick. we. -Jot Ar`AW DOCKS in Of NC
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my gmv.cnr, pirnoe call Bad;
77 G-0r1',-0CZ8
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1701 04 ttzee court sw
016 NC 28469

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USPS Tracking'
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Tracking Number: 70191640000076002287
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Yotcr item was delivered to an individual at the address at 4:07 pm on June 9, 2022 in SAUSBURY,
NC 28144.
USPS Tracking Plus Available
Delivered, Left with Individual
.June 9, 2022 at 4:07 pm
SALISBURY, NG 281,14
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N.C. DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFiCATiONIWAiVER FORM
CERTIFIE II}T REQUESTED or NAND DELIVERY
(Tap portion to be cortipieled by owner or their agent)
Name of Property Grevner: ai1
,,Wdress of Property: ,m; . , ? o"
faf.3"'ling t�iidrew ofOwner Owner's email; Owner's Phone#-,
Aqent Pho[`o*. Z",L=a c,. , r
Agents Erttwl: f fi _l , ;•� • 4 r;y ' t,°1 :i C'' = >' i.r_ �•'`ea �
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom porlion t4 b� coml�lctcd �y fho Aeliacent Protarsrt�r Olwner)
I hereby certify that I own properig edjacent to the abo e referenced property. The individual appiyirag faT INS
parrlkit has described to me, as shpassn an the attachad drawing, via devetopment they are proposing. A
AarrriniLnn nr Fir win a with dirr'i@11Sions, anusl be'iyov!,Ofzrt'r�i`h thiG Ii tfKr
LSO NOT have oir,Lcdons to this proposal..m � I DO have objections to this proposal.
if you lave icctions to what is Ztirrg ,pr6posed, you r€ru-qt notify the /Y,C. 9lvxsion or cvasrar
Management {LLCM) in,writing within 10 days of recelpt of this notice. Correspondence should be
mailed to 127 Cardinal Drive Ext.; Wilmington, NC 28405.3845. DCM representatives c.4n also be
contacted at (910) 796-721 ► No rosponse is considered the sarnca as no objection if you have boon
notified by Cardrrad Afaif.
WAIVER SECTION
I understand brat any proposed pier, dor,h, nacoriag pitings, that ran)p, breakwatca, boathouse, lift, or
groin mast be set back minimum distance of '15' from MY area of 6 asian access unless waived by me
(this dues not apply to bulkheads of riprrap rep: etrivents). tit you i.visli to waive the setback. voci must isiin
Oe appropr�ate blan' te:otiw.3
100 wish to Nvaive son1clall Of the 16 sc=c1s-
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Sr'gr atcrrc o Aqj, cWR -r,9era,arr pnvday ►vher-
I do not wish to vvaiue the 'la selbaCk reglrirement (initial the blunk) '—'4
77,
Signature of Adjacent Riparian Property Ot,-,nvs:-
TylsediArirrted name of ARPO:
Malting Address of ARPO: ' � 4a-1\II 041
ARPO's ernail. T: '1 d'1�'� ,S Y4..ARPO's Phonettd i
0aIe:a 13 "waiver Is valid for up to one year from ARPO's Signature
- - - - c Revised � my 2021

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PS. Form 3811, July 2020 PSN 7530-02-000-9M
0 Priority Mail Express
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a Signature ConfirmationTM
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Domestic Return Receipt

Date Received
Date Deposited
Check From (Neme)
Name of Permit Holder
Vendor
Check number
Check
mount
Permlt Number/Comments
Repelpt-R.1—IRea11oeated
Columnf
ColumnY
Cp1umn3
Cohmn4
Co1umn5
Columns
Column?
Co1umn8
Column8
7/27/2022
7/28/2022
Gregory Holden
Polatsek
United Bank
5639
$ 200.00
GP #85956D
PA rct. 17956
7/27/2022
7/28/2022
John McClure
Dills
United Bank
1104
$ 600.00
GP #85760D
PA rct. 17962
7/27/2022
7/28/2022
American Marine Construction Inc.
Horseman
First Citizens Bank
89783
$ 200.00
GP #85768D
PA rct. 17957
7/27/2022
7/28/2022
Vann Dean Construction LLC
Bryant
First Citizens Bank
1573
$ 200.00
GP #85767D
PA rct. 17955
7/27/2022
7/28/2022
H5 Construction Services, LLC
Hall
Truist
0144
$ 200.00
GP #85769D
PA rct. 17958
7/27/2022
7/28/2022
Tommy Earnhardt
same
Uwharrie Bank
6098
$ 200.00
GP #85774D
PA rct. 17963
7/27/2022
7/28/2022
Devane Family LLC .
same
First Bank
1529
$ 200.00
GP #87623D
BB rct. 18080
7/27/2022
7/28/2022
AMW Docks & Marine Construction
Bistarkey
Truist
7301
E1528
$ 400.00
GP #87787D
BB rct. 18082
7/27/2022
7/28/2022
James Godwin II
Godwin
First Citizens Bank
8975
$ 200.00
GP #87652D
JD rct. 18110
7/27/2022
7/26/2022
Southem NC Marine LLC
Oldham & Jade Holdings, LLC
First Bank
1535
$ 200.00
GP #87653D
JD rct. 18111
7/27/2022
7/28/2022
SouthernNC Marine LLC
Windham
FirstBnk
$ 200.00
1 GP #86061D
JJD rct. 18073