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Shoreline Length.-t-
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6 j
floitSngPlatform{sj I51rj�s
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777
Pieper piers) � ''-�-°'$ � {-"� `o �r"� � •' ! : } (' w,� �, � i:: � � `~' {{
Total Pla2larrfl ar!], , . . SM ti . f - ., .�[4 f ..I ' {,.,, rif H-�'��
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BreakwSier/siEl .;• p E _.} .F=.- � j �' i _i�.,1 p,llld
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t+lazdatarrce/length Basin, chinnel r { ' 4 L t
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Boat ramp h
Boathouse/BoatG. r { { P c
BeatlrBulidoiing + �r �a "
f^tea i tltltl a i !i i .ji i
717
SAV observed 4 M--�
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Site�Photo$ _ i
RlpariSnWaiver ,Attached: (�Yes h;•
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EUS,
UPPER drcle nc
�T .AMEN E18. ( )
i d ARjP
A building permit/ionfn6 Permit may requ rg
DermitConditions ' See.noteanback 'regardingAhrerBasinruks .
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a. Sqe adtiltionni notes/condidons on back
.ESANDCONDIT1bNSTHATAPPLYTO'THIS.PMEC7•ANE.REVIE%VFD UANCESTATEMENT leiacilrliilaija
Permit OEE YEljEla
ton back o! pefm t• • Sig VT
�o.`0(%Sr4(ik%c❑'LAMA ❑ DREDGE & FILL
GENERAL PERMIT
n New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
Na 87401 A B ,.c:,
Previous permit
Date previous permit issued
l
As authorized by theStateof North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC nor- h I Lao ❑ Rules attached. L I General Permit Rules available at the following link: www.dea.nc.Yov/CAMArules
Applicant Name P ✓1 ^ h ( a a :q l . n U Authorized Agents l '
Address —LOA Project Location (County): ^ �� c (L_L_•
City ^ e u C— State k) C ZIP 2 Street Address/State Road/Lot #(s)
Phone # `74 ZZ l � '1 rJ �-
Email u .5.l -e —.C('✓" Subdivision
T�•
City t S• e- c ZIP
❑ ❑ ❑ Ad Wtr. Body �' rwnk
Affected CW � PTA ES PTS 1• Y ` r ( )
AEC(s): ❑ OEA IHA UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body t ^ 1 t J `• li l�d
ORW: yes/no;; PNA: yes,Nnoj
Type of Project/ Activity i
(Scale) T S
Shoreline Length '!' %tJ
Access Length
i
Pier (dock) length
Fixed Platform(s)
I
Floating Platform(s) to
`
i
Finger
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
_'
..
_.
�w_._.
.
Breakwater/Sill
I
Max distance/ length
Basin, channel
Cubic yards
_.
__.
- .(
.........�-._._
Boat ramp
Boathouse/ Boatlift
Ink
J"^
Beach Bulldozing
i
Other
SAV observed: yes
j
• r s"
Moratorium: n/a yes
Site Photos: s)41
Riparian Waiver Attached: yes no
1
A building permit/zoning permit may be required by: n
r `.
z. C tA
41 ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions i — —%v t (
�,, ,1
�.. c-� �hc .�. a
❑ 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 **Plea read compliance statement on back of per
Signature
Signature
Application Fee(s) 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:
F] 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: 252-247-3330
(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: 252-948-0478
(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: 910-395-3964
(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: D-&Yl n
Mailing Address: PCB 8y
W 0Yiro-P,
Phone Number: 76 if Z2 j � � d o -7
Email Address: G »�1� 5 e� q o5r� e y, Go m
I certify that. I have authorized ��""Y'1 c� V, 5T r UA(okl
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Rc°r�%ce %u,mih „n,
Y'G__j2 GI Y�� _T � d a � � �Gi � o G l �
at my property located atD
t
in hS to)c� County.
l furthermore certify that I 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.
Properly Owner Information:
//Signature
_DeNhi s
Print or Type Name
Title
Date
This certification is valid through -_____1 !'
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 Owner: L3 kc� N bX-1 u f i(- 2$ j I
Owner's email: Owner's Phone#: I C)'--\ 2 Z - L\ 3 5�
Agent's Name: Gr` (-k J'�}�1��� Agent Phone#: 0 5-1 q WAS
Agent's Email: \>-�c,-,Ckci Uk Vig RZ ML ► I1-cI
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(13ott9m portion to be completed by the Adlacont 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.
r\ ► �u 1 I DO NOT have objections to this proposal. I DO have objections to this proposal.
N you have objections to what Is being proposed, you must now the N.C. lvJa on of Coaata!
Management (DCM) In writing within 10 days of rwolpt of this notice. Correspondence should be
mailed to 127 Cardinal Drive EXT, Wilmington, NC 20405. DCM reepr~tatives can also be contacted at
(910) 79&7215. No response Is considered the same as no objection If you have been notified by
Certifled Mall.
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 15' from my area of riparian access unless waived by me (this
does not apply to bulkheads or riprep revetments). (If you wish to waive the setback, you must sign the
appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature df Ad/scent RI rlan Property Owner (ARPO)
let —
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of AR
Mailing Address of ARPO:
ARPO's ARPO's Phone#: 910 f"n l.e 3-A1
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER 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 Owner:
Owner's email: (�� Owner's Phone#: i �� Z Z - L13 5y
Agent's Name: Agent Phone#: GAu 5-1 cA QIWAS
Agent's Email: \,�N c-,, - ACA qt- C-A �t�; Q.T �L ► (l Q �j
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom oortion to be completed by the AdjocentPropert w r)
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 prpposing.
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 notdy the N.C. Divis on of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
malled to 127 Cardinal Drive E)M Wilmington, NC 28406. DCM representatives can also be contacted at
(910) 796-7215. No response is considered the some as no objection If you have been notified by
Certified Mall.
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 sign the
appropriate blank below.)
I DO wish to waive some/all of the 15' setba I y, �,I Q1e4
-OR-
Slane of Adjacent Riparian Property Owner (ARPO)
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
\,-� VScCQ�4
Typed/Printed name of ARPO: �a ku it e-Affi l f G t ko
Mailing Address of ARPO: 1,30 quA�1 s3f• A P,30� D t,,4 ', 04 `
ARPO's email: k4 C kt G r r' l ► cA F % ARPO's Phone#: ?D 4
Date: �PLZ- "waiver is valid for up to one year from ARPO's Signature //7
Revised May 2021
to
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Data Rwelved
Date Deposited
Chack From /Name
Name ofP-mM Holder
Vendor
Chocknumber
Check
amount
Partnh Number/Comments
Receipt or Refund/Reallocated
Columnf
Column?
Cdumn3
Cdumn4
Co1umn5
Col—aff
Cplumn7
CalumnO
Calumn9
8/23/2022
8/25/2022
Rags Signs & Graphics LLC
Sunset Cove Enterprises LLC
Suntrust
25142
$ 200.00
GP #87632D
BH rot. 17707
8/23/2022
8/25/2022
Byron Lee Tedder
same
BB&T
652
$ 600.00
GP #87672D
JD rct. 17753
8/23/2022
8/25/2022
McPherson Marine Services
Gore
First Citizens Bank
5370
$ 200.00
GP #87620D
BB rct. 18088
8/23/2022
8/25/2022
Grice Construction
_
Gosney
Truist
11298
$ 200.00
GP #87401 D
BB rot. 18093
8123/2022
8/25/2022
Paul Blackwell Conway Jr.
same
Wells Fargo
8598
$ 200.00
GP #87699D
BB rot. 17929
8/23/2022
8/25/2022
John McClure
Floyd Family Properties
United Bank _
1190
$ 400.00
GP #877001)
BB rot. 17928
_
8/23/2022
8/25/2022
AMW Docks & Marine Construction
Lisk
Truist
7342
$ 200.00
GP #87437D
BB rot. 17934
8/23/2022
8/25/2022
Rhonda Curies McCall
Floyd & Linda Francis Rev Trust
Bank of America
1142
$ 200.00
GP #87697D
BB rot. 17931
8/23/2022
8125/2022
Rivers Edge Golf Club, LLC
same
Truist
63179
$ 400.00
GP #87425D
BB rot. 17932
8/23/2022
8/25/2022
Permit Pals
Furr
CresCom Bank
3817
$ 200.00
GP #87408D
BB rct. 17926
8/23/2022
8/25/2022
McPherson Marine Services
Hunter
First Citizens Bank
5417
$ 200.00
GP #87427D
BB rct. 17935
8/23/2022
8/25/2022
John McClure
Bruner
United Bank
1191
$ 200.00
1 GP #87426D I
BB rct..17933