86062D - Smith

`WT41&NCAMA ❑ DREDGE & FIL C4��� N9 86062 A B C ($
GENERAL P E R M I'n Previoussous permit
� Date previous permRconcern
® New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue 46) r I dAs authorized/b'y�the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commiis`sion in an area of ennviro pursuant to:
I SA NCAC . LAM • ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name . yam' ..tea \v
Address C-C�'J Ul ,.2
City L,ut�lw Ir�'� State_ ZIP �qC< ,
Phone # (_ )
Authorized Agent
Project Location (County): _
Street Address/State Road/Lot
Email Subdivision \
City WKn�`tL& 13ejC1 ZIP Z'Poric
Affected ❑ CW Y-EW PTA ❑ ES ❑ PTS Adj. Wtr. Body %� y � (nat/rijWunk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body / � w
ORW: yes& PNA: yes4i7
Type of Project/ Activity
Shoreline Length t1 o
Access Length
Pier (dock) length
� /
Fixed Platform(s)
Floating Platform(s) �2 "- 24f "
pier(s)
Total Platibrm area
Groin lengt\oore
Bulkhead/
Avg distancBreakwaterMax distanBasin, chan
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes dfb f
Moratorium: n/a yes
Site Photos: yes Rinarian Waiver Attached: ves o J
r�"J7iC.�
❑ 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 STATEM T. (Please Initial)
Agent or Applica PRINTEDName_
Q
I
ure "Please read compliance statement on back of permit"ation Fee(s) Check #/Money Order
Permit
Signature *0
--F1 u( Ig(Zz
Issuing Date T Expiratio 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:
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 (9107796-7215).
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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven —north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 2.8405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Fender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home - Revised6/01/2021

30�0`°""4,&OCAMA ❑ DREDGE & FILL�7 J N° 86062 A B c o
GENERAL PERMITi3` 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:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)`
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity c: , ++ s ;� .• R sln:. <.'+c. �' ..
(Scale:
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/Sil I
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no 'm i
Moratorium: n/a yes 10-
Site Photos: yes
Riparian Waiver Attached: yes 160..•
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

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 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICA`lrI
Name of Property Owner Requesting Permit: rC y �1�� \1'1,
Mailing Address: � j W I-Yr`cic ��� Ui� (S�m mom" 0.C1d1e-55
�1,5 Fra fe t 14,` 115, -i) l-
Phone Number: 3g " 6 O j Cr l.i l j is n Srn � fee >r
Email Address: / 35 -�t1 o o3 L i l i Ca n j dm i A_
I certify that I have authorized j Aer%)(\r- �rs��✓C� �`—
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA
CAMA permits
necessary for the following proposed development: re j"W-
d-0 r
at my property located at
in b t p County.
t 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.
Property Owner Information:
14
(Signature
Print or Type Name
Like r—
/ Title
;% f
Date
This certification is valid through 1 1,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
EMENT s
I hereby certify that I own property adjacent to (Name of property owner)
property located at (Address, tot, Block, Joad, etc.)
In
j✓CJ I7C,huvzr"'
on �� `�- "�='`�`�' _ (Cityi'fown andlor County)
(Waterbody) ment roposed at the above location.
The applicant has described to me, as shown below, the develop p
proposal.
t have no objection to this prop
j� 1 have objections to this proposal.
DEVELOP
_�- DESCRIPTION ANDIOR DRAWING OP PROPO bD1ow o attachENT a site drawing)
(Individual proposing development must fill in description
WAIVER SECTION
that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin a°1(if you w shet back
waive
I understandof r, area of riparian access unless waived by (
minimum distance,Youst initial he appropriate blank below.)
the setback, y
I do wish to waive the 15' setback requirement.
�✓� J 1 do not wish to waive the 15, setback requirement. l A,
t Owner Information) S�
(Propert Owner Info mate
r• ,
a' Signature
j'JtirCy
print or Type Name
L'J \-4
Mailinc Addrl sS
N ,l
City/state)ZIP
T etephone Number
Urttc
(Adjacent (o pu r y__Jz ��� r.-7� �� he Ll L
Si ttt�rrr •c � -re
Priit or Type,Wn1e h •- �_
�Zdn'ss 1lI Zg 2 t
3
lelopilot
8�'�' 427
17 umberOnle
{Revised 611812012)

I hereby certify that I own property adjacent to
property located at
j�'1
on
Wt bod)
(•i'a. y y)) (.ji_
(Name of Property
Y�KI) I
Is
Lot, Block,F�oad, etc.)
In
�,� i��-nv {�,nr•�,� , N.C.
(Cityliown andlor county)
( a er y
47�z
described to me, as shown below, the development proposed at the above location.
ve no objection to this proposal,
t have objections to this proposal.
PMENT
-f DESCRIPTION AND[OR
MustfillIn descriptionG OF below °attachOa site drawing)
(individual proposing develop
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, orrgg i ; must
be set
minimum distance of 15' from my area of riparian access unless waived by ( Y
the setback, you must initial the appropriate blank below.)
I do wish to waive the IV setback requirement.
7. I o not wish to waive the 15, setback requirement.
I formation)
(Property Owner information)
J
SlgflpAre
-
.e r C y -- -- ---
Print of Tyne Name)
Mailing Addiess
City/st p��
Telephone Number
Dare
(Atli gent Properly Owner n
Mailing Address
7ele rove Number
1)alc
ann
02(�01 �Y�ia�
T�
(Reviser! 611812012)

Check
Date Recetved
Dete Denoslfed
Check From(Neme)
Name ofPermft Holder
Vendor
Cheek number
amount
Parmh Number/C—ents
Reeefotar Reund(Realfecafed
Columnl
7/19/2022
Column2
Cofumn3
AW M Docks and Marine Construction —
Column)
DeRosa -
Co/umn5
Truisl
Co1umn6
7302
Column?
$ 200.00
Columns
GP #876190
Column9
BB rcl. 18079
RH rct. 18069
7/19/2022 F & S Marine Construction LLc smnn ,Fi..i S.— •��• ---.-- —� •------