Mangum, Alexa 88844C 126 Sound Dr.

a�1*000A41`,, ❑CAMA ❑ DREDGE & FILL
GENERAL PERMIT
❑"New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
88844
Previous permit
Date previous permit issued
A B C D
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 4' " ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name .a �,, . �; '.
Address `�' 000 i�.��� C4-<'�') ok l,l�-2.-. Z./t
y ,
City. a,.;r;'U \,%tf , !`tG't State ZIP
F
Phone #(`" ) ,Z04 _ iM�r<•�,..
Email
Authorized Agent ;:: i ! f
Project Location (County):
Street Address/State Road/Lot #(s) 2(,
Subdivision
City A4. !(%�?i1 ys - erA <', ZIP
'4r
Affected ❑ CW ❑ EW ❑ PTA El, ❑ PTS Adj. Wtr. Body 4 50 A (- Q A 1YV-AAA I (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no;
Type of Project/ Activity
(Scale: Z 0
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 "`""" `j ` '
Moratorium: n/a yes
Site Photos: yes no
.. __
Riparian Waiver Attached: yes no 4
A building permit/zoning permit may be required by: A4t r/nr1�' t- 'a.C�
Permit Conditions ? (i re'.x cZ, Y.+.�.titi,a.� yy
7 C81t C� YM@. � !'1 � >kG i I CC �
❑ 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
p
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

E`°tS'141 c❑CAMA ❑ DREDGE & FILL NO 88844 A B C D
z Previous permit
GENERAL PERMIT
Date previous permit issued
TNew ❑ 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. 0 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 ;4»..(I ,, eA 4 i t. zip
Affected ❑ CW ❑SEW ❑ PTA RES ❑ 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 rE
Permit Conditions
(Scale:
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_ .4T-1
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�rniirarl hv•
❑ 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"
Application Fee(s)
Signature
Check #/Money Order Issuing Date
Expiration Date

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RfPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
+998TlEl MAIL • REI 8N.-89-9JEQPT MUESTED or HDELIVERY
(TOP Portion to be completed by owner or their agent)
Marne of Property owner;
AddressMailing of Oe.7
.«Owners email:
1
gent's Name: ..... ... ....... A g.. !•. -
Agents
6 "I 5�• f .Y i4
! hereby certify that ! pro arty ao�jacent to the above referenced r e The individual applying for this
pa+rMit has described to tie, as shown on the ached drawing, the development they are proposing. 6
escri ti n or cfrawln d n l u be vtkh thi r.
D DO NOT have objectons to this re osal.
p p D DO have objeotions to this proposaL
you have o#}ectlans to what /a being �aed, you must ho
w ow the Nil. C# ;D IVIsMon of Coafst&l
many anent (DCN)1n wrivaq WIthin 10 days of receipt of this no#ce♦ Cw0spandence should.be mailed to 400 COMMerceAve., iWorebead Clot, NC 28587. DCM r0Pr$80nta0V4* car also be contacted
at (28 808-28 , Na fe nse is considered the saute as no obj ectlin If you have been notWed ,by
ertffi'ed l 011,
D understand that any proposed pier, dick, mooring pilings, boat ramp, breakwater, boa se, lift, or
groin must be set back a minimum distance of IS from nay area of riparian access unless waived by me
(this does not apply to bulkheads or r1prsp revetrne"ts). (if you wish to waive the setback, you muet al n
the appropriate Manic below.)
i DO vAsh to waive somefall of the t ° setback
a
osynature car`Aal8centRiperian Property Owner
D do not wish to waive the I& setback requirement (initial the blank)
Signature of Adjacent Ripadan property owner.
Date., --I I U1 A *raivor 3a Valid for up tc On;D year from ARPO to Iona ture'*
Reprised July 2021

NC- DIVISION OF COASTAL MANAGEMENT
ADJACENT ROARIAN PROPERTY OWNER NOTIFICATION'
CERTIFIED MAIL - REi6RN /WAIVER FORM
R—E—Q—E—IETL—R.EQU�STED or HAND DELIVERY
(Top Portion to be cOmpleted by owner or their agent)
Name of Property Owner: 41z-
tF #
Address of Property:
Mailing Address Of Owne,-..
T-
Owner's email: Ae (2" C'O.f'v6Winer 's Phone#:
Agent's Name: AgentPhone#:
Agent's Ernail°
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
19.0ttom Gortion W
hereby certify thatif 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
.!.ion or drawing with dimensions Must b-U_r0Vid6CLWith this letter.
/P
1 DO NOT have objections to this proposal. ___ I DO have objections to this proposal,
ff you ha
ve obloctiOns tO what is being MPOsed,
oaf(DCMi ) n wrj;tlnq usf7W-0-t-ff-y—th—eAf
, within 4 d'ays of receipt of this notice. Correspondence should be
mailed to 400 Cornmerce Ave_ MoreheadClty, NC 2855T DCM representatives can alsObecontacted
at [phone]. No response is considered the same as no objec
Ce
rtified Alal/, Vuh if you have been notified by
WAIVER SECTION
I understand that any Proposed Pier, dock, mooring pilings, boat rarer pbreakwater, boathouse, lift, or
groin must be set back a minimurn distance of 15'from my area Of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments), (If you wish to waiv
the appropriate blank below,) e the setback, you MpAj slqn
I DO wish to waive somefall of the 15'setback
-OR-
Signature of Ad-i�c-e—nt'i�l�perian—Prop-,giiy " wher
I do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian PFOPerty Owner
Typed/Printed name of AR
Mailing Address of ARPO:
ARPO's email: !?766 _
Date: 9/2 1 /2-
2WIFAM
Z
Phone #: 0 1-7-
I If,., waiver is valid fOr LIP to one year from ARPO's Signature*
Revised July 202 1

O Q
DEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat M�Crory Braxton C. Davis
Governor Director
Date ���
Applicant Name
Mailing Address
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) ,�; �� �S� �/ Za-To act on my behalf, for the
purpose of applying for and obtaining all CAIVIA Permits necessary to install or construct (activity)
at (location)
2 xlq� Pr— Al
This certification is valid thru (date) 1 -0
0
Signature
Nov 0 9 2f.�?.2
400 Commerce Ave,, Morehead City, NC 28557 One
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement, net Nort 1Carohna
An Equal Opportunity 1 Affirmative Action Employer Natuid4