87572D-TEW

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�j`°"R41 ❑CAMA ❑ pREDGE & FIL N9 87572 �A B C 0,
GENERAL PERMIT CPO]],Previous permit
Date previous permit is ed ° "� �u s
❑) New ❑ Modification []Complete RE s e [:]Partial Reissur
As authorized b the State of North Carolina, Department of Environmental y \p Quality and the Coastal Resources Commission in an area o envi nmental concern pursuant to:
15A NCAC `�� t" ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address 11
't T, c.:c:.. ­K
Ciry State -zip L►
i(
Phone #
Email
Authorized Agent Tt� �c..Sli c-, ar-' lcj.c ,,
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP��ri
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body r (nat�man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
+
ORW: yes/no,. PNA no
Type of Project/ Activity .._ -„r. f, ., , , �. i, +, r i r T 1,
(Scale: )
Shoreline Length ti<iw /
Access Length E O
Pier (dock) length L: %1 + _ € .. .
Fixed Platform(s)�����
Floating Platform(s) Xa LP
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:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zoning
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED C(
1, $ I
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
Applicatibn'Fee(s) Check #/Money Order
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Permit Officer's PRINTED Name
Signature
C/2�
Issuing Date J t 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 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: [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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;IiEC(s) 7 pGEA {tfA ptw psptl4+a► f?1NSr Closest tWaj wtr_.,Body, !
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(scale
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ACtess length' , ` r N-1
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r Ftaadng Rlatform(sy �' XI ll�+
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%tafPla 6nlarea
Sh 10,
T 1+
Groin length/tt
Aug df3ta[%e offsiicte _ _ _• , � '
'Max distetce/Itr�ft
8osin, clanoel �
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Gublcyards
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Other. •,, '
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SAV observed Yes: A
MaratoNum, n/a; Yes
R,Patian`VYafver Attached
A building permit/ ng;
AttAWAIl FFEW(d
Peimic:Cond 1 ,_ �, _ ,
,: V*:.S ' S,i '^ t' 4 _�: p See note on back regard+eg.f#W_er t3astn rules
L C r
p See a�dif3onal notesJcoiidttions
I m AWARE OF 5T. tRC RULES'AND C6N01T1ONS TH& AOPLYTt>iHiS PRQ KT AN6 RWEWEQ PIt & STATEM �
:Age,'Ap can NTEdName _— PermiOfRcet'SPRI Name r---'^ -
r:l
gatur ease'iead compliance sta'fement:on back of p' it•'' - SignSture'
2Za L I III �"� �•'�-� 3i16'>%z��,._____,_
(J _ .. Check'lMoy:Ordet' lssutitgDateT._ _.. ._Ua ...._._....
. 4 i

• AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Req g.
uestin Permit: Y �.
Mailing Address: -n SSW.
Phone Number; --u
Email Address:
o
I certify that I have authorized . _
Agent ! Contractor
to act on my behalf, for the pprpose' of applying for and obtaining all LAMA permits
necessary for the following proposed development: i
A © % , I nn r
at my property located at �QU l\'DUB Ck l\ Cj
inBT\)Y):5WLcounty.
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.
Property Owner ormation:
Print or Type !Name
l
l /Z2
Date
through / l
ceriification
is valid
F
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
OERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owr er-
Address of property -
Mailing Address of Owner: 1
OwnersemailA -0 ( (: n C,1")E �V fg3`l I
Owner's Phonell:
Agent's Name:
Agent's Email
Agent Phone*:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adlecent 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 thL
AA description or dr�vtrino. with dimemons must tie reel with this letter
r
I DO NOT have obections to this proposal. 100 have objections to this proposal.
N you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) In wrftfng within 10 days of receipt of this notice. Correspondence should be
mailed to 1 ZT Cardinal Drfve E)M WIlmington, NC 2W5. DCM mpresentadves can also be contacted at
[phone]. No response Is considered the same as no objection 1f 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 15' 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.)
1 DO wish to waive some/all of the 15' setback
ftnpturq of Adjacent Riparian Property Owner (ARPO)
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) _ 1m
Signature of Adjacent Riparian Property Owner: �.:---
1 f
TypmVPrinted name of ARPO:
Mailing Address of ARPOA� � i(N� �- 1 4� 1 f I '1 ,X ,l�'C:1 IX, aso
ARPO's email: , hdt (rdll t,UggRPO's Phoned:
Date: rl ra 2G'LZ "waiver to valid for up to one year from ARPO's Signature'
Revised May 2021

x
021
2021
6817
6829
679�ntracoastal Waterway Roberta
Roberta
Roberta Rd SW
Rd SW
Rd SW
Approx. pierhead line
}- Approx. 25' from
end of T-head to
,,,,.-miechead line
•w
it
e Eart

CAMA / DREDGE & FILL
^GENERAL PERMIT
New Modification Complete Reissue Partial Reissue
No. 73530 A' B C
Previous permit #
Date previous permit issued
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 NCACy
Rules attached.
Applicant Name �- Trw --- Project Location: County. ►isu/tcIL _
Address 8 f) [AriscovE Ayr- _ Street Address/ State Road/ Lot
City .5 M A - TIL StateAk, ZIP 214 7 /.,,mot_ a✓. II - -_i A _ VOAo-----
Phone # (1910 ) 443 - 4`11% E-Mail Subdivision
Authorized Agent NJNE
CW YEW ;(PTA [I ES ❑PTS
Affected
AEC(s): OEA HHF C IIN ❑ USA "] WA
PWs
ORW yes , no PNA yes / no
City()LeA,,q :57 c,F FrAC .► ZIP ZRle, 4
Phone # ( S t ML Rivw Basin Lw^a r_z
Adj. Wtr. Body -_ A 1 W ►J rat hn mw
Closest Maj. Wtr. Body _AI W
Type of Project/ Activity r� t Nt / BOArL, 1 a -r Re Ct,yAT IAx-, LDOC-y ? e
1JoGKf /lib TACIL li`4 (Scaksl0, 2O, )
Pier idockj length -- -- -- -- ---- _ -T-- -- -._--
F�xed Platform(s) _ _ __- _ -r r •-- *- --- - - - - ---
Floating Platf s) X It. — ----
I I J'/
Finger pier(s)__ -
Groin length
number
Bulkhead/ Riprap length"t—+
avg distance offshore + - --�-
3i�
max distance offshore _
Basin, channel
cubic yards '--`—
Boat ramp x
Boathouse, Boatf
i
Beach WIdozing
Othw
ows 12T+t�Z J j ,
Shoreline Length 1O0 1 l
SAV not sure yes
Moratorium: n/a yes no
Photos: yes
Waiver Attached: _
g p ! y�® y� N
A building permit rna rbe required b S t_E RPnC
Note Local Planning jurisdiction)
n
[- See note on back regarding River Basin rules.
Notes/ Special Conditions n 2 (--A , ZDQ $1 A0- TF1 R L OCAL T 5 7 A t L y
L 'iA I'fG,LA, LATIaNt ,dPP�y
4-no _oS i- JA .&e
� or �i P ..— —- - —
SVwme "'s Please read compliance statement on bacit of permit--
3 8_G g-
AppEi -at ton Fee(s) ---- - --- Chm*#
Mc C...tt,�-- --
PemvtOfl'icer's P ' Name
G
2 20. __ — $ 2g 12011
Lutrii j Date Exgrabon

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N.Ci- DIVISION. OF COASTAL MANACEIIAENT
ADJACENT RIPARIAN pROP'ERTY. OWNER NOTIFICATIONiWAIVER. FORM
&T E4�iVE Y
CEF'IED M IL I3ETIIRN RECEIPT Ent &FSTEb or H
(Top portion to be completed by owner or their agents .
Name of Property Owner �'.�� vt� h
Address pf property: tell r
s
h.
Mailing Address of Owner;
Pwner's i'lt. own®r's Phoney
I
} a#
...
emeilf! .G :
yt r
Agents Name: Agent
'Agent's. Email:
;s
ADjACENT-RIPARiAI� PRt3PERTY OWNER-S COITIFICATION.
w
(Bottom t�ortian 4o b'e contulated by the Adiacstrt Pro a Owner
I hereby certify that I own property adjacent to the above refersrnced property. The individual applying i'or this
permit has described to me,. as shown on the drawing, the development t aro P ig4f,.,
.attached
A description or drawing with'dimensions must be omvided with this letter. ._. .
„ I DO NOT have objections to this°proposal: E DO -have objections to thus p�roposat.
1f you have objecfi.ops to whitt is blind proposed, you must notify th# N.C. Division of Coasts!
Maneyem�nt (DCFA) in wrW64 within 10 days of receipt of"this notice., Correspondence s tactd a
1g-7CarrdinaipriveEKT, ylgimingtt n, NCZ8405.'Dcmrepres*nfativescars,atso be ce ntacf�rd t .
waited to
(910) .7W7215. No response is considered Me, some as no "objection if, yei+' have been notiFed by,
Coirano Mail; .
WAIVER SECTION
I u tderstand that atiy"preposed pier,.dock; mooring pilings, boat ramp, break*gter, boathouse, lift, orgroin
must be setback 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's you must lion the
appropriate blank Wow.)
1 DO wish to waive, sqM81611 Of;the''IV setbac
S7gnatura ofAd'ry nt,FZtpatran,Prvperty Owner (ARPO)
-OR-
do trot wish to waive"the .1a' setback requirement' (initial, the blank)
Signature o1''Atfjaperit Riparian Property trne'r.
TypediPrinted-name of ARPO: i
Mailing Addme of ARP( ..
ARPO'a $ AII: ARPO's Phonett�
Daft:Z„4�z huaivor Is. Valid for up to one •yearfrom ARPVs. SignattirO
Revised Mdy.2021. ,
q 'fft,¢�.r

Dole ReeeNed
Date Deposited
Check From Name
Name of Permit Holder
Vendor
Choeknumber
Check
amount
Permit Number/Comments
Recelot or Refund/Re 11—ted
Columnt
Celumn2
Column3
Column4
Co1umn5
Columns
Column7
Columns
Column!)
11/14/2022
McPherson Marine
Benarz
First National Bank
4028
$ 200.00
GP #87558D
PA rct. 17746
11/14/2022
McPherson Marine
Koziak
First Citizens Bank
5609
$ 200.00
GP #87557D
PA rct. ,17745
11/17/2022
Bruce Marek, PE
Michaels, Prak, Brooks
Wells Fargo
2307
$ 200.00
GP #87595D
Tmac rct. 17807
11/17/2022
Land to Sea Construction, LLC
Stober
First Citizens Bank
644
$ 200.00
GP #87451 D
KB rct. 17884
11/17/2022
Jason He ge
White
Truist
1006
$ 200.00
GP #87596D
BB rct. 18692
11/17/2022
B & B Marine Construction
Hark The Sound, LLC
Wells Fargo
1692
$ 400.00
GP #85804D
JD rct. 17863
11/17/2022
B & B Marine Construction
Van Beuren
Wells Faro
2004
$ 400.00
GP #85803D
JD rct. 17862
11/17/2022
Pippin Marine Construction LLC
Fig 8 Island Yacht Club
lWells Fargo
6138
$ 400.00
GP #85801 D
JD rct. 17860
11/17/2022
Sea Dog Marine Construction, LLC
Smith
First Bank
1958
$ 200.00
GP #87570D
BB rct. 18686
11/17/2022
E.Wayne 'Tew
same
State Employees CU
2212
$ 200.00
GP #87572D
BB rct. 18690
11/17/2022
Dianne Williams
same
State Employees CU
1017
$ 200.00
GP #87568D
BB rct. 18683
11/17/2022
Maritime Coastal Construction LLC
Thames
United Bank
3562
$ 200.00
GP #87573D
I BB rct. 18688