86767A_McEachran, Angus_20221115

11XNew
XCAMA NJ DREDGE & FILL NY 86767 C� B C D
Previous permit
GENERAL PERMIT Date previous permit issued
❑ Modification []Complete Reissue [J 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:
St
I SA NCAC -.__ ._ +!j" ' 11 CJO —_-_ ❑ Rules attached. Xi General Permit Rules available at the following link: rnww d@qnc gov/CAMArules
Applicant Name R 1 AC 0,C Ya r-Ck n Authorized Agent "i �'C�h 4 �� =-----
Address/+_-- i c) tl NP'j-) n K• Project Location (County): i:it(1}i ti }tCt ✓�� —
city -_ +�Q n S�tx Um State �c ZIP �410 _ Street Addre Wkaw Road/Lot #'s) -S2T_ #� 1
Phone # (3J'� fks — 5 k 3f ( (O i i1� - t } r, _
Email ._ Subdivision �d-e�1�r � - r G n`�,fim
City_ Creep c;� -- �� 2-7q 32
Affected GIN ©C EW PTA ® ES �]� PTS Adj. Wtr. Body t+Y�Cl-t- t£ } SoL,I (a nan/unk)
AEgs): OEA ❑ IHA UW ❑ SPIMA PWS Closest Mai. Wtr. Body
ORW: yes/{fig) PNA: yes/ o/
Type of Project/ Activity C,e rna lad OV 1r1Gta� �l hzct.$ I otti� ,n 't t[iJ111��
(Scale:
Shoreline Length
i
Access Length i
Pier (dock) length
Fixed Platform(s) i
Floating Platform(s)
Finger piers)
Total Platform area t
_
Groin length/# —
uikhea / Riprap length too r
t
Avg distance offshore
Breakwater/Sill
Max distance/ length L y r j
Basin, channel
i
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other ..
SAVobserved: ye
s
Moratorium: rn—la yes no
Site Photos:no
'"l
Riparian Waiver Attached:
A building permitlzoning permit may be required by:
Permit Conditions
RULES AND CONDITIONS THAT APPLY TO
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
��caS �� 1st3
Application Fee(s) Check #/Money order
Permit CI7f Cer'A PRINTED Name
TAR/PAM/NEUSElBUFFER (circle one)
❑ See note on back regarding River Basin rules
1-1 See additional notes/conditions on back
(Please initial)
Sign ture v
�'�Isfa�
Issuing Date Expiration Date

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address:
Z-0tvD �)
"acrcw—
eehsl NC'/ 2,741 r)
Telephone Number: 33Co Zz�'q get D
I certify that I have authorized Mj�-4,0( &W)4 (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of
C-C6 Jac � C, 2!�"v
3qj-�) i� paw p✓�
at my property located at ': 4Q BCOAV pow-r 1)(2- rdwNC--
This certification is valid through
(Property Owner Information)
- C ;- - - -
Signature
s
Int or Type Name
cujyjec
Title, co. owner or trustee for property
to It 4�--
Date
3- j;o Z.6 (4 (gk; l (]
Telephone Number
G20-CWWA yv - . L-OV/4,
Email Address
RE V -I\/ F-0
N t I 1 p V,
OCM-EC
(date).

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: W-Ty 6.
Mailing Address of Owner:
0
Owner's email:O f ner's Phone#: 3i0 ��1�,� 10
Agent's Name: t �W1P.i� 54t.�, L Agent Phone#: 7-57- ` %55
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent 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 leiter.
1 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 notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
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
t3�SAS
the appropriate blank below.).
+o
I DO wish to waive some/all of the 15' setbacks`
�*V�a4o.
Signature of Adjacent Riparian PropeV Owne /
-OR- ci?Zw,�� jti4 rz� � j; i0/!)4t .�G 2
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Printed name of ARPO: �..u� , i.�h1A �. 17i'I
Mailing Address of ARPO: b �T �•'r i! t �c� Ae
bri t PCtC-s ij•c_L�m
ARPO's email: { �451 � E'f� �`�' RPO's Phone#:
Date: 1 L( 31 ! Z/ r1-- *waiver is valid for Ar-CM O's Signature*
1 Revised July 2021
N 0 V 0 4 2022

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346 Bay Point Dr
G6'Ogle Earth
Inky 2022 Wxar Technologies
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200 ft