87458D-SHAVER

`°"R41 ❑CAMA ❑DREDGE & FILL OVAJ I- N9 87458 A B C D
GENERAL PERMIT Ia%I a� Previous permit
ate previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue ),J�� (/f
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. E' General Permit Rules available at the following link: www.deq.nc.2ov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
Authorized Agent
Project Location (County):
State ZIP Street Address/State Road/Lot #(s)
Subdivision
City ZIP LA 1
❑PTA ❑ ES ❑ PTs Adj. Wtr. Body i�. \ \ (nat/manyunk)
Affected ❑ cw ❑ EW
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 Platforms)
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 Q
Moratorium: n/a yes ;no'
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
Agent or
(Scale: ._ )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Signature "Please read
Application Fee(s)
statement on back of permit"
Order Issuing
;l 1*3
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:
1-1 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

P
t CAMA DREDGE & FILL
GENERAL PERMIT Iby`V
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I AM AWARE OF STATWW CAC RULES AND CONDIIIO_NS THAT APPLY TO THIS PNOUCI AND RIVILWtDCOM►IIANCt SIATIMIN; 0
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~ I APPIKaoon ir.'Irl �I CArt /Money Order N+aryt D Ir L.praFun 14p

► •► •► •� ���. i_ •
Name of Property Owner Requesting Permit: 0 n GiShO-(f C
Malling Address: _ �& l i a k r k' -
.y�,� shu ra' Vr, a31R'�'
Phone Number:
Email Address: 4-b'r C 0
I certify that I have authorized C0 rp. L
�( r
Agent I Conbaft
to act on my behalf, for the'purpose of applying for and obtaining all CAMA perMb
necessary for the.following proposed development: i A SM 1 a -Ade f rna
at my property located at 6 q rQ/' (101'1 beo-A-
In N`Rffi'�I�County.
I furthermore certify that I am authorized .,to grant, and do In fact grant permission to
Division of Coastal Management staff, the Local Permit OfP%aer and their agents to enter
on the aforementioned lands in, connection. with evaluaft information related to this
permit application.
Property Owner Information: :
-�22=�
signature`
AN or Type Name
DOW
RECEIVED
This certification is valid through / i S E P 12 2022
DCM WILMINGTON, NC

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AQertt's Name#. 1ny MQ-C .1 CjKe-' Mai'liing�ddreas: � �a P o r tl lilt
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIINAIVER FORA
Name'of Property Owner: -TLYXW Sb `U r
Addresa'of Property: ° r
(Lot of Sheet #,'Steetor Road, City' & County)
V2
I hereby certify that town propefty adJac w to the above mfefenoed prop". The individual
apptyatg for this permit has described to the as shown on the attached dfawk4,the-deva1opfrtent
they are proposing: A' deeaiation or drawing. vMti dlmansion& fist bs provided with this we
� dre'k
I have no objections to this proposal.' I have objections to this proposal. F d \
lfyouhmo6 etowMkbe�ropropossdy.oumustnotYyd*NvhtonofCaxWNMvwdit(OG� 1n �s�\ je
wiNap t�brn' i0 days o/noNp! of thb notles� Comp�ondience shorrld� n�fhd to f?� f�endrret Drive Prt, ���`
Waadapten; idC, 2MOS,M& WN iWaN ftetlM as efso be CWAWW at (00) 79&MI No nR mm Is
eeratd0nd tin.seet0 ai fto obiradon N you bsw bean natffladbY Cerf+lledlfa�
WAIVER SECTION
I understand diet a pier, dock, mooring pilings,- breakwater; boathouse, lift, or groin must be set
bm* a minknum distance of W.ffa of riparian some unless waived by me. (If you
wish to veal e.the setback, you appropriate blank below.)
b\ I do wish to waive the 15' setback requiremeftt
1 I do not wish to waive the I & setback requirement
(PyE� _Ownu� n motion}
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DateRECEIVED
Revised GUM
SEP 12 20 Z

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SEP 12 2022
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