87499D-KENNEDY

3&000Mrk&❑CAMA ❑ DREDGE & Fill —EL- 1 , CDA�I N9 87499 A B C D
GENERAL P E R M I T► H, Previous permit s(� "W L/
Date previous pe/nmental
'sued
[] New El 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 nvi concern pursuant to:
15A NCAC t f' (L �� ❑ Rules attached. FU General Permit Rules available at the following link: www.dgq.nc.Yov/CAMArules
Applicant Name �&�k c L,., , ( K e n. �, C-( o I
Address —k . k 1 [f Xj F
city state _ FJ C_ zip 221 (�J
Phone #
Email 't n Cc.�
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW EIEW C ] PTA ❑ ES ❑ PTS Adj. Wtr. Body. r, (/ 1 (na unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
!
(scale: N T.3)
SAV observed: yes c I I
Moratorium: n/a yes j
Site Photos:
Riparian Waiver Attached: 6� no
A buildingpermit/zoning zonin �� q p / g permit my be wired by:
re b:
Permit Conditions
I AM AWARE OF STATUTES, CRC RU
Agent or Applicant PRINTED Name
5 AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANT
Signature "Please read compliance statement on back of permit"
:r
Application Pee(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
v 2
Issuing Date Expiratidn Da e

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 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

WpNew
w"IVgCAMA I I DREDGE & FILL W R7499 A 8 C
GENERAL PERMIT Date Previouspermit S� �02
Date previous permit Issued p
rrW ❑Mo/difiicatiioon� ❑Complete Reissue I I Partial Reissue
All1wlroApdbydu of liord Cmvh �. rpworA of fW*omlwntal Q�,Alltr and the Coatt]I Rei—ces Cornnwssgn ut an area Of environmental concern pwsuant to
ISANCAC O it �ZC/lJ L I R,dnauxi,ed (� � (,r,r,AV-iwtithet wadabluatthie to" kit yn"de4nCZwJCALto!f*l
Applicant Nom LC A nha.,ed Agent h a (•a t , i�
Addrlsf taSn —l: t 6 ProlectI ratson (Cor io- �J^S.-• _
City _Lae_ Z Sine. C Zr W.. Addr.&M P e" IF(.) 2Gia$ Sit �i.,G
Errssl __(hktn^t t�u-�� 4fiNG.4-1+ Subdivision _ ---- .
:V\ city S�-epv' _ ZP
T
Affected [- ICW VqEW N"A �ES ❑m Adl.Wtr.Body "a�p ( +l
AECW L�OEA [JINA ❑UW CISPIMA ❑PW$ Closest Mal wtr Body_ /TIIJwI
ORW ye rto PNA:ye I�
Type of Project/ Activity
Shoreline length t 9fn_
Access Len(dock)
th
length
e
Fier-- ��
(dock) length
Fized Platform(%)
Floanng Platforms)
Finger piers)
Total Platform area
Groin length/A
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ tl,ft lit yr l0
Beach Bufldoring
Other
SAV observed. yes no/
Moratorium: n/a yes w
S,te Photos' ye
Riparian Waiver Attached y j no
A budding permn/torung pefiris '"yy be i
Permd Conditions
Agent or
• *Please read compliance statement on
`t -, 0o 0"
IAEA*e
IN
(scale: N j S)
4
n
u,AJ
ALo, _
TARlPAM/NEUSUBUFFER (circle one)
f
r _ See note on back regarding River Basm rules
—' --- _ See additional notes/conditions on bat k
of lerrrul•'
Z01�
Check I/Money Order
Permd 0Hfe-WRIIVEO Name
l -
Issuing

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: rVion (Ne-L --
Mailing Address: f -A O &,re e. n 14, � k U. N t
Phone Number: c110 - a 101- `)
Email Address:
�►rJ h'P- txe
I certify that I have authorized T—t )6,2, I d e.rs
Agent t Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: r'--4 cl
at my property located at
in 13T\')rA�'-_jg.,County.
l furthermore certify that l 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:
sigli&ure
AA:t'�� C V--'as..Yti
Print or Type Name
Title
Date RECEIVED
O C T 17 2022
This certification is valid through l l
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to 's
(Name of Property Ow r)
property located at p y t •mac G . C-0--'.ctk
(Address
on Sfc— re.. C-g, j1 , in
(Waterbody)
' . . (City/Town and/or County)
T a plicant has described to me, as shown below, the development proposed at the above location.
tnt"`a 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
y LD G-rrtes ti I r
Mailing Address
city, tateizip
Telephone Number
Date
(Adjacent
or
ailing `ddress b
FI
City/ tilWzip
Telephone Number
RECEIVED
Date
(Revised 2022
DCM WILMINGTON, NC

ADJACENT RIPAS
IA�NPROPER TY OWNER STATEMENT
I hereby certify that I own property edje�nt to �► ai-1 s
property located at .�.dbd W .�'c� i �'G (game�of Property. er)�-I
on_S�_ ��� tom+-r`�I (Address, Lot, Bck, Road, etc.,
(Vlfabrbody) , In ! � one, S iN.C.
:a r .
(Clty/Town and/or County)
The applicant has described to me, as shown below, the development proposed' at the above location.
I have no objection to this proposal..
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual 'proposing development mustfill In descd/pdon below or attach a site drtwing)
WAIVER SECTION
understand that a pier, dock; mooring pilings, breakwater, boathouse, lift, or groin must be set back a,
minimum distance .of, 15 from my area of riparian access unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
o wish to waive the 15' setback requirement.
1 do not wish to walve the 15' setback requirerr
(Property Owner lnformati n) (Adjacei
Data
retepho
Dole
(Revjwd &9)VED
OCT 17 2022
DCM WILMINGTON, NC

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