87483D-THUSHYANITHAN

❑CAMA ❑ DREDGE & FILL(W toy 1P),-2 N° 87483 A B C b
G E N E RAL PERMITOOA Previous permit
J Date previous per it issued
New ❑ Modification [:]Complete Reissue ❑ Partial Reissue
1
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commi Wsioinn area o e it nmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.ncyov/CAMArules
f�p,1<L 141y ,�aifi... �r�
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP
Phone # (_ )
Email
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Adj. Wtr. Body (nat/man/unk)
Closest Maj. Wtr. Body
L.,
a r
ORW: yes/no PNA: yes/no
Type of Project/ Activity.
1
(Scale: /U/
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 required by: /f F / t
Permit Conditions
❑ 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
Application Feels) Check #/Money Order Issuing Date 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

Addnua: _
/z / ,7 ,.,ar- v,r —
.. pti0ro Number:
C+,3�•7 105� ��IE� ---
K'iSAusru�b1t�'�(�wv c�,�t
ddress:
I..:b W I rrA a9bodnd . � /114. ►l�� L�71 ��� 6d4T L'I�
Ao�
to ad on my bsbsr. for ft pupm d MOV h qo for NW ObMWM d f:AMA permb
i
bitrbfk**barsrm�ddevslaOmMd: yyl�O'd_
at wl pm ail aosa M /Ol � .sRrtr�r nrv�:•.sti DQ Su er Ctq Ar_ al4trs
k.
I ti/*m" ooO"I rn b "nt and b b Ibd OW psrr00" b
OkkimaRaas"aftm-fsfttf!le LadPsmrtOWWadd Out4WftbYdi
m mw &bwm dbsfd hm* b oorrM M sla @vmkmV bbrmsfbr m"d b "
PWWJ
A0~ MNrwYla�c
=�7►rM�
k i rk� �,u+- q-nl Tt-fian(
PIIfOI Alom
r>er
1a

0 o ap p f A 1k 4 "�`., 66 i 0 1:31 PM
v
USPS Tracking' FAQs >
Tracking Number: Remove X
70221670000158332306
I Copy ;k' Add to Informed Delivery
Latest Update
Your item was delivered to an individual at
the address at 12:26 pm on September 26,
2022 in PINEHURST, NC 28374.
G Delivered
Delivered, Left with Individual
PINEHURST, NC 28374
September 26, 2022, 12:26 pm
See All Tracking History
Text & Email Updates

® ■ o e a ® 4$ 4 `:.ad 66% ■ 1:32 pM
USPS Tracking® FAQs >
Tracking Number: Remove X
70221670000158332290
Copy ;k' Add to Informed Delivery
Latest Update
Your item was delivered to the front desk,
reception area, or mail room at 11:23 am on
September 26, 2022 in RALEIGH, NC 27615.
G Delivered
Delivered, Front Desk/Reception/Mail Room
RALEIGH, NC 27615
September 26, 2022, 11:23 am
See All Tracking History
Text & Email Updates