86060D-NEWPOL

`AS4,&FICAMA ❑ DREDGE & FILL Q N9 86060 A B c o
s Previous permit
GENERAL PERMIT / l j J, Date pr ous e/rm't issued
❑ New ❑ Modification ❑ Complete Reissue ❑ Partial eissuelAs authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission i an areaenvental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.Yov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
State ZIP
Authorized Agent vt
Project Location (County): r_r ... {-'rM>° c :�'•
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale: :iS )
Shoreline Length
Access Length ! j__. A�i' .�
Pier (dock) length {
Fixed Platform(s) -
-
i
_
Floating Platform(s)
i
f
f
j
E
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/Riprap length
Avg distance offshore
-
-
--
-
---
-- t
—
- }
-
.-
Breakwater/Sill
i
I
�
Max distance/ length
i
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no `
Site Photos: yes no i
Riparian Waiver Attached: yes no .�
A buildingpermit/zoning zonin ! � ` '' "• � � , p / g permit maybe required by: Y L°`.
{� ❑ TAR/PAM/NEUSE/BUFFER (circle one)
5' iZS Permit Conditions %iN .
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
1
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s) 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:
F-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://porta1.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT AUTHONZATION FOR QW P flW APPLICAIM
Name of Property Owner Requesting Permit -5��,rrr 1 �
Mailing Address: 4740 Arf-ri u m C.O uer
Wi I m f n 9-f-vn, Nc .�-,B4o5
Phone Numtxr. 73 4- 3 5 5- 8--L I
Email Address: S h�rri r1 a W� o y�oo . coM
I certify that I have authorized
Agent / contactor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development D,,, L,y- i 7 i 1c
at my property located at 43�
in Qpt Na ` County.
1 furthermore certify that / 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 Ow w lnforrnftn:
X L'J f'l2 c u"
Signature
Sher-ri tJe\N
Print or Type Name
1 ? "Per-�V owner
r9le
x o / 4 / a�
Def a
This Certification is valid through i 1

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
I. Article Addressed to:
1 P %\) cc.: x Wit" V.NVC< tla,
61-1-7 'e3Q\Un()C CC G016
A. Signature
xf/A--,' f dill
B. ReceNed by (Panted Name)
© A erit
Addressee
C. Date of Delivery
D. Is delivery address different frm item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type v Pnority ►.• j, E,,.pressO
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?021 272D 0003 3112 4065 W
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■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
IN Attach this card to the back of the rnailplece,
or on the front if space permits.
1. Article Addressed to:
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DOmestic Return Receipt

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Data Receheed
Date Deooslted
Check From Neme
Name ofPermk Holder
Vendor
Cheek number
Check
amount
Pennit Number/Comments
Reeelot or Retund/Reallocated
Column!
12/13/2022
Column2
Co1umn3
James Helmick
C.1-4
same
Column5
Wells Fargo
COIMM6
6897
Column?
$ 600.00
Colu—S
GP #85960D
Column9
PA rot. 18633
12/13/2022
Donald Reames
same
Bank of America
131
$ 600.00
GP #87644D
BH rct. 19892
12/13/2022
North End Builders NC LLC
Newpol
Truist
1189
$ 200.00
GP #86060D
BH rot. 19894
12/13/2022
Coastline Therapy Group, LLC
Bageant
Wells Fargo
27454060
$ 400.00
GP #87539D
BH rct. 19882
12/13/2022
McPherson Marine Services, LLC
JMSM Holdings, LLC
First Citizens Bank
5702
$ 200.00
GP #87680D
Tmac rot. 17809
12/13/2022
Charles Fox Homes, LTD
Gosnell
Branch Banking and Trust
30266
$ 200.00
GP #85846D
BB rot. 18699
12/13/2022
Devane Family LLC
same
First Bank
1531
$ 2 00.00
GP #85843D
BB rot. 18696
12/13/2022
Harbor Marine Construction, Inc.
Sarbone
Bank ofAmerica
1399
$ 200.00
GP #85809D
JD rot. 17872
12/13/2022
Womack Electrical Contractor LLC
same
South State Bank
1493
$ 200.00
GP #87582D
TP for BH rot. 17829
12/13/2022
Willard Family Farm LLC
same
South State Bank
1843
$ 200.00
GP #85853D
BH rct. 19895