87936_Marla Roundtree_20221130

.�``°"7414,, flCAMA [ I DREDGE & FILL �y_.5 No. 87963 AB CD
GENERAL PERMIT Previous permit
Date previous permit issued p. /;--
n New ['Modification ['Complete Reissue fl 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:
ISA NCAC C-' 4 it . 1 1 C''C': n Rules attached. ❑ General Permit Rules available at the following link:www.deq_nc.gov/CAMArules
Applicant Name Ma a t "' Iti 01. ,1 4--sir e t Authorized Agent '" u I.tit e�f'
Address �',- ` r ` Project Location(County): ''.'t-);'' '/1 i.^; T��i,7
City , State ZIP 3-`l 1 p. Street Address/State Road/Lot#(s)
Phone#( .a� Y r/Z' 6. • 7 a 1 i;,c MY`Q r 1 N l` r> '=c L•-. i2..
Email i.)10 r' ti • , •1 L l` U Subdivision ' r '•: `,� c 1
City t I.L. l.^( •I/ ZIP X -7`-f-4
Affected I I CW n EW I--[PTA n ES n PTS Adj.Wtr.Body `- (nat/man/unk)
AEC(s): ❑OEA fI IHA n UW [ I SPIMA PWS Closest Maj.Wtr.Body - Y s.,
ORW:yes/no PNA:yes/no
Type of Project/Activity 51a) tcb 4 f' ' • I,
'k) i 1 t u av J P.,c ti S 4iU, kIi I i1 A)) CAI 110)A ei+c ri-. 1, (scale:) ' 30 f
Shoreline Length '
Access Length I _. { i --. } -.. -__{�---
I _-- - — - f�7Q f'}}c JG I-. i
Pier(dock)length i __ ____),
Fixed Platform(s) 1 [
1.
Floating Platform(s)
.. . .._ .__ _. -- _. --- t e -�
I
Finger pier(s) i �Jk` Y
1
r ' —a. �._.J'._- 1.j�v :lei 1 C
P
Total Platform area R Y J� '-j. (I f Qi ,w5
Groin len h/ffft t
. . .
Bulkhead/Riprap length — —i ---- ^t ,!�
Ft `1� 1
Avg distance offshore - *-- - r ,--, , , ,- , ,_,._,_,,, .Breakwater/Sill , { S \„.'° `i1c�Max distance/length 1 -� vh..\ P
Basin,channel 1 f \t—
I_ i �� .
Cubic yards • ,= . __-----!b._..
Boat ramp L _
Boathouse!Boatlift '� z i 1
"� j �}t,r f 7,. ti�1,r,;�Y 1
Beach Bulldozing i. IyN { . ,� CO
1SO*I ' -.1- J i1 lc
Other l ` y
r� ` , �'T to 1(�,�k'/ee T io f �ll�,
SAV observed: yes no T(,'41
Moratorium: n/a yes no: t
Site Photos: yes no l , I ;
Riparian Waiver Attached: yes no r , I /: 1 f `�` .
I
A building permit/zoning permit may be required by: , n TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions
nSee note on back regarding River Basin rules
nSee 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 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:
Tar- Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden, Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

o��COu'kdik1 1CAMA ._J DREDGE & FILL No 87963 ABCD
11s I GENERAL PERMIT Previous permit
Date previous permit issued
I New Modification Complete Reissue I I 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:
ISA NCAC Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name.__ Authorized Agent
Address Project Location(County):
City ______ State ZIP Street Address/State Road/Lot#(s)
Phone#( )
Email Subdivision
City ZIP
Affected nay n EW PTA n ES I I PT5 Adj.Wtr.Body (nat/man/unk)
AEC(s): nOEA I I IHA UW I ISPIMA PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
v-1 a (Scale: )
i
Shoreline Length -
Access Length - j —. i - ^—. ,-__-!=
Pier(dock)length
TI L_ * .-_�. ... -------
Fixed Platform(s) 1 I
/' �
1
Floating Platform(s)
. . . I- �f
Finger pier(s) r %t`
y'
f_ 4
Total Platform area I 1 , 5
l- i il
y
•
Groin length/# _ i L A ! r ,r �^
Yil ,, P�
Bulkhead/Riprap length ( C ? V
Avg distance offshore i — vli" 4,1' --c- � \1"'`y^ ' '
c+
Breakwater/Sill I I ‘'.,tk\ V ''
Max distance/length i + t' } , ^� a
Basin,channel I iti
NO4 iL. '
et
Cubic yards -' - -
Boat ramp i
Boathouse/Boatlift i B h; ,� • ! ` . ,ilk ,
Beach Bulldozing i I I 1�\J,
�'r• r1.
Other .'",' \ ) _` 4 &I- n ( ' I (' 1Y►^ 5 —� ( +r
r. t L
SAW observed: yes no { f Ili ,T'r TO
i I I(' v l)
('1 !
Moratorium: n/a yes no ! - i I
Site Photos: yes no - I i
Riparian Waiver Attached: yes no I - I I
A building permit/zoning permit may be required by:
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions
See note on back regarding River Basin rules
II 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 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:
Tar - Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie,Camden, Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

1
• N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)marl of Property Owner: I I arl fL 'Oi th Cli'le .
Address of Property: ) 47 Albemavl e Bead,.d,. 0.2 Popes-, $�JJC. 27970
p3
Mailing Address of Owner: ie bliT S• r e,. f 132 neicattcl 7 7OL0
IMQvIa. rbunclr{vec oc Wlid[axdfsd.n /—
Owner's email: Owner's one#: 932-1770-tpSO(o
Agent's Name: Er',L , , r Agent Phonefl: LSZ- 34 it— SI S3
Agent's Email: Sow wqr G.r2scaL s t, gn,Ql 1 , co
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 drawing, with dimensions, must be provided with this letter.
I 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 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be
contacted at(252)946-6481. 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
tfie appropriate blank below.)
I DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement
////(initial the blank)
Signature of Adjacent Riparian Property Owner: � � ei C
Typed/Printed name of ARPO: Da '4 L,, He/, j,oc,5 it
Mailing Address of ARPO: 10 CS- /C",,9 c !'o,•„ t Dr, J Su-PA"?e, y/r 2 39.3/-(
ARPO's email: cao1Sfotser(o��mo,/coZ po.sPhone#: 75 ?-35 S-a972
Date: 5'"/2 z/z a `waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by
owner or their agent)rt
Name of Property Owner: 1 I a Ha, aLth C Iv"Ge-
Address of Property: 113�•} / If ibe�mafrll c/ti3PQ I2 "/ Qcpev",� . Z797C
Sc,.
•
Mailing Address of Owner: CIS b4_ • C . 12+y. I 139 M ic{(.Q/4A /x 79701-0
{Yt�l-la, rc ..wlct MPc€ 141icltcu�dlsd.nefr
Owners email: Owner's one#: -1170-locrO10
Agent's Name:knit 5c wse•— Agent Phone#: 2SZ— 31 y—s1s'3
Agent's Email: Srtiul)l3er 5o45 y r. gr..e.l1• e,oM
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.
description or drawing,with dimensions.must be provided with this letter.
A I DO NOT have objections to this proposal. I DO have objections to this proposal.
7
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 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be
contacted at(252) 946-6481. 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
the appropriate blank below.)
I DO wish to waive somefall of the 15'setback 1
r'IfA roc Su Le aft_
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank) Jy✓ ✓-
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO: 1-VCILLE K. Rols'g,NS
Mailing Address ofARPO: P.O . Wx 652 6re-tLLS, MD 21054
ARPO's email: tr5373 /N ' I• ''f ARPO'sPhone#: '443 2.23 Qj(2)
Date: 7/30/2 0 2 2_ "waiver Is valid for up to one year from ARPO's Signature'
Revised July 2021
ttarif1na III . •Ii, 'i,P' .1. ' I II 't !uIII ,01I , Iln,-Yl-. ..,_. I ntmantosmournamnrmagrmarl

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner RequestingFDIC" /J Permit: Mail a-, L y Le. r7LiY1d l Yet
Mailing Address: Cl F� . SO . 01,0 Pd //aP
1Y1idlatL44, iV 1 '1w
Phone Number: L7J2- 1 c1 b — /$D(o
Email Address: VYlCtvk a. ruUhdW1e@ mid lal-t l i:rd, net
I certify that I have authorized Cr& S 4 wc✓ / 14.wy c e Sons Cwsber- "", Tne'
A ent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
l391 M/bcMc, f/c Qea.clt Rcp ; Nc- 2
c797b
at my property located at / ,
in /,4/lisA/Ayivn 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 Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner InformatIon:
math.,
00121,10et
SignaturL�
vta. Li Le RoLLnd-1i -e
Print or Type Name
Title
111I512022.
Date
This certification is valid through / /