86917A_Struble, Gregory & Sherry_20221208

IVY 86917 It v B C D
#iCMr''N [4CAMA [_DREDGE & FILL
,�
GENERAL PERMIT Previous permit
3
[rNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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 7 • 1100 _-_ _.--_ ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name C-'S r �►%� . __
Address -s-�• (..J� , - -
City (fO:A - 1(itr' State zip
Phone # (V=37
Email !` ). 4
Affected CW jt�} EiN qkA ES PTS
AEC(s): OEA [- IHA UW SPIMA PWS
ORW: yes/0 PNA: yes
Authorized Agent J _r2.
Project Location (County): C" L i +GC k 1
Street Address/State Road/Lot #(s) 3 •� �ae'�� �• i. G�
11-1t - 2- lG --- --
Subdivision
city (-'0 n oic k - - --zIP
Adj. Wtr. Body Tt�-%fg//Cp�_ J (nat/ an)tnk)
Closest Maj. Wtr, Body
Type of Project/ Activity Rg lr=eg 90v ,`f' �e i(n G.o T�v 5�
(Scalers )
Shoreline Length IC3r'
r
Access Length It
Pier (dock) length
Fixed Platforms)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/4
i
Bulkhead iprap length ( U' p
Avg distance offshore
Breakwater/Sill
Max distance/ length 2 2
Basin, channel k
Cubic yards Alt
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
r TCJ--)Ii
c�
o-
X
U
C4
2"
pr(f
SAV observed: yes (
Moratorium: /a yes no C_
Site Photos: (& rip
Riparian Waiver Attached: yes no
A building permit/zoning permit maybe required by: !' f���•�� .,
Permit Conditions A ru 4cl,�} z tita n - �-,, b� 11L t, d
4o ',XL.-kj 30' 4 1JJIkPW,J
M,
,]
TAR/PAM/NEUSE/BUFFER (circle one)
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) _
Agent of Applica t PRIN ED Narne
Sign t e "Ple a redio compliance statement on back of permit"
A lica 'on Feels) Check #/Money Order
m-byIt')- Lt fK/)-3
Issuing Date Expiration Date

9
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date /O /9 z RECEiVED
OCT 2 1 2W
Name of Property Owner Applying for Permit:
DCM-EC
Mailing Address:
Z,/,Zy k
COINJ,-,EyG 279,Z,5
I certify that I have authorized (agent) PQAl r-- FF to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
�
'
install or construct (activity) JVE� lc1�fG Gti
at (my property located at) zL.//
This certification is valid thru (date)

(Top portion to be completed by owner or their agent)
Name of Property Owner.
Address of Property. -
Mailing Address of Owrtei
Owners email ZS-5 04 r (•tt#0wner`s Phone#:
Agent Phone#: �-
Agent's Name:
Agent's Email:
7y 7 y2-ar40,
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that 1 own property adjacentto the above referenced property. The individual applying for this
permit has described to me, as slrx rt on the attached drawing, the development they are proposing. A
1 DO NOT have objections to this proposal -
objections to this proposal.
ff you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCAI) in t+rriting within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St, Ste- 300, Ear City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered tie same as no objection if you have been
noted by Certified Mail.
WAIVER SECTION (Choose only one
1 understand that any purposed per, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
grain must be set back a nk*num distance of 15 from my ar of riparianIcress unless waived by me
(this does not apply to bu&heads or riprap revetments, l_ ish to waive thq setback, you must sign
the appropriate blank bellow.)
I DO wish to waive somelall of the 15' setback
-0R-
Signature olAdjacent Riparian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
i
Typed/Printed name of ARPO: G O
Mailing Address o��~~ffG���l
ARPO: 3�j q (�9rI / �l�Li (/�GL C% 0 �/�l�G`G
ARPO's email: J�4 ��/¢- ZOARPO's Phone#: /�19% �3� 37 4/e-
Date: / 7i "waiver is valid for up to one year from ARPO's Signature*
RECEIVLU Revised August 2022
DC T 2 1 2o22
DCM-EC

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)
Name of Property Owner:
Address of Property:
Mailing Address of Ownei
Owner's email: 5 / � c 1 n, 4 i 1 "Ob pwner's Phone#:
Agent's Name: Agent Phone#: 'Z Z
Agent's Email:
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 or 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only one)
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15from 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 some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: RE r
Mailing Address of ARPO: (v`�r V�
ARPO's email: QoL .C+".\ ARPO's Phone#: a ��� �10�1'1 OCT 2 1 2022
Date: \ \ —4, *waiver is valid for up to one year from ARPO's Signature* D
Revised August 26 ''��

oLA
�� I � x t� �•r�s � ��1s
le
69 AC
m&, ),��-vtad �5 c, c,41 5 Alir� t
'Y""le -44--
ad Mks , 7/-s
YZJ
r
R�IV
0 E C 0 8 2022
DCM-E

;urrituck County GIS Data Viewer
Currituck County GIS
Phone: [phone]
E-mail: [e-mail]
381
a
This map should be used for general reference purposes only. Currituck County assumes no legal liability for the information
shown on this map.