86852A - Baker, George

a-
NNCAMA ❑ DREDGE & FILL Na 86852 B C D
GPrevious permit
GENERAL PERMIT Fs�'� Fey
Date previous permit issued
n.o �h,t/Lz
❑ New ❑ 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 environmental concern pursuant to:
I SA NCAC i�H1 - 1 a1 ^❑ Rules attached. ® General Permit Rules available at the following Bnk. www.dm.nc.¢ov/CAMArules
Applicant Name 0.1Co t°.Q � `` � l Dri1RQ RqkPX Authorized Agent
Address («rram ()C eel A l Lw W , r� Project Location (County): Pet-G
City %i2Y� h]rC� State MC ZipQ -1 ip IN Street Address/State Road/Lot #(s) "0 U%
Email Crnn
o•sle' //-��
Subdivision vt Q`
MVE G A
JWEA
City— zip �Uggq
Affected ❑ CW
EW
® PTA
❑ ES
( a unk)
❑ PTS Adi. Wtr. Body_ l 2 t Qhh
AEC(s): ❑ DEA
❑ IHA
❑ UW
❑ SPIMA
1c�w .mYy�[a
PWS Closest Mai. Wtr. Body M� [YeLr L�c
e ��C`1 "J
ORW: yes/no PNA: yes/no
Type of Project/ Activity uzr's imc,F a a 5 x IZ' 60'CL+ K(YL52
(Scale: I0= V }
Shoreline Leneth t/ 9 d
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area gY?'5=-e%f
Groin length/ti
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length -'
Basin, channel
Cubic yards ^
Boat ramp
at oi? /Boatlift
Beach Bulldozing
Other
SAV observed: yes
Moratorium: n/ yes
Site Photos:
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by: �+��tb t fV�:r� Cci�ra
Permit Conditions
❑ TAR/PAM/NEUSFJBUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1 AM AWAREOFSTATUTES,CRC RULES AND/COONNDDMONINIS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.
( (Please Initial)
k. OC. L- / 1L7 /I t , IC ir, a n : ,-,.,
Agent or liwnt PRINTED Na C��
Signature "Please read compliance statement on back of permit"
,s awl t*: 107-53
Application Fee(s) Check #/Money Order
Permit
Signature P"
�f9(23 NigIa3
Issuing Date Expiration Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: (rL� �`-r!rL' �� 94 �4fx
Address of Property:
Agent's Name #:
Agent's phone #:
(Lot or Street #, Street or Road, City & County)
Mailing Address:
a- � y'ser �?
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. n description or drawing with dimensions must be provided with this letter.
_ e I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the 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 (252)
264-3901. No response is considered the same as no objection if you have been notified by Certified
Mail.
WAIVER SECTION
1 understand that a 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. (If you wish to waive the setback, you must sign 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)
i
Signature
Print or Type Name
,AD6 / r)C—,cA �LA41
Mailing Address
-AAA A, -It
City/State/Zip
02 E-�L 3l J S'u6 !/
Telephone Number / Email Address
3',�/6 /d- v, --
Date
*Valid for one calendar year after signature*
(Adjacen Owner Information)
Signature*
Yej d
em
Print or Type Name
; G' 2 /4 ,-, Ce 4c 9 J,
Mailing Address
f N C- 27 9V
City/State/Zip
4 0 8 --s/ a —7/J =r
Telephone Number / Email Address
3— Z
Date*
Revised 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner:
Address of Property:
Agent's Name #:
Agent's phone #:
g)gk&i2
PJ (A eywo/) lvwTr--6al
(Lot or Street #, Street or Road, Mity & County)
Mailing Address:
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 have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the 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 (252)
264-3901. No response is considered the same as no objection if you have been notified by Certified
AA-:#
WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must sign the appropriate blank below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
kog�,-e 2, i344!�r4
Print or Type Name
Mailing Address
A�� �s y%
City/State/Zip
a-��- 3jj. 546 Si
Telephone Number / Email Address
(Adjacent Property
/Owner Information)
ignature *
Print or Type Name ��.� Jdi»�
Mailing Address 11
�l 7i C 7 Y
City/State ip
Telephone Number / Email Address
Date Date*
*VDate*
*Valid for one calendar year after signature` Revised 2017

"Lai C�cv -V-T
-fyw c,�,L-
1°t g L °)
S
v
CA
C9 , moo) ' ' �a/S�'-�' `I 3 C

sum•