1_Test_20010101

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CAMA ❑DREDGE& FILL NV8612.i B C D
Previous permit
GENERAL PERMIT Date ous isst�
. _- permit ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carohm, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC -- 1- Za C. _. Rules attadted. � General Permit Rules available at the followkt link yy r tJey.nc fovKJV 1Aru�s
Applicant Name a• 1a a to Authorized Agent ` S %' IN C, r t tip.
Address g Project notation (County): `.D- -�CL-
city - state Al -- ZIP _' D Street Address/State Roadllot #W
Phone # r S a ✓ r i V-r r, t
Email _ rhti, h y �' O •`, fa !1 AA Q. r 1s Subdiv" ' �fa _J.� ---�. �r'� Q t� __-- ..-V
City-7 T —ZIP
Affected CW � �PiA
ES u PTS
Adj. Mr. Body _ 43L A G I
--(nalGtwVink)
AEC(s). ❑ OEA IHA UW
SPIMA PINS
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Closest Mai. Mr. Body - � < .,A. eD Ir
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ORW: ye PNA: s
Type o f Project/ Activity :ICn .5 It
�J -- .o', 1 ee 1
3' �C � 3 r 1�✓ � �. '{"1 i -�'�"
(Scale:NVS)
Shoreline length
Access length
Pier (dock) length
FixedPiatform(s)_-
Floating Platform(s)
Finger pler(s)
Total Platform area
Gran length/R
Bulidtead/ Rhprap length '^
Avg distance offshore
Breakwater/Sill _
Max distance/ length �•
Basin, channel
Cubic Ards
boat rampou Boathse hft
Beach BuMdot
Other
SAV observed: yes no
Moratorium: yes
Site Photos: <5i5 no
Riparian Waiver Attached <Ymc
no
A building permit/zoning permit may be re4
Permit Condftiorts e
l
A w,�•�r-ef11 2 •.d
/3'y f3'
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W •
� fis�k�-PS-r
6- / k iRI.l
uircd by: .'SG't a � /V —!e S iffo- tM-4
TAR/PAM/NEUSE/BUFFER (title am)
See note an bade regarding River Basin rules
-- - - � - E] See additional Holes/conditions on back
I AM /1�tARE OF STAWES, CRC RULU AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Inkial}V- SS
AgiAtt'& �plk• ! D e Perrhit O ' er's PRINTED Name
Sig a read compYance statement on back of permit" ure
Application Fee(s) Check p/Money Order Issuing Date Expiration DdM

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: MATTHEW T. HUTH
Address of Property: 7814 S, VA. DARE TRL., NAGS HEAD, NC
Mailing Address of Owner: PO BOX 92, WANCHESE, NC 27981
Owner's email: MATTHUTH00@GMAIL,COM Owner's Phone#: [phone]
Agent's Name: Scott C Small 252-473-7695
Agent Phone#:
Agent's Email: scott§lsimarine.com
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom Rortfon to b2 comulet� ft Adiacent ProRg ft 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 dra ino with dim-nsions must b ,provided with _thhis letter.
_/ I DO NOT have objections to this proposal. I DO have objections to this proposal,
If you have objections to wire: Is being proposed, you must notify the N.C. Division of oastal
Management (DCM) In writing within 10 days of receipt of this nodce. Correspondence should be
mailed to 401 S. Grif>rn St., Ste. 300, Elizabeth City, NC, 27M. DCM representatives can also be
contacted at [phone]. No response Is considered the some as no objection If you have been
noted 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 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 sometall of the 15' setback
S grxarure of Adj&6nr mpanan Property owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:,.(��
TypediPrinted name of ARPO: WINFRED S SHREWSBURY
Mailing Address of ARPO: PO BOX 113, LERONA, WV 25971
ARPO's email, R v.'✓�- �r.ce•-
PO s Phono#:
Date: 9 Q 2 � +waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

AGENT
AUTHORIZATION OCAMA VOl •
Name of Property Owner Requesting Permit: _-A Pr4 e LA/�+'i
Mailing Address: P O ao % i J, t/ e,,., � LIL L �
Phone Number:
Email Address: ^'lw-(, . j� V u , Gs
1 certify that I have authorized CA,�3
Agent / contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: - B e at L '
at my property located at —781 y �. V i e c i n. o 7�% •) A/ f q% l k4 J
in 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;
MW
ro
Signature —
A fr4q_ w 7- #..f<
Print or Type Name
0 WA Z'e-
77t/e
Date
This certification is valid through _I

PROPOSED NEW 13K TIDETAMER BOAT LIFT & PILES
\ @ 7314 S VA DARE TRAIL, NAGS HEAD, NC FOR MATTHEW HUTH L .
RIPARIAN DRAWING 1 OF 1 � NOT TO SCALE -- 5/31/2022
DRAWING BY: SCOTT C SMALL OF LSI MARINE LLC - 252-473-7695
WWW.LSIMARINE.COM SCOTTQLSIMARINE.COM--�--m
7810 S VA DARE TRL �
CANAL
Lsl
MARINE
Construction, LLB
EXISTING DOCK ,� Is OFFSET
TO BE REMOVED,
APPROX. Y X & (IS SF)
EXISTING
BULKHEAD
.9
PROPERTY OF: -
RINEHART
7814 S VA DARE TRL
PROPERTY OF:
5v
- =�; SITI'H
I S'OFFSET i _. -
x --�i
'fP-0CR-OPOSED
NEW
' BUTT X 30'ROUND 2.5
DDnDn0en ► MAS A BOAT LIFT PILES X 4
13K - 4 PILE
TIDETAMER
BOAT LIFT - 7824 S VA DARE TRL. '
13' X 13'
�<? PROPERTY OF;
a y

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
ERTIf iED MAIL RETURN RECEIPT REC UESTED or PAND DEI iyERY
(Top portion to be completed by owner or their agent)
Name of (property Owner: MATTHEW T. HUTH
Address of Property: 7814 S, VA. DARE TRL., NAGS HEAD, NC
Mailing Address of Owner: PO BOX 92, WANCHESE, NC 27981
Owner's emair MATTHUTHOOQOMAIL.COM Owner's Phone#: [phone]
Agent's Name: Scott C Small Agent Phone#: [phone]
-- -
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER's CERTIFICATION
(Bottom cx�rtion 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
de cri t nor, drawingwith dimensions must be provided with this letter.
1 I DO NOT have objections to this proposal I DO have objections to this proposal.
Jf 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 rwWPt 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
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 Sian
the appropriate blank below.)
I DO wish to waive some/ail of the 15' setback
�,;tgnature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the
Signature of Adjacent Riparian Property Owner.-
Typed/Printed name of ARPO: DEL13ERT WORTH RINEHART A PAULA D RINEHART
Mailing Address of ARPO: 204 OAK HILL DRIVE, EDENTON, NC 27932
ARPO's email:
Date:
ARPO's Phone#:
'waiver is valid for up to one year from ARPO's SignaWW
ROVis+ed July 2021

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