Gontram, Edmond & Pamela 84232C

°``M.41I'CAMA ElDREDGE &` FILL
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GENERAL PERMIT
ew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
f
Previous permit _
Date previous permit issued
As authorized by the
-}State of North Carolina, Department of Environmental Quality and the Coast Resources Commission in an area of environmental concern pursuant to:
15A NCAC Lr ...._.._ ❑ Rules attached. General Permit Rules available at the following link: www.dpq.nc govjCAM{y ules
AEC(s): �❑ OEA
ORW: ve;no/
F...� IHA ❑ UW
PN . ye no
Type of Project/ Activity
Shoreline length � ?
Access Length
Pier (dock) length
Fixed Piatform(s) a
Floating Platform(s)
Finger pier(s) 3Y06, 3 X-2-
Total Platform area_y±�
Groin length/h
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
oathous Boatlift
Beach Bulldozing r ._
Other i
SAV observed: yeslT�
Moratorium: n/a yes
Site Photos:?
Riparian Waiver Attached: yes n0Y
A building permit/zoning permit may be required by:.
Permit Conditions I . flu-it►c)n2'F'd ..._`.,
AM AWARE OF STATUTES, CRC RULES AND
Agent or Applicant PRINTED Name
❑ SPIMA ❑ PWS
Closest Mal. Wtr, Body
Fua.�eti. Ge.J�
\r CWEX-QJ bo6,t��C (114�)
(Scak-jn )
l OX2-4
`�Xltp
V
UDW
Yr,�n TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
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See additional notes/conditions on back
THAT APPLY TO IHIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
PermiOOfflcer's PRINTED Name "o
S' nature "Please read compliance statement of ac f pe it** ' Signature
Application Fee(s) Check OAoncy Order Issuin Date Expiration Date

December 1, 2022 1:1,128
0 0.0075 0.015 0.03 mi
0 0.015 0.03 0.06 km
2022

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTE12 or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. W�'UrJV f. f'AIACL-A s
Address of Property: �E% Ee4&C42ts LA 'jQAt 59gE-y J Jc-, Z64-f—a0
Mailing Address
��of��Owner: &O �409-yI'��I E C—LU J WAK Jr /J�• 2758�
Owner's email:C,+cbgt� GOh`�y' `) ne s ione9: Om
Agent's Name: Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
n to be com leted by thePmporty 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 dimension$. must be provided with this letter,
_AL_.__ I DO NOT have objections to this proposal. I DO have objections to this proposal.
N 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
malted to 127 Cardinal Drive Ext., Wilmington, NC 20405.3845. DCM representatives can also be
contacted at [phone]. No response Is considered the some as no objection N you have been
notified by Certified Mall.
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 1 T 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 slan
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-0R-
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: K Q #1t5 {1I fwJ000 : f OileS 'V j
Malling Address of ARPO: t' t--l,( t,,ra{`ihq NC
ARPO's small:1 I� ARPO's Phone#: j " 060 i rJ
Date: Ll 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)
Name of Property Owner: n)D PAmEI,g O Yr2A l ;,�
Address of Property: �6v 1.�. G✓t� � -yam V'_4 o C)
Mailing Address
�of1Owner: lkl N(31?41-Aae ci.wvt Ve - 241W
Owner's email:ClK�tt-" �Oci;GO✓��J ers`Pfione# �(� '�i�l I - I �$�
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiscent 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 drawin-q, with dimensions must be provided with this letter.
DO NOT have objections to this proposal. ► 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 127 Cardinal Drive Ext., Wilmington, NC 28405-3845. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by CertMed 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 elan
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback Vc
`/ f)
Signature of Adjacent Riparian Oroperty Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
�,. j
Typed/Printed name of ARPO: �6t l` `j �U 2� ` � A_ V C ��-
Mailing Address of ARP: H 1 .9 � C �C' � \ h_0" � , ray\j� 1 1
ARPO's email: ARPO's Phone#: �%� ' . � 0
Date: I; 6� _ Z - ,_ �, �) -waiver is valid for up to one year from ARPO's Signature'
Revised July 2021