Thomas, Tim 84241C

(eZeE
AMA ❑DREDGE & FILL N9 84241 A BNERAL PERMIT PamprspermitDate previous permit Issued
w ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized
01141
byYthe
State of North C`arolhn, Department of Environmental Quality and the Coss Resources Commission In an area of environmental concern pursuant to:
I SA NCAC b l411-ZO6 ❑Rules attached. 7 oral Permit Porke available at the folkming link:
Applicant Name I
"
Y
V �.
-
Authorized Agent �•'aFa"-1V - .1- �Il1
'Q • L6 J ('�f�n
Address
city ,
L�
o --�
jPM
Project Location (Count'): ,� rjk
Street Address/Sta #(s)
L �s
1 Mt,
•� �t
ZIP Lw+61 1 9
j 70
a Road/Lot -.
Phone#( )
— QR11
Email
Y ()ZIMJJIJ
-I (N_
SubdMsion
CIry v/ ZIP
Affected &KW
[;KW [�er"A
L �I ss ❑ Ppg
Ad]. Wtr. Body 'SPin/ ardunk)
AEC(s): ❑FA
OINA
❑ ❑UW
❑SPIMA ❑PWS
)
Closest M. Wtr. Body AIVV V
ORW:y no
PNno
Type of Project/ Activity
Shoreline Length `frJ' r '
Access Length
Pier (clock) length Isy I C) -i L
Fixed Platforms)
UWIJUAMIT�
Floating Platform(s) .d 7- 7 I
Fingerpleds)--
_I ! _
Total Platform area I11.._}_i 1 r I _� __L r-� I�R-•C
Groin length/uL_-___ _
Bulkhead/Marais length-
+-
Avgdistanceoffshore
i r
Breakwater/SIII .� ...._..'r- I^�-_ ------
Max distance/length / I�l 7 F h•- -! Basin, channel / -I -- -I - ( i -- ---
Cubic yards
Boot ramp -
Boathouse oat I i--�_�__-
' 1
BeachBulldotln /� r-F-
Other_ i _! - _ _-
SAV observed: yes n _ i h ` �'� I �- I y - 17
Moratodum: n/a yes
Site Photos: I
Riparian Wavier Attached: yes no —;.-L-
A building permh/so g permit may be required W;
Permit Conditions
POW
a
�Mdm
permit --
Z 4*y 1'Z.
(Scale;
r
�T4
-- �.
- -ta- TI
❑ TAR/PAKNEUSE/BUFFER (clrcie one)
❑ See now on back regarding River Basin rules
See additional notes/conditions on back
Date

��`°"'w QCAMA ElDREDGE & FILL N9 84241 A B ©D
a°
GENERAL PERMIT Previous permit
Date previous permit issued
[V4ew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the Sttate of
North Carolina, Department of Environmental Quality and the Coas al Resources Commission in an area of environmental concern pursuant to:
I5A NCAC D ` , ` t' ZO6 Rules attached. 2General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name 1 1 ! V V Authorized Agent
Address //�� ''77��// JJ���� �� Project Location (County)' 17t7�
City -T i lTtach� J �_ ZIP a34L Street Address/State Road/Lot #(s)
Phone#^ (. 'f ) l CT 1
Email N thymer ' Z afnrA_d ( DID Subdivision
City n� �✓ ZIP
Affected [VW [;�CW ©PTA [91ES ❑PTS Adj. Wtr. Body Al
� pW(nnn nan/unk)
AEC(s): ❑ OEA IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body A V V LAj
ORW: y0e PN�'/ no
Type of Project/ Activity
Shoreline Length 1 Z.7
Access Length
Pier (dock) length Sy 1,C)
Fixed Platform(s) 1 1A IZ,� 12 Ccr.wrPd t 2 U•Lll
Floating Platform(s)
Finger pier(s)
Total Platform area 314
Groin length/9
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length .0�
Basin, channel 1-1
Cubic yards z/
Boat ramp
Boathouse B-ath IC i_
Beach Bulldozing
Other
SAV observed: yes Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: yes no
A building permit/zoApg permit may be required by:
1L J 41
I AM AWARE OF STATUTES. CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT
`"'A�fl'Yj6f'A'(i�li'F813�`� � ame
C"
2X
-Z) L4x1`-
'F� - I
tC/ I
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
Sig Lure'*Please read compliancektatement on back of permit*_�
Application Feels) Chec /Money Order
Date

°"❑CAMA ElDREDGE & FILL N° 84241 A B C D
jl�GENERAL PERMIT Previous permit
Date previous permit issued
❑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:
15A NCAC ❑ Rules attached. ® General Permit Rules available at the following link: www.deq.nc.goy/CAi Arules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # ( )
Email l.SfY k(It ii Subdivision
City
Affected 0-EW ❑ EW ❑ PTA 0 ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yed(no j PNA: yes/no
Type of Project/ Activity
Shoreline Length.
Access Length
Pier (dock) length
Fixed Platform(s) _
Floating Platform(s)
Finger piers)
Total Platform area
Groin length/M
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: )
❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ 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"
... tl
Application Feels) Check p/Money Order
,
Signature
Issuing Date
Expiration Date

�w"'"a❑CAMA ❑ DREDGE & FILL N9 84241 A B . c," D
GENERAL PERMIT Previous permit
Date previous permit issued
❑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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nagov/CAMArules
i.
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # ( )
Email Subdivision
City ZIP
Affected QCW FJEW ❑PTA ❑ES ❑PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length.
Access Length
Pier (dock) length
Fixed Platform(s).
Floating Platforms
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no -- !
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ 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 Feels) Check N/Money Order Issuing Date
I l l 1
Expiration Date

Name of Property Owner Requesting Permit: !i I
Mailing Address; 5 D 9--- a d 2( )III A Dr.
Phone Number: I 'T `71I D �21 I
Email Address: C,u etYGlttYIEI I�{�C9lTlatI,Gom
I certify that I have authorized L;111 LLL JY� III a115 L2C
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development:
w
at my property located at �)
in ! 1 5 1 L% L County.
1 furthermore certify that f am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permif Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Signature
(! 1' 11 C" IrlCi
Print or Type Name
r-tt�2d'"
Title
J- 1 l (7 /�d
Date
This certification is valid through

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner — t )I E1. I n Q 5
Address or Property:
Mailing Address of Owner.
C r)1
6rme's small: t'.C,(`;(YktCf7Ki-iq�-41ti't(f•�Owner's Phone#:
Agant's Name: =01)mCtI?r1E �1CY?St t'L Cil�17 Agent Phones:
Agent's Email,�!)t) f{7)kiI"lOYP/1115;rrit��nnF.tr�li�:�). nrm
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom oortlon to be comolefed b tv ire Adjacent Property Ownsr
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
pemtit has described to me, as shown on the attached drawing, the development they are proposing. A
s(. de o o d i with a tons at be provided with this letter.
Lr�I DO NOT have objections to this proposal. I DO have objections to this proposal.
n you have objections to what fs being proposed, you must notify the N.C. Olvislon of Coastal
Management (DCM) In writing within 10 days of receipt of this notice, Corrospondance should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted
at [phone]. No response Is considered the same as no objection If you have been notified by
Certified Mall.
WAIVER SECTION
p I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
. (a\Crain 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 dprap revetments), (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback
-OR-
Signature OI Adjacent Riparian Property Owner
I do not wish to waive the I5' setback requirement (initial the blank)
S /& t
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
e��DdS r
k��tC(1 Mailing Address of ARPO: �J • 4Crt
GL ARPO's email: lit 0 , , 10 ti )\A ARPO s Phona#: 1 (`i - G O
J Date: ?�- 1 1.1 ,waiver is valid for up to one year from ARPO's Signature"
t -- — Revised July 2021 �O 5
d

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: ilil t f lll `J
AdoressofProperty; TrL-Or c (IIJS 1Jj� N ltchni/ L1c«cl) kC �X�tcG,
Mailing Address of Owner. J C f %) I e o
01
Owner's email: �1.tlur 7" -i ;; .`"Owners Phonon; r1 ��I '%�i a - ✓�{�
Agent's Name: El�li` j�,Etif'MC!!" a C,Ca ftU( Z, !7 Agent Phone#:
Agent's Email: (-rm
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
1 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
1\
�1 tidescription or drewino with dimensions must be provided with this letter. cpW I DO NOT have objections to this proposal. 100 have objections to this proposal,
.. ,- .a+o vurawvvna ru wrier rs rveing proposed, you must notify the N.C.-Division of Coastal
Management (OCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC28557. 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
p( 1 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
\: (� (thls 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' setbad1 n _ TeUx ,L
� r r utn Lil
-OR- urgnehU or 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: /1 `:2 \ 10 1
Mailing Address of ARPO: 5 `13 S(o i ll�i �1 4 v
15 96-U i
ARPO's small: O Q tjtgq i'.o-, ARPO,s Phone*:
Date: ^z 1 G L 7 "waiver is valid for up to one year from ARPo's
0
t o IZIT �� 4-,
JzJ
inaturs c� ' •
"r,
Revised July 2021_
it.l

N
®sI
I