Moshos, James 88930

❑CAMA ❑ DREDGE & FILL N9 88930 A B C D
GENERAL PERMIT Previous permit
� Date previous permit issued
U 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:
V
I SA NCAC _ f I ' - ❑Rules attached. F] General Permit Rules available at the following link: viww.dec.nc.gov/CAMAruI
Applicant Name Authorized Agent VC1 l irI C Y. "lr�J�J I C.c�'_ --,-
Address Project Location (County): ir,0V 1 u t -1i"
City State ZIP Street Address/State Road/Lot #(s) F V^-J C. Y ct ,'
Phone # ( )
Email
Subdivision
City If' ZIPn
Affected ❑.CW �.EW ©PTA ❑ES ❑PTS Adj. W(naU)tr. Body %'ls t�(1 nan/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtc Body 1.
ORM�c'yes/no PNA: yes/no)
Type of Project/ Activity 4 1
(Scale:
Access Length �'
Pier(dock)length
Fixed Platform(s) I I
--
-_
--t---
--
-..._
—
+
-
Floating Platform(s)
,
Finger pier(s)
Total Platform area %. �A ft rF'Y
f
i
Groin length/ri
Bulkhead/ Riprap length
Avg distance offshore---
—,
Breakwater/Sill
Max distance/ length
It
T
`
C.'
I
Basin, channel
--j
1—
Cubic yards
Boat ramp
_�__
Boathouse/Boatlift %'
_
I
ITI
Beach Bulldozing _
Other
j
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M•
%)
`..
SAV observed: yes no
Moratorium: n/a yes no , •
Site Photos: yes no
Riparian Waiver Attached: yes no
-
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A building permit/zoning permit may be required
Permit Conditions
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 Expiration Date

ditp"`r" ❑CAMA ❑ DREDGE & FILL
N9 88930 A B ; c `D
GENERAL PERMIT Previous permit
Date previous permit issued
❑k 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 I r ❑ Rules attached. © General Permit Rules available at the following link: www.den.nc.gov/CAMArules
Applicant Name
Address+
+
City State sj A ZIP
Phone # O
Authorized Agent Y Cl t } I C `! `- t C,}--f Vi-
Project Location (County): -}-
Street Address/State Road/Lot#(s)kie(
Email f 'I Subdivision
I
City r +; ^Iri a.. ,i( ZIP '.
Affected ❑CW [AEW ❑PTA ❑ES ❑pTS Adj. Wtr. Body S;i / iC' /"i.„ir"1 fnat%man/unk)
AEC(s): ❑OEA ❑IRA ❑uW ❑SPIMA ❑PWS Closest Maj. Wtr. Body '.+ii r ( i+++rl
ORW:yes/no PNA: yes/no'
Type of Project/ Activity '' (` ( ('�_
(Scale:
Chnmlino lunmh .�
Access Length i
Pier (dock) length
Fixed Platform(s) 1
I
—
Floating Platforms)'
Finger pier(s)
I
I
Total Platform area i
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel _!
Cubicyards
Boa[ ramp
Boathouse/Boatlift %
Beach Bulldozing
Other
�I
_
!
It
r
I
!
,
—
-
j
!
+' +•
l'i
!
__
_
_
SAV observed: yes no
Moratorium: n/a yes no
Site Photos:
Riparian Waiver Attached: yes no
-
--
-
- li
!
_
_
t
—(-
I
!
_ _
_j,:
I
A building permit/zoning permit may be required by: ++—S
-; I; l rl (�{-} Irvl(� ( ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions .t
. + ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THATAPPLYTOTHIS PROJECTAND 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 q/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. James / 1/0 $ ho$
Address of Property: 34/02 Gvrw e&t ld Dr,
Mailing Address of Owner: 3t-IO2- GNta✓u 1 d Or•
Owner's email:
Owner's Phone#: 1' 703 ^ U 8-03 7Z
Agent's Name: Pd-rtck 5picktVc AgentPhone#:2
Agent's Email: f5landand rnar3ne (q_)2 ,1y"cL1I,cuM
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
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 noury me n.L.. urvraivn vl —dalu,
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence 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 Mail.
WAIVER SECTION
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
(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 OFF-irFINIFU
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) F[P 28 t (!/ ,
Signature of Adjacent Riparian Property Owner: )1& C ocm_o u ,.I re
Typed/Printed name of ARPO: R A'/Ch t W_T < t rce_
Mailing Address of ARPO: _ 3lam2_ _ E V`` -fGi �:) l>>T
ARPO's email:
ARPO's Phone#:
Dater 2—;2,Y'2023 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

'!'yPos#di>rantad. rt+rrrt+r of hftF�Cl
mmung Addass of ARPM _3-
ARgO;i;Onoith.d ARVIi It __ �,.. •+�"� t�. to
Vale:, :xaivar >s Valid for op to ,}nn yrdarhlnm ARM 5afpr,ml liu,
F7�rvt?t,lfr rp

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: — tpm7 �, ,
Mailing Address:
to
Z
Phone Number:
Email Address:
I certify that 1 have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: C7i F1
at my property located at � "Loe S _<kaL li) rc. MIhi
in Lq E .. County. Zr9t A)
c�' SJ d
l furthermore certify that / 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 a mentioned lands in connection with evaluating information related to this
permit gpl on.' r
Print or
C3 to r\�- t1._._
Title
Date
This certification is valid through
�gs.AWn
FEB 2S7pl
RF.f"FtuF-:L►
FEES 21 2p23
D(;M-0AHU CITY