Cayton, Alvah 88931

As)©CAMA ❑ DREDGE & FILL
GENERAL PERMIT
No 88931 A B , C D
Previous permit
Date previous permit issued
0 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 / f% 1 1 1 1. ����. ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name ,! G1 h CtTr1 Dy-1 1 V
Address
City State i,,A C. zip Z 1'S U6(C
Phone #
Email
0
Affected ❑ CW ❑ E W M PTA ® ES ❑ PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
Authorized Agent Cln L� \L, n f r
Project Location (County): "-
StreetAddress/State Road/Lot#(s)
City
Adj. Wtr. Body bCiC V- -, ot,t tld (naC'man/unk)
Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity :' �;7 (Ck rA n A L i � I
(Scale: )
Shoreline Length
Access Length—
Pier(dock)length—
'T��
FixedPlatform(s)
.•/r
I
7'r
`
Floating Platform(s)
I
Finger piers)
Total Platform area
Groin length/q
c
Bulkhead/Riprap length --
I
_
-
—--
-
-{- ----
—--
_.I.--
!
--F-
-
1
—
—
—
---
—
__
—
„ x
Avg distance offshore
Breakwater/Sill
Max distance/ length ' ' f\1 ti
%
--LLBasin,
Is
channel
_-�-�,
(
i -
Cubicyards
Boat ramp
W.,`
k
Boathouse/Boatlift
(
7
Beach Bulldozing
Other -'"
�-
-
_.._.-
��
��
��
_�
��
YY
L(_.�______
,
SAV observed: yes no
—
--,�^�
,�
,.�
�
�_,.0
.....
Moratorium: n/a yes no
-
r
(s�;
I
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: "t `(P-C ( I 1I,
Permit Conditions
("fir
❑ 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 q/Money Order Issuing Date Expiration Date

�❑CAMA El & FILL N° 88931 A B rc D
GENERAL PERMIT Previous permit
Date previous permit issued
W4ENew
[]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 1 1"i" L "r"( 1. ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name 1 i
1 )p-t �j�f ACTy \
Authorized Agent i, �' , I
Address
. i <'i'
Project Location (County): <�(, + r -4-
city
State t--k C ZIP L r,
';= (i
Street Address/State Road/Lot #(s) I
Phone#(_)
'I
Email
i. r-
Subdivision
City I�(l: `fl4S-1.',lr'r,.f� ZIP
Affected ❑ CW
❑ EW ❑ PTA ❑ ES
❑ PTS
Adj. Wen Body V :. i' 1 f 1 zl ,(6at/man/unk)
AEC(s): ❑OEA
❑IHA ❑uW SPIMA
❑PWS
Closest Maj. Wtr. Body
ORW: yes/no
PNA: yes/no
Type of Project/ Activity
I
(Scale:' ', )
Shoreline I ennth
Access Length
Pier (dock) length
Fixed Platform(s)
-
----
i
I
—
Floating Platform(s)
I
'�
I
Finger piers)
_
!
Total Platform area ./
Groin length/#
Bulkhead//Riprap length---
Avg distance offshore
Breakwater/Sijl -'
Max distance/length
Basin, channel
Cublcyards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
OtherMA—
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
—I
--
—
—
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it
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-
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)
A building permit/zoning permit may be required byCr 11 Yl \
Permit Conditions -
Agent or Applicant PRINTED Name
Signature "Please read compliance statemefit on back of permits"
i,
Application Fee(s) Check #/Money Order
TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
STATEMENT. (Please
Permit Officer's PRINTED Name
Signature
Issuing date Expiration Date

DocuSign Envelope ID. 8DC3FDCA-E603-4D55-BF4E-98E296419079
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Per/mit:' kl ✓a A (2, nV fo E
Mailing Address:
I
Phone Number: 2s-2,- 723• F"� ]b
Email Address: D.�c/ 4f) a) c'M6G / , C 0
I certify that I have authorized
Agent /
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: R� ca.e ^k S At 2 /'�\ e 04—
at my property located at _/
in CAL4-ere'F County,
l 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:
oocusa ny:
�5A908FIfiB OeA
Signature
Adak C-. Cau�en 17i
Print or Tye Name
Title
al l 2v13
Date
This certification is valid through
MAR 01
MXOWt Hiu CITY
e_" 1

L, I It"- n IF nvelope lD eDCJpfKA-EJbia6',S iJF4L At 2%4P,
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL__RFTURN ftF IPT REQUESTED or HAND DELIVERY
(Top portion to De ,.umpleted by owner or their agent)
Name of Property Owner t
r
r__. __ .- -- -_ -
wdressofPropercr i 1 'qr: + r��( 1lR/ Pis 14M� Y�C P— 3/
MaffigAddress ofCMner iloy
Owner s email {
.LLLQd.G_9,�.'f`dlla% 4•;,s'tt0wner+,Phone4 1.23-- 9 _1 90
Agent's Name
7 ' 7---�...__. __. Agent Phone
.2 �02 .� ya"t S % dZ 2-
Agent's Email i"I`lsyu'I1,.b�41..�QGP4nnJr:,r� O--ky-va...___..
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portlon to _bo completed by the Adfacent Property Owner)
I hereby certify that I nwn property adjacent to the above referenced prouerty The individual applying for this
Permit has described to meas shown on the attached drawing, the development they are proposing. A
descnpbo I or drawing wnh AimensronS m;i$_I Le L v_idep. with this letter.
. 1 DO NOT have objections to this proposal I DO have objections to this proposal
If you have objections to what is 6e/n -
g proposed, you must notify the M.C. Division of Coaata!
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 ff you have been notified by
Certified Mail.
WAIVER SECTION
I understand that any proposed pier dock.. nwnring 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 nprap revetments). (14 you wt I, to waive the setback. you must sign
the appropriate blank below )
I DO wish to waive someiall of the 15' setback
Sryrraho.
OR -
of Adjacent Rrparran Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) MAR 0 1 /1;7"
Signature of Adjacent Riparian Propcerrly� Owner 1_\](/ CjCM..MHLJ GITy
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
rRPO's Phone#: p3�. L� Lcl
Date: 2 • Z� ---waiver Is valid for up to one year from ARPO's Signature,
Revised July 2021

2/28/23, 12:45 PM
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CHANTILLY, VA 20151
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