Bock, Kenny 90049C

❑CAMA ❑ DREDGE & FILL Nv 90049 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:
15A NCAC fi 4 /'j 1 C a-) ❑ Rules attached. ❑ General Permit Rules available at the following link: www.den.nc.gov/CAMArules
Applicant Name
r
Address i
city AJ p i,1 Oo� 4 State AI (. ZIP
Phone #
Email
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑ OEA ❑ IHA ❑ UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length i
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/H
Bulkhead/ Riprap length
Avg distance offshore _
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/'Boatlift
Beach Bulldozing
Other
SAVobserved:
yes no
Moratorium: n/a
yes no
Site Photos:
yes no
Riparian Waiver Attached:
yes no
A building permit/zoning permit
may be rE
Permit Conditions
❑ ES ❑ PTS
❑SPIMA ❑PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s) c.
Subdivision `
City
Adj. Wtr. Body
Closest Mal. Wtr. Body
� (. - , y
c,
(Scale: )
U 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#/Money Order Issuing Date Expiration Date

❑DREDGE & FILL N° 90049 A B C, D
Previous permit
GENERAL 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 / 0( ❑Rules attached. General Permit Rules available at the following link: vAvw.den.nc.Pov/CAMArules
i
Applicant Name _
Address
City : r State i'J [_ ZIP -= r' )
Phone # (_ )
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Email Subdivision
City - (( ZIP
Affected ❑CW [2EW ❑"PTA ❑ES ❑PTS Adj. Wtr. Body f :`'. i. �./'� 1— (natiman/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 F
Fixed Platform(s) f
Floating Platform(s)
Finger pier(s)
Total Platform area t0) 11 t
Groin length/N
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 re
Permit Conditions
(Scale:l' -' 70)
' u ame m ro)
❑ See note on back regarding River Basin rules
is
❑ 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**
Application Feels) Check #/Money Order
Signatue
5 /r(I; ! J
l f 1tj
Issuing DatJ Expiration Date

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ADJACENT RIPARIAN PROP
ERTY OWNER STATEMENT I hereby certify that I own property adjacent to zxg d NgrxQ y t Jct,- k's
( arfia of Property Own r)
Property located at -41CO SWA a .
(Address, Lot, Block, Road, etc.)
on %( JAJ , in—.—tYC' a.3l�T N.C.
(Waterbody) (City own and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
L I have no objection to this proposal.
1 have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
We vno eosc 4-o f'11oett � CAe\ C9
t'r
-Act A0
�rCAJw;��
o'dd 4 C'_vtS6�
P`a cc c'r' dt 0"J
bov,� I S4 Gr6
W`f61- — It' i✓
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr perty Owner Information)
41z. tt.l /I 49
(Adjacent Property Owner Information)
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s ure
a rt S . CJA3TL 1
Print or Type Name
YL/Z tv,/Ae/,,.- Q-D.
MairPng Addre
Jn. F sti /U. C . 2� �Z
City/stalaop
31 U-(nis
Telephone Number
I—zf -;013
Dare
(Revised 611812012)

ADJACENT RIPARIAN PROP/ERTY OWNER STATEMENT n
I hereby certify that I own property adjacent to K e V� ✓1 s4,
i �o d Nn X y 8ol k
L s �� a, � (t �a a of Property Own r)
Properly located at. y Q(� Imo`
(Address, Lot, Block, Road, etc.)(
on , in AJ&I�li�on , N.C.
(Waterbody) iCitv/Town andtnr Cnanhrl
The applicant has described to me, as shown below, the development proposed at the above location.
J I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
We �t1c7 �o ;c Irnc oel CA cQ o, dd 4-o c- 5' `i
ier" �j��uc cir� , rnovt✓ �,y/ �� tvl� 1, ,kr� boc's-cQ 6 T
i rCAw;V,)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (if you wish to waive
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr perty Owner Information)
r'e4� /1 {��i
(Revised 611812012)