Willis, Sarah 88936C

NY 88936
`1*
01(OAST41 ❑ CAMA ❑ DREDGE & FILL A B C D
GENERAL PERMIT Previous permit
0 [-] 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 !» �f• '' ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name ! i' ` �i.! ! t ':; Authorized Agent
Address ' `F 11 Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone #
Email : ! ,,.` ? r ,,1 � r. ; Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ 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 Platform(s)
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:�,. {..df �"_ I,, i✓ �,3 ti y .�
PermitConditions,,h.
(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 Fee(s) Check #/Money Order Issuing Date Expiration Date

�oN-°i`°`ST41Al ❑ CAMA ❑ DREDGE & FILL NO 88936 A B c D
9= GPrevious 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:
15A NCAC ` ! } �- S ` C ' ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City ! State ZIP
Phone #
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ 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
(Scale: )
Shoreline Length
Access Length
Pier dock length
(dock)
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Ri ra length
p Rip
rap
distance offshore
Breakwater/Sill
Max distance/ length
Basin channel
Cubic yards
Boat ramp
Boathouse Boatlift
Beach Bulldozing
Other
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SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no �£
Riparian Waiver Attached: yes no I ,�
A building permit/zoning permit may be required by:
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"
Application Fee(s)
Signature
Check #/Money Order Issuing Date
Expiration Date

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)
C-, rn h I A.0 /, S
Name of Property Owner:
Address of Property:
Mailing Address of Owner:
Owner's email: ` '�b t t L t J� f r� ro
Agent's Name:
Agent's Email:
s 3 �d 3 %
Owner's Phone#: ,
Agent Phone#:
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
description or drawing with dimensions must be provided with this letter.
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 notify the N.C. Division of Coastal
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
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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 1.q' -QPthark
,D/1
-OR- 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: ,�
MAR o
Ty,ped/Priipted name of ARPO: %� ®� �, I_ � � fs., .41��. �-
Ailing Address of ARPO: --- �j�..._.Ae AelT®�y7 i T�
ARPO's email: 4oi,j6., ARPO's Phone#:
Date: /b ,V - 7-4 *waiver is valid for up to one year from ARPO's Signature`"
Revised MY 20 1-1�� I

USPS TRACKING #
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28)C�
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9590 9402 7456 2055 7651 72
United States •S - ender: Please print yo IS name, addre
print
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
e+4® in this box*
Jill III 11111111 111

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SENDER: COMPLETE
•
■ Complete items 1, 2, and. A. Sigriature
■ Print your name and address on the reverse
so that we can return the card to you. x Agent®drree
sses
• Attach this card to the back of the mailpiece, B. Received by (Print d Name) C. Date of Delivery
or on the front if space permits.
A
1. Article Addressed to: � � .-�
D. Is delivery a dress different fro
m item 17 0 Yes
if YES, enter delivery address below:
l O-NO i
1
3• Service Type C] Priority Mail Expresso • ❑ Adult Signature ®Registered Majlsra '
d Adult Signature Restricted Delivery p Registered Mail Restricted
9590 9402 7450 2055 7051 72 ° Certified Mails Delivery
O Certified Mail Restricted Delivery ® signature Confirmation` m
2. Article Number (Transfer from service label) I� ollect on 0 Collect on ry Restricted Signature Confirmation
0 Insured Mail Delivery ted Delivery Restricted Delivery
O Insured Mall Restricted Delivery
(over $50U �t
PS Form 3811, Ally2020 PSN 7530-02-000-9053 f«
Domestic Return Rec►t
'.4

W', . L�CAMA 0 DREDGE & FILL
•y�
GENERAL PERMIT
9 84451 A
Previous permit _ B D
Date previous permit issued
0 New VModification ❑ 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� ��n 1 Rules attached. General Permit Rules available at the following link: www.de .nc ov
Applicant Name _ S,4�a N W f✓ (5 _�— Authorized Agent
Address _� (s(•.� �� _ Project Location (County): : f
City A� L Zlp Street Address/State Road/Lot #(s)
Y -.��_ �, _ State __..-}L.`!--
Phone # (Z52) 3_QI
Email Subdivision
City IP
Affected L_.J cw VEW [APTA � ES PTS Adj. Wtr. Body y ��(� (i r; *a Vunk)
AEC(s): EJOEA EJIHA 0UW ❑ W
SPIMA �PWS Closest Maj. Wtr. Body so( _ `��'�
ORW: yes PNA: yes o
Type of Project/ Activity eA L =
(Scale:
Shoreline Length _ �I_
Access length
Fixed Platforms)E�I
Floating Platform(s)
Finger pier(s)
Total Platform area_ 2-1 ME
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse tilt
Beach Bulld
Other
r
SAV observed:
yes no
Moratorium: n/a
yes no
;ite Photos:
yes no
iparian Waiver Attached:
ves nn
EFFA20
building permit/zoning permit may be required by:
!rmit Conditions _ L75f N,( 4cr-' &4., to . G I I--,,. _ ._ �&i ..... A._
lei e&(h-d
1 AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED
/91irt ) f 1a'tl Y1 Jl . r
a. pllcant N INTF:U tr fne
"'
i// C ��
ure ' * lease re(-­
cr,rnpllunre statement on back Of permit**
atio
c�hl� k 1IJMI,trcy t.)rllr�r
Permit 9 ficer's @RINTF
El TAR/PAM/NEUSEIBUFFE,R (circle Lr.e�
See note on back regarding River Sa,t a F
See additional notes zndit1,m on �c
NCE STATEMENT, (Pledie ittiujo
Si
s ✓ t,xtir tote