Petrilli, Edward - 90060C

0`°"" ❑CAMA ❑DREDGE & FILL N9 90060 A B C) C
GENERAL PERMIT Previous permit
3 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 ❑ Rules attached. ❑..General Permit Rules available at the following link: www.decI.nc.gov/CAMArules
Applicant Name I
Address
City State ZIP -
Phone # ( )
Email "I
Affected ❑ CW EW 0 PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PINS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Chnmlinc I nn orh
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision _
City
Adj. Win, Body
Closest Maj. Wtr. Body
(Scale:; '-",)
Access Length
- .—
�
_
-
i
y
i
-
—'
--�
h�
l�
Pier (dock)length
�
it
�
�
I
I
_
I
Fixed Platform(s) - J
• _
p
r—
t-
Floating Platform(s) ,/vY[�
Finger pier(s)
T
I
o
Total Platform area —•' ..�.
.
f
_
_
_
._
�..{
C_
I
Groin length/#—
n
I
s �r
t�tVjs�
•
f
BulkheatJ/ Riprap length // L�
t
.-
I.
L
(
—
_I
—
-
L
—
Avg distance offshore L--
Breakwater/Sill
—
--t—
Max distance/length
Basin, channel
Cubicyards
Boat ramp
Boathouse/ BoatliftI
Beach Bulldozing
I�i1_
J_
Other 7 i.,
{(I
Y
el
S
Y^ALA
SAV observed: yes no
------
Moratorium: n/a yes no
Site Photos: yes no
RioarianWaiver Attached: ves no
_..
-
;_..
A building permit/zoning permit may be required
Permit Conditions
Vv ❑TAR/PAM/NEUSE/BUFFER(circle one)
v.4v0t- ❑ 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 Feels) Check #/Money Order
Signature
Issuing Date
Expiration Date

tamer � N° 90060 A B , c D
❑DREDGE & FILL
a 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 ❑ Rules attached. ©.General Permit Rules available at the following link: vvwwdeq nc eov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
Citv, - State _ ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email .lip L_- "+� ( (c,✓
Subdivision
City
Affected ❑ CW
.Q EW ❑:PTA
0 ES
❑ PTS Adj. Wtr. Body (hat/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 ll
Avg distance offshore 2.
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
I
h- Site Photos: yes no I
t,
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROP
�. Agent or Applicant PRINTED Name
Signature '•Please read compliance statement on back of permit" q.
i ? i , ,
Application Feels) „ Check #/Money Order
Permit
(Scale:% )
❑ TARIPAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
CE STATEMENT. (Please Initial)
�i. tl
Name
Signature f
i
Issuinj Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:0.fd
Mailing Address: eel" Ctveek 'B1 rtV�
C c�2 Co- cr--e4 I
Phone Number: a L4 t --76 a�
Email Address: E? )per Sri ti (� R YVLAA ( °'VV\'-
I certify that I have authorized two `oLa t f -725. 5415
Agent/ Contracetor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
tue0, Vle-j
at my property located at S II
in Goat' County.
i 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.
Pro yV
non:
Signature
Print or Type Name
0el
Title
Date
This certification is valid through 1 I�� tbfTy

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to � L—XCA �e: l i s
(Name df Property Owner)
property located at 51q deer' Creck `O(, nye
(Address, Lot, Block, Road, etc.)
eY Creek in Cart ao. �'/CaAu-ef,N.C.
Oil 3 e—
(Waterbody) (CitylTown and/ r County)
The applicant has described to me, as shown below, the development proposed at the above
locatio . .
f have no objection to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in descr/pf/on below or attach a site drawing)
3o`
a_
i Y : Ct<y
WAIVERSECTI.ON, __-
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin Ir+'> bb`dbf!
back a minimum distance of 15' from my area of riparian access unless waived by me. (if you
wish to �.?ive the setback, you must initial the appropriate blank below.) IJi�N Zu[3
I do wish to waive the 15' setback requirement. DCVAiviHo CITY
I do not wish to waive the 15' setback requirement.
I r
)
signqture
�a S tie-Fr�lli
Print or Too Name
5l9 r Cxeek Nailing Address L
�W �—i•Q.f�2'C rf
City/statelLip,
Telephone Number
,ltio 4 L07-3
( dja entjPropertyuOw er Information}
io�nahct•e � I
Print or Type. Name
52.1 De& GraelkTitil {
M iling Ad�res�
e Cac use F �C'_ z8�
City/ tcity/ q t 2,S'57' 0-7 t
Telephone Number
Date
Date
/Ooiicorl RHA/9f)'f 91

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent toJWaA-.J �e�llis
(Name of Property Owner)
property located at 5 i 9 �err Cr-f-c k, Inv i
(Address, Lot, Block, Road, etc.)
on 1 eeY GO�k in Cap Cor crr %��-Ger�'� N.C.
(Waterbody) �(City/Town and! r County)
The applicant has described to me, as shown below, the development proposed at the above
locah'oiy
�•/ 1 have no objection to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below orattach asite drawing)
i�epl0.c� . e�va s �inq -611 Kh@LA oc.k J4 +t- V\e-%-J .
3o'
40 b__ .IJ --_Q
M�FsrF _ .z GRA55
WAIVER SECTION , __- _ _
i understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or-groin,��rrrr��4. t be set
back a minimum distance of 15' from my area of riparian actress unless, (If you
wish 1:94aive the setback, you must initial the appropriate blank below.)
MAR 2 0 20%3
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
-5` ire d tie-�r�llt
Print or TLDe Name
Marling Address f�
(!Aoe- <ta��-i2f-2 t`f
City/State2ip�5a a N r 7�
Telephone Number
Aoil 4 ZOt3
Marling Ad res
%agerz'�ir�C ZSSS�
City/ ata/Zip
Telephone Number
Date
Date