Wall, Tim - 90078C

1}tCAMA I DREDGE & FILL A 13 (C") D
GENERAL PERMIT Date Previouspermit _
At"mNew
IJate previous pernaR Issued I ;Modification I lComplete Reissue 1 JPat -,Al Reissue
A,,iinhonaerl by the Slate of North Clrohna, Oeparuncnt of [nvironnlental Quallly and the Coastal Resources Commission in an area o(enyironnlental concern pursuant to.
I ya 1 ICAC(: 1j 1100, 1 1 Rules auarhed >C enprei Pr n tit Rules .wailablo at the following ink www,drq n[ gov((;ISMAI plox
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I AMA I f )I' STATl1T(1�SCRC RUIE AND CONDITIONS T1IAT APPLY TO THIS PROJECT_ AND REVIEWED COMPLIANCE STATEMENT.
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N° 90078
J&dMIU`'C>JGAMA ❑ DREDGE & FILL
a GENERAL PERMIT Previous permit
Date previous permit issued
ff'>�rqevv ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
A BOD
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 NCACMP. 11001 MR.17A0 ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name / `�tn �n I ( Authorized Agent 0.1vt
Address lot,- . ei V1f;r Df— Project Location (County):
City &ga.U-FE State 1 At& ZIP %i;S) l[� Street Address/State Road/Lot #(s)
Phone# ft) alit — ` 1a) J
Email Subdivision
City ,fFJPtt.l.•tD/-{'1 n ZIP Zg�I
Affected ❑cW i EW PRITA XEs ❑PTS Adj. Wtc Body l3(tCC.�_(7 _^ (nar/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body /\)�/+�A- �`V'eX
ORW: yese) PNA:
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length to, X (o '
Fixed Platform(s) .l
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length # .�
Bulkhead ipra length 315'
Avg distance offshore
Breakwater/Sill -�
Max distance/length
Basin, channel
tw°k`
Cubic yards vvoeovA 34"
Boat ramp Tt rwp
Boathouse/ oath 13`113i 13 X)31
Beach "Bu�lldozing L
Other"I'a"' Z :{1c J11 a ollUUt
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: no
Riparian Waiver Attached: yes o
A building permit/zoning permit may be required
by:
o£K kt� Permit Conditions 11 twj C)-0t. ",, `IG.Gtlcw
Agent or Applicant PRINTED Name
(Scale: f c�o' )
&W Secl v- IJ113
%eo-CA
66*V P,Vry
rb� proQoswt 13'yi3'
U n DtP''v
❑TAR/PAM/NEUSE/BUFFER (circle one)
" of, /D I t�laru,rvvf I�if'% W, ❑ See note on back regarding River Basin rules
r `k,-A .iI hnrrt8.1a1 j Y'u`1tk..Q. ❑ See additional notes/conditions on back
(Please Initial)
Permit
Signature "*Please read compliance statement on back of permi
Application Feels) Check A/Money Order
Signature
y/iil-Z�
IssuiddDatel Exp ratio Date

*iew
AMA ElDREDGE& FILL N9 90078 ACjB �D
Previous permit
ENERAL PERMIT Date previous permit issued
❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of Noah Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ' \'� ❑ Rules attached. I >(General Permit Rules available at the following link: vmwdeq c gov/CAMArules
Applicant Name /Jn 11
Address Ill V•C'
City state N ZIP
Phone#(
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision --
City I,
Ad' Wtr. Body (w� '! E'' (nat/man/unk)
Affected ❑ CW h y � EW ❑ PTA � ES ❑ PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body 1%, /�'(w (,' `•``y-'
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length _
Pier (dock) lengtt
Fixed Platform(s)
Floating Platforms)
Finger pier(s)
Total Platform area-�_-':.-------�----
-
-(
Groin length/q — - -
-
--/:
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill —
_
Max distance/ length
Basin, channel
Cubic yards t
4 o
5
"i3
Boat ramp
Boathouse/Eoatlift 1
_
Beach Bulldozing �~
Other'-
SAV observed: yes no-
_ _
Moratorium: n/a yes no t '�'--
Site Photos: yes, no -- -
-
RiparianWaiverAttached: yes no---i--
A building permit/zoning permit may be required by:
Permit Conditions
1
(Scale:i ( )
r f f.4r�
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
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature **please read compliance statement on back of per
+\ f i_ r, =T
Application Feels) Check tf/Money Order
Signature f
lssuirig'Datel Exp ratio 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: I f`'1 r
Address of Property:
Mailing Address of Owner: �` G
Owner's email: Al r _ Owner's Phone#: N ( q f
Agent's Name:
Agent's Email:
Agent
7�
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. 1 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 15from 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 slan
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
No
Signature of Adjacent Riparian Property
Typed/Printed name of ARPO: .
Mailing Address of ARPO:
ARPO's email:
Signature of Adjacent Riparian Property Owner
(initial the blank)
II Ii��/ VC-
ARPO's Phone#: �_� r6
Date: � *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner'.
Address of Properly:
Mailing Address of Owner:
Owner's email: AA
Agent's Name: HcACAV?
Agent's Email: h r
Owner's Phone#:.(9 (q) I
Agent Phon
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.
X_ 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.U. utvtston or Loasrat
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, yoy/must Si-n
the appropriate blank below.) J i
I DO wish to waive some/all of the 15' setback b � C e , �✓/ /
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:.��(
Typed/Printed name of ARPO: /V)
Mailing Address of ARPO:
ARPO's email: �t _C Ki ARPO's Phone#:
Date: ��X /o�� -waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

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