86828A - Erps, Vickie

�J"©CAMA �REDGED& FILL
GENEAL PERMIT
N9 86828
Previous permit
Date previous permit issued
B C D
®New ❑Modification E]Complete Reissue [_]Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Comr fission In an area of environmental concern pursuant to:
I SA NCAC r1 f eZ(0 _ Rules attachod. M General Permit Rules available at the foll wing fink: wswideo nc gov! eMe..ae<
Applicant Name!7�.tE
Address''`` --,9` a pYnt_.4A,,V, O'94A W r�rTp�I� 1
City )Ae" cx State._CLC _ZIP __9� J_T`.L
Phone # (- s�
Email Vg T6 �sCll�Y.7+t'o�M1ILA \
Authorized Agent
Project Location (Ccumy) rn u�lt0ott, r Q ___ _—
S[reeeAddress/Start�oRoadx,#(is) p
l�y.d dF T�PiI� �i�0 ti©,
Subdivision
city_ er-k irij ___. nP 2 779144
Affected CVV NEW ry]( PTA []ES PTs AdJ• War. Body __LLf'Q.'b � (�jsrR�{{%% �/man/Unk)
AEC(s): �OEA 0IHA EUW nSPIMA OPWS Closest Maj. Wtr. Body Lf`I" (f
ORW: yes 'o PNA: yes/0
Type of Project/ Activity
Access Length„ lb` ,,/
Pler (dock) length LtT X(.17
Fixed Plafform(s)
Floating Platforrn(s)
Finger pler(s)
Total Platform area KZSq
Groin length/g,__ 1
Bulkhead/Rlprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards _
Boat ramp ,.
Boathouse/Boatiift
Beach Bulldozing
Other—
v
observed: �"�qt yestti
Moratorium:
n n
Moratorium: �a/ ��yXX���s--�,, no i I
Site Photos: no {—
RlparianWaiverAttached: yes no'
A building permit/zoning permit may be required by:
Permit Conditions
(Scale:I'Id )
TAWPAMMEUSE/BUFFER (circle one)
❑ Sco note on back regarding River Basin rules
See additional notes/condthons on back
,rAWAREOF STAMESCRCRUIFS AND CONDITIONS THAT APPLYTOTHIS PROJECT AND REVIEWED COMPLIANCE STATEMENT (Please Initial)
1 I n / n — ... .. .� _—
or PPPUC3nt PBINTESMapre J Permit Of(iesr'sPRINTED Name
lase read compliance 3M€ment on back of permit"' Signature V r
(s) Check ri/Money Order Issuing Date Expiration Date

AMA ❑ DREDGE & FILL NO 86828 q5 B C D
a Previous permit
GENERAL PERMIT 3 � Date previous permit issued
®New [:]Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of
olif North
hlCarolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC r1 F, I aoc) ❑ Rules attached. M General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name�eItCIkte E,
]$
Agent
—,cq
Address_4 n U
Project Location (County): L�L WV
Street Addreess/Statune Road Lot
n is
_Authorized
C`42Y t,lU-J State NC. zip rr1p4y
Phone #(IM_095aJ
2
y.q OF � 1h \GC1Q
FCJ.
Emailyc_ e r rx O �Af
A MQ.� •C6-rYt
Subdivision` , n
City 1`1-Yk-pe
— ��
zip
Affected ❑ CW ®EW
® PTA ❑ ES ❑ pTS
y-A
Adj. Wtr. Body L lh O iJ Creje
K_ Guman/unk)
AECs EA
() ❑ OIHA
❑
UW SPIMA PWS
❑ ❑ ❑
Closest Maj. Wtr. Body ! `�'I
Q
ORW: yes,® PNNA: yes/`l.l
Type ofProject/ Activity Qxw tsk\L O,
a 4 "K CcinI f pits
iN (4\ IT' X he, "Z2,
P i"d
rPrN
(Scale:I r7-3d )
r
Shoreline Length
Access Length
f f
Pier (dock) length Lt x�6
v/`
C
\�
J U
�\
IV
(%.v
Fixed Platform(s) Kl "(
Floating Platform(s)
�—
Finger pier(s)
Total Platform area �It1 ZS9 1
L
Groin length/#
Bulkhead/Riprap length "-
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel -
i
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: %_�) yes n I v.,-
Moratorium: N4-- }'.�t� no �Q
Site Photos: lyes no
Riparian Waiver Attached: yes no �,,
A building permit/zoning permit may be required by: r:q L, �g,0JS.S ca,L�
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT
Agent or Applicant PRINTED Name
Permit
(Please Initial)
Signature **Please read compliance statement on back of permit** Signature V
abo• 83-I(e '413/13 `/y,23
Application Feels) Check #/Money Order Issuing Date Expiration Date

A000U74 [XICAMA ❑ DREDGE & FILL Nlj�) 86828 A B C D
GENERAL PERMIT 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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
City
Phone # ( )
Email
Affected ❑CW ❑EW ❑PTA
AEC(s): ❑ OEA ❑ IHA ❑ uW
ORW: yes/no PNA. yes/no
Type of Project/ Activity
ZIP
❑ ES ❑ PITS
❑SPIMA ❑PINS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
t ,.
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wen Body
(Scale: )
Access Length
Pier(dock) length
Fixed Platform(s)
��
�-
"1
_
/
..1.,.`
1 t
:--
__.�
_
i
Floating Platform(s)
Finger pier(s)
fit
Total Platform area
Groin length/q
_I
4
Bulkhead/Riprap length-i-
Avgdistance offshore
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards
Boat ramp
I
-
/i
--
��
»
�
.7 -
-"
1I
i
I
1
r
-
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: d/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no_�
t_..
-..
__
_.
'._
-.i..
-I—
- .-.
._.._
_.-..___._-
'
-
A building permit/zoning permit may be required by:
Permit Conditions
❑ TARJPAM/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"
Feels) Check #/Money Order
Signature
Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION!
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Prol
Mailing Adores,
Owner's email:
Agent's Name:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
9VE
MAR 13 2023
a
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. 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 (Choose only one)
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 riorap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.) //
n�
I DO wish to waive some/all of the 15' setback 0444 4 ��j!y , .'Z-)—
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: ka,0 4 d h -) 132E A ei2 �& %ci✓
Mailing Address of ARPO: Z/ 3 small b a I uc- 1geJ4 G,hT A 9 l v(,�
ARPO's email: Ac,)hesi,-a b✓en, '" i, ARPO's Phone#: '01� 14 ` -0
Date: vim- *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

N.C. DIVISION OF COASTAL MANAGEMENT RECEIVED
E®
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY MAR 13 2023
(Top portion to be completed by owner or their agent) ��M-�� ,A I n c
Name of Prope
Address of Prol
Mailing Addres!
Owner's email:
Agent's Name:
Agent's Email: r' � 1� �d wF11��hani l S J2ti� C-b F,—,
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. 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 (Choose only one)
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.) 0 , /-V A
I DO wish to waive some/all of the 15' setback
Signature of A 'cent 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:
/vrC
ry44
�2 ➢9 9V
/fir ../- C A �7cpc
Mailing Address of ARPO:1 j13,41 /C lLOn o%1I S/i1 e G z e C>
ARPO's email: `& � i'/�l .✓� `�� ARPO's Phone#: 3 3 [ — I ( r7U
Date: LY *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

N.C. DIVISION OF COASTAL MANAGEMENT l �T ��
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER F
ED
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
MAR 1 1 ZUB
(Top portion to be completed by owner or their agent)
Name of Property Owner: 1 C. , p r— Z,
Address of Property:
Mailing Address of Owner: 1 12
CM —EC
M
Owner's email: VGGr4 ckt;a. r04r1 , CL Owner's Phone#:
Agent's Name. -If /,to . LIvN L �u, n JI / Agent Phone#: �S 2 — 3 �z' ddZ
Agent's Email: � r� G�7� �. C✓kdeh u,rr/ r C shy
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying forthis
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 (Choose only one
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.)
Dac�sienea oy:
I DO wish to waive some/all of the 15' setback F „/ I —
Signature of d'qp ?1g9pan Property Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner. I A /
Typed/Printed name of ARPO:
Mailing Address of ARPO:
North Carolina
113 Airport Dr., Edenton, NC 27932
ARPO's email: pcwi 11 i [e-mail]
Date: 03/22/2023
ARPO's Phone#:
ion , Paul williams
252-482-1861
*waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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