88212_Paul Bergeron_20230403

IGENERAL
CAMA DREDGE & FILL -5N9 88212 A B C D
PERMIT - 724 7 Previous permit
Date previous permit issued
n New ❑Modification n Complete Reissue n 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 Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#( )
Email Subdivision
City ZIP
Affected n CW n EW n PTA n ES ❑PTS Adj.Wtr.Body (nat/rnan/unk)
AEC(s): n OEA ❑IHA n uw n SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:
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:
Permit Conditions n TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee 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

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden,Chowan,Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION!WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: pct ij l Bee- G rtt17
Address of Property: 'sC) c—tP„c y 1 I c c- Y 1 d 4A BP((o lief) l l._.
Mailing Address of Owner: '--Pd --BC (j qz / kettle"( rffiq o a? 1 !
M
Owner's email:Rau,I to er�icTCW1 wner's Phone#: (S6�' - -7� 4p
Agent's Name: U Agent Phone#:
Agent's Email:
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 abowe 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)s being proposed, yoJmust notify the N.C. Division of Coastal
Management(DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 943 Washington Square Mali(, Washington, NC 27889. DCM representatives can also be
contacted at(252) 946-6481. 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 br riprap revetments); (If you wish to waive the setback, you must sign
the appropriate blank-befow.),-
I DO wish to waive some/all of the 15' setback
Signature of Adjacertt Riparian Property Owner
-OR-
! do not wish to waive the 15' setback requirement(initial the blank)
\>/
Signature of Adjacent Riparian Property Owner: `
Typed/Printed name of ARPO: /J f`j i9 J 1-47eIK
Mailing Address of ARPO: ti /, ��/,) Lf�
ARPO's email:inAei t(ddA1/.1&'ry/,W/o; ARPO's Phone#: j1 '-�Z/ a 012L
Date: J - C/ 3 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

T
16)t (6

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent) •
Name of Property Owner: eREe.L4 lrTheleConnn If r nr+
Address of Property: 20 7)ectctC o a c) 110 f }(mi l 1 Gee r\ A .
Mailing Address of Owner: TU 3C (1q I ect;/kcLL/rA, M Y- as j 9
Owner's email:7...4u IP Pj 6-en.Q/O1.Cow\ Owner's Phone#: )/a L
Agent's Name: _ Agent Phone#:
Agent's Email:
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 r 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 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be
contacted at(252)946-8481. 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 15' setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement(initial the blank)
1, �Q
Signature of Adjacent Riparian Property Owner:n �.�/1/e'
Typed/Printed name of ARPO: C h RA LiE S A /�/l�/ ; 1,7 ni -N +
Mailing Address of ARPO: jt o Bp/ 7 '0 C /Y C 2 7 5-- 5/ 2—
ARPO's email: ARPO's Phone#: el/ 7 �7/ cOd 6-'
Date: Se 3 b - 2,g *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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4 ROY COOPER
'331.4h OoreMar
MICHAEL S. REGAN
.. - seoemry
Coastal Management BRAXTON DAVIS
mvRo1MENUu QUALITY 0iriector
BUFFER AUTHORIZATION CERTIFICATE •
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico&
Neuse River Riparian buffer per Division of Water Resources (DWR)regulations 15A NCAC 028.0233 & .0259.The
Division of Coastal Management(DCM),through a Memorandum of Understanding with the Division of Water
Resources(DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below.Failure to
comply with this Buffer Authorization may subject the property owner and the party(contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per day per violation.
Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees)unless otherwise approved by DCM.The .
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials:All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open-slatted wood or composite, mulch,or grass to meet the intent of the rules to the
maximum extent practicable. -
•
3. Access Width:The width of the pier or docking facility access way shall be limited to six(6) feet
a_ Project Drawing:The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way.This
drawing will be used to aid in compliance andmonitoring efforts.
Pre-project site conditions: (el / S
By your signature below you agree to be held responsible for meeting ail of the conditions listed above and rify
that all information provided is complete and accurate.
Agent or Applicant Printed Name Permit Officegnature
3/2-__3Age 4L Issd Date
CAMA GENERAL PERMIT it:
State of North Carolina I Env¢cnmental Quality(Coastal Management
Washington Office 1948.Washington Square Mall Washington NC 27889125Z-946-6481
Wilmington Office i 127 Cardinal Drive Ext.Wilmington,NC28405-3845 191D-196-7235
Morehead City Office i 400 Commerce Avenue Morehead Crty.NC 28557 1252-806-2808