Everette, Brian - 84269C

❑CAMA [IDREDGE & FILL N° 84269 A B C� D
GENERAL PERMIT Previous permit
Date previous permit issued
#F-]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: wwwdecinc gov/CAMArules
Applicant Name _
Address
City'
Phone # (_ )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/Jnan/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yea/no
Type of Project/ Activity
(Scale:
Shoreline Length
Access Length 7^^v 1 ct C��—
Pier (dock) length
Fixed Platform(s)
—
_
y
t
+
—'
t
i—
_t—
I
R
—
_
I
_i.
'"i
5
_
-d
Floating Platform(s)
Finger pier(s)\L
Total Platform area
Groin length/il
Bulkhead Riprap length
Avg distance offshore
Max distance/ ha length
Bas, channel �--
Basin,
Cubic yards -
Boat ramp
Boathouse/ Beatlik I O lC 1 it
Beach Bulldozing
Other
I
i
i
t
SAV observed: yes no
Moratorium: n/a es no
y
Site Photos:yes no
Riparian Waiver Attached: yes no
`
lt—
i
i
;
�
v
_ -
_
A building permit/zoning permit may be required by:
Permit Conditions
I
❑ 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.
Agent or Applicant PRINTED Name .. - Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit" Signature
(Please Initial)
Application Feels)
Check Jl/Money Order Issuing
Expiration Date

❑LAMA ❑ DREDGE & FILL N° 84269 A B C`. D
-r GENERAL PERMIT Previous 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 - I I ❑ 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 ❑ CW ❑ gw ❑ PTA ["]'ES ❑ PTS Adj. Wtr. Body I ` i (nat/ptan/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body
ORW: yes/no PNAf yea/no
Type of Project/ Activity
(Scale:F-� )
Ghnralinc I anoth -�
Access Length
f
-
—
—
_-
Pier (dock) length '� „ e �
) gt `` !
,L
�'^
-
i
T
I �
Fixed Platform(s)
- i
l
'J
(_�-_
Floating Platform(s)
-
-_
,,fit-4
L
(�.(
6
Y
Finger pier(s) -
Total Platform area
r
Groin length/JI
T'
i
Bulkhead/Riprap length -
-I
I
--�
-
-----
„---�-
----1-
--F
Avg distance offshore --"
-
--
-
'—
---
-
--
--
—
-=
—'i—'
-
-
Breakwater/Sill -
Max distance/ length
i
I
Basin, channel
Cubic yards
r
Boat ram P
Boathouse/
-
_
—
r
_
Boatlift
Beach Bulldozing_
Other
SAV observed: yes no
Moratorium:
n/a yes no
Site Photos:
'��-'--4--
yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit maybe required by:
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)
l
Agent or Applicant PRINT me Permit Officer's PRINTED Name
l/ s'T
Signature "Please read complian a state e t on back of permit" Signature
) Ali
Application Feels) Check JI/Money Order Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to 8 r4 An, ✓Yr's
s ' 1� ��V ame f Prop rtyQwner) r/
property located at W W t'n �j le h L'
l A dress, Lot, lock, R ad, etc.)
on 1 n t+toc�e, S�� 1 UQtQ< ( in �r� S r 6M N.C.
(Waterbody) (City/rown an or County)
Initial The applicant has described to me, as shown below, the development proposed at the above
Here on to lion.
one of I have no objection to this proposal.
these '�
I have objections to this proposal.
lines
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
4 AcpwnJ
WAIVER SECTION
I understand that a 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
Initial me. (if yo ish to waive the setback, you must initial the appropriate blank below.)
Here on I do wish to waive the 15' setback requirement.
One of
these ` I do not wish to waive the 15' setback requirement.
lines
(Property Owner Information) (Adjacent Property Owner Information)
.--
Sigrta ire n ire*
Vr aV1 �iR IS o d2lCI I'e o 11 er
Print or Type N me Print or Type Name
2517 W(,4u •v priyt
Ma"inog dress Me ngAdore
0
r1601 a aY�6
11r�ly rr
C 66pat p city/Statelzip
'��t�h_ dVv^ N� 17FD2 ?oy 7eay/e fg2h��li:t�lliiry
Telephone NuMber /email address TelephOReNuf)nber/emailaidress
-LC Z Sl 3 829 D f=vUfTr/.8v)tnQ,3Me,).a,*
Date t_i 2 1_ 13 Dare* l
77 'Valid for one calendar year after signature' (Revised Aug. 2014)

Drawing Prepared By: C3 Scott, Inc,
Date: 4/18123
Scale: V: 40'
P.r.opeyty Adqrq�ss
259 Waterway Drive
Sneads Ferry, PIG 28460
PropqqY Pwner:
Bryan Everette
and 8'xl 2' platform and haul
Off
-Construct a new S'x6O' sure
step walkway and a 20'x2O'
platform
a
deck connected to marsh
stairs
-Construct a new 5'x20'grou
deck connected to 5'x52'
'rtTJ76V'df
of the marsh access walkw
M%.Tf4w.
-#Jvwxt. I" al
-install eight 10" piles to

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 5QA-Al EVe Q Vf—
Mailing Address: S ?X co �
ROCk M T IVC 2-7 ;30
Phone Number 31,6o9' ?r 13 e as CiO
Email Address Cb-s-yAtJ CctiM
I certify that I have authorized C3 Scott, Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development::
at my property located at -A�
in ���� County.
�5`s
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.
Property Owner Information:
Signature
13Y Qk W0J5 t- EVyCNe
Print or Type Name
Title
l 7, / 2 3
Date
This certification is valid through ©J / o I /
A460

I hereby certify that I own property adjacent to
property located at 2 S 9 WA fey L
on
(Waterbody)
YM C(n L veYettE- ,s
Lb Pame of Property Owner)
Lot, 8I ck, Road, etc.)
�n Ea s 7 ew 4 N N.C.
(Cityfrown and/ rand/ r County)
Initial The applicant has described to me, as shown below, the development proposed at the above
Here on I ti n
one of x I have no objection to this proposal.
these I have objections to this proposal.
lines
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a 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
Initial me. ou wish to waive the setback, you must initial the appropriate blank below.)
Here on I do wish to waive the 15' setback requirement,
one of
these I do not wish to waive the 15' setback requirement.
lines
(Property Owner Information) (Adjac Property Owner Information)
Sign Q dire C/ Signatrnre��
�Ji�ld ¢in l /ot�so , C: Jeri a i/ e-
%i
PrintorTv Name P"'m.. T.—At.,--
Ifct.K!1 M4t+,f NC, L780z --.-
Oty/State/Zi er1 /
zsz s 3 8't9a �'vc,��t,�rt�gn�5ma;,i
City/S��%���
Telephone Number/email address Teleph a Number/e ail address
Date Date"
(Revised Aug. 2014)
'Valid for one calendar year after signature'