Dupree, Scott - 84246C

❑CAMA ❑ DREDGE & FILL N9 84246 A B C D
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 - ❑ Rules attached. General Permit Rules available at the following link: wwwdet nc.gov/CAMArules
Applicant Name
Address
City
Phone #
Email
ZIP i
Project Location (County): I` ?Y , `>IO I I, I
Street Address/State Road/Lot #(s)
I
,
Subdivision `�( 7 /
City ZIP
Affected ❑CW ❑EW ❑PTA ❑ES ❑pT5 Adj. Wtr. Body -./ i 41�A.OL ,rnatl4ian/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scaler,/
Chnralina I anmh '
:�
.Li.
t. I-
I
Access Length --
-
--
y;,-
-i
-
-
Pier(dock)length i
--
--}
T
-
Fixed Platform(s)
t
�
_
<
Floating Platform(s)
i
Finger pier(s)-
,
Total Platform area
Groin length/q_-
-
Bulkhead/Riprap length1-
Avg distance offshore
Breakwater/Sill
------
Max distance/ length )""
" "
Basin, channel--
j
I- -
-11
Cubic yards
y
.
Boat ramp
-
-
-
Boathouse/ Boatlitt
_
Beach Bulldozing
Other
--
--i
--
-
-Y"--
---
-
-
-
SAY observed: yes no
F
Moratorium: n/a yes no r -
---+
-
-
i-
-
-
----F-
Site Photos: yes no
-----
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
❑ 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)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature *'Please read compliance statement on back of permit"
Application Feels)
Signature
Check#/Money Order Issuing Date
Expiration Date

��`°"'" ❑CAMA ❑DREDGE ,& FILL N9 84246 A B C D
GENERAL Previous permit
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:
1 SA NCAC ❑ Rules attached. dGeneral Permit Rules available at the following link: www.deq.ncgov/CAMArules
Applicant Name Authorized Agent
ZIP
Project Location (County):
Street Address/State Road/Lot #(s)
Phone # (_ )
Email Subdivision
City ZIP
Affected ❑CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no `4- PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
_
—
i
i
f
Floating Platforms)
Finger pier(s) -
(__I
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore _
Breakwater/Sill
Max distance/ length _
Basin, channel
Cubic yards
Boat ramp
Beach Bulldozing
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
yes
yes
yes
yes
A building permit/zoning permit may be required by:
Permit Conditions
(Scale:
❑ 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)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "'Please read compliance statement on back of permit" Signature
Application Feels) Check #/Money Order Is g Date Expiration Date

N.O. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFI MAIL RETURN RECCiP7 REQUE57FD or MAN�RY
(fop Portion to be completed by owner or their agent)
Name of Property Owner: _. 0�•�
Addreab of Pro,
Mailing Address
Owner's email:
Agent's Name:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
( ott m n to ba ad t+ h Ad ace Praporty OwrnetV
I hereby certify that I own property adjacent to the above referenced roe The individual 1 P P rtY• apptyingforihis
Permit has described W ma. as shown on the attached drawing, the development they are proposing. A ^� } A dastx'iatinn nr A"w,(t%$,. i l _¢jjllanSio must ba (J I DO NOT have objections to this Proposal. I 'CO have objections to this r ! proposal.
8 you have 0*!;ttons to what Is baFn "must nom a —N------..
8 Proposed, you must nobly the N.C. Division at Coastal
Ma12arent (DCM) in writing within 10 days of receipt of this notice. Correspondonce should be
mafled to 400 Commerce Ave., Morehead City, NC 28557, DCbt representatives can also be contaatod
at [phone], NO response is considered the Mall. same as no objection if you have b Confileen notlNad by
iad
i understand that an WAIVER sEc noN
Y proposed pier, dock, mooring pilings. poet ramp, breakwater, boathouse, lift, a
i(A groin must t>e sat bank a minimum distance of 15' from my area of riparian access un Il (this does not apply to bulkheads or Horap revetments). of you wish to waless waived
V the aPProPdate blank below,) iby me
ve the setback,
you waived
Must *IQ
I DO wish to waive somelatl of the 1 setback
-OR•
Srgnature at AdJacant P.iparian Aroperty Own®r
i do not wish to waive the 15' setback requirement (initial the blank) --2 <--
E Signature of Adjacent Riparian Property Owner:
TypedlPrinted name of All
k�oh Mailing Address of ARPO: /JD a/'l3srbJ .rt /l id `
ARPo's email: ;,gA, l - Ir r A, ARPO's Phone#: l . & 6 1'-V G 2 C%
Data: f rf az> L L 'wstvsr Is valid for up to one Year from Ali Signature'
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
C�RTIFlED MAft_ RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Pro{
Mailing Addres:
Owner's email:
Agent's Name:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be competed by th9.A0IacentyMRfttL0wner)
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 developmentproposing. A
✓ t� description or dMI lnc. with dimenslons moat be provided with tis Ietta , they are ro
c-
v I DO NOT have objections to this proposal. I DO have objections to this proposal.
you have objections to what Ps bean
g proposed, you must nat/fy the N.C. Division of Coastal
Management (DCM) In writing within 10 days of receipt of this notice. Correspondence should be
matted 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 Malt.
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
O (Rt ��� (this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must n
t the appropriate blank below.)
'r.._...._ i
I DO wish to waive spmalall of the 15' setback_ _ _
OR �---Slg»atUre o? Adjacent Riparian P arty Owner
I do not wish to waive the 15' setback requirement (initial the blank)
�eka Signature of Adjacent Riparian Property Owner: it
�1} Typed/Printed name of ARPO:
Mailing Address of ARPO: � I) � � a _ t ((K,' -r) L
ARPO'semali: occacoy-i 3� @yV"gi1ePO Phone#: 1�1 iaiJ2- b �
Date: Z 2 alver is valid for up to one year from ARPO's Signature -
Revised July 2021

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AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Gd (} nl�e'_
Mailing Address: _I i t1 /VrC2II�J`a / Ut ! YI vie'
Phone Number:
Email Address:
I certify that I have authorized L2�nfa j't r, (6A5
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development:
bcctfhacrSP _9_'_a5Aq Gull, 5koa�Lrfi
anct ={-Ish Cleaning s-FA-hon
at my property located at C I l
in l) jb LI) _County.
t 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.
0A Q4V.
Title
Date
This certification is valid through f t