Rich, James - 84273C

"`°"" ❑LAMA ❑DREDGE & FILL N° 84273 A B IDD
GENERAL PERMIT Previous permit /
Date previous permit issued �
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized fblytthe
'State of North Carolina, Department of Environmental Quality and the Coasta Resources Commission in an area of environmental concern pursuant to:
15A NCAC 11 1 I'f 11100 Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name /y I oun
Authorized Agent f�
Address (/ W _1iiJ/.l CA (, Project Location (Cty):
City �n1 late ZIP Q Street Address/State Road/Lot #(sre�)
Phone # (Lry ge(% /J�
Email Subdivision
/ City ZIP
Affected cW ❑•F.V6 A ES ❑ PTS Adj. Wtc Body not/ //- / an/unk)
AEC(s): OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body �Lr/J
ORWyy sZtro PNA/::ye±� /� ��, /,, /� /
Type of Project/ Activity ! � Zea GfJi(LL/ i/ o?� `%i
—7 (Scale:
Shoreline Length /- I
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) V
Finger pier(s) ,i/��V
Total Platform area
Gro'�Isa
h/ft� r
Ik/ prop length
Avgnce offshore / I`
Breakwater/Sill
Max distance/length
Basin, channel `f
Cubic yards / \ / `', \'I / tl' `✓ \ I 1
Boat ramp
Boathouse/Boatlift
Beach Bulldozing III -7 C / I
Other i
SAV observed:
Moratorium: n/a
es 6
v�
yes o
GQ
Site Photos:
Riparian Waiver Attached:
yes eo
A building permit/zoning
ermrt may be required by: �rrf
❑TAR/PAM/NEUSE/BUFFER(circle one)
PermitC Conditions
(�J /'/
.S
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. i (Please Initial)
';
i
/� /
Agent or Applicant PRINTED
Name
Per cer's PRINTED N me
i
Signal re **Please read compliance statement on back of permit-`
o
5��
Sign t r
.
z5
Z
Application Fee(s)
Check /Money Order
Issuing Date
Exp ation D6te

�`°"'4 ❑CAMA ❑DREDGE & FILL N9 84273 A s,-C D
3 3 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:
15A NCAC Rules attached. ❑ General Permit Rules available at the following link: www.deo nc gov/CAMArules
Applicant Name
Address
City
Phone #(_)
Email
Authorized
Project Location (County): -
Street Address/State Road/Lot #(s)
i
Subdivision /
City ZIP
Affected ❑CW ❑EW El PTA ❑Es ❑pTS Adj. Wtr. Body !j/ [,//(/ %(nat/rhan/unk)
AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS Closest Maj. Wtr. Body14�l(.I,
ORW:yes/no
Type of Project/ Activity
Shoreline I Pnoth
State ZIP
PNA: yes/no
(Scale: �J )
Access Length
Pier (dock) length
Fixed Platform(s)---
—�--
_L—
--t--
1--
-
--
-
�
�—
-
�
_-
Floating Platform(s)
Finger pier(s)
Total Platform area
I
Groin length/#
_
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
(
Max distance/ length
-
`--
—
-
—
- —
f
)
-
---
Basin, channel
Cubic yards
Boa[ rampi
—{
i
1-
I
-I-
4
II
—
-
—
Boathouse/ Boatlift-
—
Beach Bulldozing
.._.
Other
5AV observed: Yes no-)
Moratorium: n/a yes no
-�
—i
—
—
--
Site Photos: yes no
RiparianWaiverAttached: 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) Check #/Money Order
Signature
Issuing Date
Expiration Date

1Ata"4' ❑LAMA ❑ DREDGE & FILL N° 84273 A B c D
1) Previous permit
a GENERAL 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: vvvvvdeq.ncgov/CAMArules
Applicant Name
Address
City .State ZIP
Phone # O
Affected ❑ CW
AEC(s): ❑ OEA
ORW: yes/no
❑EW ❑PTA
❑IHA ❑uW
PNA: yes/no"
❑ ES ❑ PTS
❑SPIMA ❑PWS
Authorized Agent /
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
Type of Project/ Activity / i
(Scale:
Shoreline Length �.T. _ �.F�,,. —.
Access Length
Pier(dock)length Ti _
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 j -
Moratorium: n/a yes nd',{ -
Site Photos: yes no !
Riparian Waiver Attached: yes no
A building permit/zonin ermit ma be re uired
Permit Condi
gP Y q �r
lions - 0TAR/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 q/Money Order Issuing DateExpiration Date

AGENT AUTHORIZATION FOR AM PERMIT APPLICATION
Name of Property Owner Requesting Permit: -Jamr 5 51 CL1S iG
Mailing Address: AM 1) )1)4V r/ , ve , , T)r
Phone Number:
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: �J�r , Sect U)4
at my property located at N
in 0 I M 10 County.
l furthermore certify that / 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
�IQVY)CS earl Ach
Print or Type Name
eumcr
Title
4 /
Date
This certification is valid through

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: JAM L.5 8tr l K r c h
Address of Property.
J! �
Mailing Address of Owner. a rriL
Owners email:.kAm,MarineOwners Phone#:
Agent'sName:G nef}LC Yt�S1 A[4) Agent Phone#: 3d,17-Sii(115
Agent's Email: e)1�CfiLN1QYI11Pl�Yl.S�YitriinnCJ ��ti� �. /nw
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adlacent Property Owner)
U1 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
Dne, description or drawinc with dimensions must be provided with this letter.
1 '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. Divlslon 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
Cerdfied 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
br (this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you musts n
the appropriate blank below.) / �/
I DO wish to waive some/all of the 15' setback l
.OR. Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
J L Signature of Adjacent Riparian Property Owner: � 'i t:. �., ILI
r �`{y"� t Typed/Printed name of ARPO: 5 (` �tp Jes q� Mailing Address of ARPO: �io Z q",41er (yAV r
J �
ARPO's email: ARPO's Phone#: 92 4331
Date: �—((� •- 21 *waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

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