89266-Shack

i
CAMA ZLREDGE & FILL NU 89622 '�A B C D
ENERPERMIT Previous permit
Date previous permit issued _
New ❑Modification ❑ Complete Reissue []Partial Reissue
As authorized by the Stite of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
1 SA NCAC _! �'f r I J ❑ Rules attached. ®•.General Permit Rules available at the following link: marmcleamc.gov/CAMArules
Applicant NaameTi Ax�411 3'.` s s S w $ W V Authorized Agent -'^ S'T A-!Yt t71tt-{! �+
Address 11
is a- I i B. S -LPy,% -N - Q r r Project Location (County): _ 0 ct- rut— �1 �/
City Mcl e`kew. a state tjr-. ZIP ` .-, fit! S q Street AddreWState Road/Lot #(s) L t, - 2- '- T •'1' Z
Phone # ( ) JO3 5?= -QJ °� 2-4 A t� (� C. S + f!' A,
Email J 0. V% <'-'�._� �-`'n•7^- .__...-._ Subdivision fIrG-T"-.Y Co 'N0.(�s+S��'t•"/ h L
City t,.A ,t ZIP s
Affected ❑eW OEW ORTA R nTS Adj. Wtr. Body. t ��!\ �. Vt�- .n nat/ ianfunk)
AEC(s): ❑OEA ❑ WA ❑UW ❑SPIMA ❑PWS Closest Maj. Win Body y `"-'1 0- "i %b. x�
ORW: veslAo 7 PNA:
Type of Project/ Activity
Shoreline Length I .3 Z:l
.2- -
(Scale: fdTS' )
Access length E
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) ___...._...._
,9,e.IG1 n1G
i"
f�
� vR>Jg,K
„jaa+.ND
-N -
d4l
Total Platform area _. A m -i Al T'"
Groin length/P
Bulkhead/Riprap length_
Avg distance offshore
Breakwater/Sill__ ,
Max distance/length_._
Basin, channel
Cubic yards V bs
Boat ramp 6
Boathouse/Boatlift
Beach Bulldozing_`.,_.
Other "` IZ+;�lO>-F{C�i'h ET1Y '.L' W/1'iiRAthR�
SAV observed: yes yes no 51kir, _
Moratorium: (Od yes no J
Site Photos: yei nQ� PRofP(os� �` KJ
Riparian Waiver Attached: yes no C-I' ✓ 11��__
A building permit/mning permit may be required by: _ jy�[y_-Q Mc�nTE s
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit
.___. T� ❑ See note on back regarding River Basin rules
--------- ------ ----- --- ❑ See additional notes/conditions on back
1 AM AWARE OF STATUTES CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT (Please Initial)-_._--_
>t. c) Y v a nnre__ �• Q r V C r ...
Applicant PRIN ON e Permit Officer's PRINTED Name
Signat *'Please read compliance statement onlakof permit** SI n ure
Application Feels) Check R/Money order Issuing Date Expiration Date

-DREDGE & FILL N° 89622 A' B C D
GENERAL Previous permit
PERMIT
� Date previous permit issued
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the
St to of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC _Ilr(i��
❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
G/ y� ,�1� -t S �. S K Authorized Agent �'C n=`�5 7 9 ekx /AuAi •"4
Address .1' 1 Q Q. I O. S 'T r O 1 ,11�" (� r )) Project Location (County): � R ir� t/
City ��n^�2 a State NP zip -771 SV Street Address/State Road/Lot #(s) L t 2'� '�" iPf � .
Phone#( II ate'+ /- 1 /i�it(�cS
Email � ls.. a +� a -a r CJ /1'� Subdivision f t rd-- X� J—
city Mcui o I/ ZIP 2-7 9 sr y
Affected ❑ CW VEW EZRTA Vrn- ®FTS Adj. Wtr. Body - m,lV ek 1 naU an/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑$PIMA ❑PWS Closest Maj. Wtr. Body_ v`�
ORW: yesilL.PNA: yes/.
Type of Project/ Activity
Shoreline Length i 13
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
O�
Breakwater/Sill
r
Max distance/length
Basin, channel
Cubic yards
�-
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Ef,s�lntr3 ^II
Y
sft✓LS
�,O(r
//
SAV observed: yes no $fc�Mf(ll4 IAlu1
Moratorium: yes no
Site Photos: ye no fin
Riparian Waiver Attached: yes no W�' Q✓ / 1—
A building permit/zoning permit may be required by: �» lr�n a'i mE�l1T2
Permit Conditions
,9—
(Scale: PITS )
�danlmKE
Sa rJD
%26-1A A(h NI—
A (-'T/f0tZII-ED B4ckAeAb
— �t�OtFtceritE?1T 2' wMiRrda2n
of Ezisrr nfG >q c t
11L lfil
❑ 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)&
'A.- YVtnAtt_. C. O_fv.er
YAgent or Applicant PRINTED Name Permit Officer's PRINTED Name
Sigure '*Please read compliance statement on back of permit"" natSi ure 1
Application Feels) Check #/Money Order Issuing Date Expiration Date

NC Division of Coastal Management
91 Cashier's Official Receipt
Received From:
Permit No.: C 1"" ! % (p "L. '"Z 7-3 -P-1
Applicant's Name: 1 em®-i�,y a c� `
Project Address:
i(
<t- ,)
27128( B C D
Date: . po 3
$ r
Check No.: J "'
County: n ( a -
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant:
V,
Signature of Field Representative: �%t'��'�"`�"�"-`-`-"
Date: /zj
Date: 3 %11 / z

Carver, Yvonne
From: Carver, Yvonne
Sent: Friday, March 17, 2023 11:16 AM
To: Julie Emory ([e-mail])
Subject: Shack GP & Receipt
Attachments: SHACK GP89622 + RECEIPT.pdf
Morning Julie,
A copy of general permit (GP) number 89622 issued for Shack's bulkhead project in Manteo is
attached for your review and signature.
To validate this permit please address the following:
1. print and sign the permit on the bottom left-hand corner below your printed name,
2. initial where indicated on the bottom right of the permit,
3. scan and send a signed copy back to our office.
No work can be initiated until after we receive the signed copy. If you have any questions regarding
this correspondence, please don't hesitate to contact me. Thank you.
Virarute
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-264-3901, ext. 237
yvonne.carverCabncdenr.gov
401 S. Griffin St., Ste 300
Elizabeth City, NC 27909
t✓�-D_
,- ,r;_A
beuanmertt or Frwwnnwrtzar O,ol
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.

1*ottoafru 4,CAMA ❑ DREDGE & FILL N" 25`JbLL / A li B C D
a 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.den.nc.goy/CAMArules
Applicant Name
Address
State
Phone # ( )
Email
Affected ❑CW ❑EW ❑PTA
AEC(s): ❑ OEA ❑ IHA ❑ UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
chnr Hl Ionoth
ZIP
Es 0 PTS
❑SPIMA ❑PWS
Authorized Agent `
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
(Scale: ; )
Access Length
-
I
-'a
—
i.
i__
+.•i
I
Pier (dock) length
I
_'
I
I
I
Fixed Platform(s)
I
t
��
_
,�-"•-
-
_
;
I
Floating Platform(s)
-_
i
-_I_
_
Finger pier(s)
Total Platform area
Groin length/#T
i
Bulkhead/ Rlprap length /
Avg distance offshore
i
•_
--�
I
I
III._
--,.::
j
7-
_--
_
Breakwater/SIII
-�
-
_
i-
�..__.�
..
Maxdistance/ en
J
Basin, channel
�
!
I
CubicYards
Boat ramp;
Boathouse/Boatlift
Beach Bulldozing
I
77
t r
I
`r
Other _..
—
F
R
SAV observed: yes no
Moratorium: n/a yes no r`ry17
Site Photos; - yes no
Riparian Waiver Attached: ves no
V�
"_
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.
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 Issuing Date
(Please Initial _
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: i (VI
Mailing Address: �%qa1Q ��4 Qt
in q
Phone Number: - ` —�j�_ qT)CC)
Email Address:�t''Y"'�
I certify that I have authorized �� t< } t��--4' "l n 0r c� � tp � a r i n fi, -T L V G
Agent/Contractor
to act onmy behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at U(`
In -D GR 1 County.
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
Sigma ure
Print orTyp�e Nbme
7'Itle
This certification is valid through
Y.
F
t t
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Revised Mar, 2016

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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: 1 ( <SV)o
Address of Property: a�gbin —y ij 1SSc jjI"f I (1� ' r,
Mailing Address of Owner. � n��lia ]Q I h1C)i,- _ r 7�
Owner's email: Owner's Phone#: A��- 6,3?5- -I[fir.ltn
(�
Agent's Name: t V Ma i n e Agent Phone#: pt Oi - Pt6 i3. k13l-
Agent'sEmail: i k f7'lLirIr)e- mr7 -k. C-0ir),�
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(ISUgm 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
descri tion drawin with im nsi n m at ro ido i t 's tier.
t`lfx ( ;`--e+ . S � �
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 some as no objection if you have been
notified by CertlBed Mail.
WAIVER SECTION (Choose oniv 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 riorao rev tments). (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
-OR-
Signature of Adjacent Riparian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: -HA vk r4 • coe1 i—syV
Mailing Address of ARPO: n e Vd . r csw i e3oU
ARPO's email: Mnyc.�ir el6�+t/daiiti ARPO's Phone#: _ 7J� i- 1i/03-7072.
Date: $ 2©2• `waiver is valid for up to one year from ARPO's Signature
C
Uf�O�"sr
Revised August 2022
v

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
Name of Prope
Address of Pr
Mailing Address
(Top portion to be completed by owner or their agent)
rty Owner:
arty: ` of Owner. J (t (1 tt� Yam. 1(l�y
Owners email:
It��''fr Owner's Phone#: YIcit'f[J3�'-9tj DDO
Agent's Name: WL t t , n ° Agent Phone# (t �(d -:� `
Agent's Email:,_ 1lA �lE?..0 Cl v t r�rt t—t i� Y
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(ttom portion to be completed bu tt,e 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 Ordrawinn with
I Q
have objections to this proposal. i DO have objections to this proposal.
er YOU nave objections to what is bear N.C.pu must notify the N.Division of Coastal
Management (DCM) In writing within 10 da days of receipt of this notice. Co
ould be
mailed to 401 S. Grtfffn St, Ste, 300, Elizabeth City, NC, 27909. DCM representatives can ondence halso be
contacted of [phone]. No response is considered the same as no objection if you have been
notified by Carafled 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 musk sign
the appropriate blank below)
I DO wish to waive some/all of the IT setback
-OR-
Signature of Adjacent RTparran Property Owner
I do not Wish to waive the 15' setback requirement (initial the blank)
signature of Adjacent Riparian Property Owner:
/
Typed/Printed name of ARPO:--1`y-�--��
Mailing Address of /A�RPO:
ARPO's /email. 4,6 �n � S �Qf 'e7 'RPO's Phone#:
Data:...'? - ' 'waiver is valid for up to one year from ARPO's Signature`
Revised May 2021
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