89679A - Forbes

Y �asssrt"..L .000 's .• Is. We• is
No gabr-�rc� k
uate previous perTnit Issuer
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the state of Forth Carolina, Department of ErMnanmentai Quality and the Coastal Resources Commisscm in an area of envira»rental Concern Pursuant to!
ISANCAC q ' iiQ0 ._ ❑Rules anarberd, N General Permit Rules evalable at the blowing fink—'v�vdeax¢aw[CAhW'Wt5
Applicant Names KcsbQ.i`ky 5`r'"�b_....-_;;.ii:—_ Auttwraed Agent
Addrea 1{:0 S tTe. V�/".. Project Location (county):
ow--m"--WAX—stae, NC zip a 7gs'1 Street Addrasa/stamlwatwzat#(a) lad ._._._,
Phone 2. 11 b
Email �� ._.@. n :t�..C*1Y* SubdrvCsiotr--`—
City r r s�„rYtLt.,q ET�I BP z2 (�m
Affected ❑ CW ® EW ® PTA © ES ` $
. © PTS Adj. Win Body \ � DlzlI Q n Cat V'eAt Qj'nanmr k)
AEC(5): ❑OFA ❑IRA ❑UW ❑SPIMA ❑PWS Closest Ma).Wtr.Body_. Rt1JP.YYt
ORW: yes/4o PNA: yete
iypeofProject/ Actf%dty k*A%krLi
1w Oi- t4xg_
/l..?ttah4, CA
P'LI_� ta...tr tr.—
(scale; 104'd ?
Shoreline length
Access Length
Pier (dock) length
Fixed Platform{s)
Floating Platform(s)__,,."
F-1
Finger pier(s)_�_
}W a -
Total Platform area
Groin length/g_;...-
rr
length_
Bulkhea k!E9i
- °--
Avgdistanceoffshore
Basin, channel
_
Cubic yards ...._. ...�..-.._...._,.
Boat romp
t�
Boathouse/ boatlift
Beach Bulldozing
Other
SAV observed: yes
Moratorfum: n/ no
Site Photos: no
-
Riparian WaWerAttacLed: yes no
A building permit may be required
by: f?YTti' DtwA?4
permit/whim;
_
..
❑ TAR><'AM(NEt75FJ8UPFFR (circle one)
Permit Conditions
ElSee note on back regarding River Basin rules
F15ee additional notes/conditions on back
%gent or
signature "Please read compliance statement on Mack of permit" 1ppl"ication Peels) Check 4/Money Order
Permit
Issuing Date
(Please Initial)

��1*0=?"'&®CAMA ® DREDGE & FILL
3 GENERAL PERMIT
© New []Modification ❑ Complete Reissue ❑ Partial Reissue
WI�i B C D
Previous permit
Date previous permit issued
NO 89679
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 qN' I I oo ❑ Rules attached. ® General Permit Rules available at the following link: www.deq.nc.goy/CAMArules
Applicant Name ►2tbe.t'� Authorized Agent I
Address L) (0 Ny 3 y\o m b)r. -f Project Location (County): IiC.r 4l�
City �l� �\ State NC— zip a�Qs I Street Address/State Road/Lot#(s) to *(0
Phone#(L) 90q 3351 )1(a N. 56,P, Dc
Email rat QAA.s ar @ 53YVV t` , r6y1 Subdivision 814'C {K Ko C.k
City file Y4 1-kii ZIP zZ�.
Affected ❑ CW NEW ® PTA © ES © PTS Adj. Wtr. Body C koLk I Ck A V`Q.r— Qt (nan/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal, Wtr. Body r4i 64�r[2 SOU,^41
ORW: yes/0 PNA: yes/0
Type of Project/ Activity
Shoreline Length +/— Ids
Access Length �.._
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) `
Total Platform area `
Groin length/#
Bulkhea ipra length LOS,
Avg distance offshore ICI
Breakwater/Sill
Max distance/length i0/
Basin, channel ^
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes
Moratorium: n/ yes no G,� !_ �QS pQ•
Site Photos: (9 no
Riparian Waiver Attached: yes 15 t /-� 1
A building permit/zoning permit may be required by: Rerlhe CoL'N�t,
Permit Conditions
ES AND CONDITIONS THAT APPLY"
Agent or Applicant PRINTED Name
*
Permit
N
t 4` > `
GW'
t
/S
`t �`6
k�
(Scale:10:4d )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature **Please read compliance statement on back of permit**
Application Feels) Check #/Money Order
,a,u��
4/;/g3 CIA /z3
Issuing Date Expiration Date

&10Mr4❑CAMA ❑ DREDGE & FILL NU 89679 ( i„ A. B C D
GENERAL PERMIT Previous permit
Date previous permit issued
El 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: wwvvd!M.nc.gov/CAMAruIes
Applicant Name Authorized Agent
Address I Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email Subdivision I
City � I ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no; PNA: yes/noi
Type of Project/ Activity
Chnralinn I nnofh
(Scale:I
- —_.
Access Length
(dock) length
Fixed Platform(s) MENEM
SPier
EE
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.EENEEE®EiOEEEN
pler(s).;�■E■EEI.E.EEEE
'
EEnE�E��EE
EEEEE.EEEME0E
E■s
Total Platform area
Groin length/#
OFinger
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.■■.■■■E�:11INEE
.EEC
i.'.
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EEEEE.EE.E
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SEEM
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IMMOMMEMMON
■E
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■■■�N■■■O
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SAV observed: yes no
Moratorium:. a..
■
■■ai
■"�'■■■
son
ms■'i■i�■■=
E��NON■
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m�Nuv�i
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NONERiparian
_E.
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)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit** Signature
Application Fee(s) Check M/Money Order Issuing Date Expiration Date

Date: 'n / ZG 2V -waiver is valid for up to one year from ARPO's Signature'
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
r
Name of Property owner: rbg�T ��- dog) 4 Scat V IA C4--
Address of Property:
Mailing Address of Owner: _10- 1g0,*yr_
Owner's email:914 -FOR 94 SJM41I-, Owner'sPhone* 701ifA10-1- 32—
Agent's Name: ��/d C19MAgent Phone#: Atl%
Agent's Email: OV &K
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
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. uivislon or Coasrai
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
malted to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only 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 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)4
Signature of Adjacent Riparian Property
TypedlPrinted name of ARPOc_Qn It= Ld _L� i I 1 9 _1 FYI t t
Mailing Address of ARPO:�
ARPO's email: Coc iG I
INN I ,/ "P 's Phone#:
vv%l,1PVI I II �cvm Iq P>-7t 7 • o'er r5

4/27/23, 4:01 PM
Date:
CAMA-AdjPropOwnerForm 001.jpg
'waiver is valid for up to one year from ARPO's Signature`
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or NAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: ogk ' 7-� `l,>C ltf3.. '! f='
Address of Property: lL7l 1{f 1Rfi t-71C fu ��- L
Mailing Address of Owner:ry f?4 _Ji
Owner's email: 'plZ t"S Y.S(L Owners Phone#:
Agent's Name: � f Agent Phone# __,
Agent's Email: _ aq '11 --------------
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
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.G. utwston or coastat
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 same as no objection if you have been
notified by Certified 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 13 from my area of riparian access unless waived by me
(this does not apply to bulkheads or norao 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 Aoperty Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank) 476—
Signature of Adjacent Riparian Property
TypedlPrinted name of ARPO:
Mailing Address of ARPO:
u
ARPO's email: _ e n ry ARPO's Phone#:'
hops://mail.google.com/mail/u/0/#inbox?projector=l 1l1

4/27/23, 4:01 PM CAMP.-AdjPropOwnerForm 001.jpg
Date: 'waiver Is valid for up to one year from ARPO's signature'
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: V"RG eT �`i-LJ013t�
Address of Property: 116 N. SMP S 9 Iris Mf IZRN l�
Mailing Address of Owner: 5birho Ak ABigy+r-
Owner's email: RIJ 6R 89S t�.sM41I_ Owner's Phone#: 701f-gb7`3K � " ` � „j 4j
C19M. r ¢
Agent's Name: AVA Agent Phone#: At I -A
Agent's Email: &N APR 2 8 2023
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION iS !i e
(Bottom Portion to be completed by the Adjacent Property Owner) D C 1 V 9 1-... �...
I hereby certify that 1 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
descriptip or drawina. with dimensions, must be provided with this le r.
1 DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what /s being proposeb, you must nopty the N.V. urvrsron or l,oaSrar
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 of [phone]. No response Is considered the same as no objection if you have been
notified by CertfAed Mail,
WAIVER SECTION (Choose only 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 aboly to bulkheads or norap revetments). (If you wish to waive the setback, you must stun
the appropriate blank below.)
1 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)
Signature of Adjacent Riparian Property Owner. rL1 ov yAu,"
Typed/Printed name of ARPO: FRL kc- — AA�A'W 1�
Mailing Address of ARPO:� �Atff/�Q q
ARPO'semall:ARPO'sPhone#:
httpsJlmail.google.com/maiVu/01#inbox?projector--1 111

Date: *waiver Is valid for up to one year from ARPO's Signature'
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
{
Name of Property Owner: K o r / , � 508) a SVI-V IH � ICJRgg—S
Address ofProperty: 116 N. .SYrF 9 AR_ R KXA f /IG G j %llG 272'67
Mailing Address of Owner: K,q/�d- & /4flDY,'� .. _
Owner'semail:KIjFORwJRlpt- 111-.Owner'sPhone#:-701�•-gV7'3M?—RCC 1VED
Agent's Name:
Agent's Email:
Agent Phone#: AlZ�
APR 2 B 2023
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION D C r v ° ®EC
(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 or drawing, with dimensions must be provided with this letter.
4— 1 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 nobly the M.C. Div)slon 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 same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only onel
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 riorap revetments). (if you wish to waive the setback, you must sign
the appropriate blank below.)
100 wish to waive some/all of the 15' setback
Signature of A(�acent Riparian Property Owner
•OR- ,
I DO NOT wish to waive the 15' setback requirement (initial the blank
��T
Signature of Adjacent Riparian Property
Typed/printed name of ARPO:

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�CAMA ❑DREDGE & FILL LV - g�6$� (A� B �C o
Previous permit
I GENERAL. PERMIT Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of EmironmeMal Quality and the Coastal Resources Commission in an area of envlromnencal concern pursuant to:
of
1 SA NCAC 1(1i 'y Zo o —_ DRles attached. ® General Permit Rules available at the following fink wq w.Aeq_nc.�ovJCAMANes
Applicant Name l3(%'C(A-VX n-, Authorized Agent__.
Address (,'%r�q f.A.�hi�. y10.� Ed. Project Location (Co
city1�e. r tord state Me- ZIP yq— Sweet Addresostate
Phone # (Z32f 333 — 510 l i MA L
Emall _.. �A.i2 ._. . IR..Subdivision
Cih—-.°Y�1:9i' 7JP ot, I I -T I
Affected ❑CW �EW ®PTA DES EIPTS Ad). W(r. Body e-s{��1`F.. Yr QLt��$,j,, �\VtA— a6 an/unk)
AEC(s)EOEA nIHA r,I UW OSPIMA ❑PWS Closest Maj. Wtr. Body Ort6..f�'L�iK_"
ORW: yesJO PNA: yes, t6o
Type of Project/ Activity
x
K,
Shoreline length
Access Length
'
-
t�o[�
�C
Pier (dock) length
r X J
-�tr V- -v�•
a
fixed Platformis)
t x f
ST'Kib'i
FIo atin Piattormjs)
g
finger pier(s)
Total Platform area 'L-%JV (,,,-
Groin length/A - -If "fir( j
Bulkhead/Riprip length ' "le�.. U *' . .
Avg distance offshore - -
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards
Boat ramp ...
Boathouse/ BoatliR
Beach Bulldozing a
Other_
h At
SAV observed: ���+ yes
Moratorium: 'itaJ yes rro
Site Photos: 19 no `s �w''`A-
Riparian Waiver Attached: no
A building permitlzoning permit may be required by. ?P-rg + 1 ti<z5�..rV{u
Permit Conditions
TAR/PAPUNEUSE/BUFFER (cirde 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) lea 1C'i
�
(rA Alf /-^...9 .R
Agentor
Signature --Please read Ornillanre statement on back of permit"
Application Fee(s) Check g/Money Order
Permit
Signature
5743123 ` 0(23 /23
Issuing Date Expiration Date