89682A - Golden

❑CAMA ❑ DREDGE & FILL Nv 89682 g(C, A B C
t 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.deumc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Ad!- Wtr. Body (nayman/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PINS Closest Mai. Wit, Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale: )
Length n
�.IN�MEN
.II
.01■■�iI
®■
■■■
Elm11
iii■�
C111
:.■■;v■E
I,
ME
Floating Platform(s)
I
NMI
m
M
MCI
Total Platform area
;..:.IME
Avg distance offshore
M
M
on
0
III
11
ME
ME
No
No
Elm
III
M
IIEL■■�■■■■■
�I
■■i■
■■
■■■FaIL
ME
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
(Please Initial)
Signature ""Please read compliance statement on back of permit" Signature
Application Feels) Check q/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICA npN
Name of Property Owner Requesting Permit; 2„ Lideri
Mailing Address: 1214,
�YGt��oh Afl' 29E>'32
Phone Number: 9l8z1
Email Address; e �2nPtnR,O
I certify that I have authorizedpv s l�
Agent 1 contractors-' —
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: E '
.+LkI eo d (e p,
at my property located at
in J;r ,1ao County.
1 furthermore certify that 1 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.
Properly,ftpw er Information:
Signature
MAY p g 2023
��
Print or Type Name
Title
3 1 / 3 1 o2G23
Date
This certification is valid through I I
COnz�(ihvn .u�a�

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
-
Name of r Adjacent Riparian Property Owner
i2±_S_cwlfs,
Address }
DAaif:L-,_ N C_
City, State Lip
To Whom it May Concern:
4t(.11 1r2Wi
Date
RECEIVED
MAY 0 5 2023
This correspondence is to notify you as a riparian property owner that I am applying R)t a LAMA Minor pennit to
�
tgnA,f the i ,t��iw
on mypitroperty at 174 ,l�tt„E, �h<(, ill • a 1 {c„tn�t
in Gltotutw _„ County, which is adjacent to your property. A copy of the application and project
drawing is attachedienclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, LIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my addresslnumbcr listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
1
i f
r
Prperty Owner's Name Telep and Number
Address
City
State
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
1 Adjacent giparian Signature4
Print or Type Name
Mated 202�Z� _
Date
G(_ `?3 _�,4vvG__ _
Telephone Number
Address ICity State
"Lip
m 13Z
Zip

n.c. uiviSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
J, zdz3
Date
� t7t—
Name of Adjacent Riparian PropertyOwner
- l?Qr:-
—
Address
City, State Zip
RECEIVED
MAY 0 5 2023
To Whom It Mav Concern- DM
p . 9VlmEC
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
Qpat 4e IAAW ad-
n,�.ypraayat Gut Nir� 1_ �jf ton
a
in _ ! tuw (u1 _ _County, which is adjacent to your property. A copy of the application and project
arawmg is anaenearenciosea ror your revier..
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, "ZIP CODE)
if you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely<--�
i
,� t
Prdperty Owner's Name
Telephone Number
Address City State Zip
t/ I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature Dat;
—�— c
Mot or Type Name Telephone Number
I R CGUN .Et TV t iZ n NG �i i�'1-3
Address J City State Zip

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