89683A - Choffel & Holton LLC

is a" ° ®CAMA ❑ DREDGE & FILL N9 89683 �t �} e C D
GENERAL PERMIT Previous permit --
Date previous permit issued _
®New ❑Modification ❑Complete Reissue El Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission In an area of %vhonm oral concern pursuant M.
ISA NCgC._ 7 i�.QO _ �Rvles attached. ® General Permit Rules avellable ac the following lkdc w..myd,rrc. v! Antenaws
Applicant Name. C.. n 91`t�, Ji Authorimd Agent
Address ` tS" isnl'f 1�I� Lr-�QP el� ti Project LocaBm,(Cm,my):��.
citys--�- �m state.-- iftZIP 33ZQ streaAddress/Statelioaacitilt(s) tat #10A
Phone # ('v ri 1615' — 3�f I I L., I13:1 T I rr- gat+�r r
Entail _.S�CAt, `tYM Subdivisionu �%{'�@ h-ivrZ._•- . ''[/
city -
Affected DM WEW ®PTA DES ❑PTs Adj.Wtr Body L't7{- K4V—Cr __ ra mardunk)
AEC(s): E]OFA E]IHA Dow FISPIMA ❑PINS Closest Mal. wtr. sodY_A
.—l Q�i JGuy�
ORIN: yes/e PNA: yes/40
TYpe of Pro)ect/Activity
Shoreline Length 'I —
Access Length
Pier (dock) length
Fixed Platform(s) l Zf
n
Floating Platfarre(s)
Finger pie, (s).. "` y
Total Platform ama_e_`%'{_.. '
Groin length/it
Bulkhead/Riprop length -..-
Avg distance offshore
Breakwater/Sill
Max distance/length_ '--`
Basin, channel i Cubic yards.
Boat tamp--
Boathouse/Boatiift '
Beach Bulldozing
Other
SAV observed;
Morefforium;
yes
yes
no yp,
Site Photos:
,,�
Riparian Waiver Attached:
yeses
A building permft/caning permit may be required by.
Permit Conditions
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Ej TAR/PAM/NEUSE/BUFFER (circle we)
See note on back regarding River Basin rules
See additional notes/conditions on back
IAM AWARE OF STATUTE, CRC RULESANO CON ON S THATAPPLYTOTHIS PROIECf AND REVIEWED COMPLIANCE NT. (Please lnflal) _
T
r Appli nt PRI PRI Permit O cis PRINTED Name —'
J Rau Sign um° Please read compliance statement on back of permR" L.
Signature
ApPfiwtfon Feels) Check rt/Money Order Issuing Date Fvlration Dam

EACAMA ❑ DREDGE & FILL
GENERAL PERMIT
® New ❑ Modification ❑ Complete Reissue []Partial Reissue
N9 89683 ®B c D
Previous permit
Date previous permit issued
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 /1�1t � ,f L� 1❑11 Rules attached. © General Permit Rules available at the following link: www.dgq.nc.Roy/CAMAruIes
Applicant Name
[C hO Q'`- CL -�I li-ol�l-on, MC Authorized Agent
Address J�(J L00.�V1 YIYT` Cf34P_ eAV Cj' Project Location (County):
City Gleyt p'�Ly_& State Vca ZIP ai3.3Z0 Street Address/State Road/Lot#(s) IO 1*10A
Phone#( tv rJ r0(5---64411 _1�'\ver sl,aY-e. 'Dr.
TWc\' Lr+TQ \yrEmail w
�I L'/
Subdivision
City �je r}%Dr-d ZIP Oc-7q"T//
Affected ❑ CW K EW ® PTA ❑ ES ❑ PTS Adj. Wtr. Body 4..I I"i'Ie ht V2r [C 6u_Etna man/unk)
AEC(s): ❑❑ OEA ❑IHA UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body_' I be.vysJ tc_tt n01
ORW: yes/0 PNA: yes/go
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s) I Lf K 1 Zr
Floating Platform(s) _
Finger pier(s)
Total Platform area Aw 1141A (Xi
Groin length/#
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift r.
Beach Bulldozing
Other
�4�r(Lta �nik�fyY�
d C
Vv 1
�Y`
SAV observed: yes IS el. r 6V I
Moratorium: yes \V no .//0- i
Site Photos: 1
Riparian Waiver Attached: yes (3 /� tt
A building permit/zoning permit may be required by: 1�er,Aka .e,S Cou,M1 `{a.r
Permit Conditions
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEV
Agent or Applicant PRINTED Name
Permit OfRctr's PRINTED
/t U .
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LA
❑ 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" Signature
'taco SSI GO33 5/t5/t3
Application Feels) Check ft/Money Order Issuing Date Expiration Date

RECEIVED
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM APR 2 1 2013
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or NAND DELIVERY
(Top portion to be co/mpleted�b/y owner or their agent) DCM-EC
Name of Property Owner.�lI [ / t
Address of Property: 3 Q' >C/�WO�C Q/�/ �A8// e/T ial bite_
Mailing Address of Owner. 50f3 pUi/1 �/ }Ll�e &-e'I Gvl °�Q >'i'i� ( - 33&10
Owners email: '4 / 4 Owner's Phone#: [ S7 ®� /S 3
Agent's Name:
Phone#: at7 3 1-r &31-3
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
description or drawing with dimensions must be provided with this letter.
SS 1 DO NOT have objections to this proposal. I DO have objections to this proposal.
ll 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. Giffin 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 Certified 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 16 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.)
100 wish to waive some/all of the 16 setbac ✓��
gnatureofAdjacent ipadanPropertyOwner
-OR-
I do not wish to waive the 16 setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
TyperllPrinted name of ARPO:
Mailing Address of ARPO:
ARPO's email:
ARPO's Phone#:
Date: I s If- k9,3 > "waiver is valid for up to one year from ARPO's Signature`

1� ECIEIVED
APR 2 1 2023

RECEIVED
APR 2 1 2023
:.�..,.v7wUN OF COASTAL MANAGEMENT
" '....:PARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM DC -EC
vEOT1C'iEu ""^.IL RETURN RECEIPT REQUESTED or HAND DELIVERY lsl V 1 !�
(Top portion to be completed by owner or their agent)
Name of Prooertv Owner. I'/O1YO
Address of Property: 1.3a1 2 ibblrC/ sliyle / D/gam 141) dly d inC.
Mailing Address of Owner 'V/_S L7eir n.' 6P��i
�l r7 �
Owner's email: If h -Owner's Phone#:
Agent's Name: t,Q ��P�p/ ( _ �✓t Agent Phone#:
Agent's Email: L.RNGL��ry,�'!K/ /t C [✓ /-y I r" 14-f� r • C C7 0+
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion tobecomrrie__________� __. _ _..
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
description or drawing with dimensions must be Provided with this letter.
nt-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. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
matted to 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at (252) 2043901. No response is considered the same as no objection if you have been
notified by Cued 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 must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback nV n�
Sigma/ /re of Adjacent R�( fian Property Owner
_OR_ e
I do not wish to waive the 1 F setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
TypedfPrinted name of ARPO:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date `waiver is valid for up to one year from ARPO's Signatue

RECEIVED
,
i APR 2 1 2023
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DCM-EC
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