89711A - Hielscher

❑ DREDGE & FILL
3 GENERAL PERMIT
N° 89711 4j�) B C D/
Previous permit V099 3 YA V
Date previous permit issued IWW,22
❑ 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 *%N . IaW ❑ Rules attached. N General Permit Rules available at the following link: wwwdeq nc gov/CAMArules
Applicant Name I-
eo MC? MelsCh.ev-
Authorized Agent JK
Mtl\\40.r\/UCPftKSJ c\C LC1Y�hr1"f'a'.
4
Address,,
1
IOtcaSt Iles+
1
%Y\,
Project Location (County):
ReCvE' U i vv,& k%Z
,1 �3t9
City Hlerk]PO r-J State I�l L
ZIP 279 Yy
Street A�d2dQress/Sta�tse Road/Lot
# s
() �t5+" '#' a
Phone#1(�,,,y) R3o-no
6l Ic,-,Je
Nes LA.
Email 6',eISde+".
OtPof'Qe `��'InGit
I.CC1Vt�
Subdivision Goose,
1�-
w3.'
r7
ZIP 27'iAN
Affected ❑ CW
❑X EW ❑x PTA
❑ ES ❑ PTS
Adj. Wtr. Body A lbem�t
p
ante
at an/unk)
AEC(s): ❑ OEA
❑ IHA ❑ UW
❑SPIMA ❑ PWS
Closest Maj. Wtr. Body
f.]Olc�^
Iy t�.PN0.r�1�P_
ORW: yes/ io
PNA: yes/(Co)
Type of Project/ Activity Q Or cl l3 � x 30' locicM\OLI,Se W/ Zy x LI V LI-Ae r- r'- ,e-r-
$ 3n
� X 3d h e+ (ScaIT`I& j
Shoreline Length
Access Length
Pier (dock) length , a!� �,� t1Y3" 7•'�
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) 2' xY $ x 3 r x 3or
R bt S
Total Platform area
Groin length/k '^ ('--.b t
Bulkhead/Riprap length
Avg distance offshore _ RR44}
Breakwater/Sill ^ 306
Max distance/ length n
Basin, channel ^ J
Cubic yards
Boat ramp
oathous / Boatlift it V r-' X
Beach Bulldozing 1 Q'
Other 1
wt-
SAV observed: yes
Moratorium: ® yes no
Site Photos: < no �v ,
Riparian Waiver Attached: yes � ( Pro?.
A building permit/zoning permit may be required by:
❑ TARJPAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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)
%Q Z m
Agent or Applicant PRINTED Name Permit Of erb PRINTED Name
/ �"
Signature *'Please read compliance statement on back of permit" Signature
S aco. l!" 124(01 5/I/4-3
Application Feels) Check k/Money Order Issuing Date Expiration Date

� ,a o" 'CAMA ❑DREDGE & FILL
03 _?GENE PERMIT
N9 89711 (!b B CV
Previous permit $foQ4 s b
Date previous permit issued
❑New ❑Modification ® Complete Reissue ❑ Partial Reissue
As authorised by the State of North Carolina, Department of Emlronmental Quality and the Coastal Resources Commission in an arm of arvironrnenM concern pursuant to:
1 SA NCAC e1N • 12CI O ❑ Rules attached, [F Gawal Permit Wiles available a it. rclloveing lk9c www.deo.ncaov/CAtMrulet
Applicant Name
Urxrne__ _e el-Sci.Pr
Author¢edggent U 14IiV g4n /acecs'%Ji
ck GMYw'
4
Address39 Gm—1.) se es�" Ln
Project Location (County): � g U i w•Ot
Street Addrress/St�ats Road/Lot#(s) W- #II
` E�
city Hyr4or-d1 State NC zip 2-11 Ny
phone # (9t!L) _'S
30 ^ iSo 7
151 L ceG Ili CS �- LA
Email _ h i C� �C�.er_
nr oc-ne @4mGL�
1 ccJN,
A,bdnblon G001e. IJ +
City
P aZ7 9alY
ARectod ❑ CW
® EW ® PTA
❑ ES Elm
,r� ,� _ _ - 1,, Q
Adj. Wtr, Body A IlOe4ho1 rAe ..]bu.
6ktun/enk)
AEC(s): ❑ OU
❑ IHA ❑ uW
❑ SPIMA ❑ PM
Closest Maj, Wtr. Body A llar EYhotr4p-
c��
S"
ORW: yes/0
PNA: yes/(P)
Type of Project/ Activity
8 3 � x 2ca/ V"
Shoreline Length t� 13O(�
/A
(Scale:jtr-W )
Access Length
r r r r
Pler(dock) length
_ '''sss,,ttttt"�����
Fined Dlatfon(s) i .,`4�
rt
�--- `,
1
Floating Platform(s) � 1 i � � � i ,� yt Q' 1 . r � � ._•.��
Finger pier(s)
r
$Y
Total Platform area
Groin length/q r.
Bulkhead/Riprap length ^
i--»- r s r�I�`• -
Avg distance offshore
Breakvrater/Sill
Max distance/length
Basin, channel
Cubic yards
athou
,-
i
Beach Bulldozing
Other_
i 1 1 I
r
SAV observed: yes
Moratorium: yes no - s
Site Photos: cf/E•'� no -
RlparianWaiver Attached; -Ves" 9 ;—'—
A building permit/zoning permit maybe required
Permit Conditions
7
j
t
r
.,__ r 1 _t_-•--. .tom_. l ..
i
All
- L r
.r
1
❑ TARMAM/NEUSE/BUFFER (drde 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 PROACT AND REVIEWED COMPLIANCE STATEMENT. (Pleaselnitial)
Agent
Slgnature,Please read compliance statement on back of permit•
4 260, C*6 124(oi
Application Feels) Check q/Money Order
Name
5jr 9/1123
Issuing Date Expiration Date

❑CAMA ❑ DREDGE & FILL No 89711 A B C C
f
�'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.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # I—)
ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑IDEA ❑IHA ❑UW ❑SPIMA ❑PWS
ORW: yes/no , PNA: yes/do
Type of Project/ Activity
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
i
Subdivision I'
City ZIP
Adj. Won Body (nat/man/unk)
Closest Maj. Won Body
(Scale:: )
Access Length
`
-- _
_
_
. -
y;�f
r
I
._
—+
,
A
A�
Pier (dock)length
_
Fixed Platform(s)
__—
I
I
Floating Platform(s)
,,,.4
Finger pier(s) <�
Total Platform area
#
Groin length/#
I
-._.L
�f
_
—
di
,_
—
—
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
'-;'—(—
-
ti'T,,,
Basin, channel
Cubic yards
'J
{
77
I
Boat ramp
L_
f
Boathouse/ Boatlift
_I
Beach Bulldozing
Other
i
❑
i
I
'
i
C-
SAV observed yes no
Moratorium: .n A yes no
Site Photos no
-
yes
Riparian Waiver Attached: 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" Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: &eo a& Fi i��r
Mailing Address: 4,59 &Dose Ncst- Lae1e
Wer+%rd N(. 2-1154.1
Phone Number: 91q- 230- Q75 4
Email Address: bid150W-_ a%il. GAM
I certify that I have authorized )K Mi L1fao,n /Ctawl5�CVYx+'QCt4s5
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: on .diva. a
2 +944C+wall wed I -XIIX1 i.m.t.ln.,aw A f.id. DAES on ,&eV44e',a
tOulicYl�a! Z rvtopr:.•�� ppi It'd '
at my propewy located at `f39 C"nCM . h)A9 - lake Her-Wor'd NG 2" OM4
in 1'Pr&u,/mt County.
1 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 Owner Information:
Signature
PAW or Type Name
pWnGN
Title
/l t tF J, 2m22
Date
This certification is valid through I I
APB 2 7 2023
0CMa C

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNYAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner.yaacqr. Wig -
Address of Property: Lr3Q G pe0 04,.- ' U�• µee++ ' yrd _�NL Zla4
4. Mailing Address of Owner.31 &tDS o J�%i
5+- Y1c �i+P�►�t'1 N-d &-• zZ•� 9 4
Owner's email:1pwwnne`r's Phone* ar)61 —102
Agent's Name: ,Y A•il l(ta,an ICGep.Aslde Agent Phone#: ��`3
Coil ? ac- bYS
Agent's Email LYta/L4jj�G CQy4fC1 Chq-r5 0 OWIA i CQnn
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adjacent Propertv Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying forthis
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. 100 have objections to this proposal.
H you have objections to wrier is Doing proposeu, you musr noury me rv.u. urvisror, ow �oaa,a,
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
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of IS' 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 scan
the appropriate blank below.)
I DO wish to waive somelall of the 15'setback
-OR-
Signature of Adjacent Riparian Property
Owner RECEIVED
I do not wish to waive the 15' setback requirement (initial the blank) APR 2 7 2023
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO: Norv►w,� 4Ctr<✓l`�'wc%. _
Mailing Address ofARPO: 421 GOM Nink [ant. Hwoe)4wd fJG 2",*p
ARPO's email: ARPO's Phone#: 1 47.(.O— (Aal
Date: ZZ (�k waiver is valid for up to one year from ARPO's Signature'
7 I/ Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTlFtED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. WICI SeLvs
Address of Property: a t39 G oO�e. rjggjr 11 eyr Ne✓4��•taltoped A�NC. 2L-tQyc4
Mating Address of Owner. t%'3Q �7'DD+c-D NEST t!yt� WeYi^Z"2Q4:0
Agent's Name:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be comol ed by the Adiacerrt PfePerty Ownerl
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
Permit has described to as shown on the attached drawing, the development they are proposing. 8
description or drawing, with dimensions must be provided with this letter.
CDO NOT have objections to this proposal. I DO have objections to this proposal
ff you have objections to what is being proposed, you must notfly 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 same as no objection H you have been
notified by CenttBed Mall.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, IIft, 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). Of you wish to waive the setback, you must scan
the appropriate Wank below.)
100 wish to waive some/all of the 15'setback p
Signature o/A sent Riparian Properly Owner RECEI�� E-1,,,}
-OR-
I do not wish to waive the 15' setback requirement Qnhial the blank) APR 2 7 2023
Signature of Adjacent Riparian Property Owner. AfAt-,r D Cr1 V € - E C
TypediMnted name of ARPO: Aelaiel kkinpgiFL Cwpac , /
Mailing Address ofARPO: y� 6► * Land. nd. ke✓?Yofd tXZ-MW
ARPO's email: Ah c•oA -f�i. lmA,'],Ca- ARPO's Phoneg:
Date: /%' /9 �� 1 "waiver is vaild for up to one year from ARPO's Signature'
Revised July 2021