89699A - Laugginger

u IUKtuC;E & FILL AY Z59699 A )B C D
GENERAL PERMIT 11 Previous permit_ /
Date previous permit issued
Q`New ;KModiflcation ❑ Complete Reissue ❑ Partial Reissue M 6d t f lcdt G 1(0 2OZ5 I
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 I I } ) Rules attached. General Permit Rules available at the following link: wnv .deq nc gov"CAmA ides
Applicant Name
Address 1 Y -
City .,F i (�:. State x IT• ZIP
Phone #(') ) t
Email_ 14d - •e� f= ,.yfi
AHe led �CW DEW DPTA DES ElPTS
AEC(s): OEA IHA ElUW DSPIMA PWS
ORW: yes/rfo PNA: yes/20;- -
Type of Project/ Activity , ( ' ` " ` v t
Shoreline Length
Access Length _
Pier (dock) length
Fixed Platform(s).
Floating
Total Platform area
Groin length/# -
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards p'
�r
Boat ramp
Boathouse%Boatliffi. ' _ +
Beach Bulldozing'
Tr_
Other_.
SAV observed: - yes <
fo.✓
Moratorium: zii/e.i yes no
Site Photos: es no
Riparian Waiver Attached s `. no _I _
A building
permit/zoning permit may be required by r I
Permit Conditions ;
i AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJ
Agent or Applicant PRINTED Name
Signature ""Please read compliance statement on back of permit""
Fee(s) Check #/Money Order
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body ,, • `; z i::_ -
(nat/pian/unk)
Closest Maj. Wtr. Body k
t
(Scale:., ., ...,,)
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
n.. ncv¢vvm LUMYL.IANCE STATEMENT (Please Initial)
Permit Officers PRINTED Name
Signature
Issuing Dale Expiration Date

/PCB

000MN, DCAIMA El DREDGE & FILL l 11 — 0--V77 k A')B C D
9 Previous permit i /
GENERAL PERMIT Date previous permit issued V
[3New E] Modification E] Complete Reissue F-1 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 , 1
I — [_] Rules attached. F—,] General Permit Rules available at the following link: wwvvcIeq.nc.gov1CAMAyuIes
Applicant Name
Address
City
Phone #
Email
Authorized Agent
Project Location (County):
ZIP Street Address/State Road/Lot #(s)
City —ZIP
Affected F—] CW ❑ EW ❑ PTA F—] ES F-] PTS Ad!. Wtr. Body 1 nat/man/unk)
AEC(s): F—] OEA ❑ IIHIA F] UW E] SPIMA [J PWS Closest Mal. Won Body
ORW: yes/n61/ PNA: yes/no
Type of Project/ Activity i I
(Scale: 0
iI
Ck -H- I --k
Access Length
Pier (dock) len
Fixed Platform
IV
K,
54
Floating Platform(s)
I
, e
Finger ie�r(s)
t7
rT
7V
-z,
k
Total Platform area
iL7-L
14
------
Groin length/#
•'t
4�-
21,N
—
—
—
—
—
—
--
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
4
Max distance/ length
Basin, channel
Culaicyards
+
t
Boat ramp
Boathouse/, 96atlift:-
L
4
Beach Bulldozing
Other
4-`H
SAV observed: yes no i-t-
Ak
�V
LJ-
11
1
Moratorium: n/a yes no
v
Site Photos: yes no
�7
Rivarian Waiver Attached: yes no
A building permit/zoning permit may be required L
Permit Conditions
❑ TARMAMMELISE/BILIFFER (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"
Application Fee(s) Check #/Money Order
Signature
Issuing Date i Expiration Date

N.C. rDIVla 0,N OF COASTAL i lAi'sAGEMENT
,ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT Rc—QUES-i EC or HAND DELIVERY
(Top portion to be completed by airy t�- o: their agent)
Nacre of Property Owner:
Address of Property. _. ' ' . _—..._.-_ c� � V
,,,ha ling Address of Owner: _-- ---------_.—.__-- ____-- —__---
Ownei s mai! _ Owner's Pnone9?, hC
Agents Name a , a ? u
--�---- ' gen*.
age-,,T'; E m a i;
A,Y3JAC= S'A11: IN' PROPERTY U vni R,SS ,MR f IFICAT 10N
Q-1Qtfom sror?ior _o be ca r plated 'ov the Aaiiacent Proper. Owner?
i neieby certify that 1 own propert,; ac';acen: o the above referenced,' property. The individual applying for this
permit has described to ma as shay.^: on the attached drawing.. the development they are proposing. A
description or drawing. with dimensions, rnust be orovided with this letter.
103 NOT have objections to this proposal. I DO rave objections to this proposal.
If yr; _; "% objections to what fs b3�rng proposed, you must notitpr the N.C. Division of Coastal
t'r:te.t',ZDC ) in writing wit?rin 10 days of rece!p2 of this notice. Correspondence should be
.'rpJ;':i:_: ' 0"I S. ,u%tft n st. Ste. EIizaba.11
lh C,�ity, i41, 17 v..�. .1, represc-iita,lives car a"fr-1 bS
264-3901. ,'do msnonsc- is ronsid, -ad t?-E same ss no objaction i; you Stave been
naiifaac f_y "erM ed /clad.
WAIVER SECTION (Choose c:fIIi�c3�e
I understario tP,zt any proricsed pie`, dock, me oring piiings, Li:ai 3'� 'Dafno use,
groin must be set back a minimum distance of `5 frcn-- T\r arc2 :,[-ipariZ' aCCess unless bvaived by me
(this doeS_Iot a�7i)iV tc bJliches ol: ac_1-,ap--,9Vet1i i tsj. y c,.< ._: ,v .. _.. d [i e,, setback, you inya gM
theacuroprate blank beio'n'.
I DO wish to waive some;&!' of the S setb L
-GR-
I DO NOT wish to waive the ": b' se* ack 1'egllirrl:9eia Oni5ai t'ne t iaru _ RECEIVED
Signature of Adjacent Riparian Prcpnrty
Typed/Printed nave of ARPO:
Mailing Address of ARPO:
ARPQ's arr•.ni': ciQilaL�Ci�AP� 0I -. . Kits 1'<; hone -: __.A.E d^_J`�OI^)� �?
Dwe: Q3�Q�� ��'wa der Is vsEid for up to one year fmrn ARPO's Signature*
20B
®CM -EC
Revised 14ugu .- 2022

RECEIVED
MAR 1 0 2023
DCM-EC

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
Address of Property:
Mailing Address of Owner: SCtut c
Owner's mail: Owner's Phone#:
l-Aat'u r r?CSbO1.hrdWAMat\.co»
Agent's Name: on eha lrl. Agent Phone#:o052-.:�(oN- 390 /
Agent's Finail:
ald; ® ncde-or.
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.
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
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 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 ripraD revetments). (If you wish to waive the setback, you must slan
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback a I
-OR-
Signature of Adjacent Riparian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)
RECEII/E..r
Signature of Adjacent Riparian Property Owner: " t.J 5s 'EC
Typed/Printed name of ARPO: �P6 ro" f=_ Lf
r
Mailing Address ofARPO: i i (::lam. ), / t rylD,�1jy n)
ARPO'semail: _4,,' a,.4 "g& ARPO'sPhone#:
Date: `waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

:EIVED
1 0 2023
,M-EC