89906A - Hare

KCAMA ❑ DREDGE & FILL �yL N9 89906 ® B C D
Previpermit
1 GENERAL PERMIT Date us previous
Date previous permit issued i
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 IH � ac c k. ❑ Rules attached. ® General Pennit Rules available at the following rink: www dea.nt.eovlCAMArules
Applicantil.anne.G{"J�i:�: 4YrTM
- w `f
\ `.♦
_ A
Email
r—•.
Project Location (County): C. II oU)CXVX
Street Address/State Road/Lot #(s) I A
A-W G-roG"I Noe et`it�' ���,c4., ant.
Subdivision G r `wei Cte'& t o-Kj b}y.
city Pd' ZIP
Affected ❑M ®EW MPFA ❑ES ❑PTS Adj. Wtr. Body 0'An uxtr. t—lVew-�` lRrron(unk)
AEC(s): ❑ oEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body `Y!{.YS�ta +tP Jt�tls�e]I
ORW: yesco) PNA: yes/W
(Scale:i= ,)
-y
Floating Platform(s)
Total Platform area Jk `IIY 5Y})..
Groin length/#
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Silt �' r
Max distance/ length _
Basin, channel ^
Cubic yards
Boatramp '
Boathouse/ Boatlift .. i
Beach Bulldozing
Other re Mena YE'Rt(ciCfa
SAV observed: yes
Moratorium: yes no
Site Photos: r� no
{�
Riparian Waiver Attached: es norn 'Tr
A building permR/zanIng perm it may be required by: wstA.f� C6�.e Yti -
r ❑ TAR(PAWNEUSE/BUFFER(eircle one)
Permit Conditions _
❑ See note on bade regarding River Basin rules
------- - ❑ See additional notes/conditions on back
Age for ApplicantP IR NTED Name
Signature/ -Please read compliance statement on back of permit' p
S 2-ccrQ- 11 e�
Application Fee(s) Check #/Money Order
(Please
Permit Offtfer$ PI)INTED Name
Signature /
(altZ /2'j l o/zx fr 3
Issuing Date Expiration Date

3�acouruy ©CAMA [I DREDGE & FILL N° 89906 B C D
1 GENERAL PERMIT Previous permit
Date previous permit issued
N 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 7 H - acic�a ❑ Rules attached. ® General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name' 1� Authorized Agent
Address N (a d r ) �wI > k720.{_}'\ Ed . Project Location (County): l� ko W oLy\ r�
City �_vv Py State NC ZIP Q-7q O Street Address/State Road/Lot 1#(s) IA 6
Phone # (M) ? 2 5 "^ySt _!�H (6 III
t 1 �t^i@.'Y`IS Pck Val
Email Q'nrr�U . h(l r2�L+' �CW�r ! cS IM Subdivision Gk r `III CI &- ( lLVJ l )l v.
City Tlfjls P-c— ZIP cZ-7 9� 0
Affected ❑ CW ® EW © PTA ❑ ES ❑ PTS Adj. Wtr. Body l'. 1knlA-7)0- \ \C_VeY' na man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body I'r � 0CXhA r(P wLA-J'J
ORW: yes, no) PNA: yes&j
Type of Project/Activity 1Z?.viaO'& 0.rC re
Shoreline Length %'�
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
r
Total Platform area iT91 c
Groin length/k
Bulkhead/ Riprap length
Avg distance offshore
Rf_r �f ('{4- fl C�Ac% - il. ( t g. ;rir\ O&,r SJ p (scale: 1" d
0 0C y
�W ��t
Breakwater/Sill
, �-3
Max distance/length
^
Basin, channel
^
Cubic yards
^
1
Boat ramp
Boathouse/ Boatlift
r.
Beach Bulldozing
Other �Q te.o
Y'E'O�QCp
�x� _mil
dSk\ �d fwk9�nn�l
SAV observed:
yes
Moratorium: 11[a+
yes no
Site Photos:
no
Riparian Waiver Attached:
es no
A building permit/zoning permit may be required by: Ckd. ck^Co'a.t n
Permit
I AM AWARE OF
Agent or Applicant PRINTED Name
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Permit Offtcerb PRINTED Name
Signature **Please read compliance statement on back of permit** Signature /
��106' v$5 (*/Zx./z3 to/ZZ/23
Application Feels) Check #/Money Order Issuing Date Expiration Date

�1*OCUSr" ❑LAMA [IDREDGE & FILL N9 89906 A B C D
WN
a Previous permit
GENERAL PERMIT Date previous permit issued
M 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 # ( )
Email
Authorized Agent
(; Project Location (County):
State ZIP i.-> Street Address/State Road/Lot #(s)
Subdivision -
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body c '(nat(man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body 1
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:' 1
Shoreline Length
Access Length
Pier (dock) lengtl
Fixed Platform(s)
Floating Platform(s)
Finger piers)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length _
Basin, channel -
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
L�F '
SAV observed: yes no
Moratorium: n/a yes no r ­4"
Site Photos: yes no -
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 Feels) Check ft/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:XAtv �/L' r�
Address of Property: �Tl'6d (5-/AtrTS 13eN-
Mailing Address of Owner:
q�o.
Owner's email: ^ { /t G St.n 9-S !: Owner's Phone#:
Agent's Name:
Agent's Email:
;Ls-ti 32S'- 45 00
Agent Phone#: C E I , ^ L)
lirn 1 3 Z0Z3
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 applyirg((``��ht M—E C
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 Jett r.
V 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., Sta. 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
noted 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 riorap 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 J(Ly1' (Z1Z;A
-OR-
Sign 6rre' NAdjacent Riparian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: l ! 64 � ,, )ff'�.. 6-eA G h
ARPO's email: n 15 o ctVCMq A*V0's Phona#: Z571 33 1
Date: T��'Z, •.�� *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)
Name of Property Owner: —r p— /J p
Address of Property: Y-16 O r, -/y i r-i-Y e,r 1
Mailing Address of Owner:
Owner's email: GLl�c�r to G $ �S'� Owner's Phone#:
Agent's Name:
Agent's Email:
�S'1— 43 7-5' q&-d o
Agent Phone#:
RECEIVEn
-- 13 ZUZJ
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner) //''�� q
I hereby certify that I own property adjacent to the above referenced property. The individual applying[)(;1 V 7 r
permit has described to me, as shown on the attached drawing, the development they are proposing. A
descriotion or drawing with dimensions must be provided with this letter.
ti
V 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
malled 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 somelall of the 15' setback
-OR-
gnatureofA acent RiparianProperty Owner
DO NOT wish to waive the 15' setback requirement (initialthe blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address ofARPO: ��*Lccss6Uer/'ZJye0
ARPO's email: Sl f, S2 .a �1. C'ARPO's Phone#: C`L.1 yr b •/1b,6
Date: 1/4Z 2 —.Waiver Is valid for up to one year from ARPO's Signature*
Revised August 2022

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