89936A - Allen Jr.

ate XCAMA N DREDGE & FILL IVY 899-56 ® B C V/
GENERAL PERMIT Previous permit
� Date previous permit issued
54New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As autitorba:d by the Sour of North Cwvlkta, Department of Environmental Quality and the Coastal Resources Commission In an area of environmental concern pursuant to:
15A NCAC /4 - 1100 ❑ Rules attached. ® General Permit Rules avaXabk at the following I'nk: roam migov/CA Arules
Applicant Name r � fZ, Iilleft Jr. Authorized Agatt _
Address1` _2 1(,n aA it A tkVk rJ Ly1. � f� Project Location (County);
City �'i��L'F' :-o1 state hJC ZIP __75W_ street Address/State RauuLot#(t)Re
Phena#(*q) 94T— -715b 21to Setwr.d._C3�a�ol
-O.` 1<.r1
Email SQvnea.Q.CLUe_r. ♦ C�caync I
he_' Subdivision J
Clty__tkr_ ZIP 279iW
Affected ❑CW MEW ®PTA ©ES ®Pis Adj. Wtr. Body OaAal {nat za /unk)
AEC(s); ❑OU ❑ IHA ❑ UW ❑SPIMA ❑ PWS Closest Mal. vy,. Body A ( 6¢mLLI . OLA
ORW: yes/6 PNA yes/0
type of Project/ Activity
Shoreline Length
Access Length r
Pier (dock) length
` •"-.!
Fixed Platform(s)
:.
Floating Platform(s) 1
'
Finger pier(s)
Total Platform area
_"._._._...i_..
Groln length/n
1
ikhe / Rfprap length QT—
Avg distance offshom .a
� 1
I
t '- �- l
Breakwater/Sill
- -i -
Max distance/ length
1
Basin, channel
Cubit yards
Boat ramp
Boathouse/ Boadift '-
t..
^v 1
r
r
-- •---.-ram
r
_.S"
I�f
:
'1
i 1
i
t i
Beach Bulldozing
��y- ^ ' p/�. ! r' r
ly(A t -_r
Other eil.as..Lt r---- ,.. -Y '_� j
SAV observed: //'�� yes ! ! ! 1
Moratorium: MFai as no 1--'� 't' 'a'- ---r -i-
Site Photos: no
Riparian Waiver Attached: yes't'
A building permit/zoning permit may be required iW: '`T'guas.fra.S L641N'4
Name
iigpature "Please read compliance staTement cfn back of permit
3yc>b . tx� zs�r�
1pplication Fee(s) Check d/Money Older
r
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r � �
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t_ $ILI
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1
❑ TAR/PAM/NEUSEiBl1FFER (drde ore)
❑ See note on back regarding River Basin rules
❑ See addidone( notes/conditions on back
(Please
Peonit Otflcer4LPR1JJTED Name
Signature V
Issuing Date Expiration Date

=�CAMA N DREDGE & FILL
f:=1I=12A1 D=12RAIT
N° 89936
Previous permit
Date previous permit issued
® B C D
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:
I SA NCAC -1rf - I If co T ❑ Rules attached. ® General Permit Rules available at the following link: wwwdee.nc eov/CAMArules
Applicant Name Sa�nne� rt RON Jy_. Authorized Agent
Address, , _o( K6 tOIA � u'A r-J Ly-' (],'' / Project Location (County): 'ef (A I n'�$r%a
City {'tppe&�1t4�i"0r Gl State MC zip Al-1TY Street Address/State
`CRoad/Lot #(s) toT # ISOI'f
Phone#( 4) gJ0T- A-75b `` 0.jb JULAAClt.U0.hOk h
EmailyG Yh25 (` a,lleA y QCdW�CQ bT hey Subdivision
City ZIP 2_l94ly
Affected ❑ CW © EW © PTA © ES © PTS Adj. Wtr. Body 00AR.l { (nat/ /unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. Wen Body Ai&&r►,ra.rAe SX-4.r\d
ORW: yes/40 PNA: yes/0
Type of Project/Activity �Y�%)rQ qs' of wlle. \0,11C.%% fD ci'o,.Ar 7vts,r ens�ltl�c� t rCIk.r-
boR�ho�3e (Scale:j'=-ot )
Shoreline Length 7— IDI
Access Length
Pier (dock) length Aca.l
.S'ty.npr �Cb�1T`}'
NW
Fixed Platform(s)
Floating Platform(s) I he
Finger pier(s) I I
Total Platform area
Groin length/# I ° r St4
Ikhe / Riprap length 95� ri5 d
Avg distance offshore p2 )
Breakwater/Sill
Max distance/length e4? r Phl3
Basin, channel �Ih
Cubic yards
Boat ramp
Boathouse/Boatlift)�es,�
Beach Bulldozing •1J r I �T'O
Other rY tiRY 'l`�4
SAV observed: yes 0
Moratorium: hia•/ es no
Site Photos: no
Riparian Waiver Attached: yes ® 1 (`
A building permit/zoning permit may be required by: 1 ill L&I)N ..blS `4 . Wk
Permit Conditions
I AM AWARE
Agent or Applicant PRINTED Name
iLTht�-
Permit Officer PRIpITED Name
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
SignatLu�re "'Please read compliance statement on back of permit*'
s I Vz . CGt zsy i
Application Feels) Check q/Money Order
Signature
h/tl / 23 1 t/LS/Z3
Issuing Date Expiration Date

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:
4N--R-• Q'. CW-ef
$ ner's email:
Agent's Name: Y") V�
Phone#:
Agent Phone#:
Agent's Email: W1 o— 1111
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION t r
(Bottom portion to be completed by the Adjacent Property Owner)
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.
A15 1 DO NOT have objections to this proposal. I DO have objections to this proposal.
it you nave objections to wnat is nemg proposes, you must nonry the iv.(;. uiwsion or 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.
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
ASAS 7-I/
Signature of Adjacent Riparian Property Owner:✓e,-A
Typed/Printed name of ARPO:: (�� bQ 5 L to U ((-'
Mailing Address ofARPO:t�70�
ARPO's email:
Date:
ARPO's Phone#: ZS Z Z�1 — iPZ(oU
*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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: :�'�� < A ll � ✓�
Address of Property: Eke "50uv,\6t xis j -; (-d r N C 2` l49
Mailing Address of Owner: �^Me
arts. C' (�,. � , �r C 0 er's email: Owner's Phone#:
Agent's Name: lv� Agent Phone#: �).bs t
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner) t.
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.
it you nave objections to wnat is being proposes, you musr noury me mt- urvisron or wastau
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 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
Signature of Adjacent Riparian Property
I DO NOT wish to waive the 15' setback requirement (initial the blank)
F
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: �t�' 4(,� STD
Mailing Address of ARPO: Z (.5 surd 1n1t�rc) W h , t 1� (C� �arJ ,c Z 7ri t4
ARPO'semail; I LLA(la Qf%L. sill XARPO'sPhone#: CJ7`J��-222�
Date:1'1-', 26 i r�*waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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