89774A - Lamm

��❑CAMA 0 DREDGE & FILL (� /j NU 89774 A B C D
%
imlGENERAL PERMIT Y�V 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:
I SA NCAC ❑ Rules attached. Q General Permit Rules available at the following link: www.deg.nc:eov/CAMArules
Applicant Name
City
Phone # ( )
Email
State I ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ pTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/ho:
Type of Project/ Activity
(Scale:[j
Ch— i— Ionoth
Access Length
—
-
-
-T
�.—
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
�z
t•
-
--I II—
-r
I
—
-
I
Finger pler(s)4::
I
I
Total Platform area - t
J�
_
—
—
�__.
,��
_
)
}
to
'
C
Groin length/#'J
T
_
.-
Bulkhead/Riprap length—
Avgdistanceoffshore
_
__
_
-.__�
__,__
_._;__.
_
.. _.I.
-
r--
Breakwater/Sill
i-
i
__
Max distance/ length --I �` "
}" '
"''
r---'�
'-'�"'
r"'
-
—
Basin, channel
Cubic yards
in
Boat ramp
Boathouse/Boatlift
—�-
Beach Bulldozing
I
__I_
Other
_
—
t—
I
,
l
SAV observed. yes no --
Moratorium: n/a yes no - -
1 -
-••^
''
-
f
-
-
Ikt
Site Photos: yes no
i `
�..
�I
—,
/ I
-
}
L
C,
y5s
t1
�t6�._
-
..
I—..
_.
RiParlan Waiver Attached: Yes no
4
!
-4
A building permit/zoning permit may be required by: !' j
f
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.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
(Please Initial)
Signature **Please read compliance statement on back of permit**
Application Feels) Check #/Money Order
Signature
Issuing Date
1 : ;
Expiration Date

Nameofnwi tyoamari o POW& AJ e Q. LAB O'%
EUMAd*em
tl/,4
toe�Bryi6etilmreaa>l�otiaed cc�/�Bs-1 Vi A
Aaeetltae
ba1.tU11 �batrel�TOtfiBpMpOBSOiaPPlyilgfarellfio6lai�in$81 t�Wl►peimib
necossmyfwt* Proposed dridoPMOM
EL" �b � 10f-Ad _m
at�r b saat I S
_._ P IMRn.f (�►
1 dorienwm *w t Ion a orop, d io giant and do In fact grant ponabsiDn to
Oi�idoaaflaaastalii�arnants��.taoat�,aiO�cerandineir�anesinse�tar
m 1he sonad lads it ooiriediow wiA iniiarmaim ie111ed ib his
Paimeff
P 00*O0001 N■aelione
t
_ Fliater7ipalllaa�s
MINIM M
am, F A' M-
RED
JUL 2 0 2023
DUNA.nEC

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 1 LJ f/Qk&k✓ e 2 U i u rvii r I
Address of Property: l � %{ l q- 5 HokQ W e PEA 1 &=Q Ak- D? 9 /
Mailing Address of Owner:
tl It I it I
Owners email: in lamVM n141I— CavOwnersPhone#:
Agents Name: LGvf�to✓1 t1'1�u lire Agent Phone#: ��✓I'I
• r
Agent's Email:
/t e
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adjacent Property Owner)
1 hereby certify that I own property adjacent to the above references: 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 noury me N_G. umsron or tooasrm
Management (DCAq In writing within 10 days of receipt of this notice Correspondence should be
mailed to 401 S. Griffin St, Ste. 300, Effzabeth 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 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/ail of the 15' solback
Signature of Adjacent Rpanan riy Owner
-OR- PlIVID 6YA wrn
�t a d� � f;:: r
I do not wish to waive the 15' setback requirement (initial the blank) )"� 't t.,,
Signature of Adjacent Riparian Property (timer.
JUL 2U208
TypedlPrirded name of ARPO: tit 'E c
Mailing Address of ARPO:
ARPO's email:
ARPO's Phone#:
pate: *waiver is valid for up to one year from ARPO's Signature'

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONANAIVER FORM
CERTIFIED MAIL " RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property
Address of Property: l �� R I tl 02 �R H E1V17-W-0, Al C_ d 9vy
Mailing Address of Owner. / ,�Q1 L
Owneesemail: A (ol A: ttnei'sPhone#: 65a)�?33
Agent's Name:LaWLIrl (`7Lri ll p Agent Phone#:
Agents
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 he 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 Goastar
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 Whom 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 sometall of the 15' setback v
SignatureofAdjjaicentR ' " n roperlyOwner � �
R TKIv!© I iis4;�t 4 %J .t
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:
ARPO's email:
Date:
j U L 2 0 2023
ARPO's Phone#:
'Waiver is valid for up to one year from ARPO's Signature`

ITTL
�lvJ o
N 02TH
k
1
S/
14 T 71, P 13uLK HiAj)) T
V
r
M
lUL 2 a 1�t3
L /7Z.
n I V£2
SOU T H

O-tt-a�', � /Ozzaz uw: 8,we-e rLa,�
-T I"fZO I
15CQ fi/um �404rDR
-
Pez—)Foo 00
OSO -339 -- 8>5-4/7
JUL 2 0 2023

2
$
§
\
/
§
/
0
)
(
\
.
/
j
k
\
\
\
}
f
r
r
/
/
§
A
j
(D
5
\
»-7
I
D
/f~(D
arm
m
%
C
\
CL
& \
�
■
�
w %
«;
f|�
�
;
\/
#«
i
_
}
_
\
\