91377C - Repaci, Charles

•
o40`°'14( PCAMA DREDGE & FILL N9 91377 A B © D
a = GENERAL PERMIT Previous permit --
Date previous permit issued ---
New ❑Modification I I 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:
ISA NCAC U/ ti, i; ❑Rules attached. 0 General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name ��. Authorized Agent
Address , LI V Project Location(County):
City State ZIP Street Address/State Road/Lot#(s) L/j l/',i vr°
Phone#( )
Email Subdivision
City ZIP
Affected ❑CW n EW n PTA I 1 ES PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): El OEA n IHA ❑UW El SPIMA ❑PWS Closest Maj.Wtr.Body /~+4411.1Y1 5 C IT
ORW:yes/no PNA:yes/no
Type of Project/Activity ,
(Scale:4/TS)
Shoreline Length
Access Length 0 '__w._ - -� �i _ .. r H S ....._. ;�_... . 1
Pier(dock)length . Zrail�aw� : ■11■111111111111
�� ■
Fixed Platform(s) �����
Floating Platform(s) JUIUUIUHIUflIflUI!IiiIfl
1111
Finger pier(s) t ■111NEU
111111momr11111111111111111111E ■
Total Platform area l.._.._.la �___i
Groin length/# S' 11 �Bulkhead Ri ra length a il II II
Avg distance offshore -i k i'
1-
'�j
Breakwater/Sill EIM1� �. � �■ ■� ■
Max distance/length ! �.:amii:i:
anuisaermasoi ■• �� ap �Boat ram ° ' � � i,:piip;up :'in
/•��I�/I'11_ '�� �eN,
Boathouse/Boatlift al� ma at!%m/%zIlanmo m.■iesn:ls �
Beach Bulldozing i r
•
�r r„r,
Other I mralmisz..arimuninum11 IMO ai 111111111111111111.11111611111111111111111111111111111111
IIIIIIIMIIMIIMIIMIIIIMMIIIIMII
SAV observed: yes (9` , is •
` 3)1 ■ �■� �� '\`, E11■11■ �E
Moratorium: n/a yes � `/
Site Photos: yes Eiv --- •— ��`�.r/•j7� �j !!jj��,"� _ � n�
Riparian Waiver Attached: yes no �� �'� 1161VR 11 !,I.R�'. 1111111111111111
A building permit/zoning permit may be required by: f[✓ i ,1+,,
Permit Conditions i i"i , , IK TAR/PAM/NEUSE/BUFFER(circle one)
-
i t laj b EllSee note on back regarding River Basin rules
nSee 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

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:[phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

,to`°'�rk'�Ye I'�ICAMA fl DREDGE & FILL No 91377 A B t:C' D
�i1 GENERAL PERMIT Previous permit
Date previous permit issued
n New n 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 Authorized Agent
Address , . Project Location(County):
City State ZIP Street Address/State Road/Lot#(s) ,—
Phone#( )
Email Subdivision
City ZIP
Affected CW I I EW n PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA I I IHA UW n SPIMA PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:;yes/no
Type of Project/Activity
(Scaleyj/7 )
Shoreline Length
i r
Access Length �.a t _. 'Li. _' 'S.,` ._ L..._...._.. ._._.... . .4
Pier(dock)length €.1 , GI
Fixed Platform(s) 1 ' l
Floating Platform(s) •_ ' f'( i
.4 '-_.Y.I.
is `'�
Finger pier(s) ( 4 l /
. 1 +
.
Total Platform area i _ I
Groin length/# , _.,.--r'- j .
1 i
Bulkhead/Riprap length — -+..- i . ,
Avg distance offshore t # :r •i�4.t_.. ._._..._
p) i ,
Breakwater Sill ! , - } L -- - . . . ,
N'
Max distance/length !: t,
Basin,channel 1 t !
E 11
Cubic yards ... ._.. _.i .,,. . .:.._. �,�.�,._ ,._.-----1
Boat ramp `�` ! �_.,. f:
Boathouse/Boatlift `� r
t.
Beach Bulldozing 44
Other
,
il r�1 � 1 I i i `4`k, - ,
SAV observed: yes no , ..V) j '� \�). � Y
Moratonum: n/a yes no j _ I 1 1 1."r ,_•-' •r `'
Site Photos: yes no fi S I ' . , '4 1, .- .!
Riparian Waiver Attached: es no _.. l' i ' ' I I ,
A building permit/zoning permit may be required by: , T "i n
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee 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

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax:[phone] 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

05
411 ROAD SR.1321 2%PO rj
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R/W RIGHT OF WAY I
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PEDESTAL`\\\p Cl N21'01'52'E IRE
MAGNAIL FOUND 50.13'
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CURVE LENGTH RADIUS_ CHORD MAGNAIL FOUND
iag IN1X SANDY HUSS DR, de
CI 49.59 375,00 N49.55T7'E HIDDEN HARBOR LN. RECEIVED
I.MDMAs F MAw,STRICKLAND D. P.L.S.L-3770 6 R1lr THAT IMS suREY Is OWNER:FRESE,ROBERT D SR TRUSTEE
OF AM EXISTING PARCEL OF LAM. REFERENCE:
'Pw '4s - yd�w+d,RI 6/29/16 ,,,, DEED BOOK:1422
MAMAS FDWARD SRICRIAen,m L-3776 ``` OVIA CAR,,, MB 28 PG SOS DEED PAGE:474 �O '?
L-3776 AUG 18
REg57RATIDR NUMBER Al° S/� �4 = PHYSICAL SURVEY FOR
CERTIFICATE OF SURVEY do ACCURACY: le by STEPHEN & ELINOR RUZIECKI
`RAMRm""r QJRS �"U&su erRA 'HIDDEN HARBOR ACM-MHU CITY
DRAW WOW M.SUMMERS new AN r nu saver MADE = -
14w MY swan/ism auss D ORMON IaD MD N BONC.1477 = SEAL
PAOE_414SR OMEN NESER ACE sEURCE_ ,,- LOT 10
nut RAE SWIM WES NOT sRn4YED ME NMcshD As DRAW . L-3776 .
MRI M INFORI AmR El KM PAWOR Ol16A REFERENCE SCUME,IKAT TIE rum EC MI 1. p ,� MERRIMDN TVSP., CARTERET COUNTY, N.C.
CA PORDOK.Aoa1AOT 6 1:,6DDD.No 1RAT nu MAP sum 4. '� SURVEYED+
nc easm ssas or ' uttauos or PRACTICE ne LARD `� /� . i c". STRICKLAND SURVEYING, RA,
sn oev wan "Auo ERTROC1 s cD( 4915 ARENDELL ST, STE J I6R/y2�0�/16
6/29/16 '',,,,EbW4RD 0v` PHB 132 4902 rt'
,en,uu,u"" MOREHEAD CITY, N.C.28557 p E�
_ ,.S 44 amI,I41 6/E9/16 L,-3776 (C-1496) p 6T/E9/16
MEI:SWIM LAW SURv4Ytl1 Rf$1RAmR MA®at SCALE)
THOMAS EDWARD STRICKLAND in P.L.S. I'=40'

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: c ' cc\e , A . 0a
—1
Mailing Address: \S Saes ��l \--\'t&SS .PC.
tN1 .c-• z�--1 c.e
Phone Number: 7b3 2 c\ 4-7
Email Address: c C a 6-0A \ , c w�
I certify that I have authorized ©�)Vle-, / -1-Cac-- -
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 2,ccc3 c 2evek es"-t-
at my property located at I ` av\ Dr , ea. c9 k �.
inCa.A -c—A— County.
I 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 Info ation:
Signature RECEIVED
c v c�` \ .2 epcLC}L AUG 1 8 2023
Print or Type Name
ACM-MHD CITY
13(-0 ft-e,{7c-6%rArcLc_A--oC
Title
g I I K I Z3
Date
This certification is valid through I I

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: 0\0.,6 es A
Address of Property: \, oma'/ \-u.sc t
Mailing Address of Owner: \ \S S�A.C/ \ S Or. K.1L .
Owner's email: C)Ail\.es\4c t vvuwner's Phone#: `� 2ctC(4-t 1 kF'
Agent's Name: N4 Agent Phone#: /Yn
Agent's Email: /L//I
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� ti or drawing, with dimensions, must be provided with this letter.
,lice �/ 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 400 Commerce Ave.,Morehead City,NC 28557. DCM representatives can also be contacted
at(252) 515-5400. 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/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) 4j
Signature of Adjacent Riparian Property Owner: Iff ,��„
Typed/Printed name of ARPO: 1.YV O1�-e-1
Mailing Address of ARPO: 1 Ll 5o r&, U S5 Dr, - - N(. 2$S �o
ARPO's email:ICc rie.4 ARPO's Phone#: 1 b t+- Si CI "" 141 Z
Date: 8//71Z) *waiver is valid for up to one year from ARPO's Signature*
/ Revised May 2021

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: 1e_52.> Y. c2.P?Ci
Address of Property: \\.- 'v\�` 4-/ASC„ D< .
Mailing Address of Owner: \C SG A-c \ASS p c . e c N �- z_ 5 k (-e
Yn � r �
Owner's email: A5 acti CG)_rr XOwne s Phone#: Z.s.)-3 24-C( '4 '1 R.ic-
Agent's Name: AV 4 Agent Phone#: Nril"
Agent's Email: ft/{�
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
descriptionti 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 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252) 515-5400. 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 11 of the 15' setback r jc:44t.
Signature of Adjacent Riparian PropertyOwner RECE r-
-O R-
I do not wish to waive the 15' setback requirement(initial the blank) AUG 18 ?l)?i
Signature of Adjacent Riparian Property Owner: _fQ.t?CiA-o. DCM-MH. *CITY
Typed/Printed name of ARPO: Pa.T ' C I a- Ho /f
Mailing Address of ARPO: //-3Aa/K-41A), ,L'� t444-) lilt . & mJA' C. c20-s7
ARPO's email: /// 1 ARPO's Phone#: S & '— j t'1C/�(
Date: /i f r0 3 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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Delivered
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MARSHVILLE,NC 28103
Your item was picked up at the post office at 12:45 pm on August 14,2023 in August 14,2023,12:45 pm
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