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CAMA DRl:DGE & FILL N9 89968 © 8 C D
GENERAL PERMIT
Pr....roos p«mit__. ________ _
!Ate pNMoUS penrit issued~---'"-
N w O Modniat>oO O Com p~t& Retssue O Partial Relssue
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!).~c.oASr"'~IX[CAMA IS{! DREDGE & FILL
{ } GENERAL PERMIT
N9 89968 @ B c o
Previous permit __________ _
Date previous permit issued _____ _
IX] New D Modification D Complete Reissue D Partial Reissue
As authorized by the State of North Caroli na , Department of Environmental Qual ity and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC ___ 7~H~-~'~l_CO~-----
Applicant Name Yo..t..\.\ {t CV\ ,c.. ~el \e
Address I O '.t 0--l tl \ er L n .
City Eh~ c~ State N ~
Phone# ('1.SJ ) (o,_f 1 -.;'?Lf'6~
Email :f:t:>1'.l.( ,~(q_~ (Qi;.;\\, CQ)'y\
Affected D CW
AEC(s): □ OEA
ORW:yes/€)
[XjEw
□1HA
IX]PTA
Ouw
PNA : yes/@)
D Rules attached .
Ct]PTS
0Pws
Type of Project/ Activity 1:Nk\\ ad &
Shore line Length +t-'6 (~l SiJe)
Acc e ss Length ____ -.., ____ _
Pier (dock) length ___ _._ ___ _
Fixed Platform(s) ___ -___ _
Floating Platform(s) ___ -.. ___ _
Finger pier(s) _______ _
Tota l Platform area ___ .... ___ _
"'I f Ma x distance/ length-~~----
Ba sin , channel _______ _
Cubic yard s _____ -... ___ _
Boat ramp __________ _
Bo athouse/ Boatlift ______ _
Beach Bulldozing ___ -____ _ -Other __________ _
SAV observed : ,.P"y-yes G3
Moratorium : ~ ~ no
f
' '
~ General Permit Rules availab le at the follow ing link : www.deq.nc.gov/CAMArules
Authorized Agent------==----------------
Project Location (County): ~ <g Y, ok!'\.,\(.
Street Address/State Road/Lot #(s) _____________ _
!OK H.; tl ev-Lr..
Subdivision ____________________ _
City E°jiLJ,...b,efu C¾ ZIP X-,'(Q'j'
Adj . Wtr. Body __ ~Co._~_f\a,_{~ __________ (nat/manQ
L,.lJj 'Di •=--
Closest Maj . Wtr. Body __ ~~(1T_l~,e. ___ ~_,_v_..-..J'r_ · _______ _
c:P ~
(Scale: I ~t )
Site Photos: C:Jp," ~ I
Ripar ian Waiver Attached : yes ~
A building permit/zoning permit may be required by : _ __,Yc'--'a.s'-""'....,fli<--><l<."-'l:....~>="""bc=.._~---=-c...=__:_-=-,.... ___ _ □ TAR/PAM/NEUSE/BUFFER (circle one) Permit Condition s ___________________________ _
D See note on back re garding River Basin rules
D See a dditional notes/co ndition s on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Pl e a se Initial ) ______ _
Agent or Applicant PR INTED Name
(I fil l\ ...fh.; ~ ~fre,e
Signature **Pl ~ read compliance statem e nt on back of pe rmit **
$L/00l qbf4
Application Fee(s) Check #/Mone y Orde r Iss ui ng Date Expiration Dat e
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:
D Tar -Pamlico River Basin Buffer Rules D 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
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven -south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste . 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare , Gates, Hertford,
Pasquotank and Perquimans Counties)
http://porta I. ncden r.org/web/ cm/ dcm-home
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven -north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext . Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
Revised 6/01/2021
.• t°'COOT,4(~~CAMA Q DREDGE & FILL
l i GENERAL PERMIT
N<? 89968 A s c o
Previous permit ___________ _
Date previous permit issued ______ _
00 New D Modification D Complete Reissue D 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 I D Rules attached . D General Permit Rules available at the following link: www.deq.nc .gov/CAMArules
Applicant Name----------~----'------'-------
Address -~------------------------
City ________ _
Phone# ( __ I) ________ _
Email ___ ~-------~---------------
□Ew
□1HA
□PTA
Duw
Affected □ CW
AEC(s): □ OEA
ORW : yes/no PNA : yes/no
Shoreline Length ________ .,.... __ ...... ...,.
Access Length ________ _
Pier (dock) length _______ _
Fixed Platform(s) _______ _
Floating Platform(s) ______ _
Finger pier(s) _________ _
Total Platform area _______ _
Groin length/# ________ _
Bulkhead/ Riprap length _____ _
Avg distance offshore ______ _
Breakwater/Sill ________ _
Max distance/ length ______ _
Basin, channel ________ _
Cubic yards _________ _
Boat ramp _________ _
□Es
OsPIMA
OPTS
0Pws
Authorized Agent _____________________ _
Project Location (County):----------~----------
Street Address/State Road/Lot #(s) _______________ _
I !
Subdivision ________________________ _
City ' I
~~~m_______ ~ ---------~ Beach Bulldozing r-:--::-::-:-::=i::::;:=t=!F:t:=:O:t=i 1:=t==t=:=:::=f:=,:~t=;:;:::;::::;::=t:=:;=~i--"'1➔ .... --~:-_-tt _-... ➔_-:_ic-+--..t.-,,-;-:--t-""t '"~-+-"'
Other ___________ _
SAV observed:
Moratorium : n/a ,
Site Photos :
Ripar ian Waiver Attached :
yes no
yes no
yes no
yes no
j
l
.......,__.__..___t ____ __._ __ ..._.___.___ .............
A building perm it/zoning permit may be required by : _____ .,,.; _______________ _
Permit Conditions ________________________________ _
i -+---+--+--~---!
i
□ TAR/PAM/NEUSE/BUFFER (circle one)
D See note on back regarding River Basin rules
D 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} _______ _
r
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
I ' r, /-
Signature **Please read compliance statement on back of permit** Signature /;
'
Appl ication Fee(s) Check #/Money Order Issu ing 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: __ :[j...,._,o...__.N'---"---''f __ £ ___ \ ____ A~'IL..lr.,l~~----, o, rt\11\Cfl \.ANcf Address of Property:
Mailing Address of Owner: _____________________ _
Owner's email: ___________ Owner's Phone#: _______ _
Agent's Name: __________ _ Agent Phone#:. ________ _
Agent's Email: _________________________ _
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property pwner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
pennit 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. -A-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. COir'Npondence should be
malled to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM ,....,,tatives can also be
contacted at [phone]. No response Is considered the ~me• obJl!dlon If you have been
riotllfed by Certlffed Mail.
WAIVER SECTION
J understand that any proposed pier, dock, mooring pilings, boat ramp, 1Jtillllallillb,r., boathouse, lift, or
groin must be set back a minimum distance of 15' from my area of~ 8IC08SS unless waived by me
(this does not apply to bulkheads or riprap revetments). (If you wish to w,alve 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) _____ _
Signature of Adjacent Riparian Property Owner: ....L.-..::....-.:.._.:......~.;:._;,;q_...;.... __ _
Typed/Printed name of ARPO: jh D~ G-!J hl I!.. v-f_ _
Mailing Address of ARPO: /o C, ~. il:P::-L II\ £.1 r;;:x;el/1::1 cd?{ ,,n
ARPO's email: \Vj MJ ~ W\ e , C.O:\V'.) ARPO's Phone#: W--34{) -~5/ 1
Date: l / l \ /?-W-1 *waiver is valid for up to one year from ARPO's Signature*
Revised July 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: -~/_U_Yj_-._rv1 __ , _L_L __ clc-_...-: ______ _
/J?J ~ f PLA Cf;{ Address of Property:
Mailing Address of Owner: _____________________ _
Owner's email: -....--....--------Owner's Phone#: _______ _
Agent's Name: iJ lX, [Mt\ ·-pu~ Agent Phone#: 9 S-J M "? -<3:!;( fo
Agent's Email: _J?_,·1_~_~c\_,-_1 V_\ V\.....,,~'l--'-fJ---'~~¢_L_@-____,.~-VV\_G\_d · ____ L_o_VV\ __
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 fo r this
permit has described to me, as shown on the attached drawing, the development they are proposing. ~
escri ti n or drawin with dimensi ns m st be rovided 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
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} ff
I DO wish to waive some/all of the 15' setback ~-:/(
-OR-
I do not wish to waive the 15' setback (8Quirernent (initial the blank) _____ _
Signature of Adjacent Riparian Property O~r: -----------------
Typed/Printed name of ARPO: ---,~~
1
..::::;A~;.,,,&:,4 1..-_~~H-JH,........-----:---·;;-: ~/·
Malling Address of ARPO: -~IWl..&....,.'-~~~~~-'i~~~'""""~;.+i',,'9-7'~~;; J/11
ARPO's emall ~~·· ~~:dL:~~~~~'.-. /
iver Is valid for up to one year ARPO's Signature*
Revised July 2021
Prepared by
A-A
Deadman anchor
Shore guard vinyl bulkhead
SG425
14' x¼" HOG
tiebacks
Fill dirt
8" butt pilings
Drawing ,s concept only
Prepared by American Manne
3/4" Timber bolt
Shore guard vinyl panel
Materials
American Marine Construction
Nathan A Potter Sr
All lumber and pilings treated
to 2.5% cca
102 miller lane
Elizabeth city NC
27909
All hardware to be Hot
Dipped Galvinzed
Sheeting to be
Shore Guard vinyl panels
6"x6"
wales
Exposed
bulkhead
height ranges
2"x8" rear wale
6"x6" wales
Untitled Map
Write a description for your map.
Legend
, 108 Miller L~
August 7 , 2023
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Pasquotank Cou nty NC
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