89843A - Epps (PRI)

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GENERAL PERMIT °°""`—�3
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JA&Dmy" KCAMA ❑ DREDGE & FILL N° 89843 0 B C D
Previous permit ?
GENERAL PERMIT � 351 t,
3 Date previous permit issued lLS/LZ-
❑ 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: -'f
15A NCAC 1 A • 1200 ❑ Rules attached. ® General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name VctMelA tpOS
Address A I I " 0" V_
City I V"9rvim State I ( zip 7B0,Z5
Phone#(7-3) UA '7701C
Email dcmlanskl @Ctsq. tie+
Affected ❑ CW
AEC(s): ❑OEA
ORW: yes/0
❑ EW ® PTA
❑IHA ❑UW
PNNA: yesk
❑ ES ❑ Prs
SPIMA ❑PWS
Type of Project/ Activity QoY,.sAYltie' V
o, p 0 r 4 5 r
W/ I V x I V
IS t XIf IaA>t�
Shoreline Length
Access Length
r
IU
Pier (dock) length
$0 K 5
Fixed Platform(s)
I%' X f 7
IS`xfV
Floating Platform(s)
—
Finger pier(s) --,
l
Total Platform area 34 l S14
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift ..
Beach Bulldozing
Other
Authorized Agent /t '•
Project Location (County): CROW 0.A
Street Address/State Road/Lot #(s) 16 F 'J 5 1
I gn Ku H Fai r 17 r.
t— r
Subdivision Ft.f'I kSoI ?-'t Ve'r 5Lu.J
City Edee+pn ZIP 97932
Adj. Wtr. Body 12o n1r(Auer r+ I na man/unk)
Closest Maj. Wtr. Body Al beY1`o.A*_ Sow.d
)i e,r W%11t 1r/' e.YW P((e,, rr^
aljc: � 4rrv+ /OI k 51Wc,I ieL'. yQA WScale:
`
6nlvio Qtc-"'�
61c'ft � (IQ
'A
L/ �p
SAV observed:
Moratorium: ®
yes
yes
(b � r`
no `
/' eS �n
F it,`•ir `
Site Photos:
Q
no
Riparian Waiver Attached:
<5
no
/� /�
CwoWCt1h C'ettiwA-u
A building permit/zoning permit
may
be required by:
Permit Conditions
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
A100.ry' 16Iq
Application Fee(s) Check H/Money Order
Permit
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
w
Signature ky
'/I I / 23 I/i I !24
Issuing Date Expiration Date

�`°"" OCAMA [I DREDGE & FILL NU 89843 a` e c D
GENERAL PERMIT Previous permit
Date previous permit issued
NIFINew ❑ Modification ❑ Complete Reissue FYI 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. R General Permit Rules available at the following link: www.den.nc.gov/CAMArules
Applicant Name
Address
city
Phone #
Email
State 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/nq, PNA: yes/noi
Type of Project/ Activity
Shnralina I anoth •
(Scale: )
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
J
!
Total Platform area
_
_
__
Groin length/M
-,-
--
-
-
--
—
-
J
Bulkhead/Riprap length
Avg distance offshore
i
i
-�
j
Breakwater/Sill
Max distance/ length
—
easin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
1
I
I
Other �
_
i
rt
c
i-
t
1 -
j-
i---
-
-
-
—
SAVobserved yes no
Moratorium: nA yes no
I
vJ
oarriiao
Waiver Attached: ves no
I
A building permit/zoning permit may be required
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
s
Signature **Please read compliance statement on back of permit**
Signature
Application Feels) Check M/Money Order Issuing Date
Expiration Date

N.C. OF COASTAL MANAGEENT
ADJACENT RIPARIANPROPERTY OWNER OTIFICATIONMAIVERFOUECEIVED
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
5EP 0 5 2023
(Top portion to be completed by owner or their agent) rryye +�/j ,
""-EC Name of Property Owner. � Q �rti F��S V C
Address of Property: �_a !1
Mailing Address of Owner:
Owner's email: 90,ieccu5fa I @ yal400• (gyro Owner's Phone#:
Agent's Name: Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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
descriotion or drawing with dimensions must be provided with this letter.
i/ 1 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 (DCWI) 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 (252) 264-390f. No response is considered the same as no objection if you have been
noted by Certified Maff.
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 Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: i
Typed/Printed name of ARPO: j r re 5�/—
Mai►ingAddressofARPO: ktiS vi�Q-77,f4-z P-(-D ,z !z 0 l z,0�✓ - VIf 2zyd5
ARPO's email: -t'Li ij'3 • F`'�I ARPO's Phone#: S'yO '7 7_5 - 5 v-?
Date: 01R21Z3 *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 NOTIFICATION/WAIVER FORM
CER11FiED MAIL E URN RECEIPT MQUI 99D OLMN12 29UYY�31`_
(Top portion to be completed by owner or their agent)
Name df Property Owner.
Oft M t'
U- L-�'' '
Address of Property:
I ��
/Ufa-V 4'r T)(, EdeK+L)v) 1 N
t
� -79 3 2 --
Mailing Addiosp of Qwrfer:
- a
�—
�e0(" C% C V(. riARt A KA
�zLl 73 oa
90"'(wAkiPya.koo,caw `✓�i f?��
Owners email: Owner's Phone*
�jn�
? C
Agent'SName: 3, Ji'Jy12+0h
Agent Phone
/,
Agent's Email:
0uf 1004,- . C0a•1,A
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION REMNEQ
{B6fftorft odd idii 16 bg g r�p1efad bi ffie adig nt Pnoo 2JLQ t 1
AUG 2 8 2023
1 hereby certify that t own property adjacentio the above referenced property, The Individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposIrlg._A n
desoi tga-or ii�jrig,with funnodsians. u WpLd tggWft 10Mer: --Eli
Vj�W 1 DO NOT have objections to this proposal. 100 have objections to this proposal.
if ji to fialle .eiltjecboris ie wfiat is befngr proposed; YOU Must notify Hie N.C. Division of C0492af
Martagement (DCAQ in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. GrMn St, Ste. 300, ENzabetf► City, NC, 27909. DCM representatives can also be
cot0c7ledAt (+262y 284-vol- No respodse,is con Die $ame as no obleOid" iiYou h0vo moat
notified by Certified Wit.
WAIVER SECTION
1 understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 16 from my area of riparian arxess unless waived by me
(this does not ,apply to bulkheads or riprop revelmonts). (tf you wish to waive the setback, you riiusf sign
the appropriate blank below.)
I p0 wish to waive some/all of the f 5' setback
Signature of Adjacent Riparian F4operly Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Prtntolfi name of ARPO;
Mailing Address of ARPO: l r 13 c-yf G/ tu) Rrast
ARPO's email TMLG+I f ml3.nri h, r i. ��/sPC's Pf►enetr. S 2 / G/! 3Gc
Date: 3 / i/ / _ � c 2_T_'waiver is valid for up to one year from ARPO's Signature°
Revised July 2021