89845A - Slayton

`at �dGAMA U DREDGE & FILL N9 89845 t� & C D
GENERAL PERMIT ontti�,
""� NNew ❑Modification ❑Complete Reissue ❑Partial Reissue
As lunhorr[fC by thee�State of North Carolina, Dopartmm eru of Erwtronemal Quality and the Coastal Resavices mu m C,mirtlon In an arof Nonrnmd rnntenpsuuw, + mx
I SA NCAC ... _. f H., t �Cl __4.-_,1 zoo EJ Was, attached. ® Coensal PormY Wiles "WO At the bMwk; MM: y oleo g�2GSh:Attin
Appbrnt Nam. i',+rn� C L—t*%O, ut4.et1LNv% Authorized Agent VcLOW SA ttv r3s .J" r-•,,e
Addre 125D �A I Prop m Location (County): s� •tt,� n
Oty �( h k Status DP 2�iSy Strear Addrau/Stna Poodnat/(s) 10Y +L SZ __-
Phorte#('�41>
Finail 51��1evk { ,_ essmccJ� , ht SubdMsfw
city _,_c AeA}an Z)p 22I , Z
ANemed ❑M ®EM ®PTA ©ts MP'fs Adf-Wir. Body I S 1 )
AEC(%): ❑OFA ❑IHA ❑UW SPIMAPINS aosestH4Wu.Body AIj>QWC, I,!
ORW: MOOPxk-ye$AD
Type of Project/ Activity
Shoreline length ' a— I O b
Amen Length
Pier (dock) engh YO r V 5 r
Feed Piatfornds) I(^' X I ter
Floating Plaftir (s)
-�
r X ILr rr/V
Finger picjs) ,i ;—;_r—'
t A,
Total Platform area �2Sb'S�� lr: 1-/; t. { �, _; I
Gm,nlength/a y I+ e / RiMp length I,OZ f f -. i J i i. s I 71rCca"�
Avg distancr onshore i i r 1 G ntui1
Breakwater/Sfll
Mudrstana)knch
Basin, gunnel
,
CubkyarM
Boat ramp_
Boathouse a: ,_.�Of Kl'(,f(711—
Reach Bulldozing6thrr
Moratorium: � s aw ,-•"'�� `"'�'—'"�"'i ...., jj � l
Site PhWos. no t%! i
PJPanan Wlbcr AUaded: no _-- '- _ yr,
A building permit/aoning wmh mry be required by;
Permit Conditions
Aaenta um PRINTaO Name" pemdt
Signatwe ••Plraw lead corctpilance sUKmcnl on back,( parmil.. Slgnatc
ApOtation fees) {heck A/Money Order risuing
I
t ac l7f
r
/ .
! a �
—f
5tow�ccr _ 1
, � r
,
O TAR/PKA'WUSE(BUFFER (drd, one)
Sea note,n back regatding Ricer Basin ru!as
See addMonai noKs/conditlans on back
(Phrase initial)

�,�dVOUr'1+�®CAMA U DREDGE & FILL
11GENERAL PERMIT
N9 89845 (�) B C D
Previous permit
Date previous permit issued
5dNew [-]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
f 0�
( 200 ❑ Rules attached.
n General Permit Rules available at the following link: wvv�w..�d`eg.nc.gov/CCTAMArules
Applicant Name �yrYt
frl/
+
�tSQ
`
5��
`j
Authorized Agent OCe.Ar�$1't�2 CCar..TTT�—hrs /JR �ri('S4a
Addressl� 1 2 5-00 kf r ccA
""nod Lln .
Project Location (County): (I k6 OUA
City \_)2Lk k'-t�' V State
IL4,b ZIP 'Z0�5�
Street Address/State Road/Lot#(s) �07 -(A-
`A
Phone#(Iz )
-242*1
Ikq ger'6.,-4
yk'13t
Email 5& tUh
KU30
e U+rwcx-sk . fAe -
Subdivision `111 6-'ry-4 1k h
91'
City eA+01S ZIP 2'la 3 Z
Affected ❑ CW
© EW
® PTA © ES ® PTS
Adj. Wtr. Body A ( ul'trnnha r- (Q 5bt.t_ J
t ` J(man/unk)
AEC(s): ❑OEA
❑IHA
❑UW ❑SPIMA ❑PWS
Closest Maj. Wtr. Body ^( rYs6r(� .iC)tti
ORW: yesA r
PPNA: yesAaD
Type of 11Project/ Activity Tan ., h �OZ t t� r\,.t.,h 0`O.4���In2Q(� /C j 6u'� I
(Tma+lca e(OIY_rp^e C`�i(i h%jar "0 VAJ 9irN G M 1Et R`CZ/
I
Shoreline Length t—
Access Length
r llll;(((�` SplJct^
Pier (dock) length 4a YSr
Fixed Platform(s) (or
Floating Platform(s)
Finger pier(s) / Q
Total Platform area '.i5(u5€%�' till —AII—,
Groin length/p t
49�—Y/ length IC,Z.I T
Avg distance offshore
Breakwater/Sill a Lc'y{\s YvZi'c'r
Max distance/ length 2. r{d
Basin, channel
Cubic yards
Boat ramp �^
Boathouse oat' (O t K 1-Lr �` ��.
Beach Bulldozing
Other
' e5 JI
SAV observed: yes
Moratorium: ® s no
Site Photos: no I -5 \a.y�iOT-
\ r
Riparian Waiver Attached: a no /1 A building permit/zoning permit may be required by: CWOWOLV. l /'� C9A 124
Permit Conditions
Agent or Applicant PRINTED Name
(Scale:i' -'Id )
I r,u-3
Y
�I
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
STATEMENT. (Please
Permit Officers PRINTED Name
Signature **Please read compliance statement on back of permit--
l�Ob • 9-iR ( �G I'S
Application Feels) Check N/Money Order
Signature
`Viti23
Issuing Date Expiration Date

got cour4 ❑CAMA ❑ DREDGE & FILL N° 89845 Ac B C D
GENERAL PERMIT Previous permit
3 Date previous permit issued
ONew ❑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:
1 SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwdeq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # I—)
Email
State ZIP
Affected ❑CW ❑EW ❑PTA
AEC(s): ❑OEA ❑IHA ❑UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
City
❑ ES F / PTS Adj. Wtr. Body
❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
(Scale:
Access Length !
_
iu�J
rtlIIsi.
Pier (dock) length
',-
_T_——
r
Fixed Platform(s)
� �
I
'
i
t
lr"
t
�.
ts<.
r
.I
�_
.._
' _
Floating Platform(s)
r-
-
I
Finger pier(s)
Total Platform area
Groin length/q
Bulkhead/Riprap length.
Avg distance offshore
Breakwater/Sill
Max distance/length'`
9_
—
I
_
—
_
Basin, channel
Cubic. yardsf-
_
_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
r
r
��
1/
i
I
I
I
�
SAV observed. yes no
"
r. -
- +- i
e--
!^
Moratorium: n/a yes no r --`y'^i
'""�"
T
.?
't
_
1._.
._.
_.
Site Photos: yes noi::
Rin un Wonmr Artanced vac no
A building permit/zoning permit may be required by:
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
Signature -'Please read compliance statement on back of permit** Signature
Application Feels) Check N/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATIQN FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit j, , �J(gwAUY�
Mailing Address laq &6�.
&Gdan MC
Phone Number: A4 /z
Email Address: SL vj tit a gU C? �o r� emirs ✓Ei
I certify that I have authorized 01Gpp D `ice /JX MZ44n
Agent'/ Contractor �uJ
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 10a LF %'
k.(AybiuA 64.k.WL 4 6CL7(a
at my property located at
in Ch&A M County.
l furthermore certify that l 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 I
/.� x
Print or Type Nam
Title
3/l 1 j of 4
Datee
This certification is valid through -I /�30 1C24
t AVUG 2 9 2023

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
Address of Property:
Mailing Address of Owner:
Owner's email
Owner's Phone#.
C
Agent's Name.00 rt& Agent Phone#: a5D'311-17g4
Agent's Email: dCQtYIWtl • "dixy-) ) WaJ -cam-
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 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 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 DO wish to waive some/ail of the 15' setback _j
Si tore of Adj nt Ri rian Property Owner�L-
C
No
I do not wish to waive the 15' setback requirement (Initial the blank)
r-
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: vvn • r
jE
Mailing Address ofARPO: Ja-� Bu,J� &Lldw-10 NC ing3a
ARPO's email: ARPO's Phone#:
Date: __. 'waiver is valid for up to one year from ARPO's Signature'
AUG 2 9 2023
DCM -'f,'-J-;
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT RECEIVE'",
ECIEM,
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY SEP 0 6 2023
(Top portion to be
Name of Property Owner:
Address of Property:
Mailing Address of Owner:
by owner or their agent)
i
P L1� [l ll,
DCM-D
Owner's email: ✓ SPi Owner's Phone#: SO
Agent's Name: ✓y / AA.J OCAV-49 ,O£ Z /A Agent Phone#: 1S Z�iLS S�S�U O
Agent's Email:
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
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 (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). you wish to waive the setback, you must siun
the appropriate blank below.) //'�, J
I DO wish to waive some/all of the 15' setbackl cKV X
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:
Typed/Printed name of ARPO: DAV/ b L , `�l PC, A) 0-9
Mailing Address of ARPO: /Z 3"/ �� G�� d/10u,(� �nW—
ARPO'sRPO'sPhone#:7_�_7`617q,75 0
Date: A1,2o� 'waiver is valid for up to one year from ARPO's Signature"
Revised August 2022

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