89810A - Tatman (MOD)

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[KCAMA �7 DREDGE & FILL
GENERAL PERMIT
Nv 89810® B ce
Previous permit
Date previous permit issued
❑X New NModiflcat(on []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 erMrorunental concern pursuant to.
I SA NCAC - W ` ► 'ZC'o ❑ Rules attached. R( General Permit Was avalable at the folle Mng Ink wv cea.nc.cov/CA Arules
Applinm Name �-t Q f'CCYSt + �TIh Yh Autlarhed Agent VC.Pl2/l�,(4{.¢_144�7FQLYGr3/ OIL V"ltttlg
Address 1 ri �n.� Arm �.�1.. Project Location (County): _
city keX-wt^d. state NLC- nP 2'1444 street Addressrshte RmaLot A(s) Ic+ it t3�
Plane ay( �fdy_ 303 _12Q for,ol Tay -
Email � @TT'Lir,�, cCC h _ Subdlvalonn I`S��FT[`_S WY {�Qa. l E#,d '� i
City geey/rt-all ZIP I
ANeeted ❑ cW NEW © PTA ❑ ES PTS Adl. Ww.. Body _(-�Atyt� y, ?: L 1 r—i J �rr�--niru k)
AEC(%): Flom ❑INA ❑UW ❑SPIMA ❑PWS Closest Ma).Wfr.Body rflbefrT GL Ie- SNAIJ
ORW: yes/ttb) PNA: yes,®
Type of Project/ Afctivity Qzwy iiltie�}- a 12 X2Y` hxtC6&m oter egAh, InO41A.
,'l ' n 3' cicaer er I�'/5 CO+P (scale:/=4d I
Shoreline Length
Access Length - r'.� I I I st I -ry'�. I•..._
Pier (dock) length �__�-
Fixed Platforn(s) , ;.�+n-y] .� , I ( I ' c1 �d', t- I b
Floating Platform(s)
aC-
I I iL I
Finger pier(s) pp%3
77
Rt t 4 1 t 1 i-`!
i t i
Total Platform area T-•, L .1...
Groin length/g
Bulkhead/ Riprap length
Avg distance offshore r.. i _+. , _ $_�_� T_(.-.- T�"i i. i•Qe.i—o i.—u_,- __Ir—., +- �,—..•..,
,
Breakwater/Sill
Max distance/length
Basin, channel -� --_ -r 'I' r 4
r
Cubic yards
Boat ramp I i I i i I I �
I`
I h
Boathou BoaUiR .Z y IZ i
Beach Bulldozing � � �
Other
SAV observed- ^ Yes
Moratorium: no
Site Photos:
Riparian Waiver AtUched: yet �..
A building pertnit/zoning permit may be required by PIP
❑ TARlPAM/NEUSF/BUFFER (drda one)
Permit Conditions ------------
❑ See note on back regarding River Basin rules
-' ❑ see additional notes/conditlons on back
Agent or Applicant PkIMED Pme
Si�Please read com pllance, statement an back of permit'
S aw •O° 125$1
Application Feels) Check g/Money Order
(Please Inidal)
Permit
signatureg/"
aa/a3 It'1. 2 /Z3 _
Issuing Date Expiration Date

MCAMA ❑ DREDGE & FILL
(GENERAL PERMIT
© New ©Modification ❑ Complete Reissue [:]Partial Reissue
N° 89810 e, (A e C D
Previous permit
Date previous permit issued
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 .7 N 1200 ❑ Rules attached. © General Permit Rules available at the following link: www.deg.nc.gov/CAMArvles
Applicant Name Tex
�cL�4
Authorized Agent oce__li✓l ide Gyir Ors /Vr— M1169"
Address 1 .�Cl ILOLQ.`
/�`�fi�'MQ�
�'Q1s�'fr� (A-Nn
Project Location (County): i \.t
City I,-i(-r-W-o/ro�
'-StateK(L
ZIP a�4y�
Street Address/State Road/Lot#(s)
�a T� (3q
Phone # (54 �l
-1
-
I
Email .�1 m
@ QYY�S\. CCin-%
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1
Subdivision S110re� ct.� La
c
Fri
city "e.Alpar-A ZIP AI NAIN
Affected ❑ CW
❑X EW © PTA
❑ ES ❑ PTS
7
Adj. Wtr. Body L i'A `tf, F-t V-C4— na�'man/unk)
AEC(s): ❑OEA
❑IHA ❑UW
❑SPIMA ❑PWS
Closest Maj. Wtr Body IllbtfY�rl� SOkA^41
ORW: yes/68) PNA: yes/0
Type of Project/ Activity lAi1SiY
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger piers) 3'7'a2,1 Wind j6/5-CxtE-
Al
Total Platform area
Groin length/tt
Bulkhead/Riprap length r
Avg distance offshore
Breakwater/Sill `
Max distance/length
Basin, channel
Cubic yards `
Boat ramp
Boathous Boatlift atl X IZ
Beach Bulldozing _
l�
r't9'
Other
SAV observed: p� yes
Moratorium: Yes no
Site Photos:
Riparian Waiver Attached: yes /+ j
A building permit/zoning permit may be required by: t eA- d Y.�� ryhL V's `CLi n
Permit Conditions
RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND
Agent or Applicant PRINTED Name
Permit
(Scale:/e'Nd )
J\ jA
❑ TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
(Please Initial)
Signature`*Please read compliance statement on back of permit" Signaturev'
1;100 -`p'— 1252S1 g%aa/a3 ll-o /z3
Application Feels) Check q/Money Order Issuing Date Expiration Date

o'Acour"r EICAMA ❑ DREDGE & FILL N9 89810 jt� A' B c A
'GENERAL PERMIT 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. h General Permit Rules available at the following link: www.deg.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
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/no
Type of Project/ Activity
(Scale: )
Access Length
Pier (dock) length
Fixed Platform(s)
Boathouse/ Boatlifty
O..ch :.ozing
ther
ml
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11
SAV observed: yes (n�
Moratorium: n/a no
Site Photos: 415
Riparian Waiver Attached: Ves A_
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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
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
kv
Signature -'Please read compliance statement on back of permit"
Application Feels) Check q/Money Order
Signature
Issuing Date
Expiration Date

Name of Property Owner Requesting Permit: �PlYt� -4n
Mailing Address: t Zq A04 I T^ey t^
1.1.eY#-�vrd N C. 2"19yN —
Phone Number: —
Email Address:
I certify that t have authorized �naide. Conudo✓51
Agent / Contra�ror
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits R,
jp�oux uSt�ri%kW&1-9
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t0
develnecessary for the following proposed opment: 'xtJ
�1nJoi'f�j VY osf3l $11i.` 1 Q*snj�)t
at my property located at
in Qgvi� County.
I furthermore certify that / 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 Information:
signature
7--�
Pnnt or Type Name
Title
RECEIVED
Date ry _f c2
This certification is valid through
/f-- —
AU& 0 9 2023
DCM-EC

N.C. DIVISION OF COASTAL MANAGEMENT,
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION)WAWER bR,4 I
W 3 1 2023
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
Mailing Address of Owner: same -
Owner's email:-H4m' i2raiCOM Owner's Phone#: 540-L,0U4-3143
Agent's Name: On& .5Ae 11108kQCl1 $11, Agent Phone#: [phone]WI
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Propertv Owner)
I hereby certify that I own property adjacentto the above referenced property. The individual applying forthis
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
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 aive the setback, you m t si
the appropriate blank below.) / , 77 0 ,,. ' L-
I DO wish to waive some/all of the 15' setbac V /
S gnature o Adjry nt Piparien Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
X
Signature of Adjacent Riparian Property Owner: X
Typed/Printed name of ARPO: O bb�l d- ASSUAllra 9%1t4e r'
Mailing Address of ARPO: 13Z &i al Te,nrl Qa.r . 11erKTPJ IJG 229�H --7-7 3
ARPO's email: `j ARPO's Phone#:
Date %2,.LANIver is valid for up to one year from ARPO's Signature"
Revised July 2021

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 terH -Ta+YVW 1
Address of Property: 12a 9%al fern ►r rgwd NC, 2'19gk1
Mailing Address of Owner. Same
Owner's email: y:Pffiijeenyi1. Gone Owners Phone#: '5t40—(o(o4-31Q 3
Agent's Name:
Agent Phone#: ZS2-'312—�2
ADJACENT RIPARIAN PROPERTY OWNER'
(Bottom portion to be completed by the Adiao
I hereby certify that I own property adjacent to the above referenced
permit has described to me, as shown on the attached drawing, co
description or drawing, with dimensions, must he provided with this j
c
I DO NOT have objections to this proposal. I Dd N
(o
If you have objections to what Is being proposed, you mus N
10anagement (DCII1) in writing within 10 days of receipt of thl z
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27904
contacted at [phone]. No response Is considered the sal N
noted by Certified Ma11.
WAIVER SECTION
1 understand that any proposed pier, dock, mooring pilings, boat ra
groin must be set back a minimum distance of 15' from my area of
(this does not apply to bulkheads or riprap revetments). (if you wis
the appropriate blank below.)
I DO wish to waive some/ail of the 15' setback
of Adjacent
-OR-
I do not wish to waive the 15' setback requirement (Initial the
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: _
Mailing Address of ARPO: it
ARPO's email:
Date:
ARPO's Phone#:
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AUG, 0 9 2023
Revised July 2021
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