89833A - Brady

�OCOAST41 KCAMA 0 DREDGE & FILL N� 89833 a B C D
V? 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:
15A NCAC ❑ Rules attached. n General Permit Rules available at the following link: www.den.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
Affected ❑CW
AEC(s): ❑OEA
ORW: yes/Ro.!
❑EW ❑PTA
❑IHA ❑uW
PNA: yes/no
Type of Project/ Activity
Authorized Agent 2' 4_, o\ 0'1 i-
Project Location (County):
ZIP Street Address/State Road/Lot #(s)
❑ ES ❑ PTS
❑SPIMA ❑PWS
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
-4 r:
(Scale: )
Access Length
+
I
i
Pier (dock) length
.L`_.—;—
Fixed Platform(s)
1
j
i_
-•_
(
-
,`rt
-.
—
Floating Platform(s)
a
R-' i
Finger piers)
_
__...__
�
(
�
lj—
Total Platform area
Groin length/q
--L
Bulkhead/Riprap lengthAvg
distance offshoreBreakwater/SillI—
Max distance/ length
"'—
"1
*t-
k
-'�`
—
Basin, channel
_
-
Cubic yards
Boat ramp
Boathouse/ Boatlif[L-
Beach Bulldozing
Other
�
jl
--
.
SAV observed: yes no
'
k ,
Moratorium: n/a-- yes no
Site Photos: yes no
-
-j
—
—
-
�
I
_
(
_
�'
4
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/cenditions on back
i
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
Signature **Please read compliance statement on back of permit**
Application Feels) Check H/Money Order
Permit Officer's PRINTED Name
Signature
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:
ElTar - 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
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)
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 Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:I^,ornan 5.
Mailing address: 1 I 1 Ttalt--> ra r I J
7 a b rAh �" . N. C. a 1 dug
Telephone Number: a5a - LA 5's- U 1 3 9
I certify that I have authorized Laric4 ncy, an .(agent/contractor),
to act on my behalf, forthe purpose of applying and obtaining all C`AMA permits
necessaryfor the proposed development of f�n`� t{- �/nr f bit Ikhead `E
at my property located at
Ne a` cioq
This certification isvalid through
(Property Owner information)
(date).
�//�� n
4Signature /, /
0Q l2 ml• Vrc^ 1 coma 6. -d-
k 'nt or Type Name �J �
_ C-)W tiP V✓5
Title, co. owner or trustee for property
9- 2 - -QC) a3
Date
C;�5a- y56--Dr3 q
Telephone Number
is 1 >7 C_-� Q h o� r,� a l. C b rr-,
Email Address
SEP 1 5 2023
DI. M-EC

N.C. DIVISION OF COASTAL
ADJACENT RIPARIAN PROPERTY OWNER
(fop portion to be completed by owner or their agent)
Name of Property Owner
Address of Property;
M��,,ailing Address of Owner. ✓u rime u u u urn v U
neraemal: ®hotmGti .Com ci Qwners Phone#: d ^ t iSS
Agent's Name, b ruuln'S 1 Aet UGV• t � n C . Agent Phone#:. 14,,1 tp
FORM
Agent's Email: e- lsLA. bidi rrC fQl nrrf Iea)'t. Corm
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that t 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
descrt ' n or drawing, with dimensions must be pLovidell with this; letter.
t 00 NOT have objections to this proposal. t DO have objections to this proposal.
,L
lav4
Management (DCM) In writing within 10 days of receipt or this notice. Correspondence should be
mailed to 401 & Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can at -so be
contacted at (252) 2"3901. No response is considered the same as no objection if you have been
notKed by Cerfified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
grain 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 waive the setback, you must sign
the appropriate blank below.)
100 wish to waive some/all of the 15' setback RECEIVED
-OR-
Signatu djacent R1par1an
SEP t 5 2023
1 do not wish to waive the 15'setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner:
DCM-ECR
Typed/Printed name of ARP4:/6, , /
Mailing Address of ARPO: 1�� G���Vr lsW� �7r /v G
ARPO 1s email: � � � S� /C REPO S Phona#:
��}
Date: ` -I 24Z3 '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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Own
Address of Property:
o.vin S J. a r1[tP.la rn 3 r� r
11 1 �.l,'2a6eAk &,,N 4
Mailing Address of Owner. yaffl& O fJ Q b b ✓e
�eoa ' 4 S 5 -O t 3
-A&1
wrier s email: "o4v l6 1. Co rm _ Owner's Phone#: 015
Agent'sNams: Bwn5 L.Artof Dey, Jrte.• AgentPhoneik 9 1i g -
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S
I hereby certifythat I own property adjacent tothe 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 orovided with this letter.
x 1 DO NOT have objections to this proposal. i DO have objections to this proposal.
if you have objections to wn if IS being proposea, you must notify the N.G. Division of Coastal
Management (DCM) In writing within 10 days of receipt of this notice. Correspondence should be
matted 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 sicin
the appropriate blank below.)
CLAY P LOWRY' o nyneanranrr
I DO wish to waive sometall of the 15' setback MM 2023.09.1 A OMO:3944 W'
Signature of Adjacent Riparian Properly Ownerr� �^. i
-OR- I ' ew...6
I do not wish to waive the 1 S' setback requirement (initial the blank) SEP 15 2023
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: CLAY LOWRY �� )�`'' " CM -r��
Mailing Address ofARPO. 8325 WHEATSTONE LANE, RALEIGH NC 27613
ARPO's emall:[e-mail] ARPO's Phone#: [phone]
Date: 09/13/2023
`waiver Is valid for up to one year from ARPO's Signature"
Revised July 2021

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