92421C - S + R Legacy LLc

p��F COAST ,tom_ I I CAMA DREDGE & FILL No 92421 ABC D
GENERAL PERMIT Previous permit
y Date previous permit issued
fNew Modification ❑Complete Reissue n 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 344. 0L)L )} - )-Ud �1 n Rules attached. 7 General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name =' 'i'" Po
LLC Authorized Agent
Address /i �e '� � $C7jt 4 G 00O Project Location(County): �+
City C NC- s'"- ]State N ZIP Zt S Street Address/State Road/Lot#(s) 113 )N12-p J)'
Phone#(--C2 ) ,%y1- (7O' L -p
Email SZt, °`r� oA� f _ t//I\ • C oe'n Subdivision --'"------
J City C718..Vh[_o,� n ZIP Z C�
Affected I I CW hI EW ❑PTA 7ES n PTS Adj.Wtr.Body'"I.i' P Cite.. J Bo „,: J c-w.t. (nat/man/unk)
AEC(s): 7 OEA n IHA fl UW ❑SPIMA 7 PWS Closest Maj.Wtr.Body Dyw.L J
ORW:yes/no PNA:yes/no J
Type of Project/Activity �. (7,•) v lu-,nf ilexA R.• CGt c.A-�'vrn
(Scalel`‘:N o' )
Shoreline Length
Access LengthIII C____ ..... .. t. ..._........ ..
/" i "
Pier(dock)length
Fixed Platform(s) E
ssss
111
Ili'
Floating Platform(s) 0 XS.17}9 v,
Illitrilli
ill
Finger pier(s) / -;"--147"-- '
V r
NW Total Platform area --'"' y
Groin length/# i (• dii'
_ I . .
Bulkhead/Riprap length M
rill '
Avg distance offshore ibi iii .► El 5 5r_r .._._ ...._._ ._......_.
Breakwater/Sill -.+� ; , i ■
Max distance/length / INI!9"1I! !iIlI-
Basin,channel 40 X yO x -6
Cubic yards " 11ODCyd ....,- __..._. � __.
Boat ramp — ._!_ ___ t. . _ __
i
Boathouse/Boatlift J #`at ti ��' �, I
Beach Bulldozing �• . 41 1.vf(� j
Other tN.2u SleS Z� i►.jig
ilk oursimiimmom ..,In=
I 1 I
SAV observed: yes no _ I - . _
Moratorium: n/a yes + no je � c
i - —
Site Photos: s 'no, i 1 I
Riparian Waiver Attached: iTis'N, no ',._ i i ; .
A building permit/zoning permit may be required by: M •((, i'k I
Permit Conditions -4u .;t.-,c .�i , ,,f I _ nn o(f-tiff -(Inc,.' - �NLW , 2)SPa,�i n TAR/PAM/NEUSE/BUFFER(circle one)
o.11 1a 1,iACCLI_A cfr000. T 1N-G( 1 u Ccvii L1.1 p,ok >30 tr-,, NNW. ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE O F STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
kk k\
Agent or Applicant PRINTIANam� Permit Officer's PRINTED Name 1AdJJ )--
Signatur **Please read co►fipliance statement on back of permit** Signature
i lib• i
Application Fee(s)/ Check#/Money Order 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:
Tar - 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

,"`°"INnCAMA I I DREDGE & FILL No 92421 A B (C/ D
a- iGENERAL PERMIT Previous permit
4. Date previous permit issued -----
New I 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 5A NCAC . N.2O.sl) , 0-4 d. I s i't) n Rules attached. U General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name `*" K V `+"jr,c 44Y. LLC Authorized Agent
Address 1 i j s`,'I e Grtc _�4 �U ;_,l 4 k IC Project Location(County):
City A,'lc kit.c.1 C, t e State IUL . ZIP Z f 5S-4 Street Address/State Road/Lot#(s) ,
Phone#(-CI ) ?41- isc)' L
Email ��.AAA" "`-' , ' v 3 C%� J• ,/c . (c n'N Subdivision -
V City ZIP ,`IC C-i'
Affected ❑CW jEW J PTA ❑ES n Prs Adj.Wtr.Body -- 41 - ' '`+ /B.-.., ,,,..s. (nat/man/unk)
AEC(s): ❑OEA n IHA n UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body )c?y,�t S Ate"Ck
ORW:yes/no PNA:yes/no JI
Type of Project/Activity pr- e .,, ( - t ' - — c ,(c (7v) ,-, .pile-.sev4 - k"krr(--ct.t.,ic-u,
(Scale:)`:I4 ' )
Shoreline Length
Access Length v
/Pier(dock)length - ! - t
Fixed Platform(s) j
i L`I
Floating Platform(s)_ O Y 11 f) ..-._,_. . _._ I r _. .-_ _ € _
Finger pier(s) I I 1�1 V., / Y �+' I �`Ert 1
Total Platform area ,,/ . _.,...____4 ___.___.,6._
\ J- 1
Groin length/# ��-- I
l4
Bulkhead/Riprap length , `''� ' _.--
Avg distance offshore 'ter- .� >r ------
Breakwater/Sill it ' -
Max distance/length {
I I } i
Basin,channel r--- x tit) x —le' _
Cubic yards "1,;�- (y,I r r _.. j\
Y
Boat ramp /r _ ___' _` �__ _. .�..� ___ __.__ �I
Boathouse/Boatlift _ iris' (
Beach Bulldozing �� w �� -4{` « 0 f } )
1 1 i
i -, t
Other Si� t 1..._...-...._. _... _l:Lt�c(.._...OM= .7_-I _aM(4
SAV observed: yes Ono 1 —
Moratorium: n/a yes no 1 • \\t ,� �_,j„a — i '— 'r' "�
Site Photos: yes .no., 1 \ . I - I
Riparian Waiver Attached: 'ye no - 1 \ I 1
A building permit/zoning permit may be required by: • I C.44.1,O,- l ck..A1,,%
Permit Conditions „V ) ❑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 PRINTEDIName
Signatur **Please read compliance statement on back of permit** Signature
;
1, ;u
Application Fee(s) Check#/Money Order 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:
Tar- 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:[phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden,Chowan,Currituck,Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

DigiSign Verified -23ae6f92-c70f-49d8-b4d0-eb82e725c720
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: Robert Purifoy S& R Legacy LLC
Address of Property: 713 Shepard St.
Mailing Address of Owner: 713 Shepard St. II PO Box 486 MHC NC 28557
Owner's email: Robert©olympusdiving.corrbwner's Phone#: [phone]
Agent's Name: Agent Phone#:
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
descrip ion or drawing, with dimensions, must be provided with this letter.
JS 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 400 Commerce Ave., Morehead City, NC 28557.DCM representatives can also be contacted
at(252) 808-2808. 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 revetme ts). If ou wis ..ve the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signat v •-acent Rip ►-' Property Owner
-OR-
I do not wish to waive the 15' setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:‘/ 4 `� ✓Lbb•
Typed/Printed name of ARPO: J`J(L�t^ S;,.larA.S`n
Mailin Address of ARPO: lc-{ v `tfri 1A t1v1''r`-`" 114 h I g 't
v vAc:ti �S w tzrti(Q� �, 3 C q.-1 a�J -"A-‘
q
ARPO's email: / ARPO's Phone#: d ( ', e�(�
Date: l 'L1 (L'3 *waiver is valid for up to one yelihor AR�PDO's Signature*
k Revised July 2021
OCT 0 4 2023
DCNI-MHO CITY

N
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 f completed by owner or their agent)
Name of Property Owner: 20 fit- RA/0 F l, pti 541 R LejarA4 L- t,
Address of Property: 1 I SheipaA Si
-
Mailing Address of Owner: 113 Shepard Sirs M oravead CA h N 6 2 5S1
Owner's email: RObtv1— DIt�rptndiViri fc w 's Phone#: LZSZ)241-toD�SZ--
Agent's Name: J Agent Phone#:
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
descri tion 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 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252) 808-2808. 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/all of the 15'set� .,C/
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: (�C,..t, v o(ehkeack ',.(^�
Typed/Printed name of ARPO: .( etc' it e 2')AA',Ca„�•� 1 c�'V V,c (Ace ,fc
Mailing Addre of ARPO.
• CZ \Ays a MOLrCke4 ale(
`` 'ki0:Ak i ^s® '21---' 7
ARPO's email: I el, d,,(-,I : or ARPO's Phone#:(L ) /)�'64c(
Date: p *waiver is valid for up to one year frbm-ARPO's Signature*
OCT 0 4 20„ Revised July 2021
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DCM-MHD CITY

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