92418C - North Shore MHP LLC

4, COASrq� ❑CAMA DREDGE & FILL No 92 418 A B< C D
�O
. : GENERAL PERMIT Previous permit
J. Date previous permit issued
n New ❑Modification n 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 5 H• /W O n Rules attached. I .I General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Jui 11A SVti11i MH p,L L i,-- Authorized Agent :,.0 Cam,(// €
Address +" , dot( 2 Co Project Location(County): (7.,.�.�L1
City Q^f1Y..4't( Geo-4.1.State JITG. ZIP Zj%--1 7 Street Address/State Road/Lot#(s) Akr./44 Sk✓v Dz*A4--
Phone#(2SZ) 3'i4 - 7lojts"
Email On. 1 Cc(,At, .; r c''—' Subdivision
City _ 1-"Cti.v r ' ZIP 2$'S 12
Affected n cw 7 EW n PTA ❑ES n PTS Adj.Wtr.Body _').;,9c.,--e .&P.."._ar (nat/man/unk)
AEC(s): ❑OEA n IHA n UW SPIMA u PWS Closest Maj.Wtr.Body v w1w...e/1
ORW:yes/no PNA:yes/no
Type of Project/Activity ('.r.).c ( r.'t /��o►,y.j-C—U,--&-a._ OL(1rt)I.
(Scale )
Shoreline Length
Access Length _ i-- ---,-------_ ( 1- 1.....i - __._ �.- t. / : ... . ; j -
Pier(dock)length ; --1- -' �`�'�-' � ; �-
Fixed Platform(s) �'
Floating Platform(s) -1 --h_-.
i (
l
Finger pier(s) a 1 i
IIIIIIIIFIIIIII
Total Platform area
Groin length/# i
Bulkhead/Riprap length �.* '.. } -. r — -- ;-- — -j- - li 1
Avgdistanceoffshore ._.-}..... _ )_....__..... ...--__ ----_-..
/ ,
�
:
Breakwater/Sill `- ' � � ( �` �` `
Max distance/length ../ ' 1 t �`
Basin,channel . . : , '
Cubic yards L/01 Ki,C .-
Boat ramp 1
� _ t
Boathouse/Boatlift ..."*/"'.. 3 '
Beach Bulldozing EMI
Other 011111
i
SAV observed: yes /no i i (
Moratorium: n/a yes no i
Site Photos: yes •.,no,
Riparian Waiver Attached: yes no i 1►I - i „,,,,.1„ ' a. - i
A building permit/zoning permit may be required by: t.4rdvI4'"I j,, &t LI
y n TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions t t, ?L� „••• `: -L e;, a I et coo-4,i I.A.f!uvLi
`'/ j yu ,z y < s:.,_ /t O (yi( 5 6'4L2-4....e a..A ff,c.,--rc4f '"/' n See note on back regarding River Basin rules
P y((z 1)„,),,..... 1) ey(li,,� ;WA , ,,( 4 IIr i„n, re,i (-t.j 1 ) 4) .1,� r'+ .'I , Air ay( � /QC it...._,
See additional notes/conditions on back
i1.24 6 ,.( ( n x/4'G'( (,ice 1
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) 7."------
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name -:7,`""- _--
`-.� I"
Signature**Please read compliance statement on back of permit** Signature
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

f11
� FIICAMA DREDGE & FILL No 92418 A BCC' D
1GENERAL PERMIT
Previous permit .--
Date previous permit issued o'
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 5A NCAC_ Y A f�)C /h.00 ❑Rules attached. ❑ General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name r''),r kv, ()'v , :k M i i I`,( L L. Authorized Agent
Address .-0 ;ICY 2 S O Project Location(County):
City A 1(in"i i(.. lee--G1..State Ai C ZIP /4 S i 7 Street Address/State Road/Lot#(s) �M
Phone#(2j-) 47(Ei- L Ito T"
Email it, t n,.`n('') ('tCr,, �,- . r' Subdivision
City ZIP ',
Affected ❑CW .ffW PTA ❑ES ❑PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA ri IHA n UW ❑SPIMA PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale4/13 )
Shoreline Length .�.-
Access Length ,-_ _ -1,
Pier(dock)length �
Fixed Platforms) � j i��""` 1 I1i, 0
p r .
1ilml1s1 li11E1111l11
1111111 III
NMI 1111111i11111
Floating Platform(s)
11
1.11 si i ' iirimerm. Imo -±- --
J„...---- IPI
wR
Finger piers) N M
I',
IIIIMM
Total Platform area I /
Groin length/# c
1111
Bulkhead/Riprap length -✓ -- MIMI1 III 111111111 ' all IIIII
Avg distance offshore ."--- ~ ` _ I.,-
' . _.,._... c....._.. . ....a_.
Breakwater/Sill _
--- _r_
Max distance/length MIIIIIIIIIIIIIIIIINIIIIIIIIIIINI � "'""""
Basin,channel
Cubic yards l/ h(% _.. I 111 IM .._ ___
1._._1 _
Boat ramp ..--- I I I
Boathouse/Boatlift IIIIII j
. ...... ...
Beach Bulldozing �/ � j� ' r
i
Other �'"- i.....
Mill NI nil
1111111111111111111011111111111 MN
SAV observed: yes no �
Moratorium: n/a yes no 11101110 i )
Site Photos: yes no,
Riparian Waiver Attached: yes no 1 ?Pei A building permit/zoning permit may be required by: .t4(t v,4 '(_ J��`z i(,,
Permit Conditions I) AjO (Kitt ve I-1:�,_ 2 .-4 t I i r" I' j�a t- - It Net n TAR/PAM/NEUSE/BUFFER(circle one)
e I IV( /WQ ryyz( f ,u et t is .: (IAA-1br n ,y.� "f_`,' ElSee note on back regarding River Basin rules
yr0,jtl �., 1) e /, te IC ; r '"La. ,,,- 1,4r4 rooAs t/,• 1
ElSee additional notes/conditions on back
" 1 f 1 c 41) ' I. 1' :r' i�2 L'' !..)on / %tcT fia,t /: :
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) C,/
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name •
Signature**Please read compliance statement on back of permit** Signature
1,
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

U.S.Postal ServiceeM..
CERIFIED MAIL° RECEIPT •
Vomesta Mail Only
Ir For delivery information,visit our website at www.usps.com®.
At tF PCII 0C124.1. .
Certified Mall Fee $4.3.5 0689
'O Extra.Services&Fees(checkbex,add fee at proMte) 06
['Return Receipt(herdeopy) $ 0
a ❑RetumRecelpt(electronlo) $ $0.00 Postmark❑Cenified Mali Restricted Delivery $. $t.I.n, Here .
❑Adult Signature Required $, tJ LW
❑Adult Signature Restricted Delivery$ 0.00
Postage
ru $ $0.90
ru Total Postage and Fees. 09/22/2023
$ $8.80
r Sent To
o -street androtraillii15642414 gh er
tti $©-1- 7-2-�
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• PS Form 3800,April 2015 PSN 7530.02-000.9047 See Reverse for.Instructions
Sti 014�o
DG���A

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: rf\`NV L.
Mailing Address: 7O `e) ,,c
p--sc\a .�,c 1� cr � ��- 2-8
Phone Number: 2S t-`TLC - Zg(o
Email Address: \� , ..,�� Oc �^-�-n �g . �A
I certify that I have authorized 4.)
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: �t' e) C , �,
at my property located at N-. (` ,
in �--- � e-''` County.
I furthermore certify that I 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:
`\C ignature (�
Print or Type Name
resN
Title ReD015 .:
I 'LZ'A
Date SY 4111
D
GM *\BI G�TY
This certification is valid through I I

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CQNTINENTA ,1IRE.COM

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. t�, p v"-- e—. (N\
Address of Property: �, �� 5��,c s \ 2\ 2_ \ �' 2_\�Q
Mailing Address of Owner: -o)C 2_ V (� \�„�. (��z�� Ki L 2 g
Owner's email:\L.% Owner's Phone#. ?—S.Z-- ?Z`a -
•
Agent's Name: \ Agent Phone#: S Z - \ — `-\S
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
description or drawing,with dimensions, must be provided with this letter.
V I DO NOT have objections to this proposal. I DO have objections to this proposal.
/f you have objections to what Is being proposed, you must notify the MC. 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 Mall.
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 skill
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.
Typed/Printed name of ARPO: t
Mailing Address of ARPO: U\ -v.1 c . �\\"L -
ARPO's email: 3° � (11/4.F,1 ARPO's Phoned: 2- L -- 7 L 3---7--77
Date: q\-z'J-Z 0�� `waiver is valid for up to one year from ARPO's Signature` `j
Revised July 2QZ1-"