89884A - Hockenberger

"`°"r' CAI%AA DGE &FILL
N° g98g4 0q B C D
3 GENERAL PERMIT
Previous permit
@V�Wew
Date previous permit issued
❑ Modification ❑ Complete Reissue
❑ Partial Reissue
As authorized by the SS!aJe of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC r L I r t C> a � 7"' a ❑ Rules attached.
A7T'ral Permit Rules available at the (following link: w/v wdeq nc eov/CAMArules
Applicant Name Qd CL 1 1 C Q. 6r
Authorized Agent
Address r 0 D X b s .2.--
Project Location (County):
City ✓D n. State N L zip 2% /p
Street Address/State Road/Lo(tJ'i(s) S / 22�a LC T
Phone #j (74 -1 .--/(0 3 `1
/ JLI�J W's'=„ _ 13D Q.-
Email 6 M i7 Ga dA�S O O.%V O O Ca /11
Subdivision P o r4— A-✓%n
city, f}yoil zip
Affected ❑ cW Lam° P3A tT [2�rg
Adj. Wt, Body Q 0/-A G.
( (na an/ k)
AEC(s): OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
!�
Closest Maj. Wtr. Body OA /I � -S bx A ti cL
1
ORW:ye no PNA: yesA0
Type of Project Activity k"t Vi `.B t-\ ci a n cL
g'X /Ce `J�a c-tC w`r �yxSr La f es P/a F rM (Scale: A 4E3- 1
Shoreline Length I O r
Access Length
P' r (doc ngth
Fixed Platform(s)
Floating Platform(s)
Finger piers) f
Total Platform area
Bulkhead/ h/prap length I 1�1 Ir 2�- I6 'r
Avg distance offshore �r WI, a U,(k{��.A. Z YM.0.->L.
Breakwater/Sill y / g LA
Max distance/ length �+
Basin, channel
Cubicyards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing r/1 It}tigq
Other
SAV observed: yes `ff.—J
Moratorium: n/a y no
Site Photos: es PL
Riparian Waiver Attached: yes < no L
A building permit/zoning permit may be required by:
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
THAT
or
Signature Tease read compliance statement on back of permit** ``� //
lr2 ab /LP6Y
Application Feels) Check #/Money Order
VD REVIEWED COMPLIANCE STATEMENT. (Please Initial) I Y_S,
YK-0 A. 9--
PeAnit Officer's PRINTED Name
L/
Si ure /
! D l i? ��3 2-/1 -? % 2-%
Issuing Date Expiration Date

DREDGE & FILL
N9 89884
A'` B C D
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:
ISA NCAC - Rules attached.
RA General Permit Rules available at the following link: www.deq.nc.Roy/CAMAruIes
Applicant Name - I' Y 0'1' t , (, ,. y:: ,.: 1) :ti. (e:r a /
Authorized Agent
Address - -
Project Location (County):
City State ZIP
Street Address/State Road/Lot #(s)
Phone # (`_)
Email
Subdivision
City ZIP
Affected ❑ CW E]EW PTA ES PTS
Adj. Wtr. Body
(nat/man/unk)
AEC(s): ❑ OEA IHA 11 UW ❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body
ORW: yes/ho PNA: yes/no
Type of Project/ Activity
< 1
(Scale: )
Shoreline Length_
Access Length _
Pier(dock) length
Fixed Platform(s)-
Floating Platform(s)
Finger
Total Platform area
Groin length/#
Bulkhead/. Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes -
Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: yes
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
r
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
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ,)L)1?k h� tlack-f+-"-
Mailing Address:
Phone Number:
Email Address:
i)o z A yox., ri c
/107_ `I
I certify that I have authorized / (ht2 �7Niay f Ake l/Gcp • ,
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Coley C'e v I, S
at my property located at
in J �� 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:
Title
Date
This certification is valid through

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICA770NIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(fop portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property: Ai v 9;7 livp
Mailing Address of Owner: __ 0o ay ti Z __ �e) . AIG « 7415
owners email: bMh a ens Phone#: -_ iH 3" - /65 q
Agent's Name:
Agents Email:
Agent Phone#:__ -
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent PronerN OWnOrr
I hereby certify that I own property adjacent to the above referenced property. The individual applying for thi:
permit has described to me, as shown on the attached drawing, the development they are proposing.
deSf,dotl/en or drawipg, with dimensions,must tx nroyj_ded h ]i�Letlf<I•
n/ 1 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 Coasts
Management (DCM) In writing within 10 days of receipt of this notice. Cw►espondence should b
mailed to 401 S. Gd In St, Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also b
contacted at [phone]. No response is considered the same as no objection if you have bee,
notMed by Certified Mail.
WARIER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, 1A or
groin must be set hack 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 sian
the appropriate blank below.)
I DO wish to waive somelall of the 15, setback
3ignafure 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. t I
TypedlPrinted name of ARPO: � 2 t/U 0- `fir
Mailing Address of ARPO:
ARPas e,noteerARPO's Phone#: i 7 0—
Date_ (% 2 3 _'waiver is valid for up to one year from ARPO's Signature"
Revised July 20;

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:
Address of Property:
Mailing Address of Ownei
Owner's email: 64rag(ed s tJ L47100, Crn7Owner's Phone#:
Agent's Name:
Agent's Email:
Agent Phone#:
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/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-
OR-1 do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: ! _
/ a1�
ARPO'semail: (fit �') l�{(� l=%I 9YlVi�ARP0's Phone#:
Date: [0 (Zt) 7 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

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