87026A - Lewis

„CGUT', ❑CAMA ❑ DREDGE & FILL N9 87026 A B C D
aJNAI&I
GPrevious permit
GENERAL PERMIT
Date previous permit issued
M 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 o'l 14 - ( ((_)Cl ❑ Rules attached. 0 General Permit Rules available at the following link: wwwd .ncgov/CAMArules
Applicant Name I 0 (A e"1 I_ _t , L -
Address i "yi 1 L1: ! to 1'. }-a i-• C'. (�.�:'s l
City His 6� l.7 ,V I { ( CY State &.1 C-, zip 21 4 (�
Phone # (2 4 2) ,'x. '?� 1 2) J _] 0
Email I Pi AI C'•u) 64 Ai) CA h'l ce L 1 C0 iYt
Authorized Agent y`J! i ( ij_*_ ciey
Project Location (County): I ) r r' 1 1 J C
Street Address/State Road/Lot#(s) I Ci I 6JCI %.-CC 4l
Subdivision
J City +ra w 1, v ! =; zip 2. 1 J 4
Affected ❑ eW EIEW H PTA Fv] � PTS Adj. Wtr. Body jbj C l f } 1"\ k' t U Y !`Gat/inan/unk)
ES
AEC(s): ❑ OEA ❑ IHA ❑ U W ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body r.' f t i ”. r
ORW: yes/no PNA: yes/6)
Type of Project/ Activity
r
r�
Pn
(Scale: j ra
Access Length
Pier (dockl length
149i
PR
Fixed Platforms) —
■......
MENOMINEE■�.C�CC
Hhi■■Total
■■.■■■
Finger pier(s)
EM
NO
Platform area
Ctr■■N■■■■■■■■■■■
SEEN
■M10IN■■
Groin length/#
EASE0No
1�.■.Met
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mmom
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00:��
■
WCNM■■■■N■■�■■■■■....�■.
Basin, channellCubic yards
i
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IBM
■■■■M
1410
CSC:
Boat ramp
...
.►;�j�.�■�.■■.■.■�■INS
flum
I
ME
■.■.
!MEMO
SAV observed: yes no
Moratorium:
Site Photos: yes no
Tigarlan Waiver Attached: yes no
M
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Ins
In
on
EMMUMMUJIMEMI
MEN
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A building permit/zoning permit may be required by: Li Y r 1 '�-•.) fL :. f� c: VC� ./
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 Initial)
Agent or Applicant PRINTED Name
t
i
Signature *'Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
Application Feels) Check#/Money Order Issuing Date
Expiration Date

N�
m

NOTES, Plies and wales PT,
2.5 CCA.
Bolts and tie rods to be
hot dipped galvanized with
standard washers, UNO.
5/16' bolts or 5/16 x 2 112'
lag bolts, wales to sheet
pile, Maximum 18' DC
7-5/16' bolts or 5/16' x
1 1/2' lag bolts, nailers
to sheet pile, Maximum
18, 0C
PLAN
Grade
-2x6 Nailer and cap, T 1
ground contact PT
5/8.JO' MY
c
0G TJe asbock
rods
�..her .
4x6 Wales peps
1/2' bolts at piles
5' 1q
8' Round or 8x8' x 4 Ft
Anchors, ground contact PT
r
c
d
E
a
6Q Crane Materials SG-225 Vinyl Sheet
w W Pile, Minimum 6 Ft Embedment
n. .
ro
� = SECTION
oM
Thomas Franchi, PE BULKHEAD SECTION & DETAILS
6053 Martins Point Rd. 27118 HAPPY CRAB WAY
Kitty Hawk, NC 27949 SALVO, NC
252 2610164, 2078008 March 27, 2011

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: t'o aD Le,L j r.S
Mailing Address: 78 xHp�n.j idec_i'i Ra(
Phone Number: 26-a 33 1 - 3 9,610
Email Address:
I certify that I have authorized T)% L( rz-(a ,
CIFAgent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in "rrk"eJ2 County.
1 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:
ems. o'i✓er.u�a
Signature
IQpp L eWLS
FA
Print or Type Name
Title
1O 1 tq / X0 3
Date
This certification is valid through

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: Og (1.Tvn/ Foold %uJ lS
Address of Property: % 0 1 B W,� 1-04tcti
Mailing Address of Owner: 7A -a►p i ra ti Ajex fc (ll rb r>tihcu A /1tr, a -lqw.
Owners email: -G-1_(pob ray, w (.(opwrtees Phone#: 0 2,S.,J - 33 ( -396 a
Agent's Name: ,54M,ti Agent Phone#: S wrwl X
Agent's Email: SAM r.
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certity 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
4 k I/ -_ 1,00 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, 27901 DCM representatives can also be
contacted at [phone]. No response is considered the some as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only one
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 soply to bulkheads or riorao revetmentsl. (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 yq
Signature of Adjacent Riparian Property Owner
-OR-
I DO NOT wish to waive the IS' setback requirement (Initial the blank) ! V14 _
'- Signature of Adjacent Riparian Property Owner:
-)(TypedlPrinted name of
jr-- Mailing Address of ARPO:
Jk,
ARPO's email: ARPO's Phone#: . 77 % `7C w-v
Date: 'waiver Is valid for up to one year from ARPO's Signature'
z-77�7
Revised August 2022

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: P c l,.- e Al 1 pll L e-W t,�
Address of Properly: / 0 t BL A �-Ao Gh'
Mailing Address of Owner: 1t a'7q4C
Owner's email: -IS-1 L..t) 6*000"11-� wners Phone#: 2,Sr 2 - 3S 1 -395 d
Agent's Name: 54A4/ E Agent Phone#: 5+4,11 X
Agent's Email: 5 AM Y=
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
1'00 NOT have objections to this proposal. I DO have objections to this proposal,
If you have objections to what is being proposed, you must noury me N.r;. urwsion or r.oasrar
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, 27901 DCM representatives can also be
contacted a t [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only onel
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.) ,
100 wish to waive some/all of the 15' setback )Y O
Signature of Adjacent Riparian Property Owner
-OR-
1 DO NOT wish to waive the 15' setback requirement (initial the blank) /V4
-V Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 11%414-Ck N
Mailing Address of ARPO:
-X— ARPO's email: <Wk F'1pC'e:cAnMi�°LcA
4— Date: Ci1 V J ;0:)az) 'waiver is valid for up to one year from ARPO's Signature'
Revised August 2022

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