87051A - Crank

oX ❑CAMA ❑ DREDGE & FILL
GENERAL PERMIT
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
NQ 87051
Previous permit
Date previous permit issued
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
Rules attached.
❑ General Permit Rules available at the following link: www.deg.nc.gov/CAMArules
Applicant Name
Authorized Agent 7'Ir; Ft lLY`.: la'r•L.,:U :' l
Address
r' 1 J +=-
Project Location (County): !'-; r
City State
ZIP 2'3'?2'L. t:-
Street Address/State Road/Lot#(s) I1 % }Nr
Phone # ( i)
Email 11
Subdivision
City C'-',t n{ I}rt Y'i7nC ZIP 2'796-1l.}
Affected ❑ CW ❑ E W ❑ PTA
❑ ES ❑ PTS
Adj. Wtr. Body C u ir F- : '} r t r5 o tT rn A
e5man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ U W
❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body u 4 V e , U t,
A
ORW: yes/no - PNA: yes/no
Type of Project/ Activity
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SEENE
Finger pler(s)
Total Platfor
Max distance/ lengt
Basin, channelCulacyards
Boat ramp
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Beach Bulldozing
Other
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SAV observed: yes �no_
Moratorium: h1a yes no
Photos: .
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A building permit/zoning permit may be required by: U i 'e" I
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)
or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit*
10 22_
Application Feels) Check H/Money Order
Signature
Issuing Date Expiration Date'

GENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Per.- V—,16 \ cfan l(
Mailing Address W6 u i ttow noot- Dr.
c4�5We_ YR- VA. btY)ga
Phone Number: -�51 - 5qq — U q �,3
EmailAdaress: [e-mail]
I certify that I have authorize- QtA ArJ vnvu�,w ;+Z
Anent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: L. H- i✓ 56
'eu 1K-kR-0 -d
at my property located at IOU `roir.Y I_n 1TOina- Harking, tiL 2--19(nLj.
in Cour v.
I furthermore certify that I am authorized to grant, and do in fact grant permission M
Division of Coastal Management staff. the Local Permit Officer and (heir agents ro enrs
me arorementioneo lands in connection with evaluating Information related to thi,
permit application.
=rwertv Owner.inforinabow,
rgnature
Print or TVoe Name
Tine
I`C
This certification is valid throuah

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONAMAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: V-tn1 CvA✓t)L
Address of Property: LOU -Tli1Q-( Ly\. L} Ldmy NGr 01clUL4
Mailing Address of Owner: 648 l rd(a,l oo,ll_ ar. &PssyeALe NAt a 3,AA
Owner's email:
Owner's Phone#: -16 l - 549 - (09 £j3
Agent's Name:DrAyi Agent Phone#:9'5A-t'I65-- U5.29
Agent's Email: J" AA&✓ 0-t-1ei 0 jAul l C,0 M
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certifythat I own property adjacentto the above referenced property. The individual applying forthis
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.
-%60&& 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 Certifled 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
't Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
^
LLC Underwater Properties,
ARPO's email:
[e-mail] ARPO's Phone#: [phone]
09/26/2023
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

■ Complete Items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front If space permits.
1. Article Addressed to:
A Nx)o'1xa LW\ .
jAcar 6tw 0 (-I guts ti
❑ Agent
❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery address different from Item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
0 Priority Mail Express®
Signature
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Restricted Delivery
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❑ signature CcnflrmationTM
❑ Collect on Delivery
❑ Signature Conflrmatlon
2. Article Nnmhor R'ronorn. {,,,... ,.,,-•.-_ ,_�_�
^ ^-"ad on Delivery Restricted Delivery
Restricted Delivery
7022 3330 ❑❑❑❑ 9789 2281
red fed Mai Restricted Delivery
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PS Form 3811, July 2020 PSN 7530-02.000.9053
Domestic Return Receipt I
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Tracking Number:
70223330000097892281
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Latest Update
Your item was picked up at a postal facility at 3:06
pm on August 15, 2023 in POINT HARBOR, NC
27964.
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Delivered, Individual Picked Up at Postal Facility
POINT HARBOR, NC 27964
August 15, 2023, 3:06 pm
• Available for Pickup
POINT HARBOR
9142 CARATOKE HWY
POINT HARBOR NC 27964-9609
M-F 0900-1600; SAT 0830-1130
August 12, 2023, 9:29 am
• Arrived at Post Office
POINT HARBOR, NC 27964
August 12, 2023, 9:27 am
• Departed USPS Regional Facility
ROCKY MOUNT NC DISTRIBUTION
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August 12, 2023, 4:35 am
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August 11, 2023, 12:16 pm
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RALEIGH NC DISTRIBUTION
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August 10, 2023, 9:52 pm
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GRANDY, NC 27939
August 10, 2023, 3:45 pm
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