87068A - Francis, William

&DQCAMA n DREDGE & FILL N� 87068 B C D
s GPrevious permit
GENERAL PERMIT
Date previous permit issued
�JNew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State ofNorth Carolina. Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC y/ H ' 1200 ❑ Rules attached. LD General Permit fbles available at the follovnng link: v s vdegnc nv1CAMAnIes
Applicant Name _wa1 gYYk 7Mr,CiS
Address 016,703 F fEssttn CT,
City_ s q n2a,(fR state VQ zip it332.2
Phone # rMs)) 72 4�33
Email L04--4rovltclstj--Av (_-
Authorized Agent
Project London (County): _ Ye r Jrr.t MQAvs
Street Addressfstate RoadjLot #(s) 6t "Sk 2
SubdiviWn SO -A C`t�%11�s0 �JtPI'
city Re,-t 4Z, ,4 � z P 2,79141
ARected ❑ M SW [Y"A ❑ ES ❑ M Adj. Wtr. Body ____ S_ A M K-jygC (�maniunk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PINS closeu Ma(. Wo: Body iq"�bemrx�ll� 56vc+�ni
ORW: yeses PNA: yesj B)
Type of Project/ Activity
SAV observed: /!�yes ® "
Moratorium: G. yes no —`
Site Photos: no -
Riparian Waiver Attached: a
A building permit/ioning permit may be required by: _
Pt Vt C, i
- Gt� w liarret�
30
Permit Ofhcw% PRINTED Name
TAWPAM/NEUSEMUFFER (circle ore)
See note on back regarding River Basin rules
See additional rates/conditions on back
(Please
Signature ""Please read compliance statement on back of permit" Signallyr
�4"aonr °O 1(5,71 1;L1/z3 Yly&q
Applicadon Fee(s) Check N/Money Order Issuing Date Expiration Date

&0ta"r"1 IKCAMA ElDREDGE & FILL
� 1) GENERAL PERMIT
s
®New [-]Modification ❑ Complete Reissue []Partial Reissue
N° 87068 (2) B C D
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:
15A NCAC U • fatx, ❑ Rules attached. Y General Permit Rules available at the following link: www.deonc.gov/CAMArules
Applicant Name Wi(`%Otm Fratr,.Czs
Address C 76'1 F4`rftaV a.
City Q; \eSrt oCG.; k.R. State Vo. zIP 2332.2
Phone # (t15)(� 72L4 — b433
Email u-s'4+rcly% 5t St Ie4--A C 6 Qvra I Cow.
Authorized Agent - _ t�
Project Location (County): eY t MOtYLAS
Street Address/State
II Road/Lot #(s) 6i '-a 2 h
116 H Q l tL
Subdivisionr' QI E`r�Q f r3i11ti.0 CCA+
City kle-_ Tu cd zip r2-]yCl4
Affected ❑ CW tiq EW [YPTA ❑ ES ❑ PTS Adj. Wtr. Body y,eopi ry\ Kt y w eman/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body 1'��eftllLlf�'L S6t.v�p(
ORW: yes,1 ro PNA: yes/0
Type of Project/ Activity
(Scale:
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) 131 X y r
Total Platform area % i 51! f j-
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp '—
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes
Moratorium: COf3 yes no
Site Photos: es no
Riparian Waiver Attached: a n®
A building permit/zoning permit may be required by:
Permit Conditions
Agent or Applicant PRINTED Name
T1
Permit Offic9l'S PRINTED Name
"41,
C V,CP `r-u?
arret�t(.n
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature ""Please read compliance statement on back of permit** Signal N
1671 R N/z3
Application Fee(s) Check p/Money Order Issuing Date
y/y/2
Expiration Date

Actur" ®CAMA [I DREDGE & FILL N9 87068 A B C D
a Previous permit
GENERAL PERMIT
)1]New []Modification❑Complete Reissue ❑Partial Reissue 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:
ISA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nagov/CAMArules
Applicant Name
Address
City State V. ZIP
Phone#(i)
Email `:�:; ,.t, I Y
Affected ❑CW ❑EW ❑PTA
AEC(s): ❑ OEA ❑ IHA ❑ UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
❑ ES ❑ PTS
❑SPIMA ❑PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Adj. Wtr. Body
Closest Maj. Wtr. Body
(Scaler )
Access Length
Pier (dock) length Fixed Platform(s)
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No
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SAV observed: yes no
Moratorium: Wa) yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
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A building permit/zoning permit may be required
Permit Conditions
❑ TARIPAM/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. (Pleaselnitial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Feels) Check N/Money Order
Signature
Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT RECEIVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY NOV 0 6 2023
(Top portion to be completed by owner or their agent) DCM-EC
Name of Property Owner: ' A; 11, 4 m-4 C! h i 5
Address of Property:
Mailing Address of Owner: 7 0 !V & 15 n el M L"
Owners email: W .y T ft diiL 'ia? Jp < Owner's Phone#: US - -1'2 `if - � 9 33
Agent's Name: iv�q Agent Phone#:.... !V
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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
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 (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.) �C��'/�-�/,/
I DO wish to waive some/all of the 15' setback
-OR- �1
Sr ature of m jacent? parrian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO: A19r11 /I)1_r /
Mailing Address of ARPO:
D
1f-,J/r��e
ARPO's email: ARPO's Phone#: 22 -31?--
Date: 41-&-- 2 02-3 *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

N.C. DIVISION OF COASTAL MANAGEMENT RECEIVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVER4V 0 6 2023
(Top portion to be completed by owner or their agent)
Name of Property Owner: V 31/ 19 t 4 l plr4? ✓11_- i S '"' n
CM_EC
Address of Property:
Mailing Address of Owner:
1 ec(lk'ea V A
Owner's email: Owner's Phone#:✓r
si ,
Agent's Name: 1, %>� Agent Phone#: Z`-- 1 4
Agent's Email: .✓ / >a
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
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 (Choose oniv 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 apply to bulkheads or riorao 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
990
1 DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: C211) I t e G L> aAl>/
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#: ? _fJr 2 6i 2
Date: ; ;' 7—*waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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RECEIVED
NOV 2 2023
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Prepared Apr 14, 2023
By I Miles uisciairnec Parcel lines are for tax purposes only TMs map is NOT a substitute for a land survey or legal document. The
Perquimans County, NC assumes no legal responsibility for the information contained an
this map.
252-rab4-39bi•a39 Can)4iL;