87106A - Severa, Jeffrey

❑DREDGE & FILL N9 87106 Q B C D
Previous permit
{ GENERAL PERMIT Date previous pemtit issued
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State
o�f�North, Carolina. Department of Environments! Quality and the Coastal Resources Comrtdsslon In at aea of nrveonmera l concern purwam to:
I SA NCAC —.-1 U I'•i QQ It ] `_r' Ruks auadmd. ® Gmerai Permit Rules ardlable a the loPowMg Mk: mnwdea ncx?Jv CAL'_.A++g"
APplant Namn _t��+—Tt' sMe --- -- --�ey err,
Address-QLj-�� 0.6x . YiRi
City—EOu�Vs 1tN,-____---a_- Ne _Z)P :1c?-U
Pt.#(26-, y39-'af5.�5
Email)?#i, r>sIerc. [e-mail]
Authomrsid Agent wit-tt
Project Location (County):
Street Aklrass/Sate Roadll of t►(s)
Subdivision
coy el
Affected OW ®EW ®PTA OM ❑m Ad. Wm. Body C LO W
AE,C(s): EIOEA IRA EJUW ❑SPIMA PINS Cbsest tom. Win Body_-......._�-
oftw: yes w nPNA: yele3 , - ',t
Type of Project/ Ad" l �•ns}ru�`+:- a o2 `% r )c l 4 / 1[�a7r/wtaJe l sklJ A eZ 5' a�L''th
(scale: IN� I
Shorebne Lengthit
Access Length
Pier (dock) IengtM e �'I t_'r-
Feed Platforms)
ti FT
Floating Platform(s)^ t 1 . I ,-j`- �7 _ .�!'_j�t � = _ �_s. •--- + .- -�-+--�--•--i
Fingerpier(s) .., jai.._
Total Platform area r --x.••--r.-�-I ' I r "-* t".*'_' ''�"_�— a`j•
Groff ngth/g-�-Sal
. r d • 7 I I� �j.
Bulkhead/Riprap lersgth h _-4- y -• a_-j -.i f r _i.. ,�_� ;. .-- i^iC.a' =-� ra F-a- x l.._�..y�.. r`.s
Avg distsnw o%shore
t
Mmilistance/length,-►�----� "' --i r- --*-�- '+__'_'�_) ( I I ) �1� A l .,.,_. I '•.-.` �.--',
Basin, channel `Yr
I I r
Cubk Yards i i i t ( ' i._f_ v._ t I--,t'
I-,
.
Beach Bulldozing
4 , u3Li
other! i i
SAV observed: yes
Moratorium: /y,,e�s
Site Photos; �yj nor.... -
Riparian WaiverAttached: YM
A building permiVrortmg permit may be required bN: tS2-t''TlC �^""h�'�} TAIVPMyNEUSMUFFER(circle one)
Permit Conditions
See note on back regarding River Basin rules
See additional notWorriditlons on back
r aaa awsee nc vsiT rP; rtc RULES AND CONDMONS THAT APPLY TO THIS PROTECT AND RLVIEWEOCOMPUANCESTATEMENT. (Piece Initial)
SiZ Yn i j l l Q c Yl
Agent or AppRcam PRIMED 1
Slgnat '•Please read compliance meet on back of permit"
it44C j gQ lViol k long
Application Feels) Check g/Money Order
Permit
Signature V,
lauing Date Evi ation Date

®CAMA ❑ DREDGE & FILL
GENERAL PERMIT
©New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
NO 87106
Previous permit
Date previous permit issued
(9 B C D
As authorized by the State o�f North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 9 � 1'200 a' IgM ❑ Rules attached. © General Permit Rules available at the following link: www.deq.nc.yov/CAMArules
Applicant Name
Address 1P. I
City lad
Phone # (R 5)
Email %Pt
: 71 C?32.
Authorized Agent 'Jk IMiLIgCLn /OceCLr dP— lNKrTstt ,3
Project Location (County): 9 e;+W—,..y�
Street Address/State Road/Lot #(s) 61 •M' ( 2
`144 Gov Ede,. 1:6&w
Subdivision bloc): Kocx
City
Affected ❑ CW 2S EW ® PTA ❑ ES ❑ PTS Adj. Wtr. Body C ko cA) an 1Fl Kdc / nan/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body 1'9�1��/V�f"�2 SOuy
ORW: yes no PNA: yeso
Type of Project/ Activity l,cvA
Shoreline Length /— 1 (6r
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger piers)
Total Platform area
Groin ngth/q Z� r
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length��
Basin, channel _..
Cubic yards
Boat ramp
athou / Boatlik 2 7' X (� f
Beach Bulldozing ^
Other
SAV observed: yes �
Moratorium: /a yes noST'
Site Photos: 6 no
Riparian Waiver Attached: yes (9 f') L n
A building permit/zoning permit may be required by: tS2 -Kf WkYs.�
Permit Conditions
(Scale:)
)D7
5b..
�I ��tQ�JntQ
1
❑ 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)
L.tt w'{'ISIK �O;nti�
Agent or Applicant PRINTED Name Permit OfRer' PRINTEDName
it
Signature "Please read compliance statement on back of permit** Signature
S4COr�--Q 1a'701 hr 1212Z 17-//1-/Z3 y/rg/Zy
Application Feels) Check M/Money Order Issuing Date Expiration Date

r OCAMA El DREDGE & FILL N9 87106 _iy B C D
a GPrevious permit
GENERAL PERMIT
Date previous permit issued
❑r'. 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:
15A NCAC ❑ Rules attached. M General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
City
Phone #
Email
Affected ❑cW
AEC(s): ❑OEA
ORW: yes/no
❑EW ❑PTA
❑IHA ❑UW
PNA: yes/no
Type of Project/ Activity
ZIP
❑ ES ❑ PTS
❑SPIMA ❑PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
I CX `)
(Scale:) >, )
Access Length
FC.
_
__
_
_
_
__
_
_
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
_4—
Finger pier(s)
Total Platform area
Groin len h/N
Bulkhead/ Riprap length
Avg distance offshore
i-
—�--
--
—
--
--
-
--L
Breakwater/Sill
I
I
-
I
—
Max distance/
i
Basin, channellength_
Cubic yards
Boat ramp
Boathouse/Boatliftr--
i
Beach Bulldozing
Other
SAV observed: Yes no
�.
---
Moratorium: n/a yes no
i
t
Site Photos: yes no
Riparian Waiver Attached: yes no �.._
A building permit/zoning permit may be required by:
❑ 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 Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit** Signature
Application Feels) Check H/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address.
M VjW WW . fJ C k-1951
Phone Number: 0So) " 359 - W5 as
Email Address:
I certify that I have authorized
1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMAA permits
yLt ndcessary for the following proposed development: �4 ii 07
(1046LW��t`�
at my property located at oi4t{ 6W &6n taw.uu JJ NMm WA f M C
in 1i ZP/UA,L County.
1 furthermore certify that t 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:
DECEIVED
NOV 15 20B
D w rj'e- -
Title
/1 t 3 t-�3
Date
This certification is valid through I 1 1 3 l �

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - REJURN RECEIPT REQUESTED or HAND DELIVERY
RECEIVED
(Top portion to be completed by owner or their agent)
1 5 2023
Name of Property Owner. NOV
Address of Property: °n 1°Q�� AL�%+,, N C a-1959
ft - VI-E
e
Mailing Address of Owner. ,
Owner's emaie{CC`It�LVS6 0 SMGr1 Owner's W_PhoneM
Agent's Name:J.4.M:lliganl0ceuwsb4n"'xAeAgentPhone#:QSQ"31D-414,
Agent's Email: QQ_CwVJWL,Con rcic}avK n< . CG^r
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom portion to be completed by the Adjacent Property Owner)
I herebycertify that I own property adjacentto 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. 6
I DO NOT have objections to this proposal. 100 have objections to this proposal.
H 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
notiffed 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 slan
the appropriate blank below.)
I DO wish to waive some/all of the 15' setbacksz L__ —
Signature ofAdjacent t Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (Initial the blank)
Signature of Adjacent Riparian Property Owner: TypedlPrinted name of ARPO: (�N 6u� r1 PAUJ 11
Mailing Address ofARPO: a�a Cn4 ALL i, tW U MAI N> -,NNC 'a7�51
ARPO's al • ARPO's Phone#: �5,a Pq
Date: "waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT €�lVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
OERTIF(Ep ARO� I .RETURN R���lEL13FQL1ESTFQ or NAN.Q_Q;�1y�.SY
NOV 1 5 2023
(Top portion to be completed by owner or their agent)
Name of Property Owne
Address of Property:
Owner's email:
Iil��• a• �� nl '4
Ownats Phone*a52: 3 q -g 5a 5
.Q, a ,, .� •g 1
(:• .V .• •t • •:• •t . :• . f: •I.l• • j
I hereby certify that I own property adjacent to the above referenced property. The Individual appwg for this
p^m-A has described to me, as shown on the attached drawing, the development they are propo". A
description or drayeina with dimenslons must be orovidod with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal,
d you have objections to what is betng proposed, you must notify the N.C. ONBJon of Coastal
Management (DCM) In writing within 10 days o1 receipt of this notice. Correspondence shouky bs
malted to 401 S. Griffin St, Ste, 300, Elizabeth City, NC, 27909, DCM repmsentadvas can atso bo
contacted at [phone], No response /s considered the same as no objection tryou have boon
n"W by Certjfled Mail.
WAIVER SECTION
i understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, tin, or
groin must be set back a minimum distance of 15' from my area of rlpanan access unless waived by me
(this does not apply to bulkheads or tip(ap revetments). (If you wish to we" ho setback, you MUst elan
the appropriate blank below,)
I DO wish to waive some/all of the 15' setback
-OR-
ra
SlgnartofAO&certf Riparfen Avperfy Ounar
I do not wish to waive the 15' setback requirement Qntlial the blank)
Sgnature of Adjacent Riparian Property Owner,
Typed/Printed name of ARPO: 'DAV I
Mailing Address ofARPO:_ U VIRGIHIA 'DART Q9 yittUW 6E,.,. "N5-j
ARPO's email: ARPO's Phori
Dates •watvar Is vaild for up to one year from ARPO's Signature'
Revised July 2021

RECEIVED
NOV 15 M,
[)CM EC
�ooF

RECEIVED
DEC D 12023
DCM-EC
PC B PG 527
:A 12 ,S
62
1,?8A
,,.' - 13
6729 W--
,s PG B PG 527
l,,.1411� 14 & 15
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