87111A - Witwer, Timothy and Susan

�°�`°"'"�❑CAMA ❑ DREDGE & FILL N9 87111 A B C D
3 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:
I SA NCAC ❑Rules attached. ❑General Permit Rules available at the following link: W Wwq.nc gov/CAMArulec
Applicant Name _
Address
City
Phone # ( )
Email
State _ ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City —
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:,' 'I ' )
ck—li— I nourh
Access Length
-
Pier dock length
-�
I
Fixed Platformls ) —
I
�
-_--i
i
,
Floating Platform(s)
I
I
,�
•
_
Finger piers)
Total Platform area length
Groin length/q -
Bulkhead/Riprap length rJ eJ (p+
Avgdistanceoffshore-
r}P
,
-t-
1�
+
�
-
(
-
i
i
-
Breakwater/Sill ---
�-
•
-
-
Max distance/length ,.2
Basin, channel
Cubic yardsBoat
•�^
i}
+
__
I
I
4
G
I
_
-
_
_...-.
ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
j-
y.
I.
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i I
I
I
SAV observed: yes no
-
f
Moratorium: 6/a - yes no
Site Photos: iyes no -6
Riparian Waiver Attached: yes no '_,,. �,_„_�.
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-
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-
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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
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please lnitialll/!,�•�
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
F�
Signature "Please read compliance statement on back of permit** Signature
Application Feels) Check p/Money Order Issuing Date Expiration Date vv

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that 1 own property adjacent to I-f hl er 's
(Naine of Property Owner)
property located at 0 LA "P)ree2P {,Jaod r)k .
!� (Address, Lot, Block, Road, etc.) /�
on 6L5Iuo�nR I<iVcr in `G-Ij_" >efin O�AA N.C.
(Waterbody) (City/Town and/or Comity)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
✓ I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
-�ppr-ox. 1� 50' Ob VIN yL '6U Lkhe-o,c-
Cc I S iv u c -I--wn w-l`I-Pn P'P-pairs -f'o
WAIVER
I understand that a pier, dock, mooring pilings,
must be set back a minimum distance of 15' frc
me. (If you wish to waive the setback, you must
I I do wish to waive the 15' setback r
I do not wish to waive the 15' setb<
(Property Owner
/"
Information)
"j
2S'z- 333 -O & --�D
Telephone Number/email address
Date
a
'Valid for one calendar year after signature'
1417 (z
oin
by
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I I M oTh 14 Itwer s
(Naine of Property Owner)
property located at ,�0 �4 �ree2P i �ood �k .
(Address, Lot, Block, Road, etc.)
on3LSquo -6nl< 21veY- in E- a2aheltn lit Eu N.C.
(Waterbody) (City/Town and/or Cou ty)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
✓ I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
50 Ob YIN yL Lkhe-o,D�
CO V S I v U C --tan Lk) 1 i'Pn PVC rs
I5fiv� P1 eV-.
WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.)
. I I I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
irnoi'hy Lt1 i %cam
Print or Ty e Name
c304I )cee2ew00J �- Ma7inC %r1qg Addres$ 1 a I
/r7ahZ it�[�Y
City/State/Zip
25-t- 333-0IT-40
Telephone Number/email address
z 9 MOW zOL3
Date
(Adjacent Property Owner Information)
lillj'/JIPIG/Llrl
Telephone Number/email address
Date
(Revised Aug. 2014)
n Places
*Valid for one calendar year after signature*

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