87158A - Atlantic Telephone Membership Corp

°t0"k XCAMA [I DREDGE & FILL N° 87158 ® a CPreviyq
us permit
GENERAL PERMIT Date reviousp
m Date previous permit issued
wrKNew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authortrsd byythe � �State of North Carolina, Department of Envir r mental Quality and the Coastal Resources Commission in an area of emeironmental concern pursuant to:
�t
ISANCAC 14- 16W El Rufes attached. ® General Permit Rules awaiailable at the folb link:
t { ,A/� t ` wiltg YL�!'ide30E ov
Applicant Name �,�!q AAxc- i(ryACJ2i'�bl"O. 1` C4iVi 3ry,�i C:Y'pquthorized Agent
Address V. 0 . £fOK 3 Project Location (County): VN
City .L3�ag, + lobe State �.�_.____ _ZIP x_�v 1_ Street Address(State Road/Lot#(s)
Phone # l ib)
Email Kin B,rli@Y� Subdivision
city
211 TO
Affected nCW DEW ®PTA E]ES X PTS Adj. Wtr. Body _th. ,1li"ItZi rya nan%unk)
AEC(s): nOEA �IHA �UW �SPIMA �PWS ClosestMaj. Wtr.Body......._-CKQWCIA h!�^" v
ORW: yewz) PNA: yes/00
Type of Project/ Activity
(Scale: N15 )
Access Length
Pier (dock) length .�
Fixed Platform(s)
Floating Platform(s)
i
Finger pier(s)
ai
Total Platform area
Groin length(#-
Bulkhead(Ripraplength
Avg distance offshore
Max distance( length
Basin. channal
Cubic yards.__._.
Boat ramp
Boathouse/BoatliR
.- -
- -
Reach Bulldozing-
1
SAV observed:
Moratorium: G
vas
Site Photos:
As
no
Riparian Walver AReched:
yes
A building permit/zoning permit may be, required by: J �1��+;isn_
may{ ityk7tr
- -
Permit Conditions
TAR/PAM/NEUSE(BUFFER (circle one)
11 See note on back regarding River Basin rules
ElSee additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES ANDCOND17IONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT (Please Initial)
compliance statement on
Application Feels)
Z/t
Check R/Money Order Issuing Date
Date

XCAMA ❑ DREDGE & FILL
GENERAL PERMIT
® New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N9 87158
Previous permit
Date previous permit issued
B C D
As authorized by--tthe11State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
/
I SA NCAC �' 16W ❑ Rules attached. ® General Permit Rules available at the following link: www.deq nc gov/CAMArules
Applicant Name 1C AAAQ. 14P1C filiNOaQ. 1' IPaM, S C�'"uthorized Agent kc, �41�jI. s5oc- C;�$ PA
Address Pr 0 .�i(. J 19 O Project Location (County): Wa Y\
City Shalkome State NL z I P 2V Street Address/State Road/Lot #(s) t.9_�w 4 31_
Phone#() 7S —A{�j it rD$Sil.cs dr ITt(kQrG(C �hGQ1!
Email KIrN DXd a mC r CIM Subdivision
City in Esr ZIP :279$y
Affected ❑ CW ❑ EW ® PTA ❑ ES © PTS Adj. Wen Body l" f (La f-O(,' Gre'e_ (C a&an/unk)
AEC(s): ❑OEA ❑IHA ❑uW ❑SPIMA ❑PWS Closest Mal. Wtr. Body CkDWCav\ � VC.r-
ORW: yes/Eb PNA: yes/.
Type of Project/ Activity
dk" G'11c5ric�
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger piers) ,
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other t� i t`PG1CCti�f0.t.� lSY't
SAV observed: yes
Moratorium: yes no
Site Photos:
Riparian Waiver Attached: yes n 1
A building permit/zoning permit may be required by: C W0LAn1tn Cclu,nJ!S
Permit Conditions
CONDITIONS
Agent or Applicant PRINTED Name
Signature *'Please read compliance statement on back of permit**
Application Feels) Check #/Money Order
Permit Officer's PRINTED
Issuing Date
(Scale: /NITS )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Z/ I
Expiration Date

n CAMA ❑DREDGE &FILL N� 8%158 tpl B c D
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:
15A NCAC ❑ Rules attached. M General Permit Rules available at the following link: wwwdeq nc gov/CAMArules
Applicant Name
City State
Phone # ( )
Email
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. Wen Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length _
Pier (dock) lengtt
Fixed Platform(sl
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ BoatliR
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: (yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: (' IA , CU0,�.'
—
Permit Conditions
(Scale: )
❑ 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
Agent or Applicant PRINTED Name
Signature "Please read
Permit Officer's PRINTED Name
statement on back of permit*" Signature
Check JI/Money Order Issuing Date Expiration Date
Application Feels)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION ��� rf Ej
DEC 18 2023
Atlantic Telephone Membership Corporation
Name of Property Owner Requesting Permit: dba FOCUS Broadband
CM—E
Mailing Address: PO Box3198
Shallotte NC 28459
Phone Number: 910-754-4311
Email Address: k k o Wern P,
I certify that I have authorized McGill Associates PA
Agent / Contractor
to act on my behalf. for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Installation of telecommunications
(fiber optic) conduit to extend telecommunications services to underserved areas
at my property located at multiple locations
in Perguimans County.
I 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:
Z /
Signature
Ke:
Print or Type Name
Title
1u / L / 23
Date
This certification is valid through

■ Complete Items 1, 2, and 3.
A. Signatu 7
■ Print your name and address on the reverse
X ❑ Agent
so that we can return the card to you.
❑ Addressee
■ Attach this card to the back of the mailpiece,
or on the front if space
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DEC 18 2023
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■ 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 snare nPrmite
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so that
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■ 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: /
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DEC 1 8 2023
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P.ALLARDS BRIDGE
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PIN: 699 W)O69203
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%—J'LAUNCHING, PIT
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L`EP'.ARTVENT CF
TRANSPORTATION
OF NC
PIN:689600849912,
689600848985,
689600859004,
36.7 )38,
—76.6334
POLLOCK SWANP
fE
5 M
JLI � t 2 1 J4 .4
1 1/4" FIBER
OPTIC CABLE
Tt:
" BUNCH, HAROLD
LLOYD & GAIL S
PIN: 780600043715
DELINEATED
LINELANDS
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SMALL E.)ITH
SIN 68a6C094 , _ '\ .
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jdJ1',% %- J
1 .A,N
CAMA GENERAL PERMIT PLANS T 1 1 SHEET
FOR
FOCUS BROADBAND FIBER OPTIC ROUTE LOCATION PLAN
FOCUS GREAT GRANTS 2022 M. NOfiTON A LdNDEpMILN RP-003
CHOWAN COUNTY, NORTH CAROLINA
Na+nox
PA IAPINSKY J. SIII, JULY, 2075 ]3.0I116 1505Mt