87161A - Mitchell, Charles and Allyson

DREDGE & FILL N° 87161 a C D
GENERAL PERMIT Previous permit
Date previous permit issued
New ❑ ModiTication [-]Complete Reissue ❑ Partial Reissue
As authorized by a 5([je of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
.IfI SA NCAC l / r (Z ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City Cm�n,,G�o
Phone # ([,0Z)
Email C1 s &L i
_state Nbi ZIP
-9o5(n
Affected ❑CW�
AEC(s): OEA !MA
ORW: yes/ o PNA: yes
Type of Project/ Activity <1 en
n s A t.S 0-
Shoreline Length 7
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) -.
PTA PTS
UW ❑SPIMA ❑PWS
N ( C_
Total Platform area
Groin length —�
eulkhea Riprap ngth
m'
Avg distan ore
Breakwater/Sill —'
Max distance/ length,
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozin
g
other. 11,/jk ♦^ u-C/C.�. z/D�
e I- ti u C, 1i<
Authorized Agent 44la A4, c En 1/ 1 1`1
Project Location (County): 'Z>�
Street Address/State Road/Lot #(s) Pa.(c�- 0/(� ,74' /
Ad-t a 'Y
Subdi V. �'iil �Q.r V)Ji e.�.
City Avg^. zip 279/s
Adj. Wtr. Body r 0, i� I-, c.8 .) o uKi
Closest Maj. Wtr. Body /- 6L �L t/7 Gam+ -T'a
SAV observed: yes no ,S x o 'J
Moratorium: /a ye no
Site Photos: es no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: <D c C. -
Permit Conditions
IAM
r hlQ-/,zgq_-r11**--jj% c- (Scale: N'rJ/'�)
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4Lot'b o ro Mq i-�
PL
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial) )K A-;0
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Sig f ureC-**P` a read re compliance statement on back of permit" / � � Sign
L`7 U y, q �a / 8 2
Application Feels) Check tf/Money Order Issuing Date Expiration Date

°�" pCAMA ❑DREDGE & FILL N9 87161 (A `'B C D
Previous permit
'i
GENERAL PERMIT Date previous permit issued
3 New ❑Modification ❑ Complete Reissue [:]Partial Reissue
As authorized bythei1 State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
J
I SA NCAC ❑ Rules attached. ' ❑. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name'IE'-S `LLt_ /i 1 1v 1'aA m
Address
City '�_'� n < o r'ci. State NO zip C
Phone # (f�frr=.zl)
Email � k ° Mc -
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTs
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Authorized Agent trt "f L n--1-, c E- n Y i r-, P. ht u n A, �_..
Project Location (County): �Z>ct- r z_
Street Address/State Road/Lot #(s) P0. (« O j yam/ z, /
Subdivision
city %l " ZIP Z-1 r 1—
Adj. Wtr. Body l � r, (f) c_ 'a J � �.. 'Cl : (nayman/unk)
Closest Mal. Wtr. Body / V c -''"'- �% < - _.S ^ U I J-
o._ i . ,"(k j ( E. y! -if Q :
n
v e-\ vx, _� 4/ t - b :v- (Scale: N'(—F )
..... ...... ....o. .
Access Length-
ati
J
I
I
-L
Pier (dock) length
_
Fixed Platform(s)-
L`
Floating Platform(s)
i
�•.�
Finger pler(s)
�
r4
Total Platform area
J
(
i
—
I
_
Groin length/fE _
1
T
1
I
Bulkhead �Riprap lgng[h �% iA
�
-���-
Avgdistanceaffsfiore
—
i—
Breakwater/Sill -`-
Max distance/ length �<
_
J
Basin, channel
Cubic yards
-
I
t.
Boat ramp
._—
_
-I�
7
):_,
z_
�•
,,�
__—I
— -
__
—
Boathouse/ BoatliR
Beach Bulldozing
Other i-„tn'
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no —�
—
—
-
-
—�-
-r--~
Rioarian Waiver Attached: yes no
A building permit/zoning permit may be required
Permit Conditions
�D <,, C- 1�, r `+
❑ 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 THATAPPLY 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 Jf/Money Order Issuing Date
Expiration Date
I

AUTHORIZATION TO ACT AS REPRESENTATIVE FORM
Property Legal Description:
DEED BOOK: 2055 & 2287 PAGE NO: 0323 & 0236
PIN NO: 063020913583 & 063020914730.
STREET ADRESS: 40175 CC Gray Road
Please Print:
Property Owner: Charles Mitchell.
Property Owner:
The undersigned property owners of the above noted property, so hereby authorize
(Contractor/Agent)
(Name of consulting
Act on my behalf and take all actions necessary for the processing, issuance and
acceptance of permits and/or certifications and any all standard and special
conditions attached.
2. Enter the property to obtain site information including inspections with regulatory
agencies (Dare County, North Carolina Department of Environmental Quality,
U.S. Army Corps of Engineers, etc.) for the purpose of obtaining permits and/or
certifications.
Property Owners Address (if different than property above):
59 Hooksett Turnnike Road Concord NH 03301
Property Owners Telephone Number: 304-687-1509
We hereby cerh'1y that the above
accuraterro ie bak of ojdv469oYA
Authorized , i?gnature and Title
Date: J _
submitted in this application is true and
Authorized Signature and Title

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Charles & AIIyson Mitchell
Address of Property: 40175 CC Gray Road, Avon, NC 27915
Mailing Address of owner: 59 Hooksett Turnpike Road, Concord, NH 03301
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Doug Dorman
Agents Email
[e-mail]
Agent Phone#:_252-599-2603
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
description or drawing with dimensions must be provided with this letter.
N .7. 1 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 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 f7ulkheads or nprapre_vetments). (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
of Adjacent Riparian Property Owner
-OR- T
I DO NOT wish to waive the 15' setback requirement f initial the blank) A( i
Signature of Adjacent Riparian Property Owner: (A V.=
Typed/Printed name of ARPO: Natalie Trunow
Mailing Address of ARPO: 4015 Thornapple Street, Chevy Chase, MD 20815
ARPO's email: [e-mail]
ARPO's Phone#: [phone]
Date: 01/19/24 *waiver is valid for up to one year from ARPO's Signature"
Revised August 2022

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property owner: Charles & Allyson Mitchell
Address of Property: 40175 CC Gray Road, Avon, NC 27915
Mailing Address of Owner: 59 Hooksett Turnpike Road, Concord, NH 03301
Owners email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Doug Dorman Agent Phone#: [phone]
Agent's Email: [e-mail]
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
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 or uoastai
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 (Choose only 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 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
Signature of Adjacent Riparian Property Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property OwnsF-__.JJ I M,
Typed/Printed name of ARPO: Harvey D. Scarborough
Mailing Address of ARPO: PO Box 347, Avon, NC 27915
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 01/19/24 *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

Carver, Yvonne
From:
Sent:
To:
Subject:
Attachments:
Good morning Doug,
Carver, Yvonne
Monday, February 19, 2024 9:24 AM
Doug Dorman
Mitchell GP
MITCHELL GP87161-02192024091938.pdf
A copy of general permit (GP) number 87161 authorizing the shoreline erosion control
project at Mitchell's property off C C Gray Road, Avon, is attached for your review and
signature.
To validate this permit, please address the following:
1. print and sign the permit on the bottom left-hand corner below their printed name,
2. initial where indicated on the bottom right of the permit, and
3. scan and send a signed copy of the GP back to me.
If you have any questions regarding this correspondence, please don't hesitate to contact
me.
Thankyou.
tom~
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-621-6453
401 S. Griffin St., Suite 300
Elizabeth City, NC 27909
1

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