87182A - The Pony Pen

.F ILCAMA q�-DREDGE & FILL N9 87182 �j B C D
Previous permit
I
GENERAL PERMIT Date previous permit issued
ew ❑Modification El 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:
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SA NCAC / 2- c( — lk ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwdeq nc.goy/CAMAmIe
Applicant Name I h,,L- P DA y 1 s.n / LL-/C� Authorized Agent - / e s...,o r-1 ' 0s i
Address O - e5 r G/v r') Ae C Y- u-f-''� Imo- Project Location (County): r-Q-
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City State ✓4 e40 `7"%2"%2 ZiY��-r Street Address/Suite Road/Lot N(s) .1; us���
Phones ( ) ci'c%y / L7e. / y"r` c i d';,
Email G Subdivision
City 1-6,1 r S ZIP 299vs
Affected eW ffm ffn" r
AEC(s): ❑OEA ❑IHA ❑UW
n.
ORW: yes/�I ) PNA: yes/t,Yc�
Type of Projett/ Activity — ,1 -5
n„ f fe CXce-e-A Z
Shoreline Length r o c� v
Access Length
Pier (dock) length
Fixed Platform(s)
I
Floating Platform(s)
i
Finger pler(s)
Total Platform area y
Groin length/p
Bulkhead Riprap ength U iJ
Avg distance offshore Co /
Break er SIII '�
r
Max distant length �a
Da-sfn,t annel
r
Cubic yards
Boat ramp ~
Boathouse/ Boallift
Beach Bulldozing
Other
t.A
❑ ES ❑ PTS Adj. Wtr. Body e (xAA j? & s a 4 n CL II C (_na_t�man/unk)
❑SPIMA ❑PWS Closest Mal. Won Body Pc M.17 C c, S, S C
r� � i� A0.P 00e✓.a_.�ln.r�i �a>G /M.s. n.. = -Sam �
a.r��. TAe�t�o��e✓e �j�a� (Scaled✓e �1�� (Scaled
rr.-• �.
Qa¢Mnm•n`t ��.�/Ch�`1
a 5 Sose
OD oaJ
v nssa�J
SAV observed: yes < no s{
Moratorium: n/a ye no
Site Photos: es no
Riparian WalverAttached: yes ni)
A building permit/zoning permit maybe required by: a- st 'ej
Permit Conditions
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sus t,( s
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-y-t-- h ^se
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❑ 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), PC DAD
vtoo tD Dorman yVonn2 C-4rv�r
Agent or Applicant PRINTED Name Permit O flcer's PRINTED Name
C:g�-
Signaure' lease read compliance statementon back of permit" Sig re
T
Application Feels) Check N/Money Order Issuing Date Expiration Date

AMA ('DREDGE & FILL
GENERAL N;P!rWew ❑Modification El Complete Reissue ❑Partial Reissue
N° 87182 G B
Previous permit
Date previous permit issued
C D
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 �- Z { — & ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name I Le- )PO' I 1 ¢,6 / LL/ J
Authorized Agent 2D 6 c
q �o iMa"
Addres o/
%�
e5 r C(.i'TS Ax C-'-" a-[--ry
Project Location(County): ..--f"'�-
City a-
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State ✓/✓/� 023o9y ZiP- Bt{GGt
Street Address/State Road/Lot
s, /zss j A
arc�e..
Phone#( ) AS7'T
Qom/
J�7/ia( &'",//G.
Email C Cawit
( ctc4>x--
Subdivision
City
zip 279Y3
Affected ff CW
ENT f PTJi ❑ ES ❑ PTS
Adj. Wtr. Body QM 1) tyv
Satin � an/unk)
AEC(s): ❑OEA
❑IHA ❑UW ❑SPIMA ❑PINS
Closest Maj. Wtr. Body t'�-r..1•c'J
��vM1CL
I
ORW:yesir.
PNA: yes/(�)
Type of Project/ Activity,
"10�— �-b. C-XCc-�d t
Shoreline Length { / 0 D J
Access Length
Pier (dock) length
Fixed Platform(s)
r
Floating Platform(s) a
i
Finger pier(s)
P
Total Platform area .o
Groin length/#
Bulkhead Riprap ength 00
Avg distance offshore �o
Breakwater Sill
i
Max distant length Ea
Basin, c anneI
Cubic yards r•
r
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
Other r
If
NO
L
^ S tSOOC
O pa.�aJ
y a.J
e
(Scale: /J',
R IV
dim �a BL-
BklloQQs
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: es no
Riparian Waiver Attached: yes nd ---=t-
I
A building permit/zoning permit may be required by: a J -ill
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 Initial)y�
/ I/o/J.t.2 C.arv'cr
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signaure'*Please read compliance statement on backof permit'* Sig reed / / q C�
/ �p /JU� rx[ �-�1 aY ln�///� 1
Application Feels) Check ft/Money Order Issuing Date Expiration Date

❑CAMA ❑ DREDGE & FILL
GENERAL PERMIT
NO 87182
Previous permit
Date previous permit issued
A B C D
[]New []Modification []Complete Reissue ❑ Partial Reissue
As authorized by. fie State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A I — — r/ W- ❑ Rules attached. ❑ General Permit Rules available at the following link: w Ae .nc.gov/CAMfvules
Applicant Name
j
-
'� �s
Authorized Agent
r
/� /
I- '1
Address
7' > °` '
Project Location (County):
r
City
State +'
ZIP
i-'
Street Address/State Road/Lot#(s)
<'
_} .2 / d�<i1-s `. I A
Phone#O
,��6�%'�l
. <:.t %�<.
C-:�tJ•.
ec�.
Email
SubdIVlsl n •_..~
City. (�+"�'�wZS>
i
ZIP � / r/..
Affected ❑ CW
❑ EW
❑ PTA
❑ ES
❑ PTS
Adj. Wtr. Body / `a ' / S
t
•'• `� ', C`^ (,(nat%ipan/unk)
AEC(s): ❑ OEA
❑ IHA
❑ UW
❑ SPIMA
❑ PWS
Closest Mal. Wtr. Body
C ;
I
ORW: yes/no
PNA: yes/no
Type of froject/ Activity • . � O ��:•. ,� .*,' e ✓ � � - ; N z ; �` -- � .. >< , ,rt � �•, - -5
I
(9 ; n c(a¢�- c� b'� v4 ✓,,. �F)a n 4 (Scale: N
shnrolino I ono h k .> I 4, L -,; ,
Access Length
Pier (dock) length
Fixed Platform(s)
W
11
i®
■®
■■
Nil
Floating Platform(s)
Finger pler(s)
Total Platform area
Groin length/#_
Bulkhead/ Riprap length
Avg distance offshore
®
■■�
No
mom
0
■■p�
■■
■■■■H■■■
■INN
i
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 PROJECTAND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature --Please read compliance statement on back of permit*•
Application Feels) Check ft/Money Order
Signature ,
Issuing Date Expiration Date

AUTHORIZATION TO ACTAS REPRESENTATIVE FORM
Property Legal Description:
DEED BOOK: 2622 PAGE NO: 0573
PIN NO.: 959513130707
PROPERTY STREET ADRESS: 57161 Pricilla Curve Road Hatteras. NC 27943
Please Print:
Property Owner: The Pony Pen LLC
Property Owner:
The undersigned property owners of the above noted property, so hereby authorize
Doup, Dorman of Atlantic Environmental Consultants LLC to,
(Contractor/Agent) (Name of consulting firm)
1. Acton 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):
2501 Hayes Road. Haves, VA 23072
Property Owners Telephone Number: 757-254-4901
We hereby certify that the above information submitted in this application is true and
accurate to the best of our knowledge.
u 6..
An d Signature a Title Authorized Signature and Title
Date: A Date:
Scanned with GanlSeanner

I

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: The Pony Pen, LLC -Christopher & Sarah Bucci
Address of Property: 57161 Pricilla Curve Road, Hatteras, NC 27943
Mailing Address of Owner: 2501 Hayes Road, Hayes, VA 23072
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Doug Dorman Agent Phone#: [phone]
Agent's Email: dougdaec@gmail,com
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. 6
description or drawing with dimensions must be provided with this letter.
Q 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 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 riorap 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-
1 DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: l"�lG_/_._�-•--•--- - .
Typed/Printed name of ARPO: Robert & Patricia Beran
Mailing Address of ARPO: 114 Deer Road, Boyers, PA 1620
[e-mail]
ARPO's email: ARPO's Phone#: "1" aK - t� t- O -.a-.`7
Date: 01 /25/24 *waiver Is valid for up to one year from ARPO's Signature*
Revised August 2022

DocuSign Envelope ID442BEEC5-8858-4E68-9478-E8CBB47DC7AP
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: The Pony Pen, LLC -Christopher & Sarah Bucci
Address of Property: 57161 Pricilla Curve Road, Hatteras, NC 27943
Mailing Address of Owner: 2501 Hayes Road, Hayes, VA 23072
Owner's email: [e-mail] owner's Phone#: [phone]
Agent's Name: Doug Dorman Agent Phone#:_252-599-2603
µ
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
description or drawing, with dimensions must be provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
rr you nave oDiecaons to wnar is Demg proposea, you musr noary me rv.4. wrvrs,on w wasrur
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 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 _______,____ ---djacent Riparian Property Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: L_
Typed/Printed name of ARPO: Allen & Marlene
Mailing Address of ARPO: P.O. Box 24, Hatteras, NC 27943
ARPO's email:
ARPO's Phone#:
Date: 01/25/24 *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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Carver, Yvonne
From:
Sent:
To:
Subject:
Attachments:
Good afternoon Doug,
Carver, Yvonne
Tuesday, February 20, 2024 1:49 PM
Doug Dorman
The Pony Pen GP
THE PONY PEN GP87182-02202024134652.pdf
A copy of general permit (GP) number 87182 authorizing the riprap revetment project for
The Pony Pen LLC in Hatteras is attached foryour review and signature.
To validate this permit, please address the following:
1. print and sign the permit on the bottom left-hand corner below your 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.
t�"M
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
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