87171A - White, Adam

❑CAMA ElDREDGE & FILL N© 87171 A B C D
Previous permit
. GENERAL 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. ❑ General Permit Rules available at the following link: w .cleg.nc.gov/CAMArules
Applicant Name _
Address
City i
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 Mal. Wtr. Body
ORW: yes/no - PNA: yes/no
Type of Project/ Activity
(Scale:)
_Access Length
Pier (dock) length
Platform(s)■Sliil:��
■
■■
■
■
■
■■■■�
■S■Fixed
A
CCU=��■C■
milli�'■■"�
I
Floating Platform(s).
■■
Finger pier(s)
MEMNON
:... :..
■..
i■
.
...■
.
ii■■.n■i■■...
I
IN
t
■
N■EE■■■■■
...SEEN
■
mammon
0■■■M■■
��
.■�
■
SEE■■..■■
EE■NN
■ME
■■
■■
�■f�
N
■SEE■■■■SEES
MEN
■■�■■
A building permit/zoning permit may be required by:
Permit Conditions
❑ TARIPAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) '! i
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature *'Please read compliance statement on back of permit**
(.�Vr� '1
Application Feels) Check M/Money Order
Signature
Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: AACA A CAA 'A e
Address of Property: L ± IV i
Mailing Address of Owner: K 09 -
r eo: VVLON
C-
( I jv r.1 C
'
11
Owner's email: ClAo v\SIAAAaykA
�u0M60.<0—
�ctw>
Owner'sPhone*
A2 56G 1- kc)00"
Agent's Name: lGrlderi rWflYnE. Agent Phone#: &313
Agent's Email:
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
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 or 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
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 �� { (� -R E C E !VE 1."k
Signature of Adjacent ipariah Property Ow
M
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed
Mailing Addres
ARPO's email:
v
Date: �' 'waiver is valid for up to one year from ARPO's Signature'
FEB 0 9 2024
®l.e1Vl"Ec
IV( Z 1`10'1
Revised July 2021

. __...._... _
QjA;Ml�EpDREDGE �k SILL N®PERMIT 6B C o
❑Modification Pow permit #
OComplete Reissue OPatYial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Depattment of Environment and Natural Resources
and the Coastal ResourcesCommissionin an of environmental concern pursuant to I SA NCAC n I+ • j 10:3
Applicant Name % �_ �n ! �'�' + attadted.
� � r-•' Project Location: Countycta� cat 1 C
Address - Street Address/ State Road( Lot #(s)
City_- a 7 C,�state C- ZIP Z-7 l
Phone # ) 82q* E-Mail Subdivision
Authorized Agent City EZa Z- C-Aw
I__—__—_—__
Affected q cw t�EW V(PTA $DES ❑ PTS Phone # (_) River Basin '-I
AEC(s): D CEA ❑ 14mF ❑ IN ❑ URA ❑ N/A
O PWs: Adj. Wtr. Body 1'KSa7t..tzr,&r41e—t Oman /unkn
ORW: yes /(!g) PP1A yes J,!�) Closest Maj. Wtr. Body
Type of Project/Activity t
3
(clock)
length
21lhlZ lAWG1CuMs+ Atia�) tiiGlM An (Scale: 1=(oor )
Pier dock
(bred Platform(S)
Floating Piatron i(s) -= -I-� j- ! t
Finger piers) I - _ i
Groin I�' ` I_ j
k'gtl' (FT�: �1 '1- _I_ -'-- It
}--- I
number
Bulknead/wpiap lergtF��i�l_
evil distance oit ioraa I
max distance offshore_
Basin, channel
I--. LJ—L1_
cub ,
i
k yards 2 - -. - __
Boat ramp
Boathouse/ Boat4ft
ti
Beach Bulkkrrirg
Other
I
--@f
I. _J
sh,araah.i�
SAY: notstxa d!!D no C
Moratorium: yesno
Photos:
Waiver Attached: yes
A building permit may 6e rexluired 6y; %4c.p (1[ ��(� y (/ ❑ note on back
( Note Local PlannhV jurisdiction) -� River Basin rules.
Notes/ Special Conditions ja) �'�(A )� ytd1 2t K1+-k4e944AQ
Pro posed
615 -F+ 0elotaeerle^i, 8"1I.14-eote:!
i-ly/.r51 flejoluael�Me�T ,pt'A/
Z)e-c 1. 7'n 0 1 P r7acn.% F v,,-, e-
r
FEB 0 9 2024
DCM-EC

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: +Y\(Ynvin OV Ae
Address of Property: C JC-C,S ^GCc V A
i r
Mailing Address of Owner: rt + �% l��" �{ C + ( :Z7aCCl
Owner's�1�a5�Gv Cf ctvlC� lr~�,� ✓
emai: Owners Phone#: 2rJv2 c7�2 \OG��
Agent's Name: Agent Phone#: a5-�*-33!"
Agent's Email:
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 forthis
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//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. unnsron or coasraf
Management (DCM) in wilting within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Gr ffrn 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
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_) RECEIVED
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner FEU 0 9 2024
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
DCM-EC
Typed/Printed name of ARPO: Bj /�>i3aaa J-1 kili/ !J P141196
Mailing Address ofARPO:�Qf7�7,L�izr�E711L /✓T �1/G
ARPO's email* 4�,,elH -� ARPO's Ph e#: ;;�-5 Z_ Z-7-
'Inn i I . Cony
Date: ' ! c<'! -_ *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

jA;;EjDRE1)GE & FILLNo 6733®PERMIT B c o
iflption GComplete Reissue GPartial Reissue Previous permit #
Date previous permit Issued
As authored by the State of North CaroNtq, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 1 SA NCAC n if - 1 Tex,
Applicant Name �JJ/J� � , fe I?wdesattadwd.
Project Location: CountySE7s [�
Address___1&2& f Street Address/ State Road/ Lot #(s)
City l 7 CA !: State C- ZIP Z�_ t�f l/Z Y1 7 [ tiyyL
Phone#(L�Z) L t�E_Mal
Subdivision
Authorized Agent Cny 421Z jam_____ 23P— 2! x
Affected 0CW JQIEW D(FTrA 4M [3M Phone# (_) River Basin
�g�try�yj t{[f
AEC(s): OoEA 011 ❑IN 0U13A ❑N/A
❑ NVS: Adj. Win Body. �dSe7t {t�Tnnnl+C fd tlhnan Lnkn
ORW: yes /® PNA yes J±�i Closest Maj. Wan.Body t&t_
Type of Project/Actifft t 3 svt
21 RFf1 a s>UCwm, Anal) �ilnM-1 ,n� /
Pier (dock) lemth (filet 1 -Caat9 )
Fix
Flo
Finl
Gn
Bull
Basi
Boa
Boa
fs a
Oth,
shor
SAV
Mon.
Phot
Waiv
d Pladorm(s)
{_i_
'
idng Platform(s) {L-L-L�
in
number L_
:head/ wprap length f
a"g distance offshore_ -
..
3
, I
, !
L
1
i.�.
i
1
max distance oRshorc_� (
- _ -_
i
t. channel
� ,,
--- _L
141
t
i�
cubic yards
_
!
'
house, Boadift
__,5
14
t
h Bulkloring-
r!
1
�
-
I
dine Length_!=-
---41!
i
'torium: a yVS M
lip _...
_j.
wAttached: yes
l
A building Permit may be reyimcd
( Note Local Planning jurisdiction)
Notes/ Spechd Conditions
P/'0 paSd&I
❑ See note on back regarding River Basin rules.
I
b
FEB 0 9 2024
DCM-EC

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