87205A - Copeland, William and Alice

�oAtomr°'N❑CAMA ❑ DREDGE & FILL N9 87205 A B c
GENERAL PERMIT Previous permit
0 [,T] 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. 17 General Permit Rules available at the following link: v w vdea nc gov/CAMArules
Applicant Name
Address
City State _
Phone #
Email - ? rJ ti I
Affected ❑CW ❑EW
AEC(s): ❑ OEA ❑ IHA
zip
PTA ❑ ES KI PTS
❑uW ❑SPIMA ❑PWS
ORW: yes/no PNA:yes/no
Type of Project/ Activity
Shoreline Length
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision r
City
Adj. Wtr. Body
Closest Mai. Wtr. Body
(Scale:,, l ,. )
Total Platform area
MEN
Groin length/#
ME
ONE
ONE
Bulkhead/ Riprap length
Avg distance offshore
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MEN
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MIN
0
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A building permit/zoning permit maybe required by: Y�F+ti.+.. w-:•�, CCI
❑ 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)
Agent or Applicant PRINTED Name
Signature **Please read compliance statement on back of permit**
ii,Ls I
Permit Officer's PRINTED Name
Signature
Application Feels) Check p/Money Order Issuing Date
Expiration Date

DECEIVED
6-4-2,4 ptoV'
Permit Number ---
Locality b - i Ol11cr
, Shoreline Public Trust Shoreline.,_
OCeattHazard_-•c-.EstunrineShureline_�ORW DC.M EC
(For official use only)
GENERAL INFORMATION
LAND OWNER -MAILING ADDRESS
Address Z, Z OY n ,; 9 �, 1 9 [o L•I �-
1 \/� State _ _- Zip
Zrt1y�Phene
City N Vr i(�'r � _ .., ... 1, t ,.. - r n (,, nn . (1') M—_----�--
AUTHORIZED AGENT r 1 n
Address
City
State —.
Zip Phone
7mail
d/or directions to site; name of the adjacent water Y•
street name an .
LOCATION OF PROJECT: (Address, C
1 1` n;1 i
C)A f o 1 (� 11 1 ?t.lvtcn� Yel c{ul �S e
T i \(A eP N
lob (``[gvl'Yq (gees � cirr-brie
osed construction and land disturbance.)
DESCRIPTION OF PROJECT: (List all propF ,��• UYQ.
fur e �vo �o.. a
uar \001 A v)d acres / 6
SIZE OFLOTIA\RCEL: 4 O 3.b3 square feel 1 34
(Sin e-family
Multi•faznily ❑) Commercial/Industrisl ❑ Other ❑
PROPOSED USE: Residential .® ( gl
COMPLETE EITHER (1) OR (2) DELOW (C"nim tyour Local Permit 0, j)icer iJyuu are not tehich AEC applies
ro your proper0' square feet (includes
(1) OCEAN HAZARD AECss. TOTAL ee FL ed ahove ground F PR OSp DtSTRUCTURE'. c elevated above ground level but
air conditioned living space, parking
excluding non -load -bearing attic space) ZE
OTPRINT
US OR BUILT
(2) COASTAL SHORELINE
—square feet (incluti es8he area of theLDING Ofom dat on of nN build ngs, dHER nv R ay0s coveered decks,
UPON SURFACES:our calculations with the project drawing.)
concrete or masonry patios, etc. that are within the applicable AEC. Attach y
STATE STORMWATER hiANAGENiENT PERMIT: is the proje located is d area subject ce a State '
Stormwater Manage rent Pctmit issued b the NC Division of Ens .Aineral and Land Resources (DEMLR)'.
YES__ NO square feet.
If yes, list the total built upon areatim{x:rvious surface allowed for your lot or parcel: --

RECEIVED
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
lAN 3 1 2024
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation,�l(+^ n A —C
G
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connecti tot f Adl'V'
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1, the undersigned an applicant for a CAMA minor development permit, being either the owner of properly in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as'. (check One) a 1 � . j
m 1 r I I ' dCo Ile 1 �RI"C� ' }�,1ie �•ITc � NC.I
✓ an owner or record tide, Title is vested in name of '�u m Y S County Registry of Deeds.
see Deed Book+ 5 % page to - _- the .�t—_-
_an owner by virtue of inheritance. Applicant is an heir to the estate of
- probate was in
County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that i have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit-
(1)
(2)
(3)
(4)
v�Clemmcy)5 UC
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Z9 Pq9
ACKNOWLEDGEMENTS:
I, the urtdersigued, acknowledge that the land owner is aware that the proposed development is planned for an area whit
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furtl'ferroare 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
reload to this permit application. &A /% day of r�
I // This the �, 20 Y
n
ro t as hi I er ag nt for purpose of filing a CAMA permit appucanon
C✓
Thisapplicatian Includes: general ifonnatian (thisfarm), n site a)y a 8'ecktscribeclon or $10t1.00 madepayable te back qf thiso therlocaltN, and
ownership statement, the Ocean Hazard AEC Notice where necessity, fare
any it formation as arty beprovided orallyby, the
which maybe ist. sued. Deca"l viariton from he application
details willConstited by ute a Violation of
incorporated without reference in any permit
anypertna. Any persoa developing in an AEC without permit is subject to civil. criminal and administrative action.

1001 13KR44
:IVED
12024
-EC
?DNS e

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
PARK ISLAND RD
.YWOOD SC 29449
JANUARY 8, 2024
Date
RECEIVED
JAN 2 4 2024
To Whom It May Concern: DCM—EC
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
clearing and grading lot for future homesite and construction of future bulkhead and pier
on my property at Lot 36, Bethel Creek Subdivision, Perquimans County, NC (Pilot Court, Hertford, NC 27944)
in Perquimans
County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
Cynthia Rountree, Field Officer, Division of Coastal Management, Elizabeth City District, 401 S Griffin St.,
Suite 300, Elizabeth City, NC 27909.
If you have any questions about the project as stated above, please do not hesitate to contact me at my address/number
listed below, or contact ) at 252-312-3642, or by email at: [e-mail]
Sincerely, 'VOY
4/4�r
William Kelly Copeland
223 Burgess Rd
Hertford, NC 27944 phone: [phone]
V I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
n/l VIM
Adjac ntRiparianSi nature
Print or Type Name
ate
Telephone Number
Address tj,6<� City t,1 `` VI.,
� State S� Zipl Lt
Revised July 2021

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7020 2450 0001 0555 8268
PS Form 3811, July 2020 PSN 753002 000-9053
JAN 3 i' 2024
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