87187A - Sabol, Richard and Jean

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GENERAL PERMIT NOVIOUpernait
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❑DREDGE & FILL N9 87187 Ae SB C D
GENERAL PERMIT Previous permit
Date previous permit issued
I�Tvew ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by t�h..er S e of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC I �f 1' 6 ❑ Rules attached. eneral Permit Rules available at the following link: www.deo.nc gov/CAMArule
Applicant Name K % C�K card 'f— ) -g ck ^ ,5 e, b m f
Address sip Sihn I'I S4 of oSSf 19 Dr -
City ki / I oR t/ o tate Al C- ZIP '%% % N 6
Phone # (&Lb)
Email rt (.i ;5 4 e
I (u ((d 9 M ) 1c,.•
Affected ❑CW
AEC(s): ❑ OEA
ORIN: yes/no
Type of Project/ Activity
IHA ❑UW
PNA: yes/no
Shoreline Length T 9 0
Access Length
Pier (dock) length
Fixed Platform(s)
t
Floating Platform(s)
Finger pier(s)
t
25 (� F
Total Platform area
Groin length/#
_
Bulkhead/ Riprap length
;..f
Avg distance offshore
Breakwater/Sill
_ --,- --4-
Max distance/length
i
Basin, channel
i
Cubic yards
— I....
�i
Boat ramp
Boathouse/Boatlift
I
i
Beach Bulldozing
Other`(
i Div
i
SAV observed:
Moratorium: n/a
yes no -- //�
ye no _'V- Y
Site Photos:
Riparian
ye no ry
',
Waiver Attached:
es no •y _.
A building permit/zoning permit may be required by: _
Permit Conditions
Agent or Applicant PRINTED Name
❑ ES ❑ PTS
❑SPIMA ❑PWS
APPLY
Sig ture *`Please read compliance statement on back of permit*`
`�0V I D I I
Application Feels) Check #/Money Order
Authorized Agent /n b4" CP
Project Location (County): e-
Street Address/State Road/Lot #(s) _
_,282 -s"WL fYS* C
Subdivision L f%rTS
City
Adj. Wtr. Body h !C
Closest Maj. Wtr. Body _�_19
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a 55'i 11L6
�s o L
(Scale: AJT )
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❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
NU nllt'VI1�t,WGU LUMPLIANNCE STATEMENT. (Please Initial)
uDrI,. CsJa�—(
Permit Officer's PRINTED Name
ce—�
Sigr64) —^ �
lz y /a. z l2 y
Issuing Date Expiration
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit, ,t.v 9'I p6
Mailing Address:
Phone Number:
Email Address: w K �.P-1 S?EK P VC-P 1 -00/ &l;-77-
1 certify that I have authorized 70 CK 2, +-r
Agont t Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessaryfor the following proposed development: 16x16 lower landing
With stairs
at my property located at vs/� u rrtiG
in 4P,41 116 County,
i furthermore certify that t am authorized to grant, and do in tact 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 Ittformation
tgnattira
Print or Type Name
Title
Date
This certification is valid through / ;� 1 - / 1 7-
Revised Mart. 2016

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(Top portion to be Completed by owner or their agent)
Address of Property:
Malling Address of a
Agents Name.---------m-- AgentPhonetk
Agents Email`.
APAACENT PAPAWN PROPERTY OWNER'S CERTIFICAftON
Mg tb ° r'oa 12, be g=b d W lb Adtaceat Property Owner)
am
A
i 00 NOT have objections to this proon al. I DO how objerficnsto this PrpPosaf;
...groin meet be Set DOCK a':MIMMrnn CM513"w 01 ja
(this does not apply to bulkheads or'tiPMP revetments). (if you wishto Wswe the Setback, you=gtpst elan;
the appropriate blank =b IM)
i DO wish to waive sotnelaii of the 15' setback—
SignatureofAdfar RiparlanPropertyOwner
AR -
I do not wish to waive the IV setback requirement (initial the blank}
Signature of Adjacent Mparian Propetty fawner
TypedIP4ntRd nameofARPO: `7a1anl d�rfi i
N1ingAddressofARPO: fStfl1lv'$7 rsa?trd� 77
ARPC'S email. , & ARRO's Phone*
Dade: 0 � X:'� Z,,& '� Ner is valid for up to one year fromARPO's SignatuW
RevisedJuly2021

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