87280A - Overton, James

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❑CAMA ❑ DREDGE & FILL N9 87280 A B C D
GENERAL PERMIT Previous permit
Date previous permit issued ❑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:
I SA NCAC i i )f'�' ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc goy/CAMArules
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City {-S1 y t- ; :. d State fl) 1 ZIP .) -a t `f `a
Phone # (4 a) `�'I �' ..-.1 b 7 k.
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Affected ❑ CW ❑ EW
AEC(s): ❑ OEA ❑ IHA
PTA [71 ES ❑ PTs
❑UW ❑SPIMA ❑PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Mal. Wtr. Body
(Scale:
Access Length
Pier (dock) length
Platform(s)
Floating Platform(s)
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Groin length/#
Bulkhead/ Rlprap length
Avg distance offshore
Max distance/ length_
Basin, channel
Boat ramp 4
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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 PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial),', f
Agent or Applicant PRINTED Name
Signature -'Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
I �1
Issuing Date Expiration Date
Application Feels)
Check #/Money Order

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
I MMTI E
APR - 2 2.024
Name of Property Owner Requesting Permit: JF5MCLc L, OVIF-P_ ?gu LlCIV —EC
Mailing Address: 170 i C A m P fit= R R�j M
H L"P--rroP,D n!C 27446-
Phone Number: 232 S4g-267b
Email Address: 0v67276a,tt.Af CW C rAAIL Conn
I certify that I have authorized p H r L L I P N 82 R I t.rc Tv A/ 3
Agent / Contractor
�egr�ww�l ;ncC yam, co✓x-
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:tti
at my property located at Q 0 F7 C rl ►.me 4L
in c, ` County.
I furthermore 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 related to this
permit application.
Property Owner Information:
Signature
-L, n rC PTorj
Print or Type Name
Title
o4 I yr 1 Z 4
Date
This certification is valid through

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)
RECEIVED
Name of Property Owner: _74 `y1 E5 L 0VE2 i o iJ APR - 2 2024
Address of Property: %-I- <A T' / C,<r'FW2 DCM
naEC
15.4
Mailing Address of Owner:• n c IVI
Owner's email: Oggr-tUA/k525yvk4(•(.�^Owner'sPhone#: 7S-2_Syt?-?cs7w
Agent's Name:
Agent's Email:
Agent
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,
if you have objections to what is being proposed, you must notify the N.G. uiviston 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 (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 Owner:
Typed/Printed name of ARPO: phi • 'yke—N7 %4, ,iZ.
Mailing Address of ARPO: c-NNN PE.?,i X P.h, H I~2'CFoRfl , r� C
ARPO'semail: �2c��C�e �,@coM prj-q,j(c-ro(c(4- 2�944
ARPO's Phone#:
Date: 04, CA 202'k *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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
RECEIVED
(Top portion to be completed by owner or their agent)
APR - 2 2024
Name of Property Owner: S(A (Ac 5 �- 0V6 117`b n)
Address of Property: LAMp P�-9,ey k, ENE&TFbt�ACM-EC
Mailing Address of Owner:
Owner's email: C�VEKTb PJ-S(A©Grnnr( Owner's Phone#: ;2.5
Agent's Name: Agent Phone#:
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
]-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 oniv 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
No
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
' r A1IrvPIVp—
TypediPrinted name of ARPO: ii r(axit vy , �) tt�
Mailing Address of IARPO: I I z �. c� pemr IZa , 'Aerr++,h wC 2 rT7 )y
ARPO's email: 'f�W 64t6. 6 V 4 M4 CMV1 ARPO's Phone#: ZJr Z ' �i Sq- 9Z I
Date:*waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

RECEIVED
APR - 2 2024
®CM -EC
G', CAW PCRf<,j.-r,4
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234'

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