87252A - Tice, Roger and Jessica

ovomr4 ACAMUA DREDGE & FILL N9 87252 O B C D
-1F-N RAL PERMIT Previous permit '
Date previous permit issued __1l
❑New ❑ Modification ❑ Complete Reissue Partial Reissue
As authorized bythe�Sttate of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
❑ Rulesattached. [?(General Permit Rules available at the following link:w ..d nc, ovLCAMq(ilgs
Applicant Name._9 " .JI 611C TLC:. Cyi___�___. Authorized Agent- tin � r.cF]__._ _. _..._
Address l L1
CUr� o m� _. Project Location (County): C"rt- L
City _._.__.. M.d�OG�__State. ZIP _2.-1 V !7, %R. Street Address/State Road/Lot *(s)—fS I COtJ rhA 9Ll L f^ Y
Phone # () _______—
Email Subdivision _
Ci ty M a.Lt�t'],cYck r� Zf
Affected ❑CW �EW [ePTA ► ES QPTS Adl• Wtr. Body-9-p S.L-LO-I I; F.iJ0—'C nay( arVunk)
AEC(s): ❑om ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. We w ,r'tl {'rl ]r� �r�t4 �•i
ORW: Ve PNA: VellEo Type of Project/Activity .SN .a i- n.l t2 .r.I r h U k LLea eA
(Scale:
Shoreline Length 1
Access Length
Pier (dock) length
Fixed Poatfor net K012-iki LA 9V { M sty 1) GA4) C t�
iLluER
floating Platform(sl �''t. 10 . 1 �
1V VJDVc;)5 iEv 12G t Al w
Finger pieds) U L iC{E'i> ^'� L �..�
6 j{t�� ,
Total Platform area
Groin length/zl__,T_r+'�'
udkhead Riprap length Q''.Y2 �'tt sl1G$'�' i (7r U(�-'ll C!a GI: („�tyL,C• '/
Avg distance offshore C)r {{--i,-".cL-� ?-%py'i1f
Breakwater/Sill "� {
Max distanceEie,tgth r
Basin, channel 1
Cubic yards
Boat ramp
Boathouse/ Boatiih__
Beach Bulldozing
Other Temlp alc'11 tL ---
r T- \
SAV observed: yes ge tc.P ,\
Moratorium: Fie' yes no
Site Photos: Attw no
Riparian Waiver Attached: yes
t
A building permit/tuning permit may be required by: GllYl's
Permit Conditions _ ❑ TARIPAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
__� __tli+�.(� C_fdj(____.. .... _ __.�,_ �_..__� _.. ._ _ __.__...__. ❑ See additional notes/conditions on back
I AMAWARE OF STATUTES, CRC RULESAND CONDITIONS THAT APPLY TO THIS PROLECr AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) {vvvv
A t a A%/p�plic tPiRI TEO Na • e Permit Officer's PRINTED Name
Si nature lease read corn lance staterrtAnt on back ofpermit-
0 v��
g Id Signature
Application Feels) Check P/Money Order Issuing Date Expiration bate

DREDGE & FILL N9 87252 O B C D
GENERAL PERMIT Previous permit l _
Date previous permit issued l l 2
❑New ❑Modification []Complete Reissue �J PPartial 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 �r'llR • 1100 ❑ Rules attached. General Permit Rules available at the following link: wwwdeq nc gov/CAMArules
Applicant Name ea-lex
Address ( 5Y C Ur11r,11 AJ 6a
City KOJO�State )4<t ZIP 2i95'2
Phone # (_ )
Authorized Agent Lt111-Gn_ -Se-(1''�p(j_ U rt;
Project Location (County): C) rIt7LC'.�
Street Address/State Road/Lot #(s) tca ( COU C In
City
Affected ❑CW QEW PTA [ES [�PTS Adj.Wtr.Body / nat/(an/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body r LJ Ir r l C.� 52 VLQ
ORW: vets) PNA: ye no
Type of Project/ Activity _TN 5+j j L (2rn I tj b U k Lk exA _
u f
(Scale:
Shoreline Length J J23'3
Access Length _
Pier (dock) length
Fixed Platform(s) .
Floating
Finger piers)
Total Platform area
Groin length/JET
ulkhead Riprap length 1'2,0
Avg distance offshore b
Breakwater/Sill •''��
Max distance{ler Sh J� r
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing T
Other T CA Qa!C 1w
fe2tMG f L
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
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I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMEN
tJ
Agent or Applicant PRINTED Name Permit Officer's
-PRINTED
� Name
Signature "Please read compliance statement on back of permit** Signature/
�i b[�."d 2so8
Application Feels) Check q/Money Order Issuing Date Expiration bate

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date �, - V - 7 3
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent)
Lauren Berry Burch
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) % U 67 -,P,4 e� Vyoo�k . % a & /,- ,/
at (my property located at)
This certification is valid thru (date) Cu •- cf_ Z
Property Owner Signature
Date

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the malipiece,
or on the front If scene cermifs
W\\Wxd a CQZp 4"
155 co�t� C.�u
k, uc- a�gSFf
9590 9402 7485 2055 1985 69
B.
❑ Agent
Nelivery address different from Item 74 Q' Yes
IES, enter delivery address below. ❑ No
❑ Adult
7021 2720 0002 4028 0838
Delivery
Delivery Reahloted Delivery
❑ Pdodry Mall Express® I
D Registered Mail*a
❑Regisland Mail Restrictedi
Da very
❑ Signature Confirmatan^
❑ Signature Confirmation
Reatdcted Delivery
, Duly CUGU FUN 7530-02-000-9053 Domestic Return Receipt

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