92642A - Lee, James

o��`°�'�aOt`AMA ❑ pREDGE & FILL N° 92642 ®B C D V
G E N E RAL permitPrevious
PERM 1 T Date previous permit issued , l
ew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources ComMssion in an area of envirtmmemal concern pursuant to:
I SA NCAC 4"? /--1 . t 2 o e? ❑ Rule attached. ©-Tworal Penh Rules mlhble at the following link W"__dea.BLgw/CAMAnint
Appbont Name �M 42Z5 LtS Authorized Again t n.0
Address rFO Sax 2 Jq /. Prooct Location (Canty): 15, are 19 r
CKY4& f7..'F'ryJ State _y_�_ LP _ - 8S Street AddriitrOute PmNLot #(s) 43 9J4tj'6N-A2 a An
Emiss! Itti., ft,e35/ (aj w1 w.� ae a+^ Subdivision �sl-�tusa� �.
city zip 2
Affected ❑Col LJc" � ES ❑pn Adj. Body 4-1-.QiF'N1r94! �e T�V� (nar/maNurdt)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closet Mai. Wv. Body 0`k Aht"st9gG�.sOa�s�i�
ORW: yes no PNA: yes/ o
Type of Project/Activity d5erwyb �k /"FSS /CYL i /5- /tr 244-r
r G
/ V "f Z- s ?V- z � , + �i �jn(� ?7 � 5 t (Scale�j )
/ Shoreline Length t' T O r
Access Length
Pier (dock) length
Fixed Platforms)
Fioadng
Finger pier(t)
Total Platform area_
Groin length/N_
Bulkhead/ Rlprap leni
Avg distance offshore
Breakwater/Sill—
Max distance/ length
Basin, chaiv el_
Cubic yards
Boat ramp
Boath u / Boatlift / 9" K Zr e
Beach euliduzing
Other
SAV observed: yes
Moratorium: n/a yes no
She Photos: vas
Riparian Wahter ARac ed: 3'Pbsl
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A building permw. inggppermit maybe required by: ez
Permit Condidon3- ,1f2AzAf!r= = ff{� (s•��/y - ( n/Sf^/^
(C A / 2-O U
n JM Q4 n d Agent or Applica- nt PRINTED N. Na � er [O er
Signature • ease tea$ wmphanc statement on beck of permitSi atwe t
Application Feels) Check p/Money Order Issuing
❑ TAR/PAM/NEUSEJBUPFER (circle ones)
❑ See note on back regarding River Basin rules
❑ See additional notes/oondtdons on back

PdAMA ❑ DREDGE & FILL N9 92642 <�!ZDB C D
Previous permit rt (�
.: Date previous permit issued �i
GENERAL PERMIT r a
JgM ew ❑ 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 di r-1 • f.svJ
❑ Rules attached. © eneral Permit Rules available at the following link: www.deq.nc.eov/CAMArules
Applicant Name J 4-'n E7J Lt-s
Address r✓d aax 2/0
Ci '0yA042 *7-> State_/ zip Phone # 472) 6,571 - 9
Email 15&r nt % a,/ Ce .+1
Authorized Agents
Project Location (County): 15&-4&T71--
Street AddreWState Road/Lot #(s) 43 %�GLl�sz. O A-
r/D�P�
Subdivision Gig 4-L-ww-
City ��r/.%,S �L ZIP
Affected ❑CW EJ'E�W [kpRtr ❑ES ❑PTS Adj. Wtr. Body A.airr^M/4--Z e 7-� (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. Wtr. Body
ORW: yes no PNA: yes/ o
Type of Project/ Activity zf-� f,1ST--VrD
/ d t'r Zia ;,,j��22 i Pe- ' -y (ScaleO-(�5 )
Shorelin�"iL�> '
Access Length
SOu r-0 �
Pier (dock) length ; Igs � I �� r /
Fixed Plafform(s) /.r ?f Z�� /S x2.j�
Floating Platform(s)
Finger pler(s)
Total Platform area
Groin length/M
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
�rr���l'/,�t
Max distance/ length
/ter
Basin, channel
Cubic yards
Boat ramp
, Boathouse/ Boatlift / /% X 6Je,'-Z .-J�
Beach Bulldozing
Other
y vt211
�3oG}-rYITo tc-
y
SAV
observed: yes
Moratorium: n/a yes no
Moratorium:
Site Photos:
Riparian Waiver Attacry{{ryed: 3'GAs l /�77
A building permit zodln rmit may be required by:
Permit Conditions I eDa a-zi- Op Qr--
Agent or Applicant PRINTED Name
TD Pi
C)AVCxPa--I r" I_
~P
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AND REVIEWED COMPLIANCE STATEMENT.
PRINTED
Signature "Please read compliance statement on back of permit" Sig ature t
Ll Gov a�� /'13�-
Application Feels) Check q/Money Order Issuing Date
Expiration Date

�o��`°"'^❑CAMA El DREDGE & FILL N° 92642 A B C D
a GENERAL PERMIT Previous 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:
I SA NCAC I J ❑Rules attached. ❑ General Permit Rules available at the following link: www.deq.ncgov/CAMArules
Applicant Name -
Addruce •
City. State ! �•`' ZIP
Phone#O.- z 7
Email •a i' . / , /
Authorized Agent
Project Location (County): / ,
Street Address/State Road/Lot #(s)
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 • r ; / ,
(Scalej,J-T j 1
Access Length 'f .may'
i
Pier (dock) length/ 4 '
I
11
L
-
I
i
=
—
i
I
Fixed Platform(s) Y .S, V /
_ —❑-
Floating Platform(s)
Finger piers)-1
7I
/
/
{
1 1.
-•�
i
.
L__
Total Platform areatt
Groin length/7!
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
CubicyardsI--
Boat ramp
=—�-
—
—
-
—
-r—
—
-
I
_
I
r ,
1'—
—I—
Boathouse/Boatlift ;
�-
•mot
,.�
�'
_
Beach Bulldozing
Other
_
SAV observed: yes no ?
Moratorium: n/a yes no
Site Photos: yes no
Rloarian Waiver Attached: yes no _._
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A building permit/zoning permit may be required by: -1?
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)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Feels) Check #/Money Order
Signature
Issuing Date
Expiration Date

8:43 a LTE I
All Mail Attachments n u
rui naraware woe galvamzed and all lumber to be treated except on boathouse roof. Price
includes permit. Price does nol Include Electrlcnl
Contractor Client
La- as F960MIUM 4 it,', I I W.-I !19 R LOIAlas
Name of Property Owner Requesting Permit: I.iIQ/✓k ea t-c-- Mailing Address: dig
iyw+-0ad VA n2M-7 7�1
iE Phone Number. 5 �' �o `�� / / 3
Email Address:A1II,,
I certify that l have authorized .P. (YkOQQin LMaiL nlch' doxa-
- QTent/Contrador
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 51xdcol WaQYWaN, a4'XI5'cGrY,
at my property located at Li
in N&I County.
I furthermore certify that / am authorized to grant, and do in fact grant permission to
DWsion 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:
ib>7L
S pnatum
/e LL-1✓
PnM or Type Name
3 J �Y
Date
This uvdifiwtion is vaiid iirrough 3 ; c� �a i ciJr

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)
Name of Property Owner
Address of Property:
Mailing Address of Owns
pp
Owners emall1�c
Agent's Name.
�_i
I @(kiyA.Q corn Owner's Phone#: 15� - (051- 97 y3
Phone#: a51�-3 -� - '4 74'}
Agent's Email: QUo i icla, (01tlra(twyy rV X2cJ� cc rn
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom portion to be completed by the Adjacent Property Ownsr)
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
fi S� I DO NOT have objections to this proposal. I DO have objections to this proposal.
It you have objections to what Is being proposed, you must notify the N.C. Division of Coastal
Abnagement (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
con0ded at [phone], No rdsponse Is considered the same as no objection If you have been
noWed 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 lion
the appropriate blank below.)
I DO wish to waive some/all of the 15' setbaci,/ Q/�/ j J%
�,
-OR-
y Signature of Adjacent Mparldn Property Owner
�F
I do not wish to waive the 15' setback requirement (Initial the blank)
-Signature of Adjacent Riparian Property Owner:
TypedlPrinted name of ARI
Mailing Address of ARPO:
ARPO's email:
ARPO's Phone#: 41 1- I+U — 601�3 i
Date: 4 2-7/1# "waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONM/AIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner
Address of Property:
Mailing Address of Owne
Owners email: Qo0351 QiT) Owner's Phone#: "759 - fo51- q %4 3
Agents Name: 12. T' d.1 rJr d0* Agent Phone#: c 5W-:3107-4{7L1y
n
Agents Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom portion to be completed by the Adjacent Property Ownerl
1 hereby certify that I own property adjacent to the above referenced property. The Individual applying forthis
peril 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 of coastal
Abaegement (MM In writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Grfffln 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
noWled by Certified Mall.
WAIVER SECTION
1 understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lit, 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 Stan
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback Zlk,L (/1
Signature ofAdjacent Riiparariiaan�-Property Owner
-OR-
I do not wish to waive the 151setback requirement (Initial the blank)
Signature of Adjacent Riparian Property Owner. `` _' '��
TypedlPrinted name of ARPO: �oLd CAUL)
Mailing Address ofARPO: 7 JJC c1>
ARPO's email: ARPO's Phone#: J52 " la— 8cf39
«Tate: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021