89043A - Journigan, Lloyd and Nurefsan

a❑CAMA ❑ DREDGE & FILL
�� GENERAL PERMIT
N° 89043
Previous permit
Date previous permit issued
A, B C D
0 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
15A NCAC C % 1 ICJ ❑ Rules attached. 0 General Permit Rules available at the following link: wwwc1eq.nc.eov/CAMArules
Applicant Name ' ; V t r i "xz c. l (:!) t- 1) t .,
Address+. -
City
Phone #
Email
State ZIP 2- 7 ),A '-)
Authorized
Project Location (County): D:-i 1 r_
Street Address/State Road/Lot #(s) 2. `? T , e r ' Or .
Subdivision in J 91, \71 k- ( I `)
City ',_�U'AI%r_t 1. Isk c,1 e.,:r, ZIP 2.-1-)��'..
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body Co y-, a i 4 c, Ct re.. " < - , (nat/tnad[unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtc Body CVr r1kJ, � inU11-
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:l_q. )
Access Length
Pier (dock) length17
Fixed Platform(s)
1
I
L-
Floating Platform(s)
N
-
Finger pier(s)
Total Platform area
Groin length/H
Bulkhead/RiPrap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Y
Boat ramp
Beach Bulldozintglift ( �Y li.
Other-
SAV observed: Yes no Moratorium:n/a yes no
Site Photos: yes no
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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.
Agent or Applicant PRINTED Name
r✓1 NI �'.
Permit Officer's PRINTED Name
(Please Initial)
Signature **Please read compliance statement on back of permit**
Application Feels) Check M/Money Order
Signature
r ,�.�. /
Issuing Date Expiration Wte

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: .. NIA I -IN?ff
Mailing Address: .2t ' t a � )�_
flculkt
Phone Number: 5 j y , s!:2, 0 CY
Email Address:
I certify that I have authorizedj�(��rnr
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: INSTALL 2 NEW PILES FOR I NEW
ELEVATOR STYLE BOAT LIFT
at my property located at
in _County.
I furthermore certify that 1 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:
Title
M1 A 1_
Date
This certification is valid through

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: LLOYD C & NUREFSAN JOURNIGAN
Address of Property: 28 FAIRWAY DRIVE, SOUTHERN SHORES, NC 27949
Mailing Address of Owner: 28 FAIRWAY DRIVE, SOUTHERN SHORES, NC 27949
Owner's email:[e-mail]% 252-256.3899
wner's Phone#:
Agent's Name: SCOTT C SMALL / LSI MARINE Agent Phone#: [phone]
Agent's Email: SCOTT(c,LSIMARiNE.COM / MONICA cr LSIMARINE COM
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(_Bottom portion to be completed by the Adjacent Prooetty 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.
It you have objections to what /s 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
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/ail of the 15' setback
OR Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: MICHAEL P BRESLIN & MARY R BRESL
Mailing Address of ARPO: 10022 BLUE COAT DRIVE, FAIRFAX-t, VA 22030
ARPO'semaiLYilif`yPti2Qrt'uARPO'sPhone#:�iQS�'���-5�t
Date: "i ci "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 NOTIFICATIONIWAIVER 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:
LLOYD C & NUREFSAN JOURNIGAN
28 FAIRWAY DRIVE, SOUTHERN SHORES, NC 27949
Mailing Address of Owner: 28 FAIRWAY DRIVE, SOUTHERN SHORES, NC 27949
Owner's email: NUNUJOURNIGAN(n;GMA"- COtvbwner s Phone#: [phone]
Agent's Name: SCOTT C SMALL / LSI MARINE Agent Phone#: [phone]
Agent's Email: SCOTTCa)LSIMARINF.COM / MONICA(a-LSIMARINE.COM
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
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 notlry the N.G. uivision or Goasrat
Management (DCMI 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 /f you have been
notified 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 sign
the appropriate blank below.)
1 DO wish to waive sometall 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:
Mailing Address of ARPO:
PAUL FENNIMORE & GWYN K FARLEY
5 WOODLAND ROAD, PITTSTOWN, NJ 08867
ARPO's email: z:6& coyhc,14 ARPO's Phone#:3y_ ?
Date: SAZv z _'waiver is valid or up to one year from ARPO's Signature
Revised July 2021

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