89040A - Robitaille, George

AA(OM",kKCAMA ® DREDGE & FILL NO 89040 G B C D
a I 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 7A. I 1 W ❑ Rules attached. 0 General Permit Rules available at the following link: www.deq nc gov/CAMArules
Applicant Name oh. r 1
AddressD K
"VIL�^� Alni
City State 1 ZIP
Phone # (r T B) 2q 3^ 6'36cj `
Email ex&' e5 fJtYA iq �o @�'tEfTfYtCtr�� Coyr%
Affected ❑ CW ❑ EW X] PTA ❑ ES [?�PTS
AEC(s): ❑IDEA ❑IHA ❑UW ❑SPIMA ❑PWS
ORW: yes, fil PNA: yes,sp
Type of Project/ Activity
Authorized Agent
Project Location (County): ef_ 1 O �I.ya
Street Address//tate Road/Lo"tt ( #(s) fSf'Ft
���8 t'11�'L2 7A1.� RtOI•_ '�yy
Subdivision 'l.-f1� t'�0.Qnu S1�a>e 9 t'1CYYL ^6Y1
City �er�nrd zip a'79,W
Adj. Wtr. Body �e0plyV\ IXYtRJC, na ` 1 man/unk)
Closest Maj. Wtr. Body R IL,exY�Lr(.e "s"^A
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)t,1
Floating Platform(s)
r r
Finger pier(s)
Total Platform area
Groin length/#
khea Riprap length jT
Avg distance offshore .Z
Breakwater/Sill
Max distance/ length %f
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed- �?� yes ( Qc I i
Moratorium: cp de
no
Site Photos: a no
Riparian Waiver Attached: yes CO)�^t
A building permit/zoning permit may be required by: _er4 4, I rLC \ Au"
Permit Conditions If
I AM AWARE OF STATUTES CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIA
Agent or Applicant PRINTED Name Permit O er's RINTEt
i
Signature **Please read compliance statement on back of permit** Signature
Application Feels) Check#/Money Order Issuing Date
aer',ix�'�r
❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
l0/3/. l
Expiration Date

OCAMA ❑ DREDGE & FILL No 89040 rA) B C D
GENERAL PERMIT Previous permit
Date previous permit issued
M 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 ❑ Rules attached. ❑C General Permit Rules available at the following link: wwwdeq.nc.gov/CAMArules
Applicant Name
Authorized Agent
Address
Project Location (County):
City State
ZIP
Street Address/State Road/Lot#(s)
Phone # O
Email
Subdivision !
City ZIP " i`%
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
) u! !
(Scale: )
Ck__u..e Ien k
Access Length
Pier(dock)length
-
Fixed Platform(s)
Floating Platform(s)
I
j-
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead Riprap length:—
Avgdistanceoffshore
Breakwater/Sill
i
Max distance/ length
Basin, channel s
Cubicyards
Boa[ ramp
Boathouse/Boatlift
%-----
-
—t--
--
"-
I
I
I�
°;
., s
—I—
17
-+—
---
---
—
I
i
--
—
—
V
4
SK
Beach Bulldozing
Other i-,
I
I
I
_
J_
L
-4 -
r
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached:
�
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
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** Signature
Application Fee(s) Check#/Money Order Issuing Date
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT1 ,� �y
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONItMA"ll FORTE° , IV D
-:i uF:ad RECEfP FtEt�iJESTED or HAND DELfVERY
(Top portion to be completed byMAY 0 7 2024
/ owner or their agent) r�
Name of Property Owner. r Qprc, ��o /J,'TG , [� DC - EC
Address of Property:
Mailing Address of Owner: S. e
Owner's email: ea5 ln;fe; -,iy /SS(���/ %Owner's Phone#: g41.3 .Z 9 3
yr� • GcM
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 e.--. property ad;gr�nf to the ahnve rafarannPrl nrnnPrty, Thp individin.l annivinn fnr thi
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.
L 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
-: -' -ys of re.-cipt of this noticc. ^^---•Sposdence 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 riorap revetments). (If you wish to waive the setback, you must sian
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) 5e-W
Signature of Adjacent Riparian Property Owner: w� %�
TypedlPrinted name of ARPO: G2E00RICK 2 vrazrGNT
a IngAddressofARPO: /70 101N9 'Part" 20� Ni1•7_F'-000i /JC_ 2-7 1/1/
ARPO's email: �f wr �ln�[??ajrn<< )• ARPO's Phone#: (70
Date: 317q 2o-24/ *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 NOTIFICATION/WAIVER FORM
(Top portion to be completed by owner or their agent) RE It"WED
Name of Property Owner:
i 6 G f, n-e �a. i7d // ,�1�, d ry c z'79 vv
MAY 0 7 2924
Mailing Address of Owner: Sc-,. DCM-EC
Owner's email:pcjl so r_/, o `Owner's Phone#: y�f3-zy3-o369 is
Agent's Name: Agent
Agent's Emait.
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I herebv certifv that I own oropern_, adiacenf to the above referenced mmnAfty The individrial p^^t f^r rhi�
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 notify the N.C. Division of Coastal
;agoinert (DC :I 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)
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 Horan) 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: fj - ` v � "
Typed/Printed name of ARPO: G ev, i C 6 • 4kSZ� Ate S ygS1V11oR
Mailing Address of ARPO:
ARPO's email: U S7h✓G _Q ��%r ARPO's Phone#: A 3r4- 3 3 3--�ZG zZ
Date: 3.3 6 - 2 °, *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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TECHNOLOGY RESEARCH CORPORATION

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Type of Project/ A UJ y
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AuesstengtA ....,
Pier tdacF.) k+igth.�y
F;xert vlaer>rmf) _.
Floating Platform(s)
*r
Rnger pler(r)
Total Pl�:fiemiart+a... �-.
Groin tength/it I
u hea Riprap length 1'ati
Avg distance oNzhore '—`—
BreakwaterANI
Max dtstanceJ length. � r
BaxM,.Mannd
�
i
Cubic yards
Baal nmv
Boathouse/ Bontlttt
Beach Bulldozing
Other
u
mvobserved:�—fit
Moratorium:
Yes:
i
-
no
57te Photo$.
WA' m A'U rhed:
Vim`
no
to t .a.:..._
Riparian
perm)tm y be requl(cd h
A hutICIIA9 lermtowing
LIMWA ��}P>s:
F.+'ws
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