89047A - Bartley, Philip and Mary

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®CAMA ❑ DREDGE & FILL N9 89047 v B C D
Previous permit
GENERAL 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:
' 2Oo
I SA NCAC � I� � 1❑Rules attached. ❑General Permit Rules available at the following link: vrww.deo.nc.gov/CAMArules
Applicant Name Yn% 10 S 1Yke"e UA\r l"IEu Authorized Agent \vy�((�11y-�7\-QxS LRI..Bj-y�t+diii++
Address 1 �) M o, 1e � Project Location (County): 6A L'XXV'IC,
City �CNI�E<TOYWa��2 state NC. ZIP al192 Street Address/State Road/Lot#(s) IO�-�y-fCrwc�go
Phone # (lb� 5-(00 "— 0`6 liy 1,20(
//�� �mlt.L�1��2 h c1�V •1qc-ca, r .
Email %� t��r0.Ei1CUV (�3 ��1'hoc�' COYv. Subdivision 1'i VYhtJl�r�d �jQ sTcG)1
City F—Jc :�UA 1g zip X-773Z
Affected ❑ CW NEW ® PTA ❑ ES ❑ PTS Adj. Wtr. Body CIK-6(-CCU . 1 C �a (man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body ,`IF�Q,Ol�ewt•l�. Jdw
ORW: yes(ii PNA: yes/0
Type of Project/ Activity Iy\U�a �� a 2 / X ( 31 6.0J i1 f
(Scale:
Shoreline Length
Access Length C�o�t>J-
Pier (dock) length ie�N
Fixed Platform(s)
Floating Platform(s) •'_
Finger pier(s) a I I o
Total Platform area �.
Groin length/ft }->0-AZ
Bulkhead/Riprap length�>?X n
Avg distance offshore SO w c
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards it
Boat ramp
Boathouse' —A X 1 Z.' �t
Beach Bulldozing
a
Other
SAV observed: yes
Moratorium: yes no to 1 N4• a ��t�(
Site Photos: no � \ B G'I k.
Riparian Waiver Attached: pup `
A building permit/zoning permit maybe required by: C%1`OWO,a1 COV.A'hr
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
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)
2clt�1 ..
Agent or Applicant PRINTED Name Permit Offi is INTED Name_ A
Signature•'Please read compliance statement on back of permit" Signature(Ail
—
Sign 2c133 e�aorati lo(2eD(2t�
Application Feels) Check #/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: V JIfLI P H&g-p-C- Y
Mailing Address: I I ) % y'1 f't S 77zc i
Phone Number: %5 7- 1' 6 0 - 0 a3 12
Email Address: 41 LR0-21 Lt�-_Yl 2,-3 C& 6-n4Ae-, cd`v
I certify that I have authorized L I LLI( i i+C_-e_S Cch- •r ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 1400
at my property located at 4-5P )2 01 74&rL
in r- )+70,u &> County.
1 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:
A— X25t
Signature
Print or Type Name
Title
.3 I N 1 20 Z�
Date
This certification is valid through / 2 I i�'G 1 2 dzy
RECEIVED
J U N 19 2024
DCM-EC

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: P14) I- I P R T R T(--L Lf
Address of Property: I ZO 1 (=0 W j }� r3 T Q JVI L�, L PCB!,-O r`J C_ 7-7 y 3�
Mailing Address of Owner: ) 11 -% )Il-( 7 AJL ?,Q 2'tZ
C- n r nr' L , ca -*7
Owner's email: 0)fr��L-6A-M y IL3G Owner's Phone#: 757- 5-OB!q
Agent's Name: �) LLy Agent Phone#: ?- 2 — 3 3 7 _ 50 y 7
Agent's Email: i-t:�r1/050IV Cprd 5T72✓G770^)LLCft 6-mri-iL o CUn�/
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 forthis
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
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/all of the 15' setback/\
Q f- RECEIVED
/c?� f1� X-
Sigsa&re o�acent Riparian yewner
-OR- J U N 19 2024
1 do not wish to waive the 15' setback requirement (initial the blank)
DCM-EC
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
,^,
Mailing Address of ARPO: -7 ac' 0 AL4W .
ARPO's email:
Date:
ARPO's Phone#:
*waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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