89108A - Williams, Danny

❑DREDGE & FILL N? 89108 O B c C
a Previous permit
3 :GENERAL PERMIT Date previous permit issued
w ❑Modification [-]Complete Reissue [:]Partial Reissue
As authorized by the St to ofNorth Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 7It / r / '2- m ❑ Rules attached. IEJ-'General Permit Rules available at the following link: www.deq.ncgov/CAMArules
Applicant Name V a
Address
City Z/
Phone #
Email ) U3
I 3 Authorized Agent A a; f` IS. �� _11A 04 PRIctit
id J L Project Location (County): C, 17�—A
State r zip 2,57 '7 Street Address/State Road/Lot #(s) fC cv /& S
Lo (- //Z /
oCS r C_.p nh. Subdivisiio�nr % /Tg. S Co Ja- V( y
City /r aL t 71�?_o zip 2
Affected ❑ cW 4._ j+� ❑ ES ❑ PTS Adj. Wtr. Body O'A cs Y b r an/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body �t'g/t o��-
ORW: yes/E) PNA: yes no
Type of Project/ Activity
Shoreline Length _
Access Length
Pier (dock) length
Fixed Platform(s),
Floating Platform(s) _
Finger pier(s) '^
Total Platform area
Groin length/#
Bulkhead/ Riprap length `
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse Boatlift Lf cr
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a no
Site Photos: yes no
Riparian Waiver Attached: no
A building permit/zoning permit may be
PermitConditionsr/1c�S(
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(Scale:
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) It
Age pplicant PRINT a Permit Officer's PRINTED Name
Si a re'"Please read complian< t ent on back of perm Sig re
00 G &-: /A- r 2-2l1*
Application Feels) Check #/Money Order Issuing Date IExpiration Date

❑CAMA ❑ DREDGE & FILL No 89108 A B c D
Previous permit
GENERAL PERMIT Date preiospermitissued
❑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. I0- General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
City
Phone # (
.., S Authorized Agent SA n t, at a,-
r E. Project Location (County):State zip zip - Street Address/State Road/Lot #(s) '!i . l S � /� -, r t
4 // t
Subdivision
City /)'`i <. ,! -><c _ZIP :.,. 'P `.15 Y
Affected ❑Cw ❑EW ❑PTA ❑ES ❑PTS Adj. Wtr. Body �'C'.-+e:4q �- )'�,.•.�<i / (nat/paan/unk)
AEC(s): ❑OEA UW SPIMA PWS - t
❑ IHA ❑ ❑ ❑ Closest Maj. Wtr. Body
ORW: yes/po _I PNA: yes/no
Type of Project/ Activity
(Scale: l ) )
Access Length
-
-
_-
Pier () length
Pa
Fixed Platform(s)
--
Floating Platform(s)
Finger piers)
).
;_
_I
_
!_.._._1.__.__
_
-_
-_�
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—
�_
T
r
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Total Platform area
Groin len h/q
Bulkhead/ Riprap length _.
li—
_ _
(_
___
�fr
Avg distance offshore
Breakwater/Sill
Max distance/length -
—�
--
_
I
I
Basin, channel
T
Cubicyards
4-
Boat ramp
'
!
Boathouse/;Boatlik' S '> ! "
�
�
�
I
❑
�
I
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
r
'h
;,�
��>
�.�
-
^�
.,
Site Photos: es no
(
I n
��
i-
Lt�
Riparian Waiver Attached: ves no
A building permit/zoning permit may be required
Permit Conditions
I I
❑ 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 Perm! Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
r..
Application Fee(s) Check tt/Money Order Issuing Date
(Please Initial)
I`
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: -[)A ldtd N 4/11Z L49S
Mailing Address: Z S//
S M
r d& D
A V E
?A(-t)�U�
Ak
,27[0
Phone Number: CI l 2 • 1? 51- a7Z/2 I
Email Address: G ) (4/ is N1
) 0 . Z 6
I certify that I have authorized &J4eLt/ �6M -4^
AgeiN l contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: SLA ; L,
at my property located at D R A L L 4 Sr ? b I e/ i-Dfl
in tiA2r County.
I 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:
Signature
A r)n/ LL/alOV(
Print or Type Name
Title
y Izi� 12
Date
This certification is valid through
Revised Mar. 2016

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PLC. DIVISION of consTAl wv+ActEnr
ADJACENT RIP
e� CERT1Flta Mgl�L RETLiwON��OASTAL TIFlCATrowWA1VER FORM
RrC0 (TOP Portion to be completed by owner or their agent) n � (1 ,(AN'1 �7 NmrreMRoperiyowner.UIn 1 1IJO
Addressofpmpeny. U211s 11a..zf Pal�rl h2. t1�1a D V(i �j
MW*W Addmaa of ow.,ar.
owners email: �efa ph�onsk. �/ r L1
Agerd'e Name: ^ MA/n piCaM 9PPhonalt,�z`1.i ' �ol 7`�77U 32/ �%� 1 C ,
AgenVa Emaa: S%fr10.h WLS C� ,I[�Oj,�c� •� �J�f7 )/ 0�
ADJACENT RIPARIAN PROPERTY owmEws cERTwlcATIOM
(Bottom cordon to be co oloW by the AdLcent Prooertv OWW3
1 hereby certify that I own property adjacent to the atwve referenced property. The indrvNuat Wp ying foretls
permk has described to me, as shown on the adached drawing, the devekpnent they are proyoang. 9
. n or drawing,with dmenskim must be owided with this tenet.
1 DO NOT have objections to this Proposal. _ I DO have ob)edrons to the propo`�t
ff you Nave objection to wbat Is bamg proposed, you must notiry the N-C- D�nndda xo sshatild be
Management (DChg in wrfting within 10 days of receipt of this notice. COrese o _
m (252j 264-3901. No response Is considered thsamt Giro OW&G-aw NNyyou have been
no tilfed by Certified Malt
WAPJM SECTION
f understand that any proposed pier. dock. mooring Pilings, boat ramp, breakwater. boaltlwlse. M 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 romp revetments). (If you wish to waive the setbacK you must sian
the appropriate blank below.)
100 wish to waive some/all of the 151 setbacc
Signattae ofAdAW9 Riparian Properly Owner
Ni-
o not wM to waive the 15' setback requirement (initial me blank)
at= ofAdjacent Riparian Property
ofAM.
co m
AM'a phone# -Tc/ (� �O—rrql
Vahrer is valid for up to one year from AM's Slgnaturee
Revised July 2021

N.C. DM ION OF COASTAL MANAGEMENT
ADJACENT RIpARIAN PROPERTY OWNER NOTIFICATION W WER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top Portion to be completed by owner or their a erd)
�o�105F �O nt r Ar'�-1/� l/ice/- -
ar ��
Ade,aseaowner
gyp. owner's PhoneCl:
OIY� y
ApieceName: tJ I �Vx (I Agent Phonnit
AwAcENT RIPARM PROPERTY OwfoIrs cERMCAnON
(&+ ••• nottion ro be eano d the Ad)aoeM Pr Ma Ownod
��iiss�� totheaboveiefarenoedpropedy-The aPp"forthis
�ttlten9Dyoed3yB,attownWopertY adl' d dodevelWmeM"wePmp°l^a—
`penoa time; demoted to rne, as shorn on the atlad,ed drawing � letler
.. � � � dsnendons must be anH3ded
✓ )DONOThaveobjeWonstothisp--IDOhemob*CboMtOthz VGPosaL
s you haw a+;.eop!s oe vltat [s Hansftv+aP,4 ln,, mu? nosily ew Jmgse
0lvisfoa dshouCaaaW
(D cb 6s U, 8nHhb 10 drys orreo KCP 27 .WH Carr '°o _ee
mead m Ial S ®'11J51 SY Sb. 3s po serh miry: N same KYW have been
d� 271.4geR Nods oonMmed
wipi,mi
� UAM
I utdmatanda�tnYD.tel!os0�)?'m dodG ~oat of npW= 'P!• 800M Unless vrdtved by me
akwater. 1)0311� 1111L Of
tet�t'�?)' (a YOU
®oto AsistbsdMdcsnrni!mon d`sfanPao4lSason mY�wrshii thesetbadc Younumisk"
)gdsAos rdappybbutk,eadsord�
the spyeoptiatet�dcbdow.) _
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