89125A - Yang, Ju

" ` UC%AMA a DREDGE & FILL
ffGENERAL PERMIT
�ew ❑Modification ❑Complete Reissue ❑Nrt(ai R
AY t�91l5 0e Yl
Previous permit!$'1 0 /_ y
Date previous permit issued 12
As authorized by the State of North Carolina, De erSSUe
Partment of Enviroamenral Quality and the Coastal Resources Commission in an area of envlronmenral concern pursuant to:
ISA NCAC ti (.(.1Z,p6
----- Q Rules attached. fi;G¢MM' Permit Rules available at the following link: W=deo nor W&6!J/ ml%
Applicant Name—_���.16C1
Address
Cfry_ V 1ittaXI Sure— V,A,_,_ 71P a34S
Phone # (10 11 -
,49
n
Authorized Agent_ (�.p
Proilm location (County); ...
Street Address/State RwNLot #(s) 1 I
Subdivision
city--_. D ak �-ZIP_ zz 9
�—
�
effected ❑cw QrEW VPTA DES �{75 Adj. Wtr. Body C ttiYr 1'r_3t�C. r O LL.In nadunkj
,EC(s): 1-10EA [IINA E]UW E)SPIMA E]PWS Closest Mal. Wtr.Body
IRW! ye no PNA: yesi(D
(pe of Project/Activity
horeane Length 490,
.goes$ Length
ier(dock) length
loating Platformts)
oral Platform area _
Loin length/A —
ulkhead/aiprap length _
vg distance offshgre
reakwater/SI!I
Cumctt•YJCk `5olLm > N p
S
1„FT o jEXKAl,,A 'CULTS t 1J
.. 6 7 Fi''Z 0 P~
ADatTIOPAL-, GKAS)wc-t oR
?P-0Pv5oi 15 ofit
Zoo-F Ov6p FY i 5TI &)q
PLh`1`�ORAr� 1
e w L&s* PIFY0.rid p(Qtforwl,$
asin, channel �C-kst DOeLl4
abic yards _
oat ramp �� ^•�
oathouse/ aoatldt
each Bulldozing
ther i SAY I ' �,y
W observed: yes no 1
loratorlum: (V yes no
tePhotos: s no
parian Waiver Attached: T
building permR/toningpermit may be required by: _._ 1 13 W In �t:�
smit Conditions ---
Signature
Signature"Please read coM Rance statement on back of permit** lssuingDate
y t�U C> Check plMORey order
(Scale: )
4SrCLY
'1&n 3
7, o' fo
M,yitzwt .ao
J F�
}
u TAR/PAMINEUSEIBUFM (d,cle one)
See note on back tegatding Wye% sasln wles
0 See ad iiihomt nuteslcondlli"s on back

❑DREDGE & FILL N? 89125 Og C D
Previous permit Ss'l (0 2
GENERAL PERMIT Date previous permitissuo ed \2if6f z S
[few ❑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 d • 1 Z O C�- ❑ Rules attached. E�General Permit Rules available at the follov.ing link: v ..deq.nc goy/CAMArules
Applicant
City Vr. _ 'a g Ca J^ State V A zip 7 1_aJ A SS
Phone #(7 9 2-IVB .3
Authorized Agent R O 6 tA
Project Location (County): 0- C V
Street Address/State Road/Lot #(s) 1 I k }J (yS h RA
Email jl L& d 1 Vl� �. Q `i VA06Alan Subdivision
City LL. C-k ( ZIP Z..Z i 4 9
Affected ❑ CW gEW [ PTA ❑ ES ❑ PTS Adj. Wtc Body C LXYY 1 �U`.G fC / SO L& niat»�rnan/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body G�t.Y Y 1 T t ll+_lC S c2" hid
ORW: ye no PNA: yesco
Type of Project/ Activity
Shoreline Length go,
Access Length I
Pier (dock) lengtl
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area _S --7!4_E
Groin length/M
Bulkhead/ Riprap length
Avg distance offshore
Max distance/
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
OJar ��,tt. �pl lt�
SAV observed: yes no
Moratorium: n a yes no
(Scale:
15IN 1
3
� t+FT ovE1ZH/�tycz 'Z�ULTS (p1
61. FTC oP
AM-Vk7-loNAL, e5RA0w)Ci 'FoR
pEo- bSED 16 1-7I
zoo'- ovGR_ E1L15"> I1Je �.
t aAst Soo+Vi+5
to' fo
Mtyr-moto VZ
I
Site Photos: es no
Riparian Waiver Attached:
A building permit/zoning permit may be required by: tJ In ©t tl AL
Permit Conditions
(�1 Y r' l
Agentor Ap Iicant PRINTED Name
-1(.k'\ `3
4k ''
iyr.rir
v
a
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Signature "Please read co m fiance statement on back of permit"
bU o I51
Application Feels) Check H/Money Order
Permit Officer's RINTED Name
1
Signature
Issuing Date I Expir Hon D to

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM
(Top portion to be completed by owner or their agent)
Name of Property Owner:..... --
Address of Property: tI i{G„ 1-i AQ A)
22 6ckw~Ct C7 Ufa Cfa�� �A. 23La
i
Mailing Address of Owner: ___, F �- -
Owner's email: � e „,y_/ Q Jcr h�va_. 41W e� s Phoned: Agent's Name: 5 7"�`-�-'--t-_t._f-_ Agent Phone#: ZJ-Z 202
Agent's Email: -_ys[ YA1h Q.-�Akl"n—G-4�"- ....._ ..._.—
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
description or drawing. with dimensions must be provided with this letter.
I DO NOT have Objections to this proposal. i__ I DO have objections to this proposal.
it you nave OOJyLumu w mm, ,a y p•
Management (DCM) fn wrfSng wifhf 10 day
mailed to 401 S. Griffin St, Ste. 3 , Elizabi
contacted at [phone], No rstponse is
notified by Certified Mail. %I
I understand that any prop seer, dock, r
groin must be set pack a . inim distance
(this does not apply to (kneads or riprap r
the appropriate blank eiow.i
100 wish to waive sometall of the 15' setback
of receipt of thfs notice. Correspondence should be
hAity, NC, 27909, DCM representatives can also be
AnAidered the same as no objection if you have been
boat ramp, breakwater, boathouse, lift, or
area of riparian access unless waived by me
you wish to waive the setback, you must Sittn
--
Signat—
ure of Adjacent Riparian Properly Owner
-OR-
I do not wish to waive the 15' setback requirement {initial the blank) -a/m�
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
Date:
ARPO's Phonelf:
`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 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:__p---
Address of Property: 1 I 1 N Ae, H &AO IONGT�_7_L___
Mailing Address of Owner: 1 "Z'2_ " 7 %~6Gk W CC-.,,._t_r "7 1-%!! jac. UP, 2 3
Owners email:, h ,QWers Phone#:
Agent's Name:.1%,�,,,.j+-' Agent Phone#:25 Z
Agent's Email: -----------
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adiacenl Property Owner)
I hereby c/ordcrawing,
own property adjacent to the above referenced property. The individual applying for this
permit had to me, as shown on the attached drawing, the development they are proposing. A
descriptiowith dimensions must be provided with this letter.
�t 100 NOT have objections to this proposal. I DO have objections to the proposal.
If you have objections to what is 'ing proposed, you must nobry the rv.c. urw5100 m �oabrar
Management (DCM) in writing withi ' 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 3qo, Eliza at fly, NC, 27909. DCM representatives can also be
contacted at [phone]. No re#ponse is cbn$idered the same as no objection if you have been
notified by Certified Mall. A
I understand that any prop se er. dock, m ring p: ngs, boat ramp, breakwater, boathouse, lift, or
groin must be set back a im distance o S fro y area of riparian access unless waived by me
(this does not apply to [kneads or nprap re tments). (If you wish to waive the setback, you must sign
the appropriate below lank .}
I DO wish to waive some/ail of the 15' setback
-.... .... — ...............—
Signature of Adjacent Riparian Property Owner
-OR-
i do not wish to waive the I5' setback requirement (initial the blank) _._�...__
Signature of Adjacent Riparian Property Owner:.....—
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date:" ( _-waiver is valid for up to one year from ARPO's Signature`
Revised July 2021

N.C. DWISiON OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date t.D " 20 _ 2�
Name of Prop" Owner Apphliug for Permit:
lTU f AAI(S
Mailing Address:
{2Zg S2i
yi\ i�en�U V� �3�tS5
I certify that I have authorized (agent) ,'--� � R-1—All 1 Als E To act on m%
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) `�5 k17 U()Ct rkS 57Wlr G
at (my property located at) it t 0 ' s t-d jo ICU c k /O c-
This certification is valid thru (date)
Signature
Date

-- ,17ft
15ft
Existing Pier
Proposed 15x1ZGazebo
Over existing 1016 Deck
Existing Pier

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