89123A - Rohaym, Raafat

.�Ocomt,'�❑CAMA ElDREDGE & FILL N? 89123 A,, B C D
aPrevious 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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deo.nc,gov/CAMArules
Applicant Name
Address
City State ZIP
Phone # ( )
Email
Affected ❑CW EW ❑PTA ❑ES
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA
ORW: yes/oo_;: PNA: yes/no
Type of Project/ Activity
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
❑ PTS Adj. War. Body
❑ PWS Closest Maj. Wtr. Body
(Scaler )
Access Length
At
Pier (dock) length
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Fixed Platform(s)
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IF
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/N
Bulkhead/Riprap length
Avg distance offshore—
Breakwater/Sill
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Max distance/length
Basin, channel
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Cubic yards
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Boat ramp
Boathouse/ Boatlift
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Beach Bulldozing
Other
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SAV observed: yes no
Moratorium: n/a yes no
Site Photos:
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required
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. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature *'Please read compliance statement on back of permit•• Signature
Application Feels) Check N/Money Order Issuing Date Expiration Date

IYYia•.L� . •
ftrwe Number: 516
)�4-
Agerd/Cibrftdor
to on my behalf, for the purpose of applying for and obtaining all CAMA permits
rooessary for the fbilowing proposed developmert0 piod
. ••:. ...•:rolll
t f wthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the local Permit Offlor and their agents to enter
on the eforementioned lands in connection with evalueting information related to flue
perrrdt application.
Ptop•rgr Owner Irthxmsim:
�gna�
tap rA-r RECEIVED
Print or type Name JUL 10 2024
W /\, j+ Y
7ft Dr M-CE
This oertificstkm is valid U v m4 h �. jig I

N.C. DIVISION OF COASTAL MANAGEMENT (;,►�L`G�VED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFirn nnni RETURN RECEIPT REOUEST�D or HAND DE iVE Y JUL 1 0 2%
(Top portion to be completed by owner or their agent)
Nssne of Property Owner
Address of Property:
Mailing Address of Owns
Owner's small: Q_n�b� � � Carr) Owner's Phona#:
�DD
Agrerrts Name:
t rrPT'f i�:ilin�.` r' - iC^.awrYr:�
• • : 1. . ►�,� . s►1>�•I'ei ttu7J�Nl!itlir�' �•`
ADJACENT..
(Bottom portion to be completed by the Adl&CSnt MOM OW1146
ntto the above
renced property. The Individual applying forthis
♦:- described •shown,• attached drawing, r:•• proposing.
•-
ewri lion ! t w 1 1 with�• 11 =1 r 1. ll 1 be ♦ N 1. 4 r i 81 SIIC L-1! �
(IL I.• NOT have objections to this proposal. .• have objections to this • opos
N you have objections to what Is being props
Allanagrement (DCM) In writing within 10 days of
to 401 S. GrlR1n St, Ste. 300, Elizabeth (
can6cted of [phone]. No rdsponse is con
noMd by certified Mall.
of this notice. Correspondence should be
27909. DCM rapresenWives can also be
the same as no objection N you have been
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 watered by me
(this does not apply to bulkheads or rtpmp revetments). (If you wish to waive the setback, you mug star
the appropriate blank below.)
I Do wish to welve some/all of the 15'
J, .OR -
I do not Wien to waive the 15setbaok requuvnrom knnrwi uro mare v
1*3101nature of Adjacent Riparian Property Owner."
,� ,LJ
Typed/Printed name of ARPO.
Mailing Address of ARP 10O:n f.1C o� nca
ARPO's small: -d L C. +_ _T�1�4�1a� ARPo'a Phone#: 'i':--�
I LU.4
Data: fv,12-1-wahar is valid for up to one year from ARPO's Signature*
ROO"d July 2021
-GU

N.C. DIVISION OF COASTAL. MANAGEMENT ECEIvEQ
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER F {
r RTIMED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY JUL 10 2024
(Top portion to be completed by owner or their agent)
Naeorprope
Address of Pro
Maigng Addras
Owner's email:
Apenrs Name:
Agerrt9 Email:
0-Ec
I hereby certify that I own property adjacent to the above referenced property. The Indlv1dU81 applying fortl*
PC" has described to me, as shown on the attached drawing, the development they are pmpo$lnlg A
fteadildw or drawing, Y& dimensions. must be gmvided with ttds fitter,
'✓I DO NOT have objections to this proposal I DO have objections to this proposal.
w you have objections to what Is being proposed, you must notry the N.C. Viviston of Coastal
Abriveiment (DCAV in writing wkh►n 10 days of receipt of this notice. Correspondence should be
to 401 S. GrMl7n St, Ste, 300, Elizabeth City, NC, 27609. DCIW npresenfaUves can also be
conillacted at (252) 2bW901. No rdsponse Is considered the am as no objection it you have been
salved by CardfTsd Matt.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, IIR, or
groin must be set back a minimum distance of f 5' from my area of riparian access unless waived by me
Qhh does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sion
the appropriate Wank below.)
100 wish to waive somatall of the IV setback W-
SWW ofAdjacW P4WW ftperb' Owner
.OR.
I do not wish to wetve the l V astbac k requirement (Initial the blank) At S k1
sturo ofAdJsoerM RlparismProperty Gamer:,_ ,��'dzvr�u1 � %t���/is�-f/
TypedfPrinbd nan. efARPO. 0U4o4-. (" a art 4-Nu ty,
Malling Address of ARPO:
ARPO's small:
ARPO's Phone a5a -'19q - 4Q95
aINK *wakw Is valid for up to one year hom ARPO's Etgnstura•
Revlsrd JWY2021

RECEIVED
x l U L 10 2024
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