89054A - (MOD) Fortin, Michael and Cindi

3oS,"U�'ra, �CAMA ElDREDGE & FILL
-NQ 89054 C B C D
� GENERAL PERMIT
®
Previous permit
Date previous permit issued
V�Qlew kModification ❑ 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:
15ANCAC !7(4 ❑Rules atmched.
E GF D ral Permk Rules available at the following link w .det.nc.eov/CAMArules
Applicant Name J2 LI 9-" - 4-,
Authorized Agent �—
Address P �. �� J o3
Project Location (County): � C-«
City:511-14S Sate V'4- ZIP
Street Address/State Ro/adL /-of#(s)f
Phone#(5��[f+)
7++/%C4
I2-!55-
Email ✓h rp ��-;""^ 8 ndVc'IrtCC.( Jj. �-J zr C� "^�-
Subdivision n Sin tits
city 5"- = zip 27436
Affected ❑CW &rW- PTA ❑E$ ❑pTS
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Adj. Ww.. Body 6v�Cv1 (nW ra/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑$PIMA ❑PWS
Closest Mal. Wiz Body /0cw/A./rGa.
ORW: yes/ io ', PNA: yes/ J
of Project/ Activity
Access Length
Pier (dock) length
Fixed Platfomn(s)
Floating Platform(s)
Finger pier(s) .mil r J� 2S
Total Platform area
Groin length/R
Bulkhead/ Ripap length
Avg distance offshore
Breakwater/Sill
Max distance/length -
Basin, channel
Cubic yards
Boat ramp
Beach Bulldozing '
Other/ol jt tis S y
$AV observed: yes no
Moratorium: 6/a yes no
Site Photos: yes no
Riparian Waiver Attached: s no
A building permit/zoning permit maybe required by:
Permit
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(Scale: N 15 )
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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 ANDCONDmONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.
(Please Initial) Pt
Agept Applic P INTED Name
Permit Officer's PRINTED Name
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Ssse"`Pleasereadcompliance statement on back of permit•'
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Si�ure
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Application Fee(s) Check p/Money Order
Issuing Date
Expiation Date

❑DREDGE & FILL
N° 89054 Q - B C D
t � ENERAL PERMIT
Previous permit h
Date previous permit issued
issued
Qlew ❑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 � I� mb ❑ Rules attached.
General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Namne 'LI <I--- r/ "TJ 1
Authorized Agent
Address + a % � 3
Project Location (County):
_�I�r `/5wc-
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City 5LO0.\- > �e State �T�ztzip 2--y'1'77
tl
Street Address/State Road/LotS_Q � 2- f Go'7t" 2-7
Phone # (S/') z-5.5 - % 17 C
5 / / `I Z 4� S5- 7'7"�-� 6#-, �
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Email Yh6.f-kl @
Subdivision W I e% ct - k4-J�^ ,S A e je S
City V:�f i.S�o zIP 27tj3��
Affected ❑ CW �6NL ' PTA ❑ ES ❑ PTS
Adj. Wtr. Body
(nat/ ar unk)
AEC(s): ❑OEA ❑IHA ❑\UW ❑SPIMA ❑PWS
Closest Maj. Wtr. Body %0.,r7',A<,o $o(+n.QL
ORW: yes/r—.) PNA: yes/co
Type of Project/ Activity A S (of )C, / 2 / /G,-��-a c-,r. , 3 °� �.i .F;' n4 �,p� �.� a.nd
7 /1 z !; A q S For 1 S/2 O (Scale: N'1 )
Shoreline LngtV + g Z
Access Length ^ AA-
Pier(dock) length — ✓
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) .3 r >if ZS z
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel -
Cubic yards _
Boat ramp -
Boathouse/ Boatlift
Beach Bulldozing
Other — 1 i ti
i
.; � t-
SAV observed: yes no
Moratorium: n/a yes no
i
Site Photos: yes no
Riparian Waiver Attached: es no
NL
A building permit/zoning permit may be required by:
Permit
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❑ 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) �
.� y✓onAe
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature `*Please read compliance statement on back of permit" Si ture
yin �/y1ZY 1�/v/2Y
Application Feels) Check p/Money Order Issuing Date Expiration Date

CAMA ❑ DREDGE & FILL No 89054 A B C D
GENERAL PERMIT Previous permit
Date previous permit issued _
@IF, -']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.deq.nc goy/CAMArules
Applicant Name
City
Phone # ( )
Email
ZIP
rwmonzea Agent
Project Location (County): ) -
Street Address/State Road/Lot #(s)
Subdivision
City
v
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body <.. (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger piers)
Total Platform area
Groin length/N
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill -
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required
Permit Conditions
(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)
> is
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature"Please read compliance statement on back of permit** Signatures
Application Feels) Check tt/Money Order Issuing Date Expiration Date

51172 Lassiter
Frisco, NC 2793,6
Parcel: 011678000
Pin:051614446850
Tax District: Frisco
Subdivision: Wind -haven Shores
Lot BLK-Sec: Lot: 27 Blk: Sec:
Property Use: Secondary Improvement
Building Type:
Year Built:
Tax Owners: Fortin, Michael A -Primary Owner, Fortin, Cynthia B -Primary Owner -Primary Owner
Mailing Address: P. O. BOX 903 Stuarts Draft VA 24477
Building Value: 0
Land Value: 93,600
Misc Value: 11,800
Total Value: 105,400

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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: Michael and Cindi Fortin
Address of Property:
51172 Lassiter Lane, Frisco, NC 27936
Mailing Address of Owner: PO Box 903, Stuarts Draft, VA 24477
�5 Owner's email:
mfortin@advanced-telephone. wner's Phone#: [phone]
Agent's Name: N/A
Agent's Email:
N/A
Agent Phone#: N/A
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
description or drawing with dimensions must be provided with this letter.
x I DO NOT have objections to this proposal. I DO have objections to this proposal.
9 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 (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 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 Sy
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.=�_,'i�
Typed/Printed name of ARPO: Brad dameron
Mailing Address of ARPO: 7024 gate city hwv bristol va 24202
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 5/10/24 *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

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Carver, Yvonne
From:
Sent:
To:
Subject:
Attachments:
Good morning Mr. Fortin,
Carver, Yvonne
Wednesday, June 5, 2024 10:18 AM
Mike Fortin
GP89054
Fortin GP89054.pdf, FORTIN RECEIPT.pdf
A copy of general permit (GP) number 89054 authorizing your docking facility project in
Frisco is attached for your review and signature. A copy of your receipt is also attached.
To validate this permit, please address the following:
1. print and sign the permit on the bottom left-hand corner below your printed name,
2. initial where indicated on the bottom right of the permit, and
3. scan and send a signed copy of the GP back to me.
Please contact me if you have any questions.
Thankyou.
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-621-6453
401 S. Griffin St., Suite 300
Elizabeth City, NC 27909
1

4.
x,

Carver, Yvonne
From: Mike Fortin <[e-mail]>
Sent: Thursday, July 18, 2024 7:30 AM
To: Carver, Yvonne
Subject: FW: FW: [External] RE: GP89054
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Hi Yvonne,
Below is Davids response to the dimensions of the boat lift.
Thanks
Mike
540-255-7176
From: Dave Swanner <[e-mail]>
Sent: Wednesday, July 17, 2024 4:05 PM
To: Mike Fortin <[e-mail]>
Subject: Re: FW: [External] RE: GP89054
12' wide by 12'-6" long for an 8k lift I believe that's what you wanted
On Wed, Jul 17, 2024 at 8:43 AM Mike Fortin <mfortio(cDadvanced-telephone com> wrote:
David,
Can you provide me these dimensions?
Thanks
ONE,
From: Carver, Yvonne <[e-mail]>
Sent: Wednesday, July 17, 2024 8:28 AM
To: Mike Fortin <[e-mail]>
Subject: RE: [External] RE: GP89054

3. scan and send a signed copy of the GP back to me.
Please contact me if you have any questions.
Thankyou.
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-621-6453
401 S. Griffin St., Suite 300
Elizabeth City, NC 27909
Email conesoordeme to and from this address may be subject to the North Carolina Public Records Law and .nay be disclosed to third oarties by an authorized
state off cial.
4

CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Yvonne,
We fin allyreceived a final quote from David Swan ner and find it maybe possible for us to afford a boat
lift as well. The footprint of the dock will remain the same, we would just have the lift where the slip was.
Can you tell me if this is something we can just door will I need to do another permit if we choose to go
this route?
Thanks
Mike Fortin
540-255-7176
From: Carver, Yvonne <[e-mail]>
Sent: Wednesday, June 5, 2024 10:18 AM
To: Mike Fortin <[e-mail]_>
Subject: GP89054
Good morning Mr. Fortin,
A copy of general permit (GP) number 89054 authorizingyour docking facility project in
Frisco is attached for your review and signature. A copy of your receipt is also attached.
To validate this permit, please address the following:
print and sign the permit on the bottom left-hand corner below your printed name,
2. initial where indicated on the bottom right of the permit, and

Good morning Mr. Fortin,
Since the permit is still active, and the boatlift would be in the same footprint as the slip, I
should be able to do a modification to GP89054 without requiring renotification to the
riparian property owners.
I would need an updated site plan with the dimensions of the boatlift with your request to
modify the permit.
At 'VMI ~
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-621-6453
401 S. Griffin St., Suite 300
Elizabeth City, NC 27909
From: Mike Fortin <mfortin advanced-telephone.com>
Sent: Wednesday, July 17, 2024 7:38 AM
To: Carver, Yvonne <[e-mail]@deg.nc.gov>
Subject: [External] RE: GP89054
2

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