89148A - Cheek, David

o+�te"r" dCAMA ❑ DREDGE & FILL
10111,
GENERAL PERMIT
VNew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N9 89148 B
Previous permit
Date previous permit issued
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 0:7 PC' I in b ❑ Rules attached. t General Permit Rules available at the following link: yoev.deq.nc.goy1CAMAnuIes
Applicant Name 113 y) I �.�P.P-� Authorized Agent L G -r_ i/i rL r 1 y/
Address Project Location (County); _ _C uorr t b iu { L
City PA 1-lnr r V-- ZIP-2-72g(o-+ Street Address/State Road/Lot#(s) 23C. G rirgn AC(e Ci
Phone # ('jam_) - r ' � r t 1/ I UU
Email Us(�,J.in �C :kmy+e tom. ly�T Subdivision
City Pot u l4ax-6&r ZIP '3,'1
Affected ❑CW YEW
QPTA
❑ES ❑PTS Adj. Wtr. Body Attie--9AriAC
r=OUs�.�, .A'&Thnart/unk)
AEC($): ❑OEA IHA
❑
❑ UW
SPIMA PWS
❑ ❑ Closest Mal. W[r. Body
`�`J
A16 F Lw.�, s' l C_ SAU N [Y
ORW: yes no PNA: yeNro,>
Type of Project/ Activity •-r „rk,`'
l "1
L bn2ii _f- n d kty,l 1 C4l
J Ina ^ ca r 44
(Scale:itr=tor 1
Shoreline Length Ion �
Access Length
it Lam M' k�-t✓ 1r 5 t1 tills
'^-' ^"•
Pier (dock) length
Fixed Platform(s)
h.�
Floating Platform(r)
b6A'CL1 rT
Pla{�vrn„
IC'
finger piers)
Total Platform area
��"
��•
��
Groin length/p
Bulkhead/ Riprap length
Avg distance offshore
ty-A 7 s e-='�;"
..�
Breakwater/Sill
~�
Max distance/ length
p (Z0,P 0*E-V
Basin, channel
ti-
/'��
. � 15 tJ (IA Gk • A'R-M
I..L'F'T'
Cubicyards
Boat ramp
tJ
Boatbouz BoaBi() 12. V.� 5
Beach Bulldozziyi,ng
Other Jt``X' i
V I
\
I 41
SAV
ekes&
observed: yes 4D
rye.
I 3
Moratorium: 0 yes no\(\
Site Photos: ,yt9 no
IP
Riparian Waiver Attached: yes e
I
A building permit/zoning permit may be required by:
C'.rir%- s U Gl✓ C.at in .[
❑ TAWPAM/NEUSEIBUFFER (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) FYI Y. I'll,.
1/t �L +� �. e l l
Monica L. M. Small D
M,.lk
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name -
�ar4 ��' Yam'{-
Signature ••Please read complian s a[emen on back of permit•• Signature
Application Feels) Check JI/Money Order Issuing Date Expir tion Da e

❑DREDGE & FILL N9 89148 B C D
GENERAL PERMIT Previous permit
Date previous permit issued
ew ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coast I Resources Commission in an area of environmental concern pursuant to:
15A NCAC o k+• 1 2.0 d ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.eov/CAMArules
Applicant Name :PaLUs1 C.V e e,L
Address
City P}. lAO r6nnr ate ls� G zip
Phone # UL) -
Email Aamt Ck-j.� c--t'- A®.�c t-. he�
Authorized Agent L S --r M ct, r t 16 --
Project Location (County): CAJoe V- t 7k_1y c: L
Street Address/State Road/Lot #(s) 2.3(t—lam Cx rLW-% F� C_re, S
r _ `,
Subdivision
city Polo,+ gwc6er IF.
Affected ❑ CW �W PTA ❑ ES ❑ pTS Adj. Wtr. Body A (bcvAa r l e rSg 0 Aflpran/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body A\ d e wta e � C S 612 IRA
ORW: yes no PNA: ye,10
Type of Project/Activity mnc -C,� �o2{i '_Ch �tp, S1JtLna c e-
G�t (Scale•i"I'2-o 1
Shoreline Length 100
Access Length AL3EKAV— L� Sa U14D
Pier (dack)length ^_ �~
Fixed Platforms)
ni
Floating Platform(s)
IB O
P I Srrn
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore����
N
Breakwater/Sill
P tzoP O s EY7
Max distance/ length
Basin, channel
^,
/`i
i� g w t}1 G - A-V_1A
CubBoat
Boat
L
s7 t
ramp
ramp
Boathouse Boatii t 2, 5�t 1m. 53
Beach Bulldozing
Other _1C—S
\
d
Vl
SAV
CkC,�(�
t� .
observed: yes no
fy
Moratorium: n/a yes no
Site Photos: yes na
(P
Riparian Waiver Attached: yes no
I.
A building permit/zoning permit may be required by:
f
r-, rr t �U C� Cot n.T.0
L]TARJPAM/NEUSE/BUFFER (circle one)
Permit Conditions
ElSee 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)
Mnr�1N Y\L}Gh�l�
Agent or Applicant PYNTED Name
Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of
permit** Signature
eb0 0 0
3 z-. `� "!
I z
Application Feels)
Check q/Money Order Issuing Date I IExpir
lion Da e

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Z4VI li f &jLL K
MailingAddress: i I �... i. I I► t
Phone Number: R'b 9 3JJ--7
Email Address: 12AVQ , CN K F—K. tQ C14 Z 112- ,
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: r !Ai b%;, L— P141
at my property located at -SAW C -S A-44j/r
in Lt trt 24 y"1,44 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
flif Gft) K
Print or Type Name
Title
Date
This certification is valid through /I I J-r I3lb

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
Mailing Address of Owner:
DAVID CHEEK
236 GRIGGS ACRES DRIVE, POINT HARBOR, NC 27964
236 GRIGGS ACRES DRIVE, POINT HARBOR, NC 27964
Owner's email: DAVID.CHEEK@CHARTED&Ts Phone#: [phone]
Agent's Name: SCOTT SMALL / LSI MARINE Agent Phone#: [phone]
Agents Email•.
SCOTT'rilLSIMARINE.COM / [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to ba completed by the Adjacent Property Owner)
I hereby certify that 1 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 DO have objections to this proposal.
If you have objections to what is being proposed, you must noury the mu. urwsron or coasrar
Management (DCM) In writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Grim 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
notined 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.)
100 wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
U311
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's small:
C.
WILLIAM C & ANN E SHEPPARD
240 GRIGGS ACRES DR, POINT HARBOR, NC 27964
ARPO's Phone#:
Date: 6 - f' ,;Z `f "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 NOTIFICATIONMAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
DAVID CHEEK
Name of Property Owner:
Address of Property: 236 GRIGGS ACRES DRIVE, POINT HARBOR, NC 27964
Mailing Address of Owner: 236 GRIGGS ACRES DRIVE, POINT HARBOR, NC 27964
Owners email: DAVID.CHEEK@CHARTEI jLTS phone#: [phone]
Agent's Name: SCOTT SMALL / LSI MARINE Agent Phone#: [phone]
Agents EmaiP. [e-mail] / [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom ortion to be complated by the Adjacent Propertysjv r)
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
ps _ description or drawing with dimensions, must be provided with (,this fetter.
!� t/ I DO NOT have objections to this proposal. 100 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
matted to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909, DCM representatives can also be
contacted at [phone]. No response is considered the some 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 Sian
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback
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:
Typed/Printed name of ARPO: BETTY K WISE,
Mailing Address of ARPO:
232 GRIGGS ACRES DR, POINT HARBOR, NC 27964
ARPO's small: Pan Q�taby - ARPO's Phone#: _��-122 -
Date: �i/�la�°waiver Is valid for up to one year from ARPO's Signature"
Revised July 2021

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