89187A - The Pony Pen LLC

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AMA ❑DREDGE & FILL r4v 89187 \.JBC°Previous permitN E RAL PERMIT Date previous permit issued ew ❑Modification [—)Complete Reissue ❑ Partial Reissue
As authorized by thhee SttaJje of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I $A NCAC /J a I f I `� a ❑Rules attached. ��'TPnera] Permit Rules available at the following link: www dea.nc.govICAMArules
Applicant Name
'7 /1Q voely C'jA (��S �Occj Authorized Agent /'f 7/ek,1'f^C tnVr UdA i. J4 Yo r^an
/':
Address Z, h aye (o fi Project Location (County): 1) Ci( r—
City a rCs�A��0J, State ✓ %i' ZIP Z3 ��� Street Address/State Road/Lot #(s) �'%/ (a f A-i u t l w
Phone #(/u ) �J,S•l^Y°%ca G0.rVa. l:.cj4 SR 17-s.f to
Email e-LbgArcm en 711 11 ec%A Subdivision
city i/V'f`h.rf -5 _ZIP 1-72V3
Affected ❑ CW &,W OkA (EgX - aW5 Adj. Wm. Body Ca wA as / rtlA 5,1 .n / (`W ma nk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. Wtr. Body /'Chas-��trl c!
ORW: yes/ o � PNA: yes/r
Typ of Project/ Activity J ' / n T b
r/Ja'rL 5 uin0- X%5-PLACEMGNS' hNP Ssii 6 Evi afy LA,J/i4
Shoreline Length — I % C J
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Access Length _._ C. A x A (-
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Pier (dock)length
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Fixed Platforms) — __ /
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Floating Platforms)
Finger pler(s) T „(• I y
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Total Platform area v �
Gr length/N � -k'
Bulkhead Ripraplength f a, y� �( 'V VAS
(tJ
Avg distance offshore Tn�(
Basin, channel
Cubic yards.____
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Boat ramp
1
Boathouse/ BoatliN
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Beach Bulldozing
Other
ql
SAV observed: yes no,. I �THDR r Z t-h 'f U 44<1r/k-yq Z LnN s W AR P J C-
Moratorium: n/a es no
Site Photos: yes' no
Riparian Waiver Attached: /1 -n6. /
A building permit/zoning permit maybe required by: �'D� CCV' o AAAfE
Permit Conditions
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❑ TAR/PAWNEUSE/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) K ��10
Y
Agent orApplicantPRINTED Name Permit Officer's PRINTED Name
Signatur '•Pl� e'd�e read compliance statement on back of permit' Si tyre
Applictdon Feels) Check N/Money Order Issuing Date Expiration Date

❑DREDGE & FILL N9 89187 CA)B C D
GENERAL Previous permit
PERMIT
' Date previous permit issued
New ❑Modification ❑Complete Reissue []Partial Reissue
As authorized by the Stta;e of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC R I I `� a ❑ Rules attached. �eneral Permit Rules available at the following link: www.deq.nc eov/CAMArules
Applicant Name'The, 400AV
10-A LLC - C*AImo;,S dUCcl
Authorized Agent 4110,44,C Eri
V/i C'dAS rMAn
Address /n ; e •
Project Location (County): D CLra
r
City B eA dl State
✓ /4 zip Z5
Street Address/State Road/Lot #(s) -577/
(e If A-Z Ct Oci,
�j s y" 17 � /
Phone # (/%I
Ckf-y� fed./ -' Q 125�/
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Email Chb iL%cen 94-j�I
tCAM
Subdivision
City *V T ,Xa5
zip Z% ci ig3
Affected ❑ CW ®.FW
�RTA ( EL :�PTS
//
Adj. Wtr. Body C' �A Ck � ,1Lc1
5-7 rx (na man nk)
AEC(s): ❑ OEA ❑ IHA
❑ uW ❑ SPIMA ❑ PWS
Closest Mal. Wtr. Body / 0. rvj /J C
-S'o un el
ORIN: yes/t� PNA:
yes/C
ryp of Project/ Activity_
oN e T-e- 5 � /K e-
Shoreline Length — OJ
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Plafform(s)
Finger pier(s)
Total Platform area
Gr ' length/JI
Bulkhead Riprap length ,56) Jr
Avg distance offshore
Breakwater/Sill
ax distance ength y<I
Basin, channel —
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing �.
Other VI
R
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1N�
W p
/ -V ('� j -✓ -✓
T/ V
-V
Al/ RS1f�
4 ��V SNPU
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SAV 2
observed: yes no I �4 L/,,j.�-� � y�Nra uS A/Lp
Moratorium: n/a es no
Site Photos: yes' no
Riparian Waiver Attached: Jl1�nb,,
A building permit/zoning permit maybe required by: � Coo kA+
Permit Conditions
(Scale: N73)
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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) LC
Y d e rl A
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signatur "'Please read compliance statement on back of permit" Si t re
Applic lion Feels) Check N/Money Order Issuing Date Expiration Date

#F]New
❑CAMA [IDREDGE & FILL No 89187 A B C D
GENERAL PERMIT Previous permit
Date previous permit issued
❑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: v .dea ac gov/CAMArules
Applicant Name
Address
City
Phone # ( )
Authorized Agent / '
Project Location (County):
State ZIP ' ,j- Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ p-rS Adj. Wtr. Body (nat(m )funk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/r(o PNA: yes/no
Type of Project/ Activity
Chnrclmn I h
<; -/I -t .( i /
(Scale::, T S )
Access Length
Pier (dock) length
Fixed Platform(s)
Cam.
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Boathouse/ Boatift-
Beach Bulldozing
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Other
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SAV observed: yes no
Moratorium: n/a yes no
Photos: yes no
Riparian Waiver Attached: yes no i _1
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A building permit/zoning permit may be required by: (.l Cr. f s c, �. ^.t..
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)
l�
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature **Please read compliance statementon back of permit**
Signature
Check q/Money Order Issuing Date Expiration Date

AUTHORIZATION TO ACT AS REPRESENTATIVE FORM
Property Legal Description:
DEEDBOOK: 6� 72 PAGENO: 5�73
PIN NO.: 959513130707
PROPERTY STREET ADRESS: 57161 Pricilla C=cRoad. Haticus. NC 27943
Please Print:
Property Owner: The Pony Pen. LLC
Property Owner.
The undersigned property owners of the above noted property, so hereby authorim
Doug Domnan . of Atlantic Environmental Consultants LLC to,
(Contractor/Agent) (Name of consulting firm)
Act on my behalf and take all actions necessary for the processing, issuance and
acceptance of permits and/or certifications and any all standard and special
conditions attached
2. Enter the property to obtain site information including inspections with regulatory
agencies (Dare County, North Carolina Department of Environmental Quality,
U.S. Army Corps of Engineers, etc.) for the purpose of obtaining permits and/or
certifications.
Property Owners Address (if different than property above):
2501 Haves Road, Haves. VA 23072
PropertyOwners Telephone Number. 757.254-4901
We hereby certify that the above information submitted in this application is true and
accurate to the best of our knowledge.
v fti
Au Signature apd Title Authorized Signature and Title
Date: Ail Date,
Scanned with CamScanner

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: The Pony Pen, LLC -Christopher & Sarah Bucci
Address of Property: 57161 Pricilla Curve Road, Hatteras, NC 27943
Mailing Address of Owner: 2501 Hayes Road, Hayes, VA 23072
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Doug Dorman Agent Phone#: [phone]
Agent's Email: [e-mail]
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.
'9 � I DO NOT have objections to this proposal. __ I DO have objections to this proposal.
it you nave opjections to wnat is veing proposes, you must noury the ry.u. uivision or uoasrai
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 cooly 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
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: CMG 1/___-_----- - -
TypedlPrinted name of ARPO: Rob et & P a f claBeran
Mailing Address of ARPO: 114 Deer Road, Boyers, PA 1620
[e-mail]
ARPO's email: ARPO's Phone#: re19,- o'aZ j-6,
Date: 06/01M4 *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN REC-EffIT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: The Pony Pen LLC-Chris BUCCI
Address of Property: 57161 Pricilla Curve -Road, Hatteras, NC 27943 - --
Mailing Address of Owner:-P_.O Box 68, Bena, VA 2301
Owners email:[e-mail]- Owners Phone#:-757-254-4901
Agent's Name: -Doug Dorman Agent Phone#: [phone]
Agent's Email:—[e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
certify that I own property adjacent to the above referenced property. The individual applying for this
as dpacribedl to me, as shown on the attached drawing, the development they are proposing. A
I DO NOT have objections to this proposal. _4 I DO 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
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 C A�
'Signature of Adjacent Riparian Property new r
-OR-
1 DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:-Bailey Park, LLC - Dave Dixon
MailingAddress of ARPO:-P•O. Box 250, Avon, NC 27915
ARPO'semail: [e-mail] ARPO's Phone#: -252-95-
Date: oglw194 `waiver is valid for up to one year from ARPO's Signature'
Revised August 2022

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LEGEND -
__.__._.. _WETLAND LINES
75'. A€C. LINE.
-- --- — 30'DCM BUFFER LINE
-- NORMAL WATER LEVEL
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. x x �'
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-2'0 x x 2.0' �-T •�� FINGER PIERS
x 28 _ r
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I
6 PROPOSED BULKHEAD /
500 LINEAR FEET
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NY PEN, LLC
CAMA
GENERALOPERMIT- BASIN
57161 PRICILLA BULKHEAD
CURVE ROAD
HATTERAS — DARE COUNTY — NORTH CAROLINA
15 ol 30'
60' 90'
GRAPHIC SCALE 1"=30 ATLANT/C EN!//!'ONMENTAL
P.O. CONSULTANTS,
LLC
gOX 9266, K/TTY ^YK NC,
FILE.
27g4(g
BUCCI DATE: 08/05/24 �2'S2f26/-7707, e-mo// MOMM'
REVISED: ec®gmoi/.com