89185A - Hammer, Jeff

p��F t00.S r4(❑CAMA ❑ DREDGE & FILL
3 GENERAL PERMIT
i
©New ❑Modification []Complete Reissue ❑ Partial Reissue
N° 89185 A
Previous permit
Date previous permit issued
C D
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:
I SA NCAC 0 -/ W ( t 0 Z) ❑ Rules attached. 0 General Permit Rules available at the following link: wwv✓.deq nc goy/CAMArules
Applicant Name S e i Uw,~,ct v-
Address t ?i 9 Df t x/ (_-:-
City CIl. v-v-kA0 r_.1; State f'.: !_= ZIP "'Z
Phone #( S]) 6 s'? Q l O �i G
Email tc. jnhla4 dAI(s trno.t Cn")
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Authorized Agent L a. 4 8 F- %, r' l a V-c-
Project Location (County): C 1.1 t' r i �LC.
Street Address/State Road/Lot #(s) i '21 <; > ul o „.A
Subdivision
City C u-('f \4 ALA- ZIP 2:191 tee{
Affected ❑ CW
ErEW ❑ PTA
0 ES
n PTS Adj. Wtr. Body - l I Oct- naU an/unk)
AEC(s): ❑ OEA
❑ IHA ❑ UW
❑ SPIMA
❑ PWS Closest Maj. Wtr. Body .-� <: 'r•
ORW: yes/no
PNA: yes/no
"
Type of Project/ Activity 1
_r
T (Scale$" =3c3 I
z.
.■■■
:.
C■N■
.
EICIII
ON
Finger pier(s)
=oC�
:
�IEEE
Total Platform area
I
■
®!■3
■
Groin
M3211■�'■■■■
liffINK9111
■
._.o�
��
I
■
Max distance/Jength. -2-
0
N
ON
MONO
0
Basin, channel
MY
Boat ramp
No
W
NMI
III
Beach Bulldozing
E
■..■■■
so
:'IliaIN
Other
;s
i
■®
i■
ON
mom
No
so
SAV "
III
NO ■■N
■■
■■■■■�■■■
:l���17■I
■■
mom
III
■
■■■
■■
■11101
1XIJ11
■,
Photos:Site
■■
n■■
■■
_
10
-NONE
A building permit/zoning permit may be required by: C.u.j-c\:'D 11 h:�_
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'
t .%_
Application Feels) Check q/Money Order
Signature
Issuing Date
Expiration Date

RECEIVED
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION JUL 12 2024
Name of Property Owner Requesting Permit: -1) 0+ J4/+w►eY+ Ifle,
Mailing Address:
Phone Number: % 51� %' Z� ' LP V O
Email Address:
I certify that I have authorized Lci! j& , wlonf i Q , rit L
Agen / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: )ltplapoM CnT
at my property located at 13 1 %Otn^d 5kOre K
in birrk-'uvk County.
1 furthermore certify that / 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
J (:rr(- r4A,^,,i /t_
Print or Type Name
GN�►Q/
Title
Date
This certification is valid through �l /

N.C. DIVISION OF COASTAL MANAGEMENT r'
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER F !/
(Top portion to be completed by owner or their agent) JUL U 2 2024
Name of Property Owner: SC'l r �'f A-V'v "" C Z
Address of Property: L�q S "^r8 S N-Orc('
Mailing Address of Owner. ,T—/ c,6 N L 214 2 9
C-o✓�
Owners email: 1L�n�t�sL�pC^n0'%-'Owner's Phone#-. �15� bZ
Agent's Name: � �E.�_ rYlL�r r� fref 1C Agent Phone#: ASP -
Agent's Email: f �GN �11VJA,fne ��O�MLaA CfOM
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 DO have objections to this proposal.
If you have objections to what is being proposed, you must norny me rv.v. mi-1w, — ate•
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
noted 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 si_ n
the appropriate blank below.)
DO wish to waive some/all of the 15' setback,
—Siq—na—ttu-h& A j cent Riparian P party Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO: � cgri rZ•'ii✓%�✓i7S
Mailing Address of ARPO: j � 3 5
0.�r✓D Zf� 0/2N`)e c �a2z r��1 tic. z z9
ARPO's email:
ARPO's Phone#. % 7' (7 Z "' 2.2'b
Date: 1-"L 'L _°waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT v E I `V` L D
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNUAIVER F
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY jUl C 2 2024
(Top portion to be completed by owner or their agent) `
Name of Property Owner. TL�r-'F 1-��+�^ ^�t'- DC;IVI-LC
Address of Property: b 2�0 O^J13 !')�0 0 19/L1v V
Mailing Address of Owner: C 'i't/L 1 T Jc - A) L 7
Gt�l o�{1or�v.R l i�""Owners Phone#:
Owners email: 1- Agent's Name: i G evt /%'IGtrl,4 P 1.777 c- Agent Phone#:o?Sa? ", ,3I — I
Agent's Emaii: iCUP /r -4' ` � " '
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(gettom 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
_ ___ -..:.a. A —ak {k;c lnttar
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 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
noted by Certiffed Mail.
WAIVER SECTION
1 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 GPiLL`�
Signature of A nt Riparian r perty Owner
-OR-
do not wish to waive the 15' setback requirement (initial the blank) j4
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Malting Address of ARPO: i 3 o Nb S l�o' � 17 2i j p J-?_-zl T�Cj2 N L Z 7 g 2
ARPO's email:
ARPO's Phone#: Z- )— L-L -223z
Date: rP Z _*waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

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RECEIVED
1UL 9 2 2024
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