89219A - Graves, Bonnie

A°"eAr', EACAMA ElDREDGE & FILL Nn 89219 A B C D
a GENERAL PERMIT Previous permit
Date previous permit issued
0 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:
I SA NCAC - ❑ Rules attached. ] General Permit Rules available at the Following link: www.deq.nc.gov/CAMAruk,
Applicant Name
Address
City State ZIP '
Phone # ( )
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
cFnmlinn lnnmA
Authorized Agent - --
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body (nat/man/unk)
Closest Maj. Wtr. Body i
(scale: 1''., P )
Access Length.
ME
m■
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JIM
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0
0
Floating Platform(s)
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.
C
..III
....
..... . -.
Max distance/ length -
Basin, channel
Cubicyards-
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1
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NINE
WHO
son
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:::::::
INNER
A building permit/zoning permit may be required by:
❑ 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 PROJECTAND 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 q/Money Order Issuing Date
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfINAiVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or NAND DELIVERY
RECEIVE®
(Top portion to be completed
a�by�fowner or their agent)
Name of PropertyOwner:
Address of Property IK � If
Malay, Address of Owner
Owner s emag1LGr 64J�-�:ifM � h D Owneers Phone#'._
Agent s Name- nliil ta.i Agent Phone# _._ ....-._.
Agents Email
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Dot[ m portion to be Completed by the Adjacent Property Owns)
I hereby certify that I own property adjacentto the above referenced propertyrheindivitluai applying for this
permit has describell.to me, as shown on the attached drawing, the development they are proposing. Q
descri tion gdr9w-In% with diffilifilligns.must be Provided with thi§ Igthir
___, I DO NOT have objections to this proposal. ____ I DO havo objections to this proposal
N you have ob)ect/ons 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, NO, 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 on
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
grain 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 riorao revelments). (if you wish to waive the'Setback. you must sign
the appropriate blank below.)
100 wish to waive sometall of the 15' setback
Signature ofAdjacent Riparian Property Owner
-OR-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian
TypedlPrmted name of ARPO:
Mailing Address of ARPO: L/S /il^'-hV GIM%�`%!�j/hI 27i"7t�ftlf' Ise'-2/}
ARPO'semai" d/tN%J/'M1`'JiC'� ARPO's Phone#: 7alS'..i-t1i"/
Date: _1'
7--Waiver Is valid for up to one year from ARPO's Signature*
Revised August 2022
AUG 1 4 2024
0CM—EC

OK?
o;=? Steve KIute ,6 c,,
Bulkhead
sae Aug 13, 2024 at 7:08:40PM
i- [e-mail]
RECEIVED
AUG 14 2024
DCM-EC
N.C. DIVISION OF COASTA( MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiOW WAM+ER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND D I IVPRY
(Top portion to be co
mpleted by owner or their agent)
Nave or Propeny Owner
Addressof Property
Mating Address of Owner,,,,._fjfflj�
Owners emit�Qf �') l�I�L.IyAgtl.Onets phone€
Agent's Name Agent PhnnWk_ __.,
Agent's Emait.
AWACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(4iattOm cordon to ce comoleted by the Adiat a it P rtv Ovme I
I hereby Canty that i own property adjacent to the above referenced property. The tndrvidual applying hcr Nis
WWI has (IM11 ed to Me as shown on the attached drawing. Me dawbpment they are proposing. 9
tlnscYd or tl w3' dimmons Must gMrqyd21X"iz laner.
lr✓I DO NOT have obpeclisis Ic this proposal. 100 have objections to this proposeW,.
n you nave obyecwons fa what is being proposed, you must nofffy the N.G DlWslon of Coastal
Martad to 40 fDOM) in aridng s. 300, 1d dsys of r(Y. N2 of this notice. CortespontloncC snouW be
mailed a att 5. 21PVdffl* St, Ste. gag n"FX-IS o Cfty, NC. e s a. as r s obla entafivas can also bbe
een,
""Meted d C(2S� YIMail,, . No r¢sponso it croAffdersM the same as no oblecHon if you have been
netlfletl by Certltted Mali.
WANPR SECTION (Choose onN on,
I understand Not any pfoPos¢tl pier, dock, mooring pilings, boat ramp, breokwater, boathouse, lift. ar
grain must be SM back a metmum distance of 15' from my area of dpedan access Unless wavtW by nee
(this tloes rrot eodv to bulkheads aliprap revetnwnk). (If you wish to waive the setback, you musts n
Me appropriate blank below.)
100 wish to waive wmel14 of Me 15' eacback
Sgnatum al Atf/acent Rgna.Han Property (?when
-0R.
I DO NOT wish to waive the 15'setback raqui(bment (inihai the btenk)
Signature of Adjacent Riparian Property Owner: ..rJ y"P ti I V la'4
Typed1Pdntbd name of ARPOO:,$Te'T'J7i A: tl.� �t. v i L
Mailing Addressof ARPO:
J,>yc1 C9 C1L Qs.. V,4,

ARPO's email•rARPO's PMonet: %S)' uV/�}� <j
Date: 'waiver is wild for uP to one year from ARPO% Signature'
R �EIVED
� 7u0 14 2024
- L.uiIW-EC

C;;o, RECEIVED
AUG 1 4 2024
rDCM-EC
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