89165A - Miller, Ronald

0DREDGE & FILL
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W GENERAL PERMIT
N9 89165 0 B C D
Previous permit -
DM pvvkxn permit issued
®New ElModificadon El Complete Reissue []Partiallkeissue
As wdwbW by the Size, of North Carolina, Department of awwwon"dell QuAWacth, Coastal R,,ou,,eCownrk1sslon
15ANCAC- 1/4-1100 ❑[A C..WFla,
AppkaftNave, 1<*V\CL\6 r,% % �,E+ Audmulzed Asent
Address 10S "S, W Beock mil,city U tra:.n sa" NC zr 241 1& 0-5 2C—. d ;LCi
phone # (292) 14 - %C.CA led
F--1 Subdivision Wishes &AC&.
Cky__CQkeMA'f, MP 2.74z9,
Affected [I CW NEW E]m ©ES Eim m.wtr. soir Uvwm^ Pv'er-40--rJunk)
AEPs): C] 01A ❑IM r❑JUW C]SPWA Elms cs-- m4. wn,. Bir A16comwiet
Clew, "'(rJ PNX. vwro
TVPS of Project/ Activity
Access Length
-----------
Pler (clock) lewth J-
Fixed Plafform(s)
Floating Phnfomr(s) —
Finger plerisl
Total i'latlormam--
Grolin lengdV#
Breakutwinrlsill `--
Mae distance/ laugh Qr
Basin,dwonel_
Cubic yards ------
Boat ramp
Boathouse/"Oft
Beach BuliclazIng
other
$AV observed: yes <A
Moratorium no
Site Photos:a .
Riparian Walver Aftwhed: yes
A building permit mnk* pannit vW be mqhed by:
107or
Apphmdan Fee(s) Check Alm-ney order
issuing Date
(scale: 1116 3,f)
[-] TAWAPMELWBUFFER(drdone)
F1 S. POW on back -Wwvfi.9 Rile, Basin rule,
nSee additional noWconchbons on bad
Expradon

00°"'", ®MVV n)165CA A ©DREDGE &FILL � U a c D
14 GENERAL PERMIT Previous permit
Date previous permit issued
® New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the StateofNorth Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
r�
I SA NCAC /1 ) IUG ❑ Rules attached. © General Permit Rules available at the following link: www.deo nc gov/CAMArules
Applicant Name 1IC �S�A CACI ��tUlf--
Address o S _1. (_,AAt't p beac l'S M1C=t, �J
City Cok erain State NC zip 'r179211
Phone #(25Z) 3qy-.67O74
Email fhAl to r m @ e yV00 q yy DAl C-0Yr,
Authorized Agent p 1
Project Location (County): Street Address/State Road/Lot#(s) 1.61-'ii"5 2C. a 2C1 /
105 5. W�h� 4e� 1�e�h 2d_
Subdivision W�lTea geaci%
City Cokera.lo., ZIP 274z'/
Affected ❑ CW NEW © PTA k❑ ES PTS Adj. Wtr. Body C IkO60GLir. P--(^(4aVf r— man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ iY G �
SPIMA ❑ PWS Closest Maj. Wtr. Body zo o-,,4o_ Sm�d
ORW: yesk2) PNA: yes/rl6j
Type of Project/ Activity -1ra}a.l( Zo' oP FoU lh ()l a,1 6t,.,ll_t.tad
(Scale: 1"= _V)
Shoreline Length
Access Length
!_
Pier (dock) length
Fixed Platform(s) .._
V��� () is.
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhe / Riprap length
r
3�
Avg distance offshore
Breakwater/Sill
Max distance/length
0
Basin, channel
Cubic yards
—'
Boat ramp
AWL
Boathouse/ eoatlift
Beach Bulldozing
Other
SAV observed:
yes
xc 1,
��r•
Moratorium: <�nZ)
yes no
Site Photos: CyAyAs no
Riparian Waiver Attached: yes ©o ( /+ A building permit/zoning permit may be required by: &A—e Obtn!..r
Permit Conditions
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So
❑ TARJPAM/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)
W+,Q
Agent or Applicant PRINTED Name
Permit f cer's PRINTED Name r
�f�1G/�*-,
Signature **Please read compliance statement on back of
permit**
Signature
i9co.Q
1070?
q4gt
Application Feels)
Check #/Money Order
Issuing Date
Expiration Date

❑CAMA ❑ DREDGE & FILL NY 89165 �qj B C 4
GENERAL PERMIT Previous permit
Date previous permit issued
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/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone#O if
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ pTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PINS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale: )
Shoreline Lenath
M
gill
0
0
so
I
MIN
IN
IN
MEMO
ENEM
ISO
INN
N
I
ME
ME
Total Platform area■m9..�
■ami�■■■■.■■.■■
Groin
Avg ance ore
Other
11
EMS.immmom�ima
®�lliI��
11,111
�A
®l
1■1111N0
■
.
IN
moss■■mos■N■sss
Elm
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OMNI
ME
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.......Q...CC.
on
MEN
SAV observed: yes no
Moratorium; n1a yes no; J4
Site Photos: yes
no Riparian Waiver Attached: yes no■�is
IN
Ems
i
Miiiii�
A building permit/zoning permit may be required
Permit Conditions
❑ TARIPAM/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" Signature
Application Feels) Check p/Money Order Issuing Date
Expiration Date

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: R O)n
Address of Property: 10 5-Scck 'h 1c, S 13x .3 C[1 � � A") ,a`IV1, A"'t M ` X4
Mailing Address of Owner: 521vit
{{ l4i;tN
Owner's email: M i II.Owner's Phone#:
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(f3ottom Rgrtlon to be comploted by the Adjacent Proggrty 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 DMvided 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 owng proposed, you must nomy we n.t.. iirvrsion or ,oasrei
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Grfflin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection ff you have been
notified by Certi►urd Meg.
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.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
McRa
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Malting Address ofARPO:
ARPO's email: , '
411
Date:_\GPI
*waiver is valid for up to one year from ARPO's Signature•
Revised July 2021

I
I

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: O In M � 1 I
Address of Property: 0 IT Srj(,{`K,� �/l A l i) ( R o l AA I <r-U . ZA n„ _inn t
Mailing Address of Owner: S2n1t
ino�
Owner's email: Owner's Phone#:
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adjacent Properly 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 drawinn with dimnncinnc ......r k- _., ­_ . ..
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 it 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 ff 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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO:j3 �� T
Mailing Address ofARPO: ill Si _�(ililc Ki\iop Z3cj C%
All email: — ---- ARPO's Phone#: 7 S 7- 3 3 S - /393
Date: 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

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