101376C - Wood

COAStt -c❑CAMA ❑ DREDGE & FILL N° 101376 A B C D
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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:
15A NCAC Q N U 7 rUO ❑Rules attached. ❑ General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Name 1\_ Yip " I y -7/ '1 t4/✓G d Authorized Agent I✓L ^ t /✓�
Address / ✓ ✓ %a I C"' u + Project Location(County): ✓�n
City_, State C zip 2 7 2 'I ,S Street Address/State Road/Lot#(s)
Phone#( ) -7 0 3 09
Email Subdivision
City •C J�G k ZIP
Affected ❑CW ®EW ❑PTA ©ES ❑PTS Adj.Wtr.Body 1A1( L i. VC k' (fjjVman/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body ZL 0 5 ✓L
ORW:yes/no PNA:yesi /
Type of Project/Activity
(Scale:NT S)
Shoreline Length
Access Length
Pier(dock)length '7
✓Krt
Fixed Platform(s)
Floating Platform(s) e
i
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/.R, ierap gngth r) i C .
Avg distance offshore F t l 1 f
Breakwater/Sill r /
Max distance/length
Basin,channel
Cubic yards _
Boat ramp x
Boathouse/Boatli$
Beach Bulldozing
Other
{FG
SAV observed: yes no
r ]
Moratorium: n/a yes no
Site Photos: yes no'
Riparian Waiver Attached: yes no a"
1 J
A building permit/zoning permit may be required by: L r iil'y
Permit Conditions �� i '�;SG T t + Q lr i��1 �iCJ t ❑TAR/PAM EUS 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
14 3Lr'
Application Fee(s) Check#/Money Order Issuing Dat Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

COAST",&❑CAMA ❑ DREDGE & FILL N9 101 3i 6 A B C D
3°
Previous permit
AL PER= GENERAL
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.dgq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#(_)
Email Subdivision
City ZIP
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length
Access Length
Pier(dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) l
Total Platform area sl:.�t " r-•
Groin length/#
Bulkhead/Rip.rap length
Avg distance offshore J
Breakwater/Sill
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no t
Site Photos: yes no S
Riparian Waiver Attached: yes no t t
A building permit/zoning permit may be required by: ✓E f! r� �"
Permit Conditions I
❑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" Signature
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

..siA7F q
ROY COOPER
Governor
ELIZABETH S.BISER
Secretary `QUW
TANCRED MILLER NORTH CAROLINA
Director Environmental Quality
BUFFER AUTHORIZATION CERTIFICATE FOR SHORELINE STABILIZATION
A riparian buffer authorization is required for shoreline stabilization activities within the Neuse and Tar-Pamlico River
basins per Division of Water Resources(DWR) regulations 15A NCAC 02B.0233 and 0259. The Division of Coastal
Management(DCM)through a Memorandum of Understanding with the Division of Water Resources(DWR) has
reviewed your project proposal and has determined that the project as proposed complies with the aforementioned
regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per day per violation.
1. Impacts: Impacts to woody vegetation from clearing and filling in Zone 1 (begins at the most landward of either
normal water line (NWL)or normal high water line (NHWL) and extends 30 feet landward) shall be minimized to
what must be impacted for the sound installation of the shoreline stabilization project. Unnecessary clearing and
filling in the buffer is a violation of the riparian buffer rules.
2. Clearing&Grading: Clearing and grading of Zone 2 (begins at the landward edge of Zone 1 and extends 20 feet
landward) is allowed provided that it is re-vegetated immediately and Zone 1 is not compromised,which includes
maintaining diffused (non-channelized) flow of storm water runoff through the buffer.
3. Construction Corridors: Construction corridors are allowed for shoreline stabilization projects, but they must be
satisfactorily restored as described in condition 5 below.
4. Potential Overwash: For vertical shoreline stabilization projects (bulkheads) only; sites where wave overwash is
expected to be severe,the first ten (10)feet landward (unless specifically authorized otherwise by DCM)from the
structure may be maintained as a stable lawn in order to provide for structural stability.
s. Temporary Stabilization: Immediately post-construction, bare soils must be stabilized as quickly as possible by
providing a temporary ground cover. Newly seeded areas should be protected with mulch and/or erosion matting.
This ground cover is a temporary measure used to address erosion until site restoration can be accomplished.
6. Site Restoration: At minimum, pre-project site conditions must be re-established.A site that was wooded prior to
this shoreline stabilization project must be restored with woody vegetation at a stem density of 260 stems per acre.
Non wooded sites may be re-vegetated with woody vegetation. Restoration must be completed by the first
subsequent planting season (November 1 through March 30) after completion of the bulkhead.
• Pre-project site conditions: Existing bulkhead
7. Project Drawing:The drawing on the CAMA General Permit is considered the project drawing of your property
indicating the location of the shoreline stabilization structure and any associated clearing,grading, and construction
corridors.This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the above listed conditions and verify that all
information is complete and accurate.
I i-4 'J 7` (°-c Sm �,4
Agent or Applicant Printed Name Permit Off ic is Si nature
Agent or Applicant Signature Issub Date
CAMA GENERAL PERMIT#: 101376
North Carolina Department of Environmental Quality I Division of Coastal Management
Washington Office 1 943 Washington Square Mall I Washington,North Carolina 27889
raoRni�CAFK)Q�NA
ao. dauwa+rn� /� 252.946.6481

1 '
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit ROBERT AND DONNA WOOD
Mailing Address 3027 NEW SALEM RD CLIMAX NC 27233
Phone Number 336-736-0304
Email Address
TRENTPRESCOTT
I certify that I have authorized
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: DOCK
at my property located at 1695 TINY BRYAN RD HAVELOCK
In Craven County.
1 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
Robert wood
Pant or Type Name
Owner
Title
3 24
mate
This certification is valid through `-

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)
ROBERT AND DONNA WOOD
Name of Property Owner: _ —
Address of Property. 1695 TINY BRYAN RD HAVELOCK NC
Mailing Address of Owner: 3027 NEW SALEM RD CLIMAX NC 27233
Owner's email: Owner's Phonell 336 736 0304
Agent's Name: TRENT PRESCOTT Agent PhoneM 252-838-2458
Agent's Email: tspmarineconslruction@gmaiLcom
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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 notify the N.C. Division of Coastal
Management(DCM)in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave..Morehead City,NC 28557.DCM representatives can also be contacted
at(252)808-2808.No response is considered the same 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 sign
the appropriate blank below.)
(� I 1
I DO wish to waive somelall of the 15'setback
Signaturedf Adjaceift Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner. '.Ae j %k1-a—
Typed/"nted name of ARPO: G en /}
0
�. v / Rorr,nl�
Mailing Address of ARPO: J `f'30 C c,ri2iA,) �fi L'Z7�°I(p
1 �
ARPO's email:.) ri 2 kk 1 VAR'P0's1Z Phone#:
Date: 'waiver i4alid for up to one year from ARPO's Signature'
Revised July 2021
l

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 ROBERT AND DONNA WOOD
Address of Property 1695 TINY BRYAN RD HAVELOCK NC
Mailing Address of Owner. 3027 NEW SALEM RD CLIMAX NC 27233
Owners email - _ Owners Phone#: [phone]
Agents Name: TRENT PRESCOTT Agent Phone# [phone]
Agent s Email: [e-mail]
. .�..� .., ..�.,t., .,.,.,. ­—FICATION
SENDER:COMPLETE THIS SECTION . ........ erty Owner,
■ Complete items 1,2,and 3. A. s y. The individual applying for this
■ your name and address on the reverse pment they are proposing. A
so t we Can return the Card to you.
• this card to the back of the mailplece, Reomw by itr,r ed Mar"°) C. a of
or the front tf space permits. t
t. Artca Adonesad to D. is oeirmy aches wiwen Zorn Bern 1? G _ ecbons to this proposal.
it YES,drner Cei ery aoor—below. ❑No _.
e N.C. Division of Coastal
�<< "ko Correspondence should be
fives can also be contacted
J �7 f you have been notified by
v�1oU�l �1C'
3 Sanxx Type
�, DONrY =oe�err ater boathouse,lift.or
9590 9402 8645 3244 9112 49 7 Certfadeeu+aeaarcW00-WY Sgr 'C cess unless waived by me
❑C.0"a M oewwy a 61^ 0 ""' the setback.you must sign
Cooed on De6my ftW%ted Wwy rays � Denary
AMC*. Ade N-tber
f tram sarvKro tabed) J 1ed i Ru
j589 0710 5270 0302 5362 97tiOOe"'"
DOfnGStiG P_. .
PS Form 3811.July 2020 PSN 75531)-W4)0-901�
-- - - Signature of Adjacent Riparian Property Owner
-OR-
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 Phone**
ARPO's email:
'waiver is valid for up to one year from ARPO's Signature'
Date Revised July 2021

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