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COA$U, ®LAMA ❑ DREDGE & FILL A B p D
1 14 GENERAL PERMIT Previous permit °
Date previous permit issued 9 I
[ I New ®Modification F-1 Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission In an area of environmental concern pursuant to:
15A NCAC 0 Z Y J2 00 ❑Rules attached. General Permit Rules available at the following link:www.dea.nc.gov/CAMArules
Applicant Name Ll✓S Va✓ O Ij Authorized Agent I ✓C n ✓CS ��T T
Address b 1 OR c k+ 1 a S S (_Ot4&e Project Location(County): �v�' 17 1 A
City ���✓ G✓✓) State G zIP R f Street Address/State Road/Lot#(s) � /I L �' ;//�,7 ✓1 VC
Phone#( )
Email 1,✓/5 D✓h SubdWhIon -
city/V �✓ I�iC✓ ZIP
Affected ©CW ®EW [ PTA 7ES PTS Adj.Wtr.Body Il✓+ G C� C yOG /T nan/unk)
AEC(s): OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal.Wtr.Body
ORW:yes/10 PNA:yes&
Type of Project/Activity ✓d04SL `''� y �� he f I oh S� (Sca1e.1V / S)
Shoreline Length _ __ _ _ __ _ ______ _+_ _ _ __ _ _
Access Length S �'`30 - �' = - - -- - --�-- _ - I._ -JI ` _ y Y4 _ i__ _ _
Pier(dock)length -f`X3"6
Fixed Platform(s) 9 i V U -
Floating Platform(s) i -'- - - - - - - - �- - - - - -- -
Finger piers)
Total Platform area �' _ _ _ __ _ _�__ __'_. _ _ _.� t_
Groin length/#
Bulkhead/Riprap length
Avg distance offshore
_ r
Breakwater/Sill
Max distance/length
Basin,channel — - --;- - -- -j- I - --I-- - - + - - - - - - - ; - - -- - - - ' -
Cubic yards _ - - --:•._...-1-- - - - - _ _ --I- - --� -� --�-
Boat ramp - --f- - - s-- - --�- i -
�gy�/Boatlift 13 `X 3 0' _ _ - -- -r- - --�- 71-
Beach Bulldozing ' - - I r-
i '
Other O h .' _ _ _ _ _ i -, bqo
_
SAV observed: yes
Moratorium: n/a yes - - - - - -�-- --f - - - - - -- -- �n
Site Photos: yes ---
Riparian Waiver Attached: no
A building permit/zoning permit may be required by: L y°?ter'V1 G��►�-y /� /
Permit Conditions 1)To to f70 7 -4° GXede 80at�� l �7 � a�� TAR/PAM/�$ BUFFER(circle one)
v a7tL' �G7 !kt 3 wer J'Ja�ee note on back regarding River Basin rules
ceii I w. Giw '` i,J, '- /
�a71�, I�dc►) See additional notes/conditions on back
✓vm il/ Lv L
f 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
y00-91111- i V / � 9//
Application Fee(s) Check#/Money Order Issuing Difte Expiratio Date

M.0 ONloolf OF C04&S-AL V"At;EjW/T
ADJACEW R»AR{AM P am'' -imago w--WCA;1p1VIMANER -:
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PON to tf P nm!y OWWG h
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Ad"n of Pup"
64W&q Ad&ou of Owner
0~1 email Owr+w s-"Lvgw
A90M s Name !tit r7�4v> again -"MV
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ADJACENT RIPARIM pRppERnr C%VNEW 5 'E-R-*tCA-CM i
t3ottonr 0ornon tti tta ror.,ol.se e,..rw. �, arq�ar� -,-
I hereby certify that I awn property adlaLvnt to ten a0ws rarwerxx,_vgywrtv �r•,>v+ �„al 4.1 }
pernvt has deserted 10 me, as strewn an the atta rW arawrg. 7►a .:0varcLx-m-4 swv xe argANOs
OesCnDtlon Or Or3%VM WrQt @nWM$, Tn441 to Weyfe r rrrh'fl'v 414. n
I DO NOT have Obtectnns to!his prvppsiif, Ct 'pare► _rj*t.ax+S c,sus p�epra�►.
M you have oni 10 pr nwxr wdh r+n ti`+wa+.
Management(DCM.►+n wrrHng WOW" 10 days o1 racoW of mt3 wtlrr N
mailed to I00 Comma+cv A w. Mwahoad Crry.NC Z&V, 01M rawoomom ww vo alw aawur.wrr
St(252)808-2008 No rvsPOnse rs If ywr Ph"a Jwr+/Maf wr Q!�
Cwti ed Mail.
WAIVER SECTWN
I understand that any Proposed Pier di**-*, n>tvrrlV pdurgs,bust imio.NudKwdtw �v ttiwsv, rtt
groin rnusi be SN DaCk a mnru►urn ctk;>afrxy Of I hor►r my rw ut va4"r t��r. .���w+tw.ti rw
(tens does not apply to tvWXk%le;,x nprtlp rereo"O ts). tlf VW wwh W*+*vo 7►v vuv., v" •%JILL W&V
the sppropnate blank below )
I DO wish to wales somu/t+N of thr 15'**U> ,'k
�I krll,�tl.'r 3Jjih M,rl ti'!tia hen, '�l.}qA l) �>•,1a
-OR.
I do not wish to wa+vu tha Iti' vpltweh rehluuwrra+rl k"Idw,Ihv Nell*'
Signature of AdWont Rtsw+leur Pro4wty Owrwt ( .�^+►►^ � ?• �` ,
TypediPrinted name of ARPO: (G,�/ L� 4�v Av6w%,l
Mallhip Address of ARPO:
ARPO's small _ . Altl"(► Ptwwt#,t.
Date: 'wolver 10 valid h4 up h•woo year AWu 4xv% % Vwk"401
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ACAMA I DREDGEd FILL V� 1U 1084 A 9ac
Previous p ,rnGENERAL PERMIT pate PrevwxA perrTut suwd
[ IModifKatwn (;Complete Reissue 'Partial Reissue
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A^*-111.e/.Wily Chad NA"-- Order 11SW'o�G""_"_ _ o,a

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: CHRIS VARHOLICK
Address of Property: 411 LILLIPUT DRIVE NEW BERN NC
Mailing Address of Owner: 411 LILLIPUT DR NEW BERN NC
Owner's email: Owner's Phone#:
Agent's Name: TRENT PRESCOTT 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.
*—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 DO wish to waive some/all of the 15' setback
Signature of Adjacent Pitfarian Property Owner
-O R-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: /�0�� (/, /���ti/✓i
Mailing Address of ARPO: �� (<<f0r��. ��e�l (�C/✓1 AL, 261Z
q
ARPO's email: b% �� /+y�yr�a. 1.cc" ARPO's Phone#: 1 37"Gs7-5"10 j
Date:20 waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

9ftx20ft no exceeding the allowed amount
9FT x 20FT 59ft total from waters edge
13ftx30ft Boat house with boat lift
50ft x 5ft concrete walkway from water edge of river shore
30ftx5ft walkway into shore
CHRIS VARHOLICK
411 LILIPUT DR
DRAWING BY TS PRESCOTT MARINE CONSTRUCTION DOCK STARTING IN ZONE 2 30FT FROM WATER EDGE GOING THROUGH ZONE 1
TRENT PRESCOTT NO SEAWALL WILL BE INSTALLED AT THIS TIME
252-838-2458