89307A - Terryberry, Daniel

9
GENERA
dNew [-]Mod'.
As authorized by the State of North Ca
City E liae be.)t, crt-y State
Phone # ( )
Email O t 6rry
IEDGE & FILL N9 89307 ' A B C D
. PERMIT Previous permit
Date previous permit Issued
ion ❑ Complete Reissue [:]Partial Reissue
Department ofEnvirormsentai Qualityand the Coastal Resource, Commleslon in Maras of emlronntental ctxrcern Pursuant m:
❑ Ralb attached. ❑General Pertnk Rulm avalyble az the (oBaMna erdc w.M.rrl.,, ,. a...rr•nwsn_v�
ry oath
III, r
C- _zl
Glpvd, Cp+.
Affected ❑CW YEW LJ�A
AEC(s): ❑OEA IBA ❑UW
ORW: yes/® PNA: m4g.
type of Project/Activity. REs`s "° CX7s
4 Pile i3ana17Ff f+, t -
Shoreline Length + SJ
Access Length —
Y'
Pler(dock) length
r-
Fixed Plafform(s) """
r
Floating Platformis)
' 7
Fingerpfer(s)
I_
Total Platform area
Grain length/H
Bulkhead/ Riprap length
,Avg distance offshore �.
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse oatl IZ.S, 13.5"
Beach 9611dot ng
Other �7
SAVobserved: yes no
Moratorium
a yes no
Site Photos: lam' IS
Rlpadan Waiver Attached: yes no
A building permit/zoning permh may be n
Permit Condldons
Application Fee(s)
Authorized Agent Ear}A 61-.n/r.5 M1r/„C t.Le
Project Location (County): p45Cww k. of
z 7q.pq
Street Addrecs+5tate Rpad/I.ot #(s) _ 1 oS M ✓� � rr } p r•
Subdivision
city lE1:2,SC;1, /c"H 71P 27909
[es
26s
Adj. Wrr. Body Pa Si"o1-p..
j( R;,icC'._._
na wiNnk)
❑sPIMA
❑PWS
Closest Maj. Wt: Body
/�.
f %SQvpi-n..lt R irE r
o,a Re ploce wif't+
-L r Sgr+.r poor,
on back of permit*4
Z.r 'X
TAWPAM/NEUSMUFFER (circle one)
see note on back regarding River Basin rules
❑ see additional notes/conditlons on back
m
I
VD REVIEWED COMPLIANCE STATEMENT.
(Please Initial)
Ro ae+
Penni[Officers PRINTED Name
Agnature
10/z�/z�'2/z8/zs/2�2/Z8/]
$
Issuing Date
Expiration Date

❑DREDGE & FILL
a
GENERAL PERMIT
[New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
'N9 89307 A B C D
Previous permit
Date previous permit issued
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 7 H • 1 2-0 0 ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwcIeq nc govLCAMArules
Applicant Name p a n s a ferry 6"'
Address l o S /h w-
4.10- or
city E V2.a6e,L, crf-y State NC- ZIP 71,9
Phone # ( )
Email " ' err I'rmy Z,$�(� ) Llo v�, C,
Authorized Agent 5>r+6 54. Ker5 Mar/,tee LL
Project Location (County): _ Q 45q.. It r
Street Address/State Road/Lot #(s) 10S /" t erJc n re'L 0 r'
City G%f"y ZIP 1790
Affected ❑ CW Q PTA l ES �pTS Adj. Wtc Body Pa S�VpO }o- K V C r' �( man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body 11 R�"e�
ORW: yes/(9 PNA: yes/0
Type of Project/ Activity Rem. Pt-e ex
4 P l le Q oa 4-17Pf w"1-t, %,
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) _
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards --
Boat ramp `�
Boathouse/ eoatliff IZ, SAX m. S
Beach Bulldozing
Other KGB
�y
SAV observed:
yes
no
prop,
Moratorium: n/a
yes
no
I
Site Photos:
ye
Riparian Waiver Attached:
yes
no
A
♦yt-
A building permit/zoning permit may be required by: _
Permit Conditions
sF;�9 Ocn+Iif-i- a.,d Repl4ce wril e`V 12.f'X IL.S-
>«,[ S4� r Fc, pr�Tl, (Scale:AITS )
H/ V
E1C'sF°"9 a Pt°'+f0rx*x
1- \ CX'SfAJ I�'*Ikfje*�
cJt:s�r��
ewo+rf+
6 etif2t cf-
Prof
�/�
❑ 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)
R06er4-
Agent or Applicant PRINTED Name Permit
pO(�'s
(iccers PRINTED Name
Si nature **Please read compliance statement on back of permit** Signature
1kGlO,00 R 9s (o/Z�/2y 2/z�/1-9-
Application Feels) Check #/Money Order Issuing Date Expiration Date

Name of Propely Owner Requesting Permit:
Mailing Address 1 D 5 IUtaPgaref -Dr.
�I tu+b C�Iu WC a-790ci
Phone Number
Email Address: _GG`_ ruolJ@ IGloud•cow"
I certify that I ha fe authorized
Agent i Contractor
to act on my bE t alf, for the purpose of applying for and obtaining all CAMA permits
necessary fort following proposed development:
,e ocetY�zn� 0� �ov}h StD�, t' 0A.-rLi rT-
at my property sated at
in�o-Sgvo-1 k Countv.
I furthermore
Division of Q
on the aforer
permit appifc,
Property Owner
This
V that l am authorized to grant and do in fact grant permission to
Management staff, the Local Permit Officer and their agents to enter
ned lands in connection with evaluating information related to this
II
Title
is valid through 41 1 110 1_ a T

N.C. DIVISION OF COASTAL MANAGEMENT
RIPARIAN PROPERTY OWNER NOTIFICATIOWWAIVER FORM
Mdll
(Top portion to be completed by owner or their agent)
Name of Prop,dv owner
Address of
Mailing Ad(
Owner's an
Agents Na
Agents Em
Phone#:
Agent Phone#_r�
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
ottom oortlon fo be completed by the AAiacent Pro oft n i
Permit cerbtyihatiown Property adjacenttofheabovereferenced Permit
has de cribed to me, as shown on the attached drawing, theeddeve. The individual applying ing. A
d on �� vri oath 'i en io s mustbe provided v' 81s lettar lopmen they�r�R reposing.
�(�opr LIFT K+=PLACF(^
NOT have objections to this proposal. __ I DO have objections to this proposal. 1 P posal.
if you have o jCN) I s hi1:1 ing !s n fdng proposed, you must notify the N.N.C. D/vlsdoof Coastal
Mailed W erit DCM) !n wridnp wlthtn 10 days of racelpt of this notice. Correspondence should be
matted a at
S. Griffin St, Ste. 200, Elizabeth Chy, NC, 27909. DCM representatives can also be
contacted at ( 52) 264.3901. No response /s considered the same as no objection if you have been
nad led by Ce filled Matt
1 understand any WAIVER SECTION (Choose only onet
Y Proposed pier, dock, mooring pirmgs, boat ramp, breakwater, boathouse. rdt, or
Groin must be back a Minimum distance of 15' from my area of riparian acces
this doess unless waived by me
Home ret2vnanfs}. (If you wish to waive the setback, you mum t abn
the appropriate
i b Iheads or riopriate blank lteWw.)
100 wish to wE ive someleli of the 15, setback
-OR- Signature ofAdjacerd Riparian property Owner
I DO NOT wish I to craw® the 16 setback requiremant (initial the blank) _
Signature of A 1jacent Ripartan Property Owner. �"T 1✓.7.as SG( t
TYPed/PrinW ame of ARPO: _ R U552i i fi1d, L
Meiling Addm s of ARPO: go Z2
ARPO's email: ! ��'� 7'tt pp
i� ARPO'a Phone#:
Date: ��` ,' �. �:. •waiver is valid for up to one year from ARPO's Signatunp
Revised August 2022

Name of Property i
Address of Propert
Mailing Addreg� of,
ownere entail..
Agent's Nama
Agent's Email- 41
N.C. DIVISION OF COASTAL MANAGEMENT
RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Z AI RC 1 URN RI GLIP I RECaU f,._ gL,j tAND DELIVERY
(lop portion to he canfplotnd by owner or their agent)
- �Amr_
FOOwner's Phone#,
LL C, Agent Phone#: r'X_-�Q - 3 30 -,a L4 c�
RIPARIAN PROPERTY OWNER'S CERTIFICATION
I hereby certify, that I own property adjacent o the above referenced property. The individual applying forthis
Permit has describ to me, as shown on the attached drawing, the development they ereAropcsing. A
description ar-draw g with dimensions must be provided with this left *J-10H,r LI f- K" LA-" ne f.3?-
I DO li have objections to this proposal. I DO have objections to this proocsai.
n you have objec ions to what is being proposed, you must notify the N.C. Division of Coastal
Management (DC j In writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. C. riffn St, Ste. 300, Elizabeth City, NC, 27909. DCM representatives car also be
contacted at (252) 64-3901. No response Is considered the same as no abjection if you hays been
notified by Certifte d Mail.
tE WAIVER SECTION (Choose only onel
F i understand that ar y proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse lift, or
groin must be set b ck a minimum distance of 15' from my area of riparian access unless waived try me '
this dons not appi to bulkheads or ri ra ev en ), (If you wish to waive the setback. you must sign
the appropriate blar k below.)
1 DO wish to waive ome/all of fh 15, setb \ ignafu of Adjacent Riparian Proparty Owner v—
-OR- �1
I DO NOT wish tow ive the 15 etback requirem (initial the blank)
nature of Ad*nt Riparian Property Owner:
Typed/Printed naofARPO: --P)a+rfy M �c
Mailing Address taf ARPO: ©Q S tYl t7 V
RPO's e"l- ARPO's Phori ZS Z ` 33c ' wwd
kit (Cj i 'waiver is valid for up to one year from ARPO's Signature•
Revised August 2022

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