89344A - Anderson, Chris and Dani

❑DREDGE & FILL N9.89344 (,_A,, B C D
GENERAL PERMIT Previous permit
a 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. O�General Permit Rules available at the following link: www.d .nc. ov CAMArules
Applicant Name
Authorized Agent
Address
Project Location (County): t
City
State
ZIP
1 09
Street Address/State Road/Lot #(s)
ri
Phone#(_)
Email
Subdivision
City !"
ZIP 2 7 `1 `' I
Affected ❑ eW
❑v EW ❑ PTA
❑ ES
❑ pTS
Adj. Wtr. Body '-
(na ma unk)
AEC(s): ❑ OEA
❑ IHA ❑ UW
❑ SPIMA
❑ PWS
Closest Mal. Wtr. Body
ORW: yes/no
PNA: yes/no
Type of Project/ Activity
(Scale: VTS )
Shoreline I enmh
Access Length
��C
Pier (dock) length
.
■.■
.
■
.■
■.■■
Fixed Platform(s)
MOM
NONE
M
■■■
ON
=6=Em■■■..■.■�
Floating Platform(s)
W■:■M:■■■■■:M_
No
MM
MEN
N:
■
Finger pier(s):C0ME
:
I
=ME::Total
C:.■::■
Platform area
Groin length/# Bulkhead/ Riprap length
Avg dl�ance offshore Breakwater/Sill _7..�.�::6■...E�.■yamMax distance/ length
Boat mmp':
Boathouse/ Boatlift■
Bulldozing
::'
'�
■N;;
�:::GI
:
m�.���
■■■■■■■■■A■■®■■■N■■■■■■■■■■■■■■■■■
C
o:'
E
�C�CC�C
::
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IF
.NM
u■
■■■■■■■■■®■■
.
■■■■■w■■■■o■
'■oBeach
ii■■■■■■■■■■■■■■
OMMERNIA
lither
no
C
■1�
■
C
�
ZAV observed yes nOD)
Moratorium; yes no
Zite Photos: yes no
Niparian Waiver Attached: yes rio�)v7■■■■9�
■.■.■■■■■■■■
■■■■■■■■.�
.■■■
MEE
M
mum
MEEM
ENE
■SI■a�9�■�■!■
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A building permit/zoning permit may be required by:
Permit Conditions
P,Sq o4.,•,IY co
C-
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
i.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"' Signature
� �I
_ 1
Application Feels) Check tJ/Money Order Issuing Date Expiration Date

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: Chr'i h F IJAd An Ll .r ian
Address of Property: 15_P2l*k C a rl Tk t Eli -a hr-4-h C.i-L . (U c 2 7-qD�
Mailing Address of Owner: 162- 4une Couv-I-i CA r-fk Cii4 rvi 2�ia�
Owner'semail: dAnirnCgS(? grnp;I Co»'IOwner's Phone#: 56- 4-9Cl9'5 �ChrS>
Agant's Name:
Agent's Email:
Agent Phone"'
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
! hereby certify that I own property adjacent to the above referenced property. The Individual applying fortis
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.
tr you nave oniaerrons to what is acing proposed. you must notify the N.C_ Division of Coastal
Management (6do fry writing within 10 days of rece/pt 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 if you have been
notified by Certified Mall.
WAIVER SECTION
1 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) ` J
Signature of Adjacent Riparian Property Owner:
TypediPrinted name of ARPO: nct�-� �U4r) ( �rw.
Mailing Address ofARPO: g0o&(Uuiktr k Qri✓l t 2, Q5aeec4-4 -, Uf`/� 2332z
ARPO's email: nun�NN 5e yarn. C0fh ARPO's Phone#:.C757 7'19 -o27/aq
Date: 10 Z 2 I- *waiver is valid for up to one year from ARPO's Signature*
Revised Juiv 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED fv1AIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: C hrl h I J61VI %art JPNt�0Y1
Address of Property.
q
c
Mailing Address of Owner: I O� r, Clt &-' Ztth L I4- tNC- �:El& q
Ownersemail: Cait9Owner'sPhone#:
Agen s Name.
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I nereby certify that I own property adjacent to the above referenced proparty. The individual applying fortis
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.
100 NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must noury me ,v.t_.. ✓.v...... — ��••-••••
Management (0CM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste, 300, Elizabeth Clty, NC, 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
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 sometall aline 15' setback
Stgnaturc of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement (initial the blank) Al ks
Signature of Adiacenl Riparian Properly Owner: i v I tvx.Axk K..t::.z: 0 -�u+•��""•�-.
Typed/Printed name of ARPO: MI :+vs ( t, 1 IL G i 41 j^rC df,,, +en
Mailing Address of ARPO: l t' % Li i C,%v 06n+-C ur• E A zn44ACi 4 yJ
c.M NC.179t7%
ARPO's email,. [i�X S�t`_�cr Cr va�er FAPO'a Phon- -
e#:25311-33is�
Data: 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021