76933A_Scarborough, Jule_20200625

\�<;AMA / DREDGE &FILL '*�1t.+ - (' '):� �, B C D
E N E RAL PERMIT Previous permit # } b S o ► /A
Modification (Complete Reissue Partial Reissue Date previous permit issued I / I (e / 7o a a
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 4i. a uO
.Rules attached.
Applicant Name 5��t 5 r_ a r-►�orc ✓.cl Project Location: County i)o ( C
Address JQL,(' q y �� i� . --,�• ; Street Address/ State Road/ Lot #(s)
City -Nko n1•• Q- State P t- ZIP..a_3�'LS4_.. - 1 \ ),. O-cI.Io i7 �1. Zr_._..� 0� ►.)3 _...
,1
Phone # ($IS) �_].'.6b.b a E-Mail J .1tS{�-f�]i._.� 1h_LC1i.A.2au Subdivision C 1Z 1` lit nr.1 IC- ve ,,)
Authorized Agent _ City . P\a rN 4• 0 _ _ ZIP a
CW x EW PTA AES PTS Phone # ( ) River Basin Pn s ' � c,4C V JL
Affected OEA HHF IH UBA N/A
AEC(s): Adj. Wtr. Body _co. �• !tomc.,•.,� c? . . .t lMan /unkn)
PWS:
ORW: yes /nn PNA yes /r% Closest Maj. Wtr. Body
Type of Project/Activity1o' wt.\kwn` J(i n 1=S«w.O,wv1} to JJV_LJ►�kZ xG 12eef" Xla llali,+,�l
CTorr,.\ I., J
-' P,►Gh(�•,.,�; G-Ki' IC,,d,,., t..,/Sk,r 1+ -w_( rri(Scale:
dock) length I a $ X L,
-
fixed laf tfo� ' ) N X I(i' �l x�
Fleeting Raatw(s) I b x 4' b x'
�1\`y
Finger pier(s) `I'
�Y
V
iG no�C�
Groin length
number
Bulkhead/ Riprap length _ —i•�'
-
�- ✓� Avt)NoeiE
avgdistanceoffshore _
Y
C.nhlu'xy tuv�! rral4vry
max distance offshore
Basin, channel
---- \>"
1 d d 116 -,
cubic yards
1.
Boat ramp
wal)LLe.y
.
Boathouse/ Boatlift
1\1
\t1 11\ 111 Il\ ltr 15
\11 I1` 1tt 1►r .' )11 It 1�l Ill 111 .
rK
Beach Bulldozing c
6
(
-Sa:.r
Nun- iac.aicl yt
T•t-P.\a>CaN
Shoreline Length lla
1%'
ay`%Ib fr1cF��„r
SAV: not sure yes
A,ey.%.14 Es1r.lr 1
NwL ��
Moratorium n/a yes no
AP\'
`.
Photos: yes no
Waiver Attached: yes On
A building permit may be required by: MCA n Ito 0- (t Cam•,,,. i
See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions �1)A\0 c.=
`
9,M,..i� y\ j4 `l►l1•h -�*..t1�•!'l `►W ftC^a„r, 7 ►l 4r.rv, Prr(lHrl\I 1.,\t� 2 X►r. ruck
u..:4-t//�.� i.0 1, ��ryti l...
rfh �.•-+:. `6�,/ QC1-(.1S tis 1:]
MGY r%dk ,n �L%La.�C 1!� WtY1C•e.C�
Agent or Applicant Printed Name / PermrtOfficer's Printed�OL�me '
i vA
Signs re Please rea compliance statement on ck of permit' Signature
�uv uv _._..I. '�I�x /ate
Application Fee(s) Check # Issuing Date
J
L Q ix j a-C)
Expiration Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: 7: Y-VU�,
Address of Property:
(Lot or Street #, Street orr Road, City & County)
Agent's Name #: rJ0\) 62I Mailing Address:
Agent's phone #:
I Z DI N - 14 `-1 (,o.+-1 Zla 4-t /vY:� K) T-xs^fl , (Vv
I hereby certify that I own property ascent 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 have no objections to this proposal. I have objections to this
proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal
Management (DCM) 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 if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
i
�� ✓� // I do not wish to waive the 15' setback requirement.
(Property Owner.lnformatiop)
Sig ature
nt or Type Name
t I Z U- \'\ (f 2 L,C�►
Mailing Address
(Adjacont Property Owner Information)
J �
Signature*
Print or Tvoe Name
Mailing Address
K\. o _heart l

1Z�[3) 1
Date
*Valid for one calendar year after signature"
City/StateMp
ZSZ-moo 7-ni 23S
Telephone Number/Email Address
/2-131/ 2-Ole
Date#
Revised 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner:
Address of dY
Prop e 1 Z- 8 `'� L2�
(Lot or Street #, Street orRoad, City & County)
Agent's Name #: 75-7 Mailing Address:
Agent's phone #: Z LJ Z --;; 6.5 i!b--,Cf- (p
tit t t-Al, M Tti'o t N't,
1 hereby certify that I own property adja cent to the above referenced property. The individual
applying for this permit has described to me as showni—anthe attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this
proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal
Management (DCM) 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 if you have been
noted by Certified Mail.
WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Informati n)
Signature
\2, U s "
Print r Type Name
Mailing Address
(Adjacent Property Owner Information)
Signature*
Print or Type Name
ti �, \ Cam\ �0 2 `�, ��—
Mailing Address p,
=)-I Cy -<- -

,'ate/Zip
City/StateMp
Telephone Number/Email Address
Date
zsz-1-73-Z 1,F7
Telephone Number Emad Addmss
� - �z
Date*
"Valid for one calendar year after signature* Revised 2017

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.r wa - Nwu soar / / [p.,yR roe. ? :S 4aJ / V .w. ­Proposed
with 2 slep•w
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NpNITY MAP (NTS) '[<\Nq��'��•jO
JOHN PATRICK RILEY, III
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THIS DOCUMENT 230 - ON ISSUED AND STHS DI Y HASON
\ / 0 nOT BE C NSWED 2. ON FIED DOCUMENT.
NT. N[oiA snN
gpary �Iq /P�y/ NOT BE CONSIDERED A CERTIFl[0 OOCUYFNT.
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GRAPHIC SCALE
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CONSTRUCTION joes&aaaaacuff. M /I g�emhm P1 M- - I l-*Lc-Aiamlp!l LfAt4c
ENGINEERING f
SERVICES, INC. OHM NM I - - I of
Box 665, Manteo, NC 27954 DATE
[phone]
FAX [phone] DAM
ROANOKE SOUND
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(Distance 20.7 Feet

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