Tutwiler, Kyle 76398C

CAMA / CJ DREDGE dr FILL No. 76398
A 8 (� D
NERAL PERMIT Previous permit#
ew I.JModification L _JComplete Reissue ❑Partial Reissue 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 f) %
%///� Rules a
Applicant Name�(Project Location: County_
AddressStreet Address/ State Road/ Lot #(s)
City_ _ State Me,ZIPAE312
Phone # OV) - E•M •i Subdivision _
Authorized Agent City ZIP
PT11 �
Affected FiCW JAW A DES 'OS Photo # (_) River Basin !• s%
AEC(s): 1:10EA ❑HHF DIN O VOA O WA Adj. Mr. Body aZ4
❑ FINS:-Fi(�-�s.dl
ORW: yes no PNA yes no Closest Mal Body
Type of Project/ Activity
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Float
Fing
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A building permit maybe required by: aV LAn
( Note Local Planning)urisdiction) ���
Notes/ Special Conditions
N PPd&V d compliance statementon backofpwn*"
C� V I
❑ See torte on back regarding River Basin rules.

CAMA / El DREDGE & FILL ���/
G NERAL PERMIT
New ❑Modification ❑Complete Reissue ❑Partial Reissue
No. 76398
Previous permit #_
Date previous permit
A B © D
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`E6
'n��� rRules attached.
Applicant Name Kiel 1 i i 1 (I/ 1 l C� Project Location: County L-Luf2l
Address i%�(j / A� O$ Street Address/ State Road/ Lot #(s) e<�
City.
Phone #)(`T' 7 E-Mail
Authorized Agent �_o_"
ZIP
Affected �CW .,�'EW PTA ❑ES ❑PTS
AEC(s): DOEA ❑HHF ❑IH ❑UBA ❑N/A
❑ PWS:
ORW: veO no) PNA / vei l no
Type of Project/ Activity
pia
Fize
Float
Fing
Groff
Bulk
Basil
Boat
Boat
Beac
Oth
Shor
SAV:
Mor
Phot
Waiv
Subdivision
City / ZIP ^/
Phone# () River Basin am -se
Adj. Wtr. Body na man unkn
Closest Maj. Wtr. Body
N (Scale: /� /© / )
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A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
V�
i
Lai) C+f�lj El See note on back regarding River Basin rules.
,�'� ture ** Please read compliance statementon backof permit**
�:21x�%
Application Feels) Check #
SignatureIqUo — ? /tf-Q
Iss ng date E pir ion Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific 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 or certified mail return receipt has been obtained from the adjacent riparian
landowner(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:
❑ Tar -Pamlico River Basin Buffer Rules ❑ Other:
❑ 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. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: Kyle Tutwiler
Mailing address: 2076 Temples Point Rd, Havelock, NC 28532
Telephone Number: 252-229-9841
1 certify that I have authorized Doug Banks/ coastal Boat Lift Repair
(agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of adding a new dock section to access other
side of boat lift.
at my property located at 2076 Temples Point Rd, Havelock, NC 28532
This certification is valid through 12/31/20 (date).
(Property Owner Information)
z�
c
Signature
Kyle Tutwiler
Print or Type Name
t°(-
Title, co. owner or trustee for property
Date
z2�'4;�

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Ky �e �l t}-DUI tG s
property located at acn l0 Tit 11y S tM (} le of Property Owner)
nA��"�_�� (Address, Lot, Block, Road, etc.)
on (Utr'fE,l'iG4I �Y�'>�K fJC. , N.C.
(Waterbody) (Cltyrrown and/or County)
The applicant he described to me, as shown below, the development proposed at the above
I lion
ave no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
w MiRild l Creek
�d a
I
1 t
I 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 Initial the appropriate blank below.)
O)) A4 r . o wish to waive the 15' setback requirement.
G Y I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
lxv#
for one calandar year after signature"
horn arbo7torraa) address...��.
r 13fCF-I\ark
(Ravhmd Aug. 2014}
MAY 01 t020

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ADJACENT RIPARIAN PROPERTY OWNER RTATEMENII-
I hereby certify that I own property adjacent to _Ky Ie IU W I 1 s
Property located at acne � YV QyS�I(1� (ma of Property Owner)
on IVY hrl.l (�� (Address, Lot, Block, Road, etc.)
>�K , In �VP Qr , n, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
mki el i CYO
)Z
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 Initial the appropriate blank below.)
I do wish to waive the 16' setback requirement.
X I do not wish to waive the 15' setback requirement.
(Adjacent Property Owner Information)
OIL
_—___—_
Nu r/emaN adalreaa
paw• / .
RECEI0 ED
(Revised AU9. 2014)
"Vaud for am calendar year after signature* MAY 01 Z020
DCM-MHD CITY

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