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Merchant, Dwight 78816C
6ix•a.rytvtrs r uncu�ac a rra.c* j (' A B 'C.. ,t•, D GENERAL PERMIT Previous permit# !/New Modification --Complete Reissue 'Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality I and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC��� �, l Rules/attached. Applicant Name I 7I \ t_— ' I '(' �:1 < t �(J_f _ _ Project Location: County _l . t Address ( i .� �;_ pr yStreet Address/ State Road/ Lot #(s) State - ZIP Phone#.(>k..,+?¢ ��'_// E-Mall _ Subdivision ___ ------ __ Authorized Agent ., ,"- , , ( (._ r Gf: --- City '�-t -- -. ZIP_. -q --- Affected CW 7€W .A; PTA Es PTs Phone # (__) River Basin ..,OEA 1-HHF _:IH UBA KA �� AEC(s) PWS: Adj, Wtr. Body 1--.. - I. _(,/(; A _ i (man Lunkn) ,.-., Closest Mai Wtr. Body _ AL�%Ln unv: yes!/ no rNA Type of Project/ Activity _ Pier (dock) length / h Fixed Platforms) �JI -. r-[L Floating Platforni _ Finger pier(s) Groin length number Bulkhead/ Nprap length _ avg distance offshore _ - max distance offshore Basin, channel cubic yards Boat.�a�ngD ..- . ( Boathouse/ Boatlif[ Beach Brdllgo'mg -� Other' - j_e aCX74 -- no i A_ (Scale: Shoreline Length_.___ SAY: no[sure �l(/yes.'- ��511 Moratorium: n/a yes no _ 1, Photos: yes no t: jt c•f'iri.�r Waiver Attached: yes no. - - - A buildingpermit may be required b : �,, ,,, t"n t r '{ p y Q y 1 _- 1 _.. See note on back regarding River Basin rules. ( Note Local Planning Jurisdiction) f Notes/Special Conditions Ili, �i� Y.`/'- /I � r .=.i. �. t `1 t':, Pil .:ii-/>.itl f i•::$C'/E/'1 J'�Cl/�X' Vl� l I Agem'or Appltcan l inted Ir Signature "* Please read compliancestatementon backofpermit'6` f 4 + ha Application Fee(s) Check # PermkOffi Signature wing Da I CAMA / ❑ DREDGE & FILL N9 78816 A B eE D GENERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reissue [-)Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality �7 ,-�,,m� and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC�'Z o /rf , , -J ules attached. Applicant Name Project Location: County �a'Vt°� Address ( Street Address/ State Road/ Lot #(s)� City / State ��IP Phone # 61 E-Mail Subdivision Authorizet �6i ("1 /1 City(/Qi [J ZIP Affected Ll CW ")yw— ' <_ - O PTS Phone # ( ) River Basin k e— AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Bodyr �� I M! na man Junkn ���1 Mrt- or Appant Printed Name Y i tore �`*Please read compliance statementon back o(permit** plication Fee(s) Check # 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 [)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, certifythatthis project is consistentwith 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 howto complywith these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ I-888-4RCOAST Fax: 252-247-3330 (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:252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax:910-395-3964 (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 FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit Mailing Address: Phone Number: Email Address: &VA Dwy4 I certify that I have authorized —"" l M,C-1 Agent to act on my behalf, for the purpose of applying for and } obtaining all CAMA permits < necessary for the following proposed development: L )0 is k-kh©L at my property located a`r"� � v�G�— County. VI I n 1 furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: Signature 06&11='-� ' E 6&4y4L Print or Type Name OW nr C Title ZaZ-0 Date This certification is valid through _ 1 _i L 1 2-o2," RECEIVED DEC 0 9 2020 DCM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to V'6216rfiT' /rIgYG['*gA (Name of Property property located at "L5l CGttt�'4WU f'/r+7 KD W (Address, Lo , Block, on %RENT k1Llr"YL in NEW (Waterbody) (C 's CMUE0 , N.C. 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) f1 y t 1 1 f 70 7 GkgC L w axiN A qT 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) /1 /cn/A -A A49 64,:,u Signature Uc.73 r(�� /b/Ozeig 4I,✓T Printo! Sor Type Name n ^ !�2lCFS C>zlc Kv Mailing,A ress NEtJ id ltlG 2?�b2- Crtyy/State/Zrp 2S2' 67/ 9 Telephone Number/email address i /// ' ` a Date O01W,/bir' W-44AWi'Q A/oT/yAtc.CO - *Valid for one calendar year after signature* (Adjacent Property Owner Information) S. Ir Print or v-� a �7•cu .caAA rV P- ),Y6 6 9— Telephone Number/email address A-5-2-- 4 3 Y- Date * (Revised Aug. 2014) IALTD 4 t. . ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to _OL)(�7 %I �o"? CGq Aw% s (Name of Property Owner) properly located at 23/fclil�y(1t fiF/ o R� .1/EL� w..��62 ----- /� (Address, Lo Block, Road, etc.) on — /2£I I�!<'L'it.----_----_._—_-, in NEW &tn2w NC � U61-i , 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) � I •I I _- � t I IIl li I .. a Cl-I" 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) i%/d' lip ,,-P --- I✓L ii,r"—1 �1�1LGNA ✓� Print or Type Name Mailing Ac,- of ess 1�2- Telephone Number / errgil addre -s Dungy Ot"I6'6;/t9t.zrAiAt.S (t!' If fJ;4.C.C);,_ (Adjacent Property wner Information) 31 ._) C Jai ,i ct tt4Yl 1-- fpp / c(. i (Revis_....... [014) 'Valid for one calendar year after signature' OQ