Litchfield, Eric 76773C

kCAMA / ❑ DREDGE & FILL
�ENERAL PERMIT
New ❑Modification ❑Complete Reissue ❑Partial Reissue
No 76773 A
Previous permit #
Date previous permit issued
B D
As authorized by the State of North Carolina, Department of Environmental Quality rr� ����ii,,
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (� f'f a /r�ti
K-Rules attached.
Applicant Name �Dp�j �IIC�'1�1� Project Location: County Gr0.Ven
Address , -12 b� nP Nj- . Street Address/ State Road/ Lot #(s) � ,
City Jinb,'i/
Phone # Atl
Authorized Agent
Affected
AEC(s):
❑ CW -ArfW :ROTA / �(S ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes /
Type of Project/ Activity
Pier (dock) length r i
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards I—,
Boat ramp
Boathouse/ oatlif F 3x ,
r
Beach Bulldozing
OthasC
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes I no
Waiver Attached: yes
j. %Subdivision
City ZIP /
Phone # () River Basin V
Adj. Wtr. Body7Bo!dy
,ems 1 11 n ' /man /unkn
Closest Maj. Wtr.
V
A building permit may be required by: iC(�������_�A
( Note Local Planning jurisdiction) L
Notes/ Special Conditions j�( ""I &
\7C IA s t or Applicant Printed Name
Si ature "Please read compliance statement on back of permit"
Application Fee(s) Check#
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!a 1
(Scale: �� )
[See note on back regarding River Basin rules.
i s>
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Permit Officer's rin me
Signatu a �q
• �� / V
Issui g Da a Ex9 ration Date

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
1AME OF PROPERTY OWNER APPLYING FOR PERMIT Eric Litchfield
MAILING ADDRESS _202 Bridge Pointe Dr
New Bern NC 28562
-ELEPHONE NUMBER 252-626-7207
certify that I have authorized Dan Foley (agent/contractor) ,
:o act on my behalf, for the purpose of applying and obtaining all LAMA permits
necessary for the proposed development of Dock
at my property located at Same
This certification is valid through (1) Year (date).
(Property Owner Information)
�:tc[6USCC�
Signature
Ln c- L L "-tick(
Print or Type Name
Title, co. owner or trustee for property
Z0Z
Date
Z 52.1A_ 7Zc 7
Telephone Number
L AA6 U m00 CCW\-
Email ddress
RECEIVED
JUN 0 5 2020
ucm-ml HEJCITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to NI 's
e of PropertyOwner)
property located at
1 (Address, L Block oad, et t
on We �� ' , in
(Waterbody) (City/Town nd/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
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.)
V_ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signalur *
Pri (or Type Name /
ailing ddres's
City/State2ip
Telephone Number/email address
RPM D
Date*
(Revised RddW @18) 2020
I 6 mIi .Y di. U T Y

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to & `-\ eA "k 's
- L Ve of Property wner)
property located at _l'
(Address, Lo Block oad, et
on �.i , in j � �l , N.C.
(Waterbody) (City//Town nd/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 rill in description below or attach a site drawing)
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.
(Properly Own
Information)
Signature
t
(-
1
Print or Type Naroe
�V9ailing dress
City/State2ipra
6 -p
Telephone Number/email'address
Date
(Adjacent Property Owner Information)
Signature
.5??C r ; �. a nJ
Print or Type Nafnq
Mailing Address
City/State2ip,
y Of'i
Telephone Number / email address
Date*
(Revised Aug. ) 0 5 2020
*Valid for one calendar year after signature*
DCM-MHD CITY

12
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RECEIVED
J U N 0 5 2020
DCM-MHD CITY

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