Moore, Henry E. III & Mark Annis

ti
❑ CAMA / ❑ DREDGE & FILL No 70915 A B C D
GENERAL PERMIT - Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Departrfient of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern Dbrsuant to I SA NCAC
El Rules attached.
Applicant Name iNroj"4t�Lo6ti3n: County j
Address t ". " Street Address/ State Road/ Lot #(s) / 14,
71�,`
City State ZIP x '
Phone #
( E-Mail
Authorized Agent
Affected ❑ CW ;�] EW PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ' ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: ves / no PNA yes / no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length f
avg distance offshore i
max distance offshore F`
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift-
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
yes no
Moratorium: n/a
yes no
Photos:
yes no
Waiver Attached:
yes no
Subdivision
City ZIP_
Phone # ( ) �iver Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
A building permit may be required by: 1
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s)
(Scale: r` )
❑ See note on back regarding River Basin rules.
r
Permit Officer's Printed Name a
Signature
Check # Issuing Date
Expiration 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/ 1-888ARCOAST
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)
http://portal.ncdenr.org/web/cm/dcm-home
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)
Revised 7/06/ 17

05/01/2018 13:37 FAX f?j001%002
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: L -AAA �S
Phone Number:
Email Address:
I certify that I have authorized
("IL) ��1� Ifq-51a
)Arn,5 �a,Uo,
Y Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development-
y<A WA-41 .
at my property located at L4 A- l 44� Ayt
in C,4 -+44--s'' - County.
I 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:
49
Signature
Print or Type Name
b ir'h4n---
Title
¢ j Il t (-v
Date
This certification is valid through �- I 11 I
/$ RECEIVED
MAY 0 7 2018
DCM-MHD MY

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: 3
�ncu iL . CCI©cyer
0 ✓&-®( )a.nr-1 Hw
(Lot or Street #, Street or Road, City &
Agent's Name #: 16/1-C "-o- 4,-1- ps—r n4- Mailing Address: too 6,.- a �
AXR�3a
Agent's phone #: 2 s z -J�,v y o .-7 3 -7 Mw-,-heJ c ,' J-,v A/C 2 $7P 7
I hereby certify that I own property adjacent 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.
X 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. Contact information for DCM offices is
available at http://www.nccoastalmanagement.netlweblcmistaff-listing orby calling 1-888-4RCOAST.
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, or lift 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.)
x I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
M 4n;s
Print or Type Name
Mailing Address
r✓ I A w N (, 2. 1 5 L-)
City/StateYZip
�{g 7
Telephone AlumberlEmail Address
y ► 1 "1 l 1,6
Date
(Riparian Property Owner Inform lion)
Si ature
+N e—rl r ooy-e 7=--
Print or Type NaIrne
3C ((� 0 &0 LLa V-1 NVv
Mailing Address
City/State/Zip
0 31 L�-J9A7
Telephone Number/Email Address
+ -. I q -- 10
Dote RECEIVED
(Revised Aug. 2014)
MAY 072018
DCM-MHD CITY

05/01/2018 13:37 FAX Z 002/002
URTIFIED MAIL - RETURN RECEIPT REQUFSTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
1 P`
Name of Property owner. I f I '! t�A11
Address of Property: 2j0 RPj►/tWk,-- t&--
(Lot or Street #, Street or Road, City 8 County)
Agent's Name #: B 1 c 4 ►„10..4 o' Ma"Address: P.o eo, c Ct 3
Agent's phone #: [phone] /vier h tcei C9 44 PVC Z gISs 7
I hereby certify that I own property adjacent 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.
--k_ i have no objections to this proposal �, I have objections to this proposal.
Ifyou have objections to what is being proposed, you must rlotNy the 0tvlslon of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact Information for DCM offices is
available oth nccosat imp anaaoamentrt@t/web/cn:/stf-llsiinaorbycallingf-8884RCOAST
litoL"�nse Is conskiered the some as no objection if you bays been no~ by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (if
you wish to waive flit. SPthack, Vitt must initial the appropriato blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
`l (Property Owner Information}
Sig
Print or Type Name
(Riparian Property O e In rmation)
Ff
Signature
M&6j
Pnnt or Type Name
/0 3z0 t7..�er Ll>j Cs ft-- #3
Mailing Addrem Mailing Address
"A4_ lve� Iqk , lVf �7lol�f
c;rylStr�te/Zi ''-
IR
e eptwne Number /Ems# Addmss Telephone Number/ Ermff Address
Dery Dare RECEIVED
(Revised Aug.2M4j-..
MAY 0 7 2018
DCM-MHD CITY

I
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Ilev,(--1, 4
Mailing Address: 6080 6-ar krt�il"x-t
Phone Number:
Email Address: V1 P . ) <<t'�ar ►� 5 • LJ�
I certify that I have authorized AG, O,4-
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: ay/,-%ta �
at my property located at , 0 CI Lin y1e�tt k e- , Lft� /V C
in (fzi County.
I 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
Print or Type Name
-fyt'e"�
Title
Date
This Certification is valid through I I
RECTIVED
JAN 2 3 2018
CCM- MH® CITY

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIA PROPERTY O ER NOTIFICATION/WAIVER FORM
t(t� Name of Property Owner. -
Address of Property. L�� �y� Z �(�� , Al'-L�'1e'���
0 (Lot or Street #, Street or Road, City & County)
Agent's Name*
I3t d-c V-4er
~A—
Mailing Address_ /',
Q /joy R 3
Agent's phone #:
2S2 So ti
07a?
Me--e he,, l �,,l,
AIC, 2 ASS 7
I hereby certify that I own property adjacent 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.
V 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 wriSng within 10 days of receipt of this notice. Contact information for DCM offices is
available at ht4p:lAvww.nccoastaimanagement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
A) C
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
lAN 2 3 2018
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Pnnt or Ty0e Name
2
Mailing Address
City/StatefZip
110-, ►I,+
Telephone Number/Email Address
�I- -�c
Date
(RI avian Pr rty Owner Information)
Sigma e
Print or Type Name
3 I � 1-4-e_► � 1� .
Mailing Address ar Y
CitylStateop f K i al t a M � S a- woo Gt:m
Telephone Number/Email Address
Date i
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiONIWAIVER FORM
Name of Property Owner: _t�<in r—\ E,
Address of Property
'� ��� � 4\)kti��e
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Ql v4- W&kC A04'1'.-G Mailing Address: P p &x 9 5
NAgent's phone#: Zs2 So'i 0-73- Mcrol+e✓ C,-4y TNC 2,.*557
I hereby certify that I own property adjacent 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.
V 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. Contact information for DCM offices is
available at httpJ/www.nccoasialmanagement.netlweblcm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been noted by Certifl"ed Mail.
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me_ (If
you wish to ive the setback, you must initial the appropriate blank below.)`��
I do wish to waive the 15' setback requirement. 2018
JAN � 3
I do not wish to waive the 15' setback requirement_
/ (Property, Owner Information)
Si re
4 y � l vor
Print or TypelVame
Mailing Address
CitylState/Zip he+1 f� p�q r►.
Telephone Numberl Email Address
)-�^ U. 1�
Date
(Riparian Property Owner Information)
Dploture
Print or Type Name
Mailing Address
c v/r lit�ylStatel�Zip
cZ,5 - $x3- 49 cSkAr�NS �cf� Rod, Cd�L
Telephone Number/Email Address
Z l
Date
(Revised Aug. 2014)

0,0i
Fes, cv
TM
Posed
QeP1cLewoad
Pro Perky
6,dRke-,/ w LA)
v I'tI yr wr-ii.
• wall will ha✓tr a•
w: �c doa�J walk �a�.