Casey, Helen M.

PAIVIA / 11 FILL DREDGE & Nb 78460 A 13/.C D
ENERAL PERMIT Previous permit #
New ElModification LIComplete Reissue ElPartialaosue Date previous permit issued
Or
As aut orized by the State of North Carolina, Department of Environmental Quality
and th Coastal Res ces Commission in an area of environmental concern pursuant to I SA NCAC
Ids attached.
k0
Applicant Name t ty Project Location: County
Address d/ Lot #(s)
Street Ad r ss/ State R
City State ZIP ill(',(
Phone # 14 If- I — Mail Subdivision, 1
Authorized Agent V", tN( ( "
ty ft
City' 4
-
ZIP
`11
-d"
llcw EW DES El PTS
11
Phone# (JIM- J;
ver Basin
Affected El OEA JHHF lH DUSA E] NIA
AEC(s):
Adj. Wtr. Body
(hat /man
RPWS:
Closest Maj. Wtr. Body
ORW: yes / no PNA yes fo
?
Type of Project/ Activity
Pier (dock) length_
Fixed Platform(s) —
Floating Platform(s) —
Finger pier(s)__
Groin length
number
Bulkhead/ Piprap length
avg distance offshc
max distance offsh
Basin, channel
cubic
Boat ramp
Boathouse/
Beach
Other
Shoreline Length
SAM not sure yes (in
Moratorium: n/a yes i
Photos: y IV i
Waiver Attached: no I
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature " Please read compliance statement on back of permit
App
lication Fee(s) Check #
❑ See note on back regarding River Basin rules.
Permit Officer's Printed .me,
Si n7 /rV I Lb�,
EXDirafion Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own proper adjacentto rlJ`4P � n
U 1
's
property located at L A-0 P
(Address, L- ot,�tock, oad, etc.)
on �n _ in r� ? i" J , N.C.
(W erbody) ^ (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Iocatio .
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)
ReCEFI VED
JAN G 9 2020
DCA4.ryy yC CITY
Helen Casey 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.)
116 Ripple Water Lane
I do wish to waive the 15' setback requirement.
I doe** tmiiNe the 15' setback requirement.
(Property Owner Information)
919-961-1393
(Adjacent Property Owner Information)
C,11•-C)<-% LC1LtJ%'UL '��Jr f JL(�A6GV1 �t CC.Q_
Signature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/ email address
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to Helen Casey 's
(Name of Property Owner)
property located at 441
Circle
(Address, Lot, Block, Road, etc.)
on ICW , in Carteret N.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locati n.
M
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)
Jr 7 2020
DCAy.,Wyn cav
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)
Signature
Helen Casey
Print or Type Name
116 Ripple Water Lane
Mailing Address
City/S ate/
919-961-1393
Telephone Number/email address
Date
(Adjacent Property Owner Information)
Sign t¢ •e�
JohW Lewis
(Revised Aug. 2014)
*Valid for one calendar year after signature* ;

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Pl�n `'( �/�'� rev
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
y 1/ y- T(Ai-- /3 "
Agent/
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed developrpent: On l MQ a,(kUOiv
at m locattedaen tasey
Y property 4V 'F/2
in 0. County.
U
der'f /V(
5�0
I furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of CoastaHW98hgement 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:
Signatt e
C �P_4 /fit
Print�ype Name
�tZ C,4 ? eq 9v
nat
This certification is valid through A i '- I t a 0
RECEIVED
JAN 2 7 2020
DCM-MHU CITY
12

Stvron, Heather M.
From:
Teresa Brewer <[e-mail]>
Sent:
Monday, January 27, 2020 11:33 AM
To:
Styron, Heather M.
Subject:
[External] CAMA for 441 Pearson
Attachments:
Casey AA signed.pdf; Casey Casey APO signed.pdf; Casey Lewis APO signed.pdf; Casey,
Helen drawing-Layoutl.pdf
This one is bit messy sorry its Dorian
100,
HARDER
CONTRACTING INC.—
Teresa Brewer RECEIVED
[e-mail]
252-424-0100
DCM-MHD CITY
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