68591D - Simmons

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�CAMA / C DREDGE & FILL j / l 8591 A B
,� E N E RAL PERMIT Previous permit #
New _._Modification ❑Complete Reissue El Partial Reissue Date previous permit issued_
prized by the State of North Carolina, Department of Environment and Natural Resources
Zoastal Resources Commission in an area of environmental concern pursuant to I SA NCAC ❑ �� , �.UU
❑ Rules attached.
it Name � it { ❑4 YI m V \(1 Project Location: County r,A-A Sk.J,LAk
3101 (. j , l-(I c ,4 Ly� .
X State A)C ZIP14:�5 3{
t () / E-Mail
L :ed Agent A v,t ale (lM C
❑ Cw ktw KPTA AS XPTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
yes no PNA yes no
f Project/ Activity 5
)ck) length (A X ��
latform(s)
Platform(s) X
.ngth
amber
Id/ Riprap length
g distance offshore
ax distance offshore
hannel
bic yards
'n
ise/Boatlift I .r I
lulldozing
ie Length
not sure yes n�
rium: n/a yes no
//yes no
Attached: tves� no
Street Address/ State Road/ Lot #(s)
! 3q dart n D,-�
Subdivision
City �10 (r%v1 b-cAGl' ZIP 2SY,C
Phone # ( ) River Basin
Adj. Wtr. Body Cry A ( (nat
Closest Maj. Wtr. Body
(Scale: I
ing permit may be required by: c�In}i� OO (r �Cstr,� ❑See note on back regarding River Basin

US MAIL
CERTIFIED MAIL — RETURY RECV1rrr"rn, m
DIVISION OF COASTAL MANAGEMENT
AWACEN'T RIPARIAN PROPERTY OWNER STATEMENT
Narne of Property owner -
Address ot'Property _. �t��_.. x►1S1,U� �R. .. iyy,mL7r1 L/16M....i��+_a8y(►2
(Lot Of Street x, Street or Road, City di. County)
Apptkenrspnc>ncx:_.iZ�-_4.g� i�L�. . _:_ MailingAtkben _ 311)1 _lZL2if15_jA^KT_k.ANf
I hereby cenil'y that I own property adjacent to the above referenced property. The individnd applying for this permit
has described to me as shown on the alinehad drawhtg the development Mel. are proposing: A-diliSmdizll yf Ar"W.Wg,
willidim mitms, multbfl Pr2y7dAd with d,it ietesr
esecL-
: ' __ I imve no objections to this prupesal. `.._ i have ottiectinns to this pnr,--al.
If you have objections to what is being propwsed, you roast notify the Division of Coastal Management (DCM)
In writine within is days of rateipt of this notice. Cornapondenee should Tie mailed to 127 Cardinal Drive F.ti.
Wilmington, N(' 28405.111145. DCM representatives CAN Alta be conta6-1 cted of (910) 79215. 1Vo response is
£oPlMsrod the same M Mo o6 *ChQa if son have been notiliM D rtiiie Maii.
W AIVER SRCr1ON
I understand that s pier, dock, mooring pilings, breakwater, boathtntsc, or lift mtisl bo sat back a minimm, distance of
15' front my area of riparian access unless waived by ine Wynn wish to waive the setback, you must mitiat the
riate blank below.)
MT,
1 do wish tri waive the I5' set back requirement.
I do not wish to waive the 15' set back mquiremeat.
hOwner lnforunitien) —
Signature c (�
Pain or Typ,. tmrs
Mailing Address
city7sateizip
_ ._. is ��rnwtiot )
Signature �.
(Mailing Address
City/ State 175p
Telephone Number
/�„,�.�1�
127 Cwdi al Nye Ertl, Wilmington, With CaNMta'28405-3645
phone: [phone] FAX [phone]a 1 IrNenrrrl www rnxtrstctalmanaoemont net
M E,Wa 0pp,nuraly i An,un:,iiw! 0.nen FndnYA 5p1i Rer,YdM 1 IttY, (hi;fl t',Mwme! Paper .

CERTIFIER I A t utrnUXN RFCFIPT RE'QUF �"r F,u
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of proprrty Owner
Address of Property: _ �>fttul tf Q ta!�it 1.1--tom- A kl�
e� (L of ra sbvat is, Street or Rood. city do Q.M Y)
Applicant's phone >E. Mauro Address:
tb .__Wo_1oMftrCul►dY t ...IL
I hereby eertifg that I own property adjn em to the abeae Ths ndivldwi
has described to me, as shown on the attached iDPIY�K this
drawing the devalppttusat Ntey are tab• TICS t7b901t Af t1111Ndti0.
K�+Ht St4,.rnalketxo�'Jdasl.WilR.tlti;..l4lsc.
—WWRa-- I haw m objections to this proposal. I have objections to this prgperael.
If you have objections to what is being proposed, you rnael notify the Division of Coastal Ma"Iment (DC M)
in -tiling within 19 days of receipt of this notice. Correspaudcnct sbonld be a IRW to 127 Catd'taal Ihtve Ext.
WihWulliton, NC 29W-3945° DCM r•epre"Otutives can &Iw he cootacted at (910) 796-721S. He rnapottse is
�f ��e °' ^g o��H,r��Rtlhaye been aoliliai by [:ertifitd hWi.
W A 1 VFR RE(TION
1 tmderstend that a pier, deck, mtxniog pilings, breakwater, bn4thOUS-5, or lift mus< he net back a minimwti distance of
1 S' Rom my area of riparian access trnless waived by me (Hyou wish in waive the setback, you mun initial the
IIPProriatc blank below.)
I do wish to waive the ! 5' set back requirement:
I do got wish to waive the 15' set back requitcrrenl.
'1�21wtE 45 .. ` ► � Print of Type Name Pow or � Name
31a9 t7„�ceti•,� 1.+�t
Mailing Address
xC
City r s rate / Zip
LUA
Ma bq Addrbtr
s _�15�
City / Stara / Zrp rr�'j p p
Teiopitnrre Munber ei,,,
Date 1 -
-`: 127 Ctsdinai Dare Erd , W*Tvrgtm, *tth Catdina M06-3"5
placate 910-IW 72151 FAX 910.395.396d t kgamel. wrtw.ncoa5tAraVqeMeM.net
An Fa1aI r)Ofrikrgr t nl6rrn$oe Achon Fr^DM"+ - $U% RM�vieV 1 foX oaq Girtsunkr PtpW
Ga�JeS,
G°r /

oa. VcCrory
North Carolina Deoarmert :cf c^wronment and Natural Resources
N C D+visior of Coasta: Management
AGENT AUTHORIZATION FORM
Date p / ;Ij I -(
Name of Property Owner Applying for Permit Narne of Authoriz
e
d
Agent for thi;
Owner's MaNng Address AgOM's MaNkV Address:
Ermali b Sl MMM g 'P, a-&�`tS • Corn Email C l�7
Pr,o^e -91°l1 (o3a- \81(c Pr'a^e �- �1 '1$- - --
_ert'v teat i have authorized the agent listed above to act on my bet ff for the purpose of
'o, a^d ootainwig all CAMA Permits necessary to ,nstall of construct the rollcivWng (activity)
F z). my prooerty bested at _-- \3 "� \ d. r\c iry -

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n:Proactive Real Estate To:3502004 02/16/2018 14:42 #436
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n:Proactive Real Estate To,3502004 02/16/2018 14:42 #436
10ft is ft 10 ft
----6Fieti skis
boat Ilift
deck
ramp
zebeth Wall Trust LOT I Frederick Mci
B Marlin Dr
51 ft wide 132 Marlin
Jennifer Simmons
134 Marlin Or

n:Proactive Real Estate To:3502004 02/16/2018 14:42 #436
July 10, 2017
Larry & Elizabeth Wall Trust
1022 Pinnacle Drive
Boone, NC 28607
Re: Adjacent Riparian Property Owner Statement
Dear Larry & Elizabeth,
I hope you had a good Fourth of July holiday and you had a safe return home to Boone. As I
mentioned on the phone, we have made an offer on the adjacent lot. However, it is contingent
on our ability to construct a dock and lift suitable to store our boat and jet skis.
While we are flexible on the design, we realize it will be necessary to obtain a waiver from you
as well as Mr. McConnell regarding the 15' set back. The preliminary design indicates we would
need 35' of the 51' available along the canal. Should we be able to center the dock, this would
leave 8' to the property line on both sides. The final design is subject to approval by CAMA and
could require some modification to meet their requirements.
I have enclosed the required statement and preliminary design. I respectively request your
favorable approval and have highlighted the areas for your initials and signature. For your
convenience, I have also enclosed a self-addressed stamped envelope so it can be sent back to
me prior to closing. Without this form, unfortunately, we will not be able to purchase the lot.
Thank you in advance for your consideration and we look forward to being your neighbor. If you
have any questions or concerns, please don't hesitate in contacting me at 919-632-1816.
Sincerely,
t J
Barry & Susan Simmons