79091_Eddy Greenwood_20210308

It"CAMA/ F DREDGE & FILLi;-11
GENERAL PERMIT 67921'Il No. d q B C D
Previous permit#
New LiModification J Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC
Rules attached.
Applicant Name Project Location: County
Address ,/,/ ,.a, Street Address/State Road/Lot#(s) /- / , /1 ,
_
City— /_;� i. ,.->s. State ZIP _
Phone#(_ %t'-) )el (,/ E-Mail _ Subdivision
Authorized Agent / City b , ZIP .___.
,_,TiAffected CW 7 EW PTA ❑ES ❑PTS Phone# ( ) River Basin
OEA 7 HHF _IH C UBA D WA
AEC(s): Adj,Wtr. Body_ , / (nat /man /unkn)
PWS: ,
Closest Maj.Wtr. Body ORW: yes / no PNA yes / no
r >-
Type of Project/Activity / / ,
(Scale: / -.. ~` j )
Pier(dock)length
t -...��......._. i � i t t t 1 I I I � a t IL_
, l i
FixedPlatform(s) 1 g._ _�.._ _ _ I __ _ /. -. i i i 1 _ J—_,.__ 1 ._ -
I ' I
Floating Platform(s) I (__ — i , .. i _... — I — l 1...
r
r i
i Finger pier(s) t� _ 1# ; t� �
' i
1
i Groin length e I ! 1 i 11 I i , r 1 i ! ; _, ' i d °
I 1 . tt i4 .,1
number , s
v S
Bulkhead/Riprap length •{ I ,# ..1T -_.------- i _.,1+_--A-- - # _ -T.-
4_
avg distance offshore I �_I i_ f
-_ .;_,.
max distance offshore I 1 i I
Basin,channel I- ; / ! -A i ' i
It S vr{...... ._, I1"_^"" « «— —_ ' i
cubic yards a 1 1 v t F/,...„ s I l H
-� 7
Boat ramp f p + 1 .II Boathouse/Boatlift '/- j- .: ..._..._.... ._ _.� ( I � . ` _....,. .._..
l k .i r l
Beach Bulldozing ( I �`� 1 I .,_ 1
i
i i f
I• t i 1 T {
Other 1 I
i
- l 4 4. 1
Shoreline Length_ i ( ( i i t t
SAV: not sure yes no . ... _ 1 I 1 d
Moratorium: ry'a es no — 7 iY '" I , I- LL-
Waiver no i `Attached: yes no
A building permit may be required by: t . r See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
r v _ r I,
Agent or Applicant Printed Name Permit Officer's Printed Name
' s° i t fi ;:,
' Signature **Please read compliance statement on back of permit** Signature
o00 _� -
Application Fee(s) Check# Issuing Date Expiration Date

dRCAMA/ ❑DREDGE & FILL N° 79091 A 4) C D
GENERAL PERMIT Previous permit# /,
>Z L New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued :'/-4
As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
/ [mules attached.
Alc.Applicant Name - (;ic r.-, ,,,;, j Project Location: County c
Address j ::,/,; % Street Address/State Road/Lot#(s) J6: - .. , L��,c
City A f/!" State rye ZIP „'/' ' / C. /
Phone#(2/9). 14''- 0/ E-Mail Subdivision ,V,7
Authorized Agent 1, ->' ,/,/r- 4 4 City '.-e-k-,. . ZIP 7 d�/
Affected ❑CW ❑EW LAA ❑ES ❑PTS Phone# ( re"-zy e River Basin
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body �+ J . A•'e r :(nat /man /unkn)
❑ PWS: /
ORW: yes / no PNA yes / Closest Maj.Wtr. Body ./ r
Type of Project/Activity AN"4„.. r e e /T' / / ..r- --=...-- =_.
(Scale: / 'i'70 , )
Pier(dock)length
I I l
Fixed Platform(s) I I I j 1 '
' _ � i*
� I i I
Floating Platform(s)
I •
Finger pier(s) ``. 11 'i t t i _. ......._
Groin length { , �� ` f
number iTi�...._._ ..._J....�......r...- — - _
Bulkhead/Riprap length ,-- --- 4' , N. --.. _ —
avg distance offshore I _
max distance offshore IIII I f
Basin,channel i / ilt..II ! �L 1 1
f I
cubic yards /.,/ ! 1 / 4 V/'4 d I 1
Boat ramp V/*/c I /, Y Gi el r e ✓G
f
Boathouses B /.2 } T —
Beach Bulldozing / - ` .._._. —_ —_— .
C
Other i i I
/ . . I
Shoreline Length 5'J i I
SAV: not sure yes �_"— -- —L i _--
Moratorium: n/a yes no L/ n ' 1 1� l� 'R r
Photos: yes no ' -_.'' .._"...w .......... ,. I ..._........... .._ _._
Waiver Attached: yes /no L
ll A building permit may be required.. by: Zi G.4,, r ' (7."-[,, . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 'i G% '//, ,i 20G'
/1L 0 / L _ C-` j s
Agent Aipplicant Printed Name l PermitOfffer's Printed Name
cl.) , 0 (� I A / ? /f1 / .�. —
Signature **Please read compliance statement on back of permit** Signature
-42e0-sz-=-- /e/s-i- / :///;, 7/2/2/
Application Fee(s) 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 I)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(9 I 0-796-72 15)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford,Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

0 CAMA / DREDGE & FILL No 79091 A BCD
GENERAL PERMIT Previous permit #
)C New Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC .
Rules attached.
Applicant Name Project Location: County
Address Street Address/State Road/Lot#(s)
City State ZIP
Phone# (- ) E-Mail _ Subdivision
Authorized Agent City ZIP -
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS Phone# ( ) River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body _ - (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body _
Type of Project/Activity -
(Scale: j )
Pier(dock)length
1
fFixed Platform(s) t
Floating Platform(s) ' +-. Mail 1 Ij _ I _
Finger pier(s) \4 ! , ! �l L. r ; —
Groin length i t... _ 7,_
— I1
number —__. ..�._._... ._ • i — �k I--
number --
Bulkhead/Riprap length I f - ---- —i--+ !_. ......_..-........._._ t._.._ _
II 1
avg distance offshore I I
max distance offshore /
r
Basin,channel I f Iii ,
c- , f I
I
/ �,
cubic yards / /`
Boat ramp /Il- ' { '> j ` ✓�
1 r I
Boathouse/Boadift f - { ;-....._�.. -?
,
Beach Bulldozing j 1111
Other I
i' - 1
! I
Shoreline Length _ j
SAV: not sure yes no —_-.
1 i I -'^
Moratorium: n/a yes no .i' , ri
.—__ - --'- -tos: es no Waiver Attached: yes noIIIIIH-------
r
A building permit may be required by: H See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions • /i ! % ,,,„
/,
Agent or Applicant Printed Name PermitOfficer's Printed Name
Signature **Please read compliance statement on back of permit Signature
iti, / 7// / -}/
Application Fee(s) 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 I)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 (252-946-648 I) or the
Wilmington Regional Office(9 I 0-796-72 15)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie,Hertford,Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY
Director
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 026.0233 & .0259. The
Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation.
>. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees) unless otherwise approved by DCM. The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This
drawing will be used to aid in compliance and
//monitoring efforts.
• Pre-project site conditions: y"r Q � tom.h�cl h�yt
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
tha I i for tion provide is com lete d accurate. ZZ1
o Ap licant Print d Na e Permit Officer's S' ature
Age r Applicant Signature Issue Da e
CAMA GENERAL PERMIT#: 770 "7��
State of North Carolina i Environmental Quality I Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 27889 1252-946-6481
Wilmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-3845I 910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808

. ,
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June 8, 2020
I am aware of and have no objections to Eddy Greenwood of 77 _lacklyn Lane,
Belhaven North Carolina installing a boat lift on his pier adjoining and within his
property boundaries.
By signing below I agree for Eddy Greenwood to proceed with installation at this
time.
Name n rjaitak,U:11,A
Address i
Date C:-) Q -
-1/
Name (
Address 5-3 T 73,,z1.4 c \s,L
Date 7 :Lc

Authorized Agent consent Agreement
PC 6 4 , herby authorize
�
r trty Ow ,1 Tobin Jay Tet#ertQn of
P ner(q,; v
TJ's Marine Construction, LLC to act on my behalf in obtaining CAMA permits for
the location listed below.
PROPERTY ADDRESS:
{
PROPERTY OWNER'S MAILING ADDRESS:
frl
t— , 1 ®-c 9 — 6 13.5
Eddy Z.:PROPERTY OWNER'S SIGNATURE: (�' e atwu
AUTHORIZED AGENT SIGNATURE:
DATE: / _
W/Authorized Agern Concert Agree

r CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER CATION/WAIVER FORM
Name of Property Owner: Ed/ ( � ' e/'10 D()6
Address of Property: - / 7 0 Q / /1 Q C/Aaua
y (dif-
(Lot or Street#, Str � �1 e-
et or Road, City&County)
Agent's Name#TJ nil eL1)11 ji LL MA Address: /i cL ox �1�7�-5
Agent's phone#A D /3 �O 7/ /1 D C 7e/
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. •-�;
I have no objections to this proposal. I have objections to this proposal. j l AVM
If you have objections to what is being proposed,you must notify the Division of Coastal Management ,v 4
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is ,<�`��
available at http://www.nccoastalmana_gement.net/web/cm/staff-listing or by calling 1-888-4RCOAS T. 6 t 1c
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15 setback requirement.
(Property Owner Information) (Rip an Property Owner Information)
Signature ignature
/( Me ti titw v �AlltAK aJ6oit
Print or Type Name Print or Type Name
ti "roe-_:kiy A La A e-- 365 /9/4-wA-- S-f
Mailing Address Mailing Address
e I ha veA NC 0?76Pid ,/0' G k.4"r
City/State/Zip City/State/Zip
Telephone Number/Email Address Telephone Number/Email Address
c21):',Q I (
Date Date
(Revised Aug. 2014)

R 4
Pill '4t4: / ' 7?
IN "..1,..
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itiwi - , a
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till: 414;
A f �►.._ - - _ J_.
OPEN:7614-10-2115 LAND_VAL:131496 DATE:3/25/2020
GP1NLONG:7614-10-2115 BLDG_VAL:182468 DB_PG:2017/00371
NAME1:GREENWOOD EDDY L TOT_VAL:313964 STAMPS:600.00
NAME2:HARMON AMY C TAXABLE VA:313964 SALE_PRICE:300000.00
ADDR1:77 JACKLYN LN DEFR_VAL:0 REIDI:34291
CITY:BELHAVEN PREV_ASSES:363987
STATE:NC ACRES:0.64
ADDR2:77 JACKLYN LN PROP_ADDR:77 JACKLYN LN
ZIP:27818 TOWNSHIP:07
PROP_DESC:1 LOT#4 PUNGO MBL:76140018
SHORES WEST PIN_I:07007530

I
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: EC 6--"Thre,eiltdOneg
Address of Property: 17 7 o Q �Ai �.r) AA � U a, /G
G
(Lot or Street#, Street or Road, City&County)
1 Agent's Name#:T 1 If FO
ile 1 jtJL'Maili r• Address: �L (,,U(�)X f�9
Agent's phone 03. ? 9 413-4 77 . 0/'1`±y��2 AC 47J
J
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.
see
I have no objections to this proposal. I have objections to this proposal. J mu/,`�3
fj
if you have objections to what is being proposed,you must notify the Division of Coastal Management of 4
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is l='`'`r
available at http://www.nccoastalmanapement.net/web/cm/staff-listing or by calling 1-888-4RCOAST. 6 1
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
- ( ' Pre“ • '1 •wn=r Information)
Signature -Signature�" 1111
katil h. cme i � ' a� 63
y r) -
Print or Tyipu Name Print or Type Name
t7 7 cj iy n la n e _ 1 ed r\ il /c1
ailing Address I Mailing Address
eiha VC /VC c 9 7�d caw OAOIAI -t-►CC
City/State/Zip City/State/Zip ) c,7( {q o3
(Q�� � �A 9 -0 /3 3 h c o nEc-�sud�e,��Ank •l �
Telephone Number/Email Address Telephone Nu�be1 Email Address asa,°tos - 1.ir5
/- -2:321 a- 1/ - 901.1
Date Date
(Revised Aug. 2014)

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' GPIN:7614-10-2115 LAND_VAL:131496 DATE:3/25/2020
GPINLONG:7614-10-2115 BLDG_VAL:182468 DB_PG:2017/00371
NAMEI:GREENWOOD EDDY L TOT_VAL:313964 STAMPS:600.00
NAME2:HARMON AMY C TAXABLE VA:313964 SALE_PRICE:300000.00
ADDR1:77 JACKLYN LN DEFR_VAL:0 REIDI:34291
CITY:BELHAVEN PREV_ASSES:363987
STATE:NC ACRES:0.64
ADDR2:77 JACKLYN LN PROP_ADDR:77 JACKLYN LN
ZIP:27810 TOWNSHIP:07
PROP_DESC:1 LOT#4 PUNGO MBL:76140018
SHORES WEST PIN I:07007530
I

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: eddyire,e,i i.i Q ne
J , i
/7 r r') jL Q e_/Aa CllAddress of Property: / � l�Q �!y �J �
(Lot or Street#, Street or Road, City&County)
Agent's Name#: I 0.5I Y eiriAeeUn5tJLMaI,jg Address: /1) AV< bA ent's phone# / 3- D 7/ /\ VD �f� 77J o
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 pr posing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal. j
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 J�
available athttp://www.nccoastalmanagement.net/web/cm/staff-listing or by calling 1-888-4RCOAST. c.5ilt
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 ive 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) (Ri n'Prope Information)
G . 4o1, -
Signature Si ure
J( h. Cmen Wm) , - Ut
Print or Type Name Print or Type Name
ri `� 1 3 Lf ; ) j k ucG� �4 l�/� o
Vic. 40n e-•-
ailing Address Mailing Address
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GPIN:7614-10-2115 LAND_VAL:1314% DATE:3/25/2020
GPINLONG:7614-10-2115 BLDG_VAL:182468 DB_PG:2017/00371
NAMEI:GREENWOOD EDDY L TOT_VAL:313964 STAMPS:600.00
NAME2:HARMON AMY C TAXABLE VA:313964 SALE PRICE:300000.00
ADDR1:77 JACKLYN LN DEFR_VAL:0 REIDI:34291
CITY:BELHAVEN PREV_ASSES:363987
STATE:NC ACRES:0.64
ADDR2:77 JACKLYN LN PROP_ADDR:77 JACKLYN LN
IZIP:27810 TOWNSHIP:07
PROP_DESC:1 LOT#4 PUNGO MEL:76140018
ISHORES WEST PIN_1:07007530
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Ec/q11 (?re e 1,1)0 ne
Address of Property: 17 7 l)a ci v6 Ma ti a 6`6/
(Lot or Street#, Street or Road, City&County)
Agent's Name#:TiIs raledU49/ Maili Address: At) AV< L
Agent's phone#. .S / 3 4(j 77 /� I ��� C ,e10
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. •_;
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V I have no objections to this proposal. I have objections to this proposal. ,'y •
If you have objections to what is being proposed,you must notify the Division of Coastal Management vf�;�
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is II
available at http://www.nccoastalmana_gement.net/web/cm/staff-listinq or by 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature Si nature
all h. me Milo r•-•• •
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(Revised Aug. 2014)

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s GPIN:7614-10-2115 LAND VAL:131496 DATE:3/25/2020
GPINLONG:7614-10-2115 BLDG_VAL:182468 DB_PG:2017/00371
NAME(:GREENWOOD EDDY L TOT_VAL:313964 STAMPS:600.00
NAME2:HARMON AMY C TAXABLE_VA:313964 SALE_PRICE:300000.00
a ADDR1:77 JACKLYN LN DEFR_VAL:0 REID1:34291
CITY:BELHAVEN PREV_ASSES:363987
STATE:NC ACRES:0.64
g ADDR2:77 JACKLYN LN PROP_ADDR:77 JACKLYN LN
i ZIP:27810 TOWNSHIP:07
'! PROP_DESC:1 LOT#4 PUNGO MBL:76140018
SHORES WEST PIN_1 :07007530
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