79150_Charles Shewbridge_20210419

12'165
1..GAMA/ DREDGE.FILL zI)-1 A ga 4 I N9 7915(} ep C D
GENERAL PERMIT Previous permit# .,-
ew Modification Complete Reissue Partial Reissue Date previous permit i �,v/
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 SA NCAC C �/ /Zoo
``// ' Bides attached.
Applicant Name, 2ttc-/t i 4ggr.4�e,J.)G)L 2t //�N't,i,Project Location: County .,/.-- +
Address Y/77f6i 1tr G /r_.. Gam _............ Street Addresss/s//,State Road/Lot#(s) /07 To ,r --
�y �tp.,r/L) stat ZIP,,,10/i S /v4�/ `/-
Phone#(? ).-28.7• `y7 E-mail ch. ,Aeari-i;.-Loj -,. ( Subdivision
Authorized Agent ,-74,,Kc.7:-,,s ila"ef City Oe rx._crzJC. ZIP .,2,79 4
Affected CW cam' ,t A . ES I PTS Phone# ( :/�r River Basin :
AEC(s):
OEA 'HHF .-,III '.::',WA /'
Pvvs: USA Adj.Wtr.Body. D�,.z. e- e'er// 6Cm, / ..oat to unkn)
ORW yes PNA yes !� Closest Mai.Wtr.Body..._."?..-'44..J o4."cot
Type of Project/Activity ,/// ,p o;//`., /J'''-/7' t•if.`r-e,/ }t /){,t 7. i.m1
(Scale: /'l_` )e) )
Pier(dock)length —
Fixed Platform(s) ---
Floating Platformis) "--- flu' 14i ^A
ar.
Finger pier(s) __ _.. --
Groin length '--
numbei '
Bulkhead/Riprap length
avg distance offshore --- -
max distance offshore -
Basin,channel ---` - `,
I )
Q
cubic yards t V rr ,
• ,*fI J
••
Boat ramp c 1 r a'4' _ .- -4-"1' !), i :
Boathous /�r' �J' •
a
Beach Bulldozing "'----- 'r ' I •
Other I / .
ywL /y �! 1 ta a -se4�L
Shoreline Length //S'f �L ' /A
SAV. not sore yes C1 ��
Moratorium: ala yes V)L-r f'!j' 3-4,vI:r J,G j t-��
Photos: no ` Y
Waiver Attached no I _...._._.
A building permit may be required by: OW/yr ._ i..__ See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/special conditions _fee. b 71Y.I. €'o) ji t...e,d K = /9. S'
—•t_ec,), , eotv‘a_e&i,asd., ', 6,0( (
t or App' t Printed Name PermitORtcv(.Printed Name - . ........
. �-
gesture '"Please read compliance statement on back of permit me Signature
GD �_ ©� V/i . -2 - �'/i f
icatian Fee(s) Check* issuing / .. _.._. Expiration Oa Oate

41 LAMA/ DREDGE & FILL N9 79150 a, C D
GpNERAL PERMIT Previous permit# ..r.
Datepreviouspermit i sued
IJ�New ❑Modification El Complete Reissue Partial Reissue ��
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 2 7// 1-'O0 .
J ) ///// yules attach .
Applicant Name 0�<r`/ 5 �{- ne � � /1� Project Location: County attached.
Address if 7790 ,e_ •-// Street Address/State Road/Lot#(s) Jo 7 7 ,
City _ 7 er/L.3 State,//VA-zIPo2O/6 544.-,/ pp-,
Phone# (707)o.2cP?‘6Y7 E-Mail ch,a&At //n•Ife &J1—• I Subdivision y/�
Authorized Agent ,L9 <,.7He e/t ',ace City OGn<cafe - ZIP 96 0
Affected ❑CW �v{/ A ❑ES ❑PTS Phone# ( c,_ - River Basin .r el
AEC s : ❑OEA ❑HHF ElIH ❑UBA ❑N/A Adj.Wtr. BodyOrr h- 14,H„
( ) ❑ PWS. (nat �r�'unkn)
ORW: yes / no PNA yes /� Closest Maj.Wtr. Body ,- ,•''ha —CZ.-, d
Type of Project/Activity iilf, / ,6 e,-// LA 7-7' /-7' <'aLpe d.,1 A Lti 4 t<c d
(Scale: /"-,...2e) )
Pier(dock)length
I
Fixed Platform(s) w J�� . f hb I ! i
Floating Platform(s) (� !
Finger pier(s) ��'.- _.-._...._... _—._..
1
Groin length i I ! I
IIIIi ,
number -._._.l..._.__� — i �-- -..._4— I ---- ---- --
Bulkhead/Riprap length --._._ _..-�..-. t ..I._- j — _._.
avg distance offshore I I I
I i I Pelf' i
max distance offshore I I I
I l i
Basin,channel ( I I i I i' • 1
cubic yards ( i I I
Boat rampi•
t—_`
e /'>Boathous "/.7' A I
- . -- 1.. _ _ _
7.
—_ 1 I — I
Beach BulldozingI ? i -
I I - i t
Other I
�wL
r __ -
Shoreline Length //.5' I
SAV: not sure yes CZ) ' � � � • 1 i 7 --- t - _-- I
_ i.
Moratorium: n/a yes o ! Is.,-, ; - _—T
cl
Photos: no l_.._.__ 1_+ _. -�- .1 1 . 1.. —
Waiver Attached: no f� — — ' 1 . 1 - I •I • . •
A building permit may be required by: /7 1_ c- n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)Notes/Special Conditions See2 b 71/ /-2-0U) - ./ w-ci/ - r/9 J
sL0e ,r 7/%,
Agent or Applicant Printed Name Permit Officer' rioted Name
Signature a Please read compliance statement on back of permit** Signature
Jr 260 7903 y/i 9 .Z/ erhf/�(
Application Fee(s)
Check# Issuing Dat� 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(910-796-72 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 252-946-648 I
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

411 OCAMA/ ❑DREDGE & FILL N° 79150 A di; C D
GENERAL PERMIT ' ' Previous permit# !!'1
CINew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit igsued v-74
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 -'// /- v v
/ [Rules attached.
Applicant Name -.I' �r - ,,, her -/c �
. ) , J r 1/ �/t Project Location: County // ,/.._ ‘
_
Address (/ J/"yG 1/i, C. // '7/ Street Address/State Road/Lot#(s) /6 7 / ,-,
City - 1Pr /........) State VA ZIP E 20 /6 5 ,. <,
Phone# (%� ) -j -7 17G�/ 'E-Mail ,, :))r�'Zr If e <) Subdivision ;i/,j-�
Authorized Agent / .,,.,- ,.< - � - c City ()i P. :, is ZIP -' ,7 D
Affected ❑CW Plea
• ES ❑PTS Phone# ( ---) - River Basin //,
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body a . /. C ream ' l'1' " ( )
ElPWS. nat •
an�'unkn
ORW: yes / no PNA yes / Closest Maj.Wtr. Body /""" ' ,/ f'% -/
Type of Project/Activity %! /` ,per I/ f
(Scale: /" .0 )
Pier(dock)length
Fixed Platform(s)
Floating Platform(s) '
le,„ (� (c lC /" .,c ( {
Finger pier(s) 1 —
1
Groin length I
number I L —, — i 1 _..
Bulkhead/Riprap length _-----_ — _;
avg distance offshore i
I. !
max distance offshore I f
Basin,channel — F I ` II
1 '
cubic yards I
Boat ramp ,•, ti,,!
Boathouse/.Boatlifty /%7/.7 _................-_._.__ I.._` ....._.._......__._.._ -_._._........--_-- -_..._ n ' _...._.. f
1 i }
rj 1 I .41‘'Beach Bulldozing Iy I f , j/,(///,\
______ , /,,,,,..
Other , C ' f x { i I — I i
f j
s' r
Shoreline Length /1J -'� �
I I
SAV: not sure yes no �� —_1 .._-- -t - d7
4
I ,
Moratorium: n/a yes o i _ _ —
Photos: es no I' 6,
Waiver Attached: yes no 1 :
A building permit may be required by: /4-(/' See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 0 7/' )00 /,, ,;.cy R / J
._Sly P,e /- J J `/ -
Agent or Applicant Printed Name Permit Officer's Printed Name
Signature **Please read compliance statement on back of permit** Signature r
-.1 0 yyo3 /// /1e/ �//�/- ,
Application Fee(s) Check# Issuing Da 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(910-796-7215)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

41❑CAMA/ ❑DREDGE & FILL N0 79150 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, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑Rules attached.
Applicant Name Project Location: County
Address Street Address/State Road/Lot#(s)
City State e4 ZIP K2(i /C .5 - % ,-,-
Phone# ( ) E-Mail `f / Subdivision
Authorized Agent // City ZIP
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS Phone# ( ) ---- River Basin
AEC(s): ❑OEA El HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
❑ PWS: ,,
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity ,
(Scale: / ,,U )
Pier(dock)length „
Fixed Platform(s) I ,` ,," i ' , 1 ,
Floating Platforms) ' -
Finger pier(s) ._,__- ----
Groin length j j ' - {
I �.
number 1 I
' i
Bulkhead/Riprap length - - ..-,_ t ........-
avg distance offshore ! i -
max distance offshore
Basin,channel
IV
I , j► , {
cubic yards I i i ` i ( �
1 '
Boat ramp ` ,
Boathouse/Boatlift / _.........- -+; t._, .__ - 1 i - .--- -
_
Beach Bulldozing --
I
i
Other ` j
I
vg. t i a
Shoreline Length _
I } i
SAV: not sure yes Li,-- - - -E - - _.-.. - __.
Moratorium: n/a yes no:
Photos: yes noY .- .... . _...__ -_ .. -+... ......._ ':::' 1 ._ ._..,
i -- ,-
Waiver Attached: yes no ' '
A building permit may be required by: // / See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
Agent or Applicant Printed Name PermitOfficer's Printed Name
Signature **Please read compliance statement on back of permit** Signature -
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 I] 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(910-796-72 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Charles Shewbridge,for FKM Holdings LLC
Mailing Address: 47790 MacGill Ct
Sterling,VA 20165
Phone Number: 703-283-6647
Email Address: [e-mail]
I certify that I have authorized Emanuelson&Dad Inc.
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 4 Piling Boat Lift
at my property located at 107 Tom Neal Dr,Ocracoke,NC 27960
in Hyde 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
Charles W Shewbridge
Print or Type Name
President FKM Holdings LLC
Title
03 / 17 / 2021
Date
This certification is valid through 07 / 31 / 2021

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a07 --No-c-, ep•\ 'i),c

CERTIFIED MAIL• RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: IXS C 1\ SR i o �v
ew t .�
Address of Property. 1°7 I M Nam( { dke.NGZ7f6 c
(Lot or Street N,Street or Road.City 8 County)
t
Agent's Name#. Ct.6 Mai�ling Address: r . (1Ft�
� /J
Agent's phone*: a-Si-7h -Zzf2 I`r/ajjs f'11�f�C�. ,iJC Z7jrs3
Aettv-
y�} I hereby certify that I own property adjacent to the above referenced property. The individual
P t. applying for this permit has described to me as shown on the attached drawing the development
they are proposing.ileieecriotion or drawino.with dimensions,must be omitted with lhi6 letter
w(1.----1 have no objections to this proposal. I have objections to this proposal.
` t 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
curl"-
available at http://www.nccoastalmanagementnet/web/c,NstMH-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 appropnate blank below.)
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 Signal
C
Pont or Type Name S Print or Type Name
4-3-7 50 / tQ C q71( 2t-L - o �3()X
Mailing Address Mailing Address
S1;24-- iv .V' 2.1 6� �� /( / r yc �7S7o
city/state/Zip City/State/Zip
7°3-ZZC3 - 6611-7. 1/ -5/3/
Telephone Number/Email Address Telephone Number/Email Address
3 /7. 1/ Z/
Lua- Date ..
CbM !� (Revised Aug 2014)
r�lL Who red (dvr-

I—
I. . 'ostal Service
CERTIFIED MAIL° RECEIPT
,-1Domestic Mail Only
Na For delivery information.visit our website at www.usps c,.
'1AL USE
Emanuelson & Dad, Inc. . Coated Mai Fee V,60
0459
PO Box 448 r` $
g
O e. aac a* a.. - -
Nags Head, NC 27959 r- S
Phone:[phone] DRi°e.duri .crimeOlooloo $ •n rir7,1 279
tI ❑ Nrit.wud,dea�.y a �.J ..... M
Fax [phone] 0 �"°* : '7 bpi,
Email:emanuelson(a�embargmail corn �Awn �ituslebil'�"� `r
o Pie 10.55 = N
R Total Postap,and 7
03/17/2021 _ 'a1;00 +/ .9b J�
8 To
t7 Sent --- it ----Fla. ! e-- gfr•--- ---`�/
James and Tracey Kelley y,sane,21.P.
� �T
PO Box 224 PS Form 3600 r .,t a G _ ,r 4.o
Ocracoke, NC 27960 nw
i 2015°s"-sazox-'7 sea Reverse tor instruceens
Re: C. Shewbridge trustee—107 Tom Neal Drive,Ocracoke, NC 27960
We have been requested by the above property owner to do the following work:
1. Install 1 -13K Boatlift with 4-8"x 25'poles.
In order for us to obtain the Cama(Coastal Area Management)permit for this project,Cama requires
each adjacent property owner to be notified.We would ask that you sign the attached form and return it to
us as soon as you can. You may scan and email,fax or simply mail.We are also attaching a sketch of the
proposed project.If you have any questions,plea_ca do not hesitate to contact us-If you do have any
objections to the proposed work,you may contact Cama(Coastal Area Management)at 252-264-3901,
We thank you for your cooperation in this matter.
Sincerely,
SENDER:COMPLETE THIS Si:C77C:• THIS SECTION ON DELIVERY
Jacqueline Lewis- _
Emanuelson 8 Dad Inc le Complete items 1,2,and 3. 40,47.
'► /
' • Print your name and address on the reverse
so that we can return the card to you. Adiessee
INAyach this card to the back of the mailpiece, 1 ) C.7ate o
6rorlthe front if space permit.. C 4<e v
1.Article Addressed tot' / delivery {i l
// '� D.is item �v
Jant s - I �'G.`�'1 f(e,(,{ei M •enter delivery address below- ❑No
( o 1301- t2 �5 _, �
0ctr�cdke rli_Z�16v A Jt ,
IIINIIIIIi!IIIIIIIIIIIIIIIIIIIII)1IIIllIII o D
ab.koilhen Do Ter, o��rr,ae�tt
mir
9590 9402 6133 0209 1054 04 ❑`a admsnarawbfoseches.y ❑ y to
Delbssr
2.Article Number(Transfer hnm service)seat) o Casa o Orars.vRe etweve,y"l ,uro Confirmation'.
7018 1130 0001 7767 1718 Iisrlcted °RowcredOrivery "
odvwy Restricted txir„f•
PS Form 3811,July 2015 PSN 7530-02-000-9053
-- Qai7eatic Retail Receipt

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER1
N FORM
Name of Property Owner: C t`�( I�S U" t i
Address of Property:
l o7 / �( I �JU''a-c alb .nlC--Z75'G o
(Lot or Street#,Street or Road.City&County)
Agent's Name#: ' '`ENV OrL• / �Maiiling Address: • O ° �(�u
Agent's phone#: cZ--U>I ZlZ" I" aj Z75'Sj�'
'C?Le
i-;a
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
kit are proposing.A description or drawing,with dimensions,must be provided with this letter.
�';Cv
i A 1 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 athttp:Uwww.nccoastalmanauement.net/web/cm/staff-listingor 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.)
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)
Ak
Signature Signature
C S tew h r C1( A/444--
Print or Type Name Print or Type Name
-1-11 o (K QC 4 (( PC :13 252
Ma ling Address Mailing Ad Tess
� ! .UG 20 16 Cii-2,e"L1Ce'je)lGF
City/State/Zip City/State/Zip
7o3"2 — 64-7. 62e'2.(. -✓L2,tif&5/4-,c°o
Telephone Number/Email Address Telephone11/24
Number/Email Address/
3 . 1-7. 1(
(Revised Aug.2014)

•• • -• a ervice
CERTIFIED MAIL- RECEIPT
Lfl Domestic Mail Only
cis Cy r„, : our webslte at wwwusps.com'•
Emanuelson & Dad, Inc. " A L- U S E
PO Box 448 N m s 1.47Q
ervlcesa BM Ow*box..aaA. .. C.279 ^
Nags Head, NC 27959 -3 ors s s9
Phone:[phone] • •IV
Fax:[phone] S. °'�� • ,7
Dario servers Restncie0 Ddivety Mg
Email: emanuelson(a embargmail.com o Postage
• ``
03/17/2021 3eru To
,4a3
Neal E Cody, .. . •� Q li Zi
PO Box 8725 L ..`. R.e - ekic_7Yegi
PS Form 3800 A.II eo-281,.;•,-
Asheville, NC 28814 See Reverse for Instruction,
Re: C.Shewbridge trustee—107 Tom Neal Drive,Ocracoke, NC 27960
We have been requested by the above property owner to do the following work:
1. Install 1 -13K Boatlift with 4-8°x 25'poles.
In order for us to obtain the Cama(Coastal Area Management)permit for this project,Cama requires
each adjacent property owner to be notified. We would ask that you sign the attached form and return it to
us as soon as you can.You may scan and email,fax or simply mail.We are also attaching a sketch of the
proposed project.If you have any questions,please do not hesitate to contact us.If you do have any
objections to the proposed work,you may contact Cama(Coastal Area Management)at 252-264-3901
We thank you for your cooperation in this matter.
Sincerely, '
SENDER:COMPLETE THIS SEA TION •G'•i%'I.ETE THIS SECTION ON DELIVERY
Jacqueline Lewis. ■ Complete items 1,2,and 3..
Emanuelson&Dad Inc. • Print your name and address on the reverse xAgent
•` 0 Address
So that we can return the card to you. Pri
•Attach this card to the back of the mailpiece, eoe by/t'� Na e) .<te�of¢D,eliv<
or on the front if space permits. -�tvedl.�r;� ±v/L
Article Addre•sed to:/// D.is delivery address from Item 1? 0 Yes
Ne ) ( . C O�� if YES,enter delivery bebvr. 0 No
3. &nice Type CI Priority
IIIIIII II IIIIIII IIIII I I III 1 Iilal 2= °d. o`q3ephS0oB•1teade
9590 9402 6133 0209 1053 81 Delesy o Rehm Receipt+or
Merchendse
2.Art51e Ntx _transfer from service terse) • O Golluellinflabory Resukted Delivery ❑&Vett,.Corr vatic
;]Sgneose Cmrlrnstic
7 018 1130 0001 7767 1725 sesjiM.11Rastricted Delivery Restricted Delivery
PS Form 3811,Jiiy 2I115-PSN 2.uo-eo53 Domestic Return Rece