Jumping Run POA 79676C

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❑CAMA / ❑ DREDGE & FILL ON. 79676 A B C D
GENERAL PERMIT Previous permit#
❑Modification ❑Complete Reissue CJPartial Reissue Dater ious rmit 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
I� . ' 1z/ Rules a hed.
ApplicantnN^ame-5)06 (4� b r41VJ7> Project Location: County
naa.-.......'^X l±17f l/•.�-L� YI M A _ �ii„ff Suva, Address/ State Road/ Lot #(sL. A 4 n.
—
v �
(Scale: /
Pier (dock) lengtl�
Fixed Platform(s)�—_
Floating Platform(s) JJJI "`�}X' II (�t/t✓— T
Finger pier(s)Groin length
i�—
number
Bulkhead/ slength
t
av distance offshore .
max distanra
t/
!1�inhb;aine
c yards �~
Boat ramp Boathouse/ Boatlift A/ I/i I l ��
Beach
Other Bulldozing /© \/ y{ / E), y — I r-,—]Qi /' — /� IV 1
Shoreline Length Y i I _
SAV: not sure yes no / ten'
Moratorium: n/a yes no I `97 V�
Photos yes Waiver Attached: yes �r
A building permit may be required by: ❑ S no e o , back regarding River Basin rules.
( Note Local Planning Jurisdiction) /
No s/ Special Conditions
t(�
t r
Kg f or pplicant Printed Name APermitfi,rint&ame
ture *''P azeread compliance statement nbackof permit** Signatur
Opp cation Feels) Check# Issuin Date Expiration ate

Styron, Heather M.
From:
Bryan Leach <[e-mail]>
Sent:
Wednesday, March 31, 2021 11:11 AM
To:
Styron, Heather M.
Cc:
Williams Teresa
Subject:
[External] Jumping run creek Peter Kaplan
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Heather ,
I have attached the tracking number for Peter's mail again seeing he is never able to sign the ones we send him.
I will scan and send over the rest of the canal signatures that were required for us to dredge

I I f _ d _L
f Pam,.». k . , .EVICE*
oti/:31/2021.
Product
>PARTA
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(800)2,Pi-8/..1
t1:06 AEI
OIN Uni I Pr i
Fri (se
US Flat #10 Env 1 $0.69 $06
19
Fi rvt--Ll ass Mai l@) 1.
Letter
Nast i nc s-on-Nudsor7 0 NY 10700
Weight: 0 1b 0.50 oz
Estimated Delivery Dare
Mon 04/05/2021.
Certified Mail(@
Tracking #:
701907000000 71,858708
Return Recei fat
Tracking #:
9 590 9402 601.7 0069
Aff i xed Pottage
Aff i xed AmOUnt : $0,56
Total
V
$2.85
5270 88
_,$0.51
$6,4
Grand Total: �l.14
Casa $10 ,110
Change _ . _w....
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I
property located at (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
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.
do not wish to waive the 15' setback requirement.
(Pro aTj-
or Information) (Adjacent Property Owner Information)
Signature -Signature*
r G
Print or Type Name ( Print or Type Name
'21.J &rO0K C(?,KP
Mailing Addres w OJg
/ J Mailin Address
?� try ��OiI
CiWstate2i City/statelzip
' SSI(r,?>-73(l art o�1@ic(ovd' cara
Teleph5�re umber/email address Telephone Number/email address
tar� ��I
Date Awe *
'Valid for one calendar year after signature' (Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
property located at (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
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.
trrop rt owner information)
C1 latt(i'e
Print or Type Name
3/5 dTie/L G—N
Mailing Address
,A'Ya✓Foa.T "-s- 7C
Telephone Number/email address G,
3 p/ W;� i
'Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature*
Print or Type Name
Mailing Address
Telephone Number/email address
Date
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _N1IlM4 �41Q uGi fn�Wl� 's
property located at �� % (jlo-pk d "t (Name f Propert caner)
in 'f�1 , -T N.C.
(Waterbody) (ity/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
V� 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)
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.
t/ I do not wish to waive the 15' setback requirement.
(Property Owner information) (Adjacent Property Owner In ormation)
or
Addres
a.Ylrn
iZJLL
telephone Number Iam tl a�(0`� /
Dare 5oi — �2
Q- bh` l e_
Print or Type Na e an 8abk (j[at
Malting Ad ress 1C
City/S ate .ip
Telephone Number/email addres
Date* �'�
��q _GC _ i
'Valid for one calendar year after signature`
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to s
property located at (Name of Property Owner)
(Address, Lo Block, Road, etc.)
on V U m /�r,�/ i2 t N __ p/Z� in A.L . a r ( o-Li , TI/ N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locat(ory
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)
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) (Adjacent Property Owner Information)
Si$fifr }r Signature
Print or Tye Name Print or Type Name
Type Name 1'400" L.d/
Mailing Address Mailing Address
City/State/Zip City/State/Zip
Telephone Number/mail address Telephone Number/email address
�L 4/ , /
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I
property located at (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
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)
`C,Pakl-) n a
Sionann•a
ag(-'7901
Telephone Number/email address
Date
'Valid for one calendar year after signature'
(Adjacent Property Owner Information)
Signature*
Print or Type Name
Mailing Address
City/state/Zip
Telephone Number/email address
Date
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to I
property located at (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on , in
N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
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.
party Owner Information)
ter- -
zture
or Type Nam
lY Afrtece7 PC,,, Rc
Telephone Number/email address
(I%(D-)H
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature*
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/email address
Date*
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Mali(.( 9411"k s
Property located at 11,13 (up(.I l /l iv (Name of Property Owner)
tArtdress, Lqt, Block, Road, etc,)
on �1jl�Dll�t Uh ,1ts' IL In _1yjll)[kl
Waterbody) (City/Town and/or County) N.C.
The applicant has described to me, as shown below, the development proposed at the above
iocaJion.
V 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)
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) (Adjacent Property Owner Information)
Signature* -
or Ty��RRa� Nam Pant or Type Name
�rz Yl�i;I"tl {1 1tr�.i
7g, ^Addrasj� s � Melling Adtlress
a te/Z!p City/State2rp
� to •��`,'i L"% 1l�
shone Number/email address Telephone Number/ email address
.I•f.,i
Date . —
Drna
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Name of Property Owner)
Block, Road, etc.)
I hereby certify that I own property adjacent to
property located at
(Address,
on in
(Waterbody) (City/Town and/or County) N.C.
I
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
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.
trroperty owner
Meilin Address
City/Sfate/Zip
/ P C Z70
Telephone Number/email address
A sue- So3- SG �S
Date —
'Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature*
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/email address
Date*
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ____ •s
properly located at (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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) (Adjacent Property Owner Information)
Signalirre*
Print or Type Name
Melling Address
Dare• — --- -
(Revised Aug. 2014)
'Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
property located at (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on ,in
N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
1 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)
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.)
Date
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Property Owner Information)
Signature *
Print or Type Name
Mailing Address
City/state2ip
Telephone Number/email address
Date *
(Revised Aug. 2014)
'Valid for one calendar year after signature'

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