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HomeMy WebLinkAboutEnnis, Bill 84838C,o1*q``°"S"1Al, OLAMA ❑ DREDGE & FILL 84838 A B C D C E N E RAL PERMIT Previous permit Date previous permit issued New ❑ Modification ❑ 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 , I SA NCAC �' J ❑ Rules attached. 0 General Permit Rules available at the following link: www.deq.nc.zov/CAMArules Applicant Name I Address City Phone # Email Affected ❑ CW ❑ EW ❑ PTA AEC(s): ❑ OEA ❑ IHA ❑ UW ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Length w� Access Length Pier(dock)length Fixed Platform(s) Floating Platform(s) Finger pier(s) Total Platform area Groin length/# Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin,.channel.' at Cubic yardsl Boat ramp Boathouse/ Boatlift Beach Bulldozing Other SAV observed: yes no Moratorium: n/a yes no Site Photos: yes -- Riparian Waiver Attached: yes no A building permit/zoning permit may be required by: _ Permit Conditions 1 ,/14 ZIP Authorized Agent Project Location (County): Street Address/State Road/ Lot #(s) !'"t Subdivision City f ❑ ES ❑ PTS Adj. Wtr. Body%(nat/man/,unk) ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ' e e,. ,f.-e.1- / (Scale: V ) ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Nam Permit Officer's PRINTED Name r Signature "Please read compliance statement on back of permit" Signature Application Feels) Check #/Money Order Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit 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: 1) 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 from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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: F-1 Tar - Pamlico River Basin Buffer Rules F-1 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. If you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven — south of the Neuse River, Onslow Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 (Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 ❑CAMA ❑ DREDGE & FILL Nd 84838 A B C '° ti I GENERAL PERMIT Previous permit Date previous permit issued ❑ New ❑ Modification ❑ 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: 15A NCAC ❑ Rules attached. ❑General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name _ Address City Phone # (_ ) Email State I IZIP Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City P Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity (Scale: ) Shoreline Length. Access Length Pier (dock) length Fixed Platform(s) " Floating Platform(s) Finger pier(s) Total Platform area Groin length/# Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing_ Other SAV observed: yes no Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached: yes no A building permit/zoning permit may be re Permit Conditions U TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. Agent or Applicant PRINTED Name. Permit Officer's PRINTED Name Signature "Please read compliance statement on back of permit" Signature Application Fee(s) Check #/Money Order Issuing Date (Please Initial) Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit 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: 1) 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 from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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: F] Tar - Pamlico River Basin Buffer Rules 1-1 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. If you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, INC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven — south of the Neuse River, Onslow Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 (Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 William R. Ennis, Jr. November 4, 2021 NC Division of Coastal Management 400 Commerce Way Morehead City, NC 28557 Attn: Ryan Davenport Mr. Davenport, I am applying a General Permit, on behalf of myself, Cindy Weatherby, 221 Straits Dr., Beaufort, NC 28516, and, Joan Davis, 314 Joan Ct., Beaufort, NC 28516, for maintenance excavation of the canal in front of our homes. Maintenance excavation was last done in August of 2010 under CAMA General Permit #56827. Agent Authorization for CAMA Permit Application forms designating me as Agent for Davis and Weatherby are enclosed. A copy of the original excavation plans, dated 8/20/2010, is also enclosed, which we intend following. Certified letters have been sent to two of the riparian property owners, hand delivered to the third with the CAMA form and a copy of the plans. We do not anticipate any objections as there were none last time. We await your response. Thank you, William (Bill) Ennis (828) 817-3306 Enclosures (3) NOV 0 9 2021 219 Straits Dr. L)CM-MHD CITY Beaufort, NC 28516 Email: iinmennisjr0yahoo.com 00)4� i f lo firxmi) J� 1411 V" Al (4(is '71,; brin fl,30L T"I E 'givwIl ?fiv (loili ,"\ It KI , Ajiin-04: 690: elllo- leis PA fli -:,flob 1:vPol. wv]1 (":Ai ?,i Of OMS fyxobei#I fir, Nifin, w,)X-.-,i lEiLi4v udflu ,,qw) A I U 11 �561'10 ovv"', ot oj 1,, M A D -A i ilvi I S�att�iV -)iVe, A 78 R M folo"ee.,; you 5-3o to p popose- cd ,gip as Nov 0 9 ?021 a-, 4�0 -,M-M HD CITY uAte, k. psiev iws:s Vy 1717 j 17 b in a ?C 7 Ri uRnm in ou,,,,, *044 a wM.VW�Pv�l f Alf n 717 . v, Nk'N "N 4; 41 'Al ';24 -------------- -v ha!• A wilt WIN R W, CA A, "Sao Irk, "OL J k YU, (whasuipy, _511'1'lk AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: Email Address: l+ 1-)0,644 X I certify that I have authorized y-4S « , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: �G•��l r1,a �' I li�Gt 6,*4A5t,-_ LH at my property located at in 6A:��Vi r County. 1 furthermore certify that 1 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: 6,--, t6l�" �-- Signature Print or Type Name Title /1 —1 �I 0 Date ECEIVED This certification is valid through I I NOV () g 2021 OC`a`iAMHD CITY AA005- p xi4 14: -lifyint n Jf WN. -,bbA If !F16PA o uavq I iuj oi- J no os 0i ol 'I'liviptl yry X A.P. yi lieqolq, yrn r,-. YtOuoo . Vlltl lmv? 4Yki-mv,114 W-oo, -1 aM lit' e, Irlomewamm Aeaatw'.) to i .so ­violni wivC, Ooqav�i -vM AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: Email Address: I certify that I have authorized �Aw ✓W414�7 Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development:��►"r� at my property located at in G�� County. 1 furthermore certify that 1 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: or Tvpe Name Title ^ 1 , Date This certification is valid through I 1 NOV ® 9 2021 OGWI.AHD CITE" I -)bA horn- o v c d Wil yllhcio 1 atga AMAp I ►u"oft" m'itsftcyrn m) 13sC' Ile 4x- qc ta oe 44 -7v kp -m o o I'Japsm tall i,y'NIwOo4e ftw od"6iwW. d v"n 0, A f— :XI.CJM•]A / JQ DREDGE & F11" NU iiWNewGENERAL PERMIT Previous permit * ( 'Modifkntlon _ ]Complete Reissue ( ]Partial Reissue Date previous permit inured_ ►z aufhorizsd by the State of North Clrollrta, pepartmenc of Environment and Natural Rosources uid the Coastal Res mission In an area of environmerual coromrn pixsuant to I SA NCAC % VplWw Name 's " a�1n�►dn ij4,fiules atraled. Project Loraion: County— Wdreiss_ , -_2.y 'Ji'e►a~tr r, Street Address/ StaiteRoad/ Lot #(s) .ItyStaple 0- ZIP' 4 22 l 'horse # {^ } Fax #•(� �) Subdivision Wthorizedggent �ka�af pAsr City ... "ti ` � . ZIP '15'i1(0, kffecaed n CW T f SEW r)t,PTA I I Es Lim Hone # { �) _ ?25 - ll�gr5 River Basin n OEA :J M14F I : tH IJ USA 1'1 N/A SEC{a): Adj. wtr. Body--- �V ^i�„Y. _(It Atnkn� )RW: yes / 05 PKA yes( r Caft.Hafs. yes 1 no ClosestP'laj,Wtr. Body c. 1.... •Ytr' _._ Type of Project/ Activity (Scale. { } Picr (dock) bngth _ - Piatfarrrs(s) Groin tenCth . number.... Bvikhrad! 10prap length _ rng dbtar,ec a6iss}+ore _... .. . max distance offshore asi eI - 70 's 2 1_ I cubic yards leia.. -•��• Boat ramp_ -_ --_----- Bo st3+ousc/ Beatlirt Beach Bulickwing. „ Other Shoreline lVgeh . , _IU SAY: not sWe )Ns i sent: wt sum yes Mamorium: n/a yes Photos yBS ,• r W&NwAt'tsched: yes AA,bu, building permit may be required by I I Sea twte o/r`t backs rat;fir+dk•+�R} (Uvjja�r rules. / ({ , a , - Ij •rytso,t4 1` Lfif Cft*M L.J. 7 YVf. y$.a�snf J �} 1.1 .�FT'�.�r..N -{� • f:• • l /� ~ ��{ l l 17�� t><+fi6��11 'j'! •� � �S � A "1F�►'•�aV • Y .^� `a �' ' Cs . f`'. �! �.i • i� t'st. t�rli Is � G ' 1C` � �. `� t�'. TMEr '71easere2t I stiumntonbatkofpermitas IpplieatlanFee(sj _ Cheseks# EX Qm Islas LoWPlanaftjurhdletlon •�� PAWFIeName �Ya� . � y . I •� � '� � ar ys a` � Fes%. 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DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: J0154 Address of Property: t7* 'Ne ` L 1� ,_ l 1� i♦ 11 Mailing Address of Owner: Owner's email: Owner's Phone#:y�O� Agent's Name: iL (�/ �%i Agent Phone#: U `� - �% � f- Agent's Email: w _ G `� LOW ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adlacent Property Owner) 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 1 DO NOT have objections to this proposal. I DO have objections to this proposal. ff you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted at (252) 808-2808. No response is considered the same as no objection if you have been notified by Certified Mail, WAIVER SECTION I understand that any proposed 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 (this does not apply to bulkheads or riprap revetments). (if you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) r n Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Mailing Address of ARPO 5 1 (o cpw ©t-t-" T � NL- ARPO's email: t • COM ARPO's Phone#: Date: *waiver is valid for up to one year from ARPO's Signature` Revised July 2021 t-Villirrrir R. Ennis, Jr. ------ 6eln November 3, 2021 Sara Beth Faust 3213 Stanford Dr. Durham, NC 27707 Dear Ms. Faust, I have -been asked to assist Cindy Weatherby in obtaining a CAMA Permit which would allow for the maintenance excavation of the existing canal in front of her house at 221 Straits Dr., in the community of Straits, Carteret County. A plan for the project is enclosed. CAMA rules require that all adjacent, riparian owners be notified of this proposed project and be provided the opportunity to submit comments to the Division of Coastal Management within 10 days of your receipt of this letter. The address you may submit your comments to is provided in the attached CAMA form which should be filled out and signed; however, no response shall be interpreted as no objection. If you have any questions please don't hesitate to contact me at the below address or email. Thank you, �6� Williarn (Bill) Ennis (828) 817-3306 Enclosures 219 Straits Dr. Bear jbrt, NC 8516 En7ail: ,vmenkdi rkyahoo.con? N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner Address of Property: Mailing Address of Owner: Owner's email: Owner's Phone#: f tf • P77, - f�l Agent's Name: rzlw V44rit / Agent Phone#: ?�f- �• r- Agent's Email: \k1q! ewiVutj hw .60 ►'1 ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to, be completed by the Aglacent Property Owner) 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 descrption or drawing, with dimensions, must be provided with this letter. I DO NOT have objections to this proposal. 100 have objections to this proposal. If you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted at (252) 808-2808. No reSpon� hsstderbnF dw same- ` + have been r otblad 01 tf Mail. ' WAIVER SECTION I understand that any proposed 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 (this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign the appropriate blank below.) 1 DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner ME I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Mailing Address of ARPO: ARPO's email: Date: ARPO's Phone#: *waiver Is valid for up to one year from ARPO's Signature* Revised July 2021 i { It 70 rl Ac 7�y V.Eoy - i l r a �•d a • 11 I Waj�w iE rr -�� r t * -:)� C:f- ... vatei ! a s —1,0,— Eo 4� tti i tmnc7c7 p9w Riunnainnv�nin .i,, z1 r. R,,. • 11 I Waj�w iE rr -�� r t * -:)� C:f- ... vatei ! a s —1,0,— Eo 4� tti i tmnc7c7 p9w Riunnainnv�nin .i,, z1 r. R,,. William R. Ennis, Jr. Mr. Robert Sellers, Jr. 123 Bremer St. Fayetteville, NC 28203 Dear Mr. Sellers, November 4, 2021 I am applying for a LAMA Permit which would allow for the maintenance excavation of the existing canal in front of my house at 219 Straits Dr., in the community of Straits, Carteret County. A plan for the project is enclosed. CAMA rules require that all adjacent, riparian owners be notified of this proposed project and be provided the opportunity to submit comments to the Division of Coastal Management within 10 days of your receipt of this letter. The address you may submit your comments to is provided in the attached LAMA. form which should be filled out and signed; however, no response shall be interpreted as no objection. If you have any questions please don't hesitate to contact me at the below address or email. Thank you, SENDER: SECTION M Complete items 1, 2, and 3. ■ -Print your name and address on the reverse William (Bill) Ennis so that we can return the card to you. (828) 817-3306 ■ Attach this card to the back of the maiipiece, or on the front if space permits. 1. Article Addressed to: Enclosures RK +�� 11 `� 13 Agent ��.�//�[ ❑Addressee B. ,�Eoeiv�b�`� t�? „'. C. to of elive I 4 11110/�Ml D. is delivery address different from hem 1? t ❑ * If YES, enter delivery address below: [3 No 3. Service Type ❑ 1 0 Adult Signature MEvresso ❑ Regtstered Ma11T^� Registered li'm 0 Adutt Signature Restricted Delivery ❑ R�ee�gtstered Malt Restricted 9590 9402 6834 1074 6415 94 0 certified Mail Restricted Delivery 0 Signature Confirmation^ 0 collect on Delivery ❑ Signature confirmation 2. Article Number (transfer from servke ta6en __— -- Collects Delivery Restricted Delivery Restricted Delivery 7 0 21 0950 0001 9821 1231 91 Restricted Delivery Ps Form 3811, July 2020 PSN 7530-02-000-9053 Domestic Return Receipt 219 Straits Tar. Beaufort, AIC8516 L)ntid ivmenAisjr' yy ihoo.corn �; r N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or NAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. \NiU-4 AsM�%i� Address of Property: �� �'��7 ' '�!�� �•1.Ci ��Y Mailing Address of Owner: Owner's email: WK ftyWi!V'&-y W -cow% Owner's Phone#: 0 (q Agent's Name: Agent's Email: Agent Phone#: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) 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 DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to what is being proposed, you must notify the N.C. Division of Coastai Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC 28557 DCM representatives can also be contacted at (252) Boa-280a.-1 r ivspdi is conskiw'ed <sar * r,irei +e ct#o 3#yo `frave'beeni nc fe txy CortiffitdNeit. WAIVER SECTION I understand that any proposed 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 (this does not apply to bulkheads or riprap revetments). (if you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner Ow I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Mailing Address of ARPO: ARPO's email: ARPO's Phone#: Date: *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 w .rom,y„ 1• � ,4 �., p 1' 're Vio 1 Jt t ' 01 ;r'r'r'�f� /!1 r k tom" • _^'�-----i �1R-'.1,1��1/Y'_ ,a Ik�k, tit�ltmnc7C7 fi�t�Rn�tncvnn�n ,��,�• �• �R...� �: .h' y, J�� ' ' w t v' _ _. � .. • i y' �'