Killion, Joel 84333C

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30�0 &EICAMA ❑ DREDGE & FILL 9 9 84333
mit
GENERAL PERMIT D to previous Preous 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 Authorized Agent
Address Project Location (County):
City State ZIP Street Address/$tate Road/Lot #(s)
Phone # (_:)
Email Subdivision
City ZIP
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
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 required by:
Permit Conditions
(Scale:/';
E 'Tt ❑ 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 Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #/Money Order
Signature s
Issuing Da et 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:
1-1 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, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(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: [phone]
(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: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

`U4,1 ❑CAMA ❑ DREDGE & FILL N9 84333 A B C D
GPrevious permit
GENERAL PERMIT T
Date previous permit issued
❑ New ❑ Modification ❑ Cohnplete 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 Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone #
Email
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
i I
SAV observed: yes To
11 i
Moratorium: n/a yes ,no
Site Photos: yes no - i - -
I
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
( I
i
), ❑ TAR/PAM/NEUSE/BUFFER (circle one)
1 s
j ❑ 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 Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s) Check q/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 F1 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: [phone]
(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: [phone]
(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: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

Styfon, Heather M.
From: J Killion <[e-mail]>
Sent: Wednesday, October 27, 2021 1:09 PM
To: Styron, Heather M.
Cc: David Braswell
Subject: Re: [External] Atlantic Beach
Attachments: USPS Green Card-Carlisle[2].pdf; —FedEx Detailed Tracking --Delivered
10-27-2021 [58].pdf; 10.20.21 - Killion Letter to Adjacent Property Owner - Sam
Carlisle[27].pdf; 10.20.21 - Killion Letter to Adjacent Property Owner - Sue
Holding[79].pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Heather,
Please find the following attached regarding my general CAMA permit application for 101 Hoop Pole Creek Dr.:
1. Letter of Notice to Sue H. Holding Re: Application for CAMA Permit for 101 Hoop Pole Road;
2. Letter of Notice to Sam Q Carlisle Re: Application for CAMA Permit for 101 Hoop Pole Road;
3. Fed Ex Tracking Proof of Delivery of the CAMA Letter of Notice to Sue H. Holding; and
4. USPS Green Card evidencing proof of service of the CAMA Letter of Notice to Sam Q. Carlisle
Please let us know if you have any questions or if there is anything else you need from us.
Best,
Joel
From: Styron, Heather M. <[e-mail]>
Date: Tuesday, October 26, 2021 at 1:50 PM
To: J Killion <jgkillion @gmail.com>
Subject: RE: [External] Atlantic Beach
You're welcome.
1

From: J Killion [ma ilto:jgkillion @gmail.com]
Sent: Tuesday, October 26, 2021 1:07 PM
To: Styron, Heather M. <[e-mail]>
Subject: Re: [External] Atlantic Beach
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Thank you!
From: Styron, Heather M. <[e-mail]>
Date: Tuesday, October 26, 2021 at 1:04 PM
To: J Killion <OgkiIlion @gmail.com>
Subject: RE: [External] Atlantic Beach
It will. We just need to make sure it was delivered and on what date.
From: J Killion [mailto:[e-mail]]
Sent: Tuesday, October 26, 2021 12:18 PM
To: Styron, Heather M. <[e-mail]>
Subject: Re: [External] Atlantic Beach
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 hope that your week is off to a good start. I have a quick question, would a Fedex receipt of delivery (as opposed to a
certified mail receipt) suffice for evidence of the start of the 10 day period for purposes of notifying my neighbors?
Best,
Joel
From: Styron, Heather M. <heather.m.st ron ncdenr. ov>
Date: Wednesday, October 13, 2021 at 1:52 PM
To: Joel Killion <jgkiIlion @gmail.com>
Subject: RE: [External] Atlantic Beach
PJ

From: Joel Killion [[e-mail]]
Sent: Wednesday, October 13, 2021 10:43 AM
To: Styron, Heather M. <[e-mail]>
Subject: RE: [External] Atlantic Beach
rCAUTIGiN: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
eport Spam.
Heather,
My apologies for missing your call earlier. AT&T has a safe calling feature on my account, and it turns out it's blocking a
lot of legitimate calls. I've white listed your number. So, please feel free to call anytime (I also tried you back).
Best,
Joel
From: Styron, Heather M. <[e-mail]>
Sent: Wednesday, October 13, 2021 9:22 AM
To: J Killion <[e-mail]>
Subject: RE: [External] Atlantic Beach
What is your number?
From: J Killion [mailto:igkillion gmall.com]
Sent: Monday, October 11, 2021 11:26 AM
To: Styron, Heather M. <heather.m.styronncdenr.gov>
Subject: Re: [External] Atlantic Beach
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Heather,
Thanks for getting back to me. It might be most efficient to hop on a phone call if you have a few minutes? The
property is 101 Hoop Pole Creek Dr.
Best,
3

Joel
From: Styron, Heather M. <heather.m.styron @ncdenr.gov>
Date: Monday, October 11, 2021 at 10:02 AM
To: J Killion <jgkiIlion (@ gmail.com>
Subject: RE: [External] Atlantic Beach
Hello Mr. Killion,
I had a quick moment to email you. What is the property address and what are your questions?
Heather
From: J Killion [mailto:j kig llion( gmail.com]
Sent: Friday, October 8, 2021 1:24 PM
To: Styron, Heather M. <[e-mail]>
Subject: [External] Atlantic Beach
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good Afternoon Ms. Styron,
My name is Joel Killion and I own property in Atlantic Beach, NC. I understand that you are the appropriate contact
within the Division of Coastal management for my property. I would appreciate guidance from you on project that I
believe falls into CAMA's jurisdiction. Is there a good time to call you?
Best,
Joel
n

October 20, 2021
Sue H. 1-Iolding
P.O. Box 1587
Wake Forest, North Carolina 27588
Via Certified Mail
Re: Application for LAMA Permit for 101 .Hoop Pole Creek Drive
Dear Sue:
This letter is to inform you that I am in the process of applying for a CAMA general permit
for a new boat lift and finger pier at my property located at 101 Hoop Pole Creek Drive, Atlantic
Beach, North Carolina.
As required by CAMA regulations, I am enclosing a copy of the project drawing showing
the location of the proposed boat lift and finger pier that will be added to the existing pier. No
action is required by you, or you may return the enclosed No Objection/Waiver Form. If you have
any questions or comments regarding the proposed project, please feel free to contact me directly
at 917-434-0465 or by e-mail at igkillion`&)grnail.conn. If you wish to file comments or objections
with the Atlantic Beach CAMA Permit Program, you may submit them to:
Local CAMA Permit Officer for the Town of Atlantic Beach
125 West Fort Macon Road
Atlantic Beach, North Carolina 28512
Sincerely,
Joel Killion

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONtWAiVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to becompletedby owner or their agent)
Name of Property Owner:,` t �' 01-1
Address of Property: O� v t! CYteV-
Mailing Address of Owner:
Owner's email 1 Owner's Phone#: �I "7 '�`" -'
Agent's Name Agent Phone#;
Agent's Email
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
des n tion or drawin_with dimensions, must be provided with this letter.
I 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 [phone]. 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
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 May 2021

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign -off by the owner on this form) or certified mail return
receipts (showing delivery of notice) are needed, or any other method which satisfies the Local Permit Officer
(LPO) that a good faith effort has been made to provide notice.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM or the LPO an opportunity to consider these comments/objections before a permit decision
is made. "Pe mission" of adjacent roe owners is not neeessaril re uir d for DCM to issue a permit;
however, permission must be obtained for certain types of proposed developments if they fall within a 15'
setback area along the riparian access area of the adjacent property, as determined solely by DCM. It is in
the applicant's best interest to provide comprehensive and accurate notice so that any concerns or objections
can be resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals
the permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note. DCM r ads this bro dl to ensure comment by potentiallyimpacted nei hbors)
• A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the street/road could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person fisted as the registered agent on the NC Secretary of
State's Corporations Look Up site: h+_tpS:_, �� rr �. soFor Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised May 2021

October 20, 2021
Sam Q. Carlisle
P,O. Box 1209
Pinehurst, North Carolina 28370
Via Certified Mail
Re: Application for LAMA Permit for 101 Hoop Pole Creek Drive
Dear Sam.
This letter is to inform you that I am in the process of applying for a CAMA general permit
for a new boat lift and finger pier at my property located at 101 Hoop Pole Creek Drive, Atlantic
Beach, North Carolina.
As required by CAMA regulations, I am enclosing a copy of the project drawing showing
the location of the proposed boat lift and finger pier that will be added to the existing pier. No
action is required by you, or you may return the enclosed No Objection/Waiver Form. If you have
any questions or comments regarding the proposed project, please feel free to contact me directly
at 917-434-0465 or by e-mail at ;lgkiIlion wgi ail.coni. if you wish to file comments or objections
with the Atlantic Beach LAMA Permit Program, you may submit them to:
Local LAMA Permit Officer for the Town of Atlantic Beach
125 West :Fort Macon Road
Atlantic Beach, North Carolina 28512
Sincerely,
Joel Killion

N Complete Items 1, 2, and 3. {;
! ■ Print your name and address on the reverse
so that we can return the card to you.
11 Attach this card to the back of the maiipiece,
or on the front if space permits.
1. Article Addressed tom}`,
1-207
1111111111111111111111111111111111111111111111111
9590 9402 6754 1074 0887 21
2. Article Number (Transfer from service label)
7021 1970 0000 9926 34
PS Form 3811, July 2020 PSN 7530-02-040-9053
XAddresses
Accelved by (Printed Name) /+P.Pato ooff De1i1
�61s deliVery address different from item V 17 Yes
If YES, enter delivery address below: 191 No
3. Service Type 0 Priority Mail Express®
0 Adult Signature 0 Registered Mail'"
t Signature Restricted Delivery 0 Registered Mail Restricted
Mall(O Delivery
ertified
0 Certified Mail Restricted Delivery 0 Signature Confirmation -
[I Collect on Dollvory 0 Signature Confirmation
0 Collect on Delivery Restricted Delivery Restricted Delivery
0 insured Mail
]� S
0 Insured Mail Restricted Delivery
{overoo�_
Domestic Return Recopt

10/27/21, 12:42 PM
Detailed Tracking
FROM
RALEIGH, NC US
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2021
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2021
9:51 PM
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1:06 PM
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Package delivered to recipient address - release authorized
RALEIGH, NC On FedEx vehicle for delivery
RALEIGH, NC At local FedEx facility
RALEIGH, NC At destination sort facility
RALEIGH, NC Left FedEx origin facility
RALEIGH, NC Picked up
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10/27/21, 12:42 PM
TRACKING NUMBER
775030230421
DELIVERED TO
Residence
TERMS
Shipper
SPECIAL HANDLING SECTION
Deliver Weekday, Residential Delivery
ACTUAL DELIVERY
10/27/21 at 10:32 am
SERVICE
FedEx Priority Overnight
TOTAL PIECES
1
SHIPPER REFERENCE
04666.00002
SHIP DATE
10/26/21
Detailed Tracking
WEIGHT
0.5 Ibs / 0.23 kgs
TOTAL SHIPMENT WEIGHT
0.5 Ibs / 0.23 kgs
PACKAGING
FedEx Envelope
STANDARD TRANSIT
10/27/21 before 12:00 pm'
https://www.fedex.com/fedextrack/?trknbr=775030230421 &trkqual=2459514000-775030230421—FX 2/2

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: Z0cl ". I l i-o "t
Address of Property: lot
Mailing Address of Owner:
Owner's email:
Agent's Name.
Agent's Email:
Owner's Phone#.
Agent Phone#:
2-16 al
3+ o44,, S
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
desorption or dra-lying- with dimensions must be_provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
!f 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 [phone]. 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) flf 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 Ovvmer
-OR-
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 May 2021

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign -off by the owner on this form) or certified mail return
receipts (showing delivery of notice) are needed, or any other method which satisfies the Local Permit Officer
(LPO) that a good faith effort has been made to provide notice.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM or the LPO an opportunity to consider these comments/objections before a permit decision
is made "Permission" of adjacent propert owners is not ne essaril re iced for DCM to issue a permit;
however, permission must be obtained for certain types of proposed developments if they fall within a 15'
setback area along the riparian access area of the adjacent property, as determined solely by DCM. It is in
the applicant's best interest to provide comprehensive and accurate notice so that any concerns or objections
can be resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals
the permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this roadl to ensure comment b otentially impacted rigig hbors)
A property that shares a boundary line with the site of proposed development; AND
A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
Streets/Roads? Only if the street/road could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especiaily on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
WholWhat is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. if the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: htt3j.1/Nvww—s0snc ov/searphtirtdexlcc�r; . For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised May 2021

Styeon, Heather M.
From: David Braswell <[e-mail]>
Sent: Wednesday, October 20, 2021 2:20 PM
To: Styron, Heather M.
Subject: [External] Permit Application
Attachments: Killion Slip Proposal.pdf; Agent Authorization signed by Joel Killion.pdf
CAUTION* External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Sham.
Heather,
Please see attached application for:
Joel Killion
101 Hoop Pole Creek Rd
Atlantic Beach
Let me know anything you may need further. I know he said it's the 10 day period so he asked me to go ahead
and submit the drawing and start the application.
Thanks,
David Braswell
Dynamic East Construction
Sent from my iPhone
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
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Name of Property Owner Requesting Permit:
Mailing Address: -122-
2_-1(0C)9
Phone Number:
Email Address: VA
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Aj ne.
-�e�g r,>IC4 +D 0�4� ax>C.�-.
at my property located at
tot
in + O+ ekv� —County.
/ furthermore certify that / 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
-Z;e I k I U vvi
Print or Type Name
Title
10 1 2-o I 2,o2.1
Date
This certification is valid through W 1 ;ZO / 2.,02.7-.

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