86160A_Carpenter, David_20211207

�`°"r",&F,]CAMA ❑ DREDGE & FILL
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GENERAL PERMIT
No 86160
Previous permit
Date previous permit issued
'A 'B C D
0 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 r� _ J I �`:�, ❑ Rules attached. El General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name 1)Cr- ✓ C. C, r.tf -e- n 4— r Authorized Agent cz, r ^, 0, \
Address 13 <--r r i c, Project Location (County):
City i— r C J 1, +',I State N zip � b `� �� `� Street Address/State Road/Lot
Phone #( 3$ ell 3.5 -/ 3 5 6 o o 2 F
Email dC c* P e /,7 c u T+'1 Subdivision �a .y z�'-Tl►i o-�. 1% / (" y"
C. c G Z_? 9 3 4
City r f"I c zip
Affected ❑ CW EW E PTA ❑ ES ❑ PTS Adj. Wtr. Body
AEC(s): ❑ OEA NIHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity .. c e , -t w,, d x_ l is
(Scale: N i" S )
Shoreline Length y2
Access Length
Pier (dock) length
Fixed Platform(s) iC (�
Floating Platform(s)
Finger pier(s)
Total Platform area
Groim1ength/#
Bulkh [Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
1,
2V
i
SAV observed: yes no ti
Moratorium: n/a yes no t }
!X,
Site Photos: yes not
Riparian Waiver Attached: yes A6 r
A building permit/zoning permit may be required by: o.0 4 _I
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Permit Conditions to 0 d c, /1 J <j ' .S t , 4 *-z- Is
-17
❑ 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) -71
Agent or Applicant PRINTED Name
Sign,4ture "Please read compliance statement on back of permit"•
Application Feels) Check #/Money Order
Ty a n n
Permit Officer's PRINTED Name
Signat r
Issuing Date Expiration Date

NIF \ CHARLES & JOHANN WILLIS
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DAVID CARPENTER \•\ q,� `
52156 SPORTSMAN DR
EXISTING
HOUSE
REPLACEMENT 220 FT
I j --_EXISTING
1 1 DRIVEWAY
STING
ULKHEAD
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PLATFORM `
(8, X 16')
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MEDFOR AUSTIN .
CAMA GENERAL PERMIT
DAVID CARPENTER
52156 SPORTSMAN DRIVE
FRISCO — DARE COUNTY — NORTH CAROLINA
20' o'. 40' so' 120' ATLANTIC £NV/RON�tf£NTAL CONSULT,4NTS, LLC
GRAPHIC SCALE 1"= 40' P.O. 9OX 9266, KITTY 114WA,, N.C. 27949
[phone], e-moil dougdaec®gmail. com
FILE. CARPENTER GP DATE: 11/04/21 REVISED:

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AUTHORIZATION TO ACT AS REPRESENTATIVE FORM
Property Legal Description:
DEED BOOK: 1196 PAGE NO: 0559
PIN NO.: 05062 9916712
PROPERTY STREET ADRESS: 52156 Sportsman Drive
as�v 2-�93�
Please Print:
Property Owner: David C "enter
Property Owner:
The undersigned property owners of the above noted property, so hereby authorize
Doug Dorman 10f Atlantic Enviranmental Consultants LLC to,
(Contractor/Agent) (Name of consulting firm)
1. Act on my behalf and take all actions necessary for the processing, issuance and
acceptance of permits and/or certifications and any all standard and special
conditions attached.
2. Enter the property to obtain site information including inspections with regulatory
agencies (Dare County, North Carolina Department of Environmental Quality,
U.S. Army Corps of Engineers, etc.) for the purpose of obtaining permits and/or
certifications.
Property Owners Address (if different than property above):
1300 Garland Lane Lincolnton INC 28092
Property Owners 'Telephone Number: % 41` `Z
We hereby certify that the above information submitted in this application is true and
accurate to the best of our knowledge.
A orize 'ignature and " the
Date:,�`
Authorized Signature and Title
Date:

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
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A. Signature
X ec;
A
O-Addre
B. Received by (Printed
Name)
C. DP
eliver
D. Is delivery add
nt from item 1
❑ Yes
If YES, entg��
below:
❑ No
NOV
0 8 2021
III IIIIII III IIII I I I I IIIII III I II II II II (I3. Service
Adult
° dS
❑ Mail Restrict
ertified Mail® Delivery
9590 9402 6361 0296 8616 42 Certified Mail Restricted Delivery ❑ Signature confirmation
❑ Collect on Delivery ❑ Signature Confirmation
,�. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery Restricted Delivery
❑ Insured Mail
J 2 0 3160 0001 2523 2770 ° loser $Oj it Restricted Delivery
DO C....., Q.Q11 1,d.i Or»n Dcrd 7ran_n9_nnn_anra nnmactin RPtnrn RacPinl

■ Complete items 1, 2, and 3. A.
■ Print your name and address on the reverse X
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
ricD Fri' lzo /4U5�1— 'j
i Z>6 GJO�e' g
irqz,'s�, NC-
Is ddL* at
If YES, enter
❑ Agent
ate of Deliver,
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from item ❑ Yes
wNIIIIIIIIIIIIIII ❑ No
3. Service Type
❑ Priority Mail Express®
I
❑ Adult Signature
❑Registered MalITM
II
I'
I
I II
I
III
II
I I
I I I
I
III
II
I
I I I
I
❑ Adutt Signature Restricted Delivery
❑ Registered Mall Restrict
�� =,,fled Mail®
Delivery
9590 9402 6361 0296 8616 35
15 Certified Mail Restricted Delivery
❑Signature Confirration T
❑ Collect on Delivery
❑ Signature Confirmation
2. Article Number (Transfer from service label)
❑ Collect on Delivery Restricted Delivery
Restricted Delivery
❑ Insured Mail
120 3160 0001 2523 5269
❑ Insured Mail Restricted Delivery
(over $500)
3S Form 3811. July 2020 PSN 7530-02-000-9053
Domestic Return Receipl

N.C. 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. David Carpenter
Address of Property:
52156 Sportsman Drive, Frisco, NC 27936
Mailing Address of Owner: 1300 Garland Lane, Lincolnton, NC 28092
[e-mail] 704-735-1398
Owner's email: Owner's Phone#:
Agent's Name: Doug Dorman Agent Phone#: [phone]
Agent's Email: [e-mail]
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.
s
/ tt�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 Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 15from 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
KOTG2
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: ' <<JE
Typed/Printed name of ARPO: NCDOT - Steve Trowel[
Mailing Address of ARPO: 113 Airport Drive, Suite 100, Edenton, NC
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 12/01/21 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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