86191A_Fuller, J. Webb & Dorothy_20211118

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o�0U-1��VCAMA ❑DREDGE &FILL co o � Q s ��� 1 � 4Na 86191 1` A B C D
Previous permit
' GENERAL PERMIT Date previous permit issued
')New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue V
As authorized bytheState of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC / ! t I / 2 0 " ❑ Rules attached. General Permit Rules available at the following link: www.dgg.nc.ggv/CAMArules
Applicant Name (w,�'Z- A 4'
p
J o
Address T- r' . Q b X ( d v J City Al G % Q-A State N` ZIP 27 9 s 1 p
Phone # (_ a ' 7
Email C. t-, P_ Yf t�. b x , c C' :-V
Affected ❑ CW [�EW MRTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
ORW: yesA0 PNA: yes
Type of Project/ Activity
i"b a . c. / k
Shoreline Length Ito
Access Length
r
Pier (dock) length t �2
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
Boathous Boatlift t 1 i r
Beach Buildoz
Other
(
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: no
Riparian Waiver Attached: yes no >
A building permit/zoning permit may be required by:.
Permit Conditions u ^ 9 i o. c
n _ I
w0.%,r dL
Authorized Agent A E br-4 0.. & /,z-
Project Location (County):
Street Address/State Road/Lot #(s) Z'+ �Z—
!V.5 2- W. V i / 1 a v, nos fir,
Subdivision A 4 I pk -f,.'I E s
City — a zip 1_7959
Adj. Wtr. Body. 19 a �^ Kc- S -_ K ^4 (n.man/unk)
Closest Maj. Wtc Body ^ , J6._ S ,, I
f /0.fi4t'r"'
(Scale: ^/i $')
J�/ 11 ❑ TAR/PAM/NEUSE/BUFFER (circle one)
rr ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
A -, ci a _l r, dS G.AT- 1 l r - N t� L, LA
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Ap ' ant PRINTED Name Permi(Officer's PRINTED Name
t
Si nature **Please read k9pliance st tement on back of per it** Sign
Application Feels) Check #/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: James Webb & Dorothy Fuller
Mailing Address:
Phone Number:
Email Address:
Nags Head, NC 27959
(252) 4804702
[e-mail]
I certify that I have authorized Affordable Bill'sMilliam Eger
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Install Ux212' pier with a 20'x20' deck.
Install 4 pilings for boat lift and install boatlift (no electric included)
at my property located at 452 W Villa Dunes Dr, Nags Head, NC 27959
in Dare
County.
i 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:
x
SignaNre
Print or Type Name
Title
V
Date
This certification is valid through 1

Affordable Bill's
300 W Albemarle Drive
Nags Head, NC 27959
252-489-9555
To: Ralph and Donna Buxton
Stanford White
We will be installing a 6' x 212' pier with a 20' x 20' deck at end and installing a boatlift
on the right side of deck and 4 pilings for the boatlift. The pier will be located on the far
left side of the property where approved by CAMA.
Please sign and return the CAMA adjacent riparian property owners form either by email
to: [e-mail] or by mail to: 300 W Albemarle Drive, Nags Head, NC
27959.
If you have any questions please feel free to email or call.
Thank you,
William Eger
252-489-9555

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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)
Dame of Property Owner
Address of Property:
James Webb & Dorothy Fuller
452 W Villa Dunes Dr, Nags Head, NC 27959
Mailing Address of Owner* P,0. Box 1003, Nags Head, NC 27959
Owner's email: [e-mail] Owner's Phonelt: [phone]
Agent's Name: Affordable Bill's/William Eger Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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.
descriotion or drawina. with dimensions, must be roovided with this letter,
I DO NOT have objections to this proposal. I DO have objections to this proposal.
as Y4.'U Fla-V vmj6-.&#V114 4" WO'CF& " wasery pfvvvawul Yvu Fro"44 f."Co'y &..= —
Management (DCU) 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. DCU 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 rarrip, 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 1 5'setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
TypedlPrinted name of ARPO: Stanford Whi
(460 W Villa Dunes)
Mailing Address of ARPO: P.0 Box 1447, Nags Head, NC 27959
A fr. C.'a ^
ARPO's email: &4111ARPO's Phone* ? ?
Date: Z O—zkl—zz *waiver is valid for up to one year from ARPO's Signature'
/ I Revised May 2021

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:
James Webb & Dorothy Fuller
452 W Villa Dunes Dr, Nags Head, NC 27959
Mailing Address of Owner: P.O. Box 1003, Nags Head, NC 27959
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: affordable Bill's/William Eger 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.
9 1 DO NOT have objections to this proposal. I DO have objections to this proposal
es I— a .. .r.: .r., .. •.. ..4—A +, :.. . - .,.... ..... 4 __*.x..r... . s n.,....a-
rr yvet slave L0LiJc4trVt8a tV what to Licitly HIUJ/UJCu, yvu ttluat +wary ilia lv.41. U/Ylarvrt VI trvaatat
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 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
U-0
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
TypediPrinted name of ARPO: Ralph or
Mailing Address of ARPO: 448 W Villa Dunes Dr, Nags Head, NC 27959
ARPO's email: 1.�' c gA RPO's Phone#: 2,cP7— 5_01 0
Date: try 2 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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