Flowers Dev. Corp. 84362C

\. LAMA DREDGE & FILL C1 84362 A s
GENERAL PERMIT Ntmwoo, swrrY* �- _.._�. �.a....____.._�._�.__
New ; Modification ' __ } Complete Reissue [_� Partial Reissue
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Type of Project/ Activity
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;o� CAMA ❑ DREDDE &FILL "{� �`�(///- N . 84362 A B
I lo Previous permit
i 3 Date previous permit issued E N E RAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized b the,S t o North f/Ilina, partment of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15, NCAC / ` ❑ Rules attached. , General Permit Rules available at the following link: www.deq.nc.goy/CAMArules
Applicant Name
Address
City
Phone #
Email
V �
Authorized Agent _
Project Location (County):
Street MS? Roa t-#(s)
�)Y
Subdivis' r� �i
City �7�'SiC�1 ZIP
Affected ElCW ""NkW pJrA ElES ❑ PTS Adj. Wtr. Body L� (nat/man/unk)
AEC(s): OEA ❑ IHA 111 Uj`W ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/ o ) PNA: yes
Type of Project/ Activity
Shoreline Length ! l
Access Length n '
i
Pier (dock) length )�
Fixed Platform(s)
Floating tform(s)
Finger piers IJ
n
Total Platform area
Groin length/#� �f
Bulkhead/ Riprap length"' .
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel— —' NI
Cubic yards"— �p
(/
Boat ramp
Boathouse/ r
Beach Bulldozing
Other JW X AJ
13
l ❑ TAR/PAM/NEUSE/BUFFER (circle one)
L/Y ❑ See note on back regarding River Basin rules
❑ See add itiona��s/conditions on back
)OV11- f

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:
Tar - Pamlico River Basin Buffer Rules F] 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

N.C.DIVISION OFCOASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be COD1Dle|ed by owner Ortheir agent)
Name mProperty Owner: Flowers
Address of Property.
|m 16. 0^eanview, 1323 pmmStreet, oeaufowNC. 20516)
Mailing Address nfOwner: 300 Friendly Road, Morehead City, NC 28557
Owner's email: FSLandAndM@nne@grna0 com Owner'sPhune#.- 252-349-2990
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owne
| hereby certify that | own property adjacent bothe 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
descr 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 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) 808-280& 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 boset back a minimum distance of 15'frorn my area of riparian access unless waived by me
(this does not apply tobulkheads ornprepnavmtmentm) (if you wish towaive the setback, you must sign
the appropriate blank below)
|UOwish tuwaive some/all ofthe 15'setback V NJ
Signature of Adjacent Riparian Propetty Owner
I do not wish to waive the 15'setback requirement (initial the blank)
Signature ofAdjacent Riparian Property Owner: >*�\
Typed/Printed name ufARPO: Peter mWniams
Mailing Address ofARpO: 33O9Felton Place
ARpO'memaU: pwmimms@m»fcvrg ARPO'aPhono#: »1om»»�rr3
1z/15i2, *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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Styron, Heather M.
From:
Peter M. Williams <[e-mail]>
Sent:
Thursday, December 16, 2021 10:41 AM
To:
Styron, Heather M.
Cc:
F & S Land and Marine
Subject:
[External] Adjacent Riparian Wavier Williams for Flowers Lot 16 Oceanview 1323 Front
Street, Beaufort NC
Attachments:
Riparian -Williams for Flowers 12162021.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:
Attached is the signed Adjacent Riparian Wavier form where I have no objections to the proposed pier at Lot 16
Oceanview, 1323 Front Street Beaufort NC.
Please contact me if you have any questions.
Blake Flowers is copied on this email also.
Peter
Peter M. Williams, CFO
3308 Felton Place, Raleigh NC 27612
919.630.4773
1

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' APPLICATION FOR
LAMA MINOR z
i
Coastal Management DEVELOPMENT
EDlYtRONhfEIJTAI QUALITY PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive areas that
border the state's sounds and oceanfront. Along with requiring special tare by those who
build and develop, the General Assembly directed the Coastal Resources Commission
(CRC) to implement clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the
Commission's effort to meet the spirit and intent of the General Assembly. It has been
designed to be straightforward and require no more time or effort than necessary from
the applicant Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
O
or she needs before you apply.
n
r
Under CAMA regulations, the minor permit is to be issued within 25 days once a
complete application is in hand. Often less time is needed if the project is simple. The
process generally takes about 18 days. You can speed the approval process by making
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Officer to determine
which of these you may need. A list is included on page two of this folder.
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast
Coastal Resources Commission
Division of Coastal Management
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Naf ay A0f- t�r-2
RECEIVED �
DEC52021 z�
®CM-MHD CITY z
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DCM Form EB1952-2015/Re-,zsed

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GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
s
Name Elo vlevS I2e✓eic)emeo + 6g r e
Address -300 FrjCll
City %©ye- head 64y State Al Zip _'25 i 7Phone 7,51-3
Email .__._B1.._�(b S I met �_ c.0.M
AUTHORIZED AGENT
Name �Xt`y� 2 a S LcI n OW ne ✓ j o f-o
Address
City State Zip Phone
Email
LOCATION OF PROJECT: (Address, street name and./or directions to site; name of the adjacent waterbody.)
13.� Li ���► 5 air+ , luc2S.�l6
S c ree
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) 6V t I d I ✓1 y (( 11
l� r?t/ rCQ vial F� `(1 S last i in 2cul
SIZE OF LOT/PARCEL: "/00 square feet acres
PROPOSED USE: Residential 0 (Single-family Multi -family ) Commercial/Industrial ❑ Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: __ square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO)<
If yes, list the total built upon areaiimpervious surface allowed for your lot or parcel: square feet.
RECEIVED
DEC 15 2021
DCM-MHD CITY

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SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAiVMA minor development permit
The Local Permit Officer will help you, if requested.
PHYSICAL DIMENSIONS
Label roads
I abel highways right-of-ways
a/i.abel local setback lines
�abel any and all structures and driveways currently existing on property
abel adjacent waterbody
PHYSICAL CHARACTERISTICS
Draw and label normal high water line (contact LPO for assistance)
Draw location of on -site wastewater system
If you will be working in the ocean hazard area:
Draw and label dune ridges (include spot elevations)
Draw and label toe of dunes
Identify and locate first line of stable vegetation (contact LPO for assistance)
Draw and label erosion setback line (contact LPO for assistance)
Draw and label topographical features (optional)
If you will be working in a coastal shoreline area:
Show the roof overhang as a dotted line around the structure
Draw and label landward limit of AEC
Draw and label all wetland lines (contact LPO for assistance)
Draw and label the 30-foot buffer line
DEVELOPMENT PLANS
Draw and label all proposed structures
Draw and label areas that will be disturbed and/or landscaped
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled
Show all areas to be disturbed
Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable? CF.-AAFFLI,,
• notified and listed adjacent property owners?
• included your site drawing? DEC 16 ZOV
• signed and dated the application?
• enclosed the $100.00 fee? C o HU CITY
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner)

r
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FLA
Certification, Sand Dune, Sediment Control, Subdivision Approval. Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
de
scribed as: (check one) I tt
owner or record title, Title is vested in name of !(7 �►� C' V2 iD Yl'lei 1" C O Y
see Deed Book 075.5 —00 "17.2 page in the C a ✓ 1f r—' County Registry of Deeds
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County,
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
1 furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) Flower-5 QeVei0eJ;U 14-- core 132y r5n)i-1- 51 kWo"r4- r"siE
(2) To Hh E7w<<7(z 1325 Frorlf 5f. 6-01Wr-'r ;Z8-5i�
(4)
AC;KNOW.LEDGEM.EN &
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I 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.
•.Phis the G� _ day of ��DY2l�/ 2019
✓" 5 --- ow ne v—
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit
This application includes: general information (this form), a site drawing err described on the back of'this application, the
ownership statement, the Ocean Hazard AEC Notice where necessa?y a check for $100. 00 made pavable to the locality, and
arty information as may he provided orally by the applicant. 777e details of the application as described by these sources are
incorporated without nference in arty permit which may be issued Deviation from these details will constitute a violation of
atD, permit. Any person developing in an AEC without pennit is subject to civil, criminal and adininistrative action
RECEIVED,
CEC 15 ZOZI
DCM-MHD OTY

I

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: Flo we rS 0--e ✓6l o PA1e i7 f C2 °nP
Address of Property: 13;7, T� y)+ S f � &au 1) �s)7ri N 212 L (o
Mailing Address of Owner: :500 Fri-ely h Ifua �/
Owner's email: (31ai:n f)ow', S I G 62 c Qwner's Phone#: �V,✓�� 9 : 7�rp
Agent's Name: glake F/or L-e;-5 Agent Phone#: 2 S1 — j 1-f 9 =2 % 472
Agent's Email Sak4e c15 cLdn¢rs"
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
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 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 sicin
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback���
Signature of Adjacent Riparian Property Owner
-0 R-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Ehke
Mailing Address of ARPO:
ARPO's email: / �u.J,ARPO's Phone#: � Sl -3y y"� �� 9'0
ECEIVED
Date: If Cl =���� *waiver is valid for up to one year from ARPO's Signature*
Revis&1*5?C27Q_ 1
UUM-1WHI) CITY

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: Flo vie CS D-evelo men+
Address of Property: E 3.� H Fr-o o 4- S � Uecc
Mailing Address of Owner: 3JC)O Fv-i,fn �i , RA/tijo ✓AeaJ C � f�N � ;Z 55 7
Owner's email: Olieflo��erS9,q cfheu,/,c� Owner's Phone#:
�--
Agent's Name: o k k e r(nwer.� Agent Phone#:
Agent's Email: Sa Ol e a S O wner5
Se-z i=-ie
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.
V I DO NOT have objections to this proposal. I DO have objections to this roposal.
/;)- AI/
If you have objections to what is being propose , you must notif 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
ME
I do not wish to waive the 15' setback requirement (initial the bla
Signature of Adjacent Riparian Property Owner:
lows
� O v
Typed/Printed name of ARPO: N
Mailing Address of ARPO: �a �� ��r� ka 6� �1
ARPO's email: PO's Phone#: -� J a °�� '�3
Date: J!R *waiver is valid for up to one year from ARPO's Signature*
/lia h"",91 V E & Revimofipffln,
aa�s�
DEC 15 2oz,

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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)
Name of Property Owner:
Address of Property:
, Attn Stake F
Lot 16, Oceanview, 1323 Front Street, Beaufort NC. 28516
Mailing Address of Owner: 300 Friendly Road, Morehead City, NC 28557
Owner's email: FSLandAndMarine@gmafl,corn Owner's Phone#: [phone]
Agent's Name: Agent Phone#:
Agent's Email:
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.
clescriptionor 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 Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should he
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 LA
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
I \
Signature of Adjacent Riparian Property Owner: w V\,\ 0, A t\4 � t Z- I (� (I- I
Typed/Printed name of ARPO:
Peter M Williams
Mailing Address of ARPO: 3308 Felton Place
ARPO's email:
[e-mail] ARPO's Phone#, 919-630-4773
Date: 12115/21 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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\1�4CAIVIA DREDGE & FILL W 9436A 6 C
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GENERAL PERMIT Date pm-ysom pwf"t nuied
j
sliNew Moclification Complete Reissue f Partial Reissue
A.0 &~U*d 1frW-M of Erm unrrw"w QoAky Wyj the Cf.,a*tgl PA-Wll r M- An V"
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Aiidwuod A#wd
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70 Street
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fA 1"A E SPIMA OPM Wtr- Wf A -A —4
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Type of Project/ Activity
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;o� CAMA ❑ DREDDE &FILL `/// Previous permit
- N . 84362 A BOC
I lo
i 3 Date previous permit issued E N E RAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized b the,S t o Northnlinn,partment of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15, NCAC e ` ❑ Rules attached. , General Permit Rules available at the following link: www.deq.nc.jzoy/CAMArules
Applicant Name
Address . l
City
Phone #
Email
Authorized Agent _
Project Location (County):
Street MS? �eloM)
)V
Subdiviv
City ZIP
Affected ❑ CW NW �j.pJ!rA ❑ ES ❑ PTS Adj. Wtr. Body L, (nat/man/unk)
AEC(s): OEA ❑ IHA ❑� Uj`W ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body '
ORW: yes/ io PNA: yes
Type of Project/ Activity
Shoreline Length ! l
Access Length n '
i
Pier (dock) length )�
Fixed Platforms)
Floating tform(s)
Finger piers IJ
n
Total Platform area
Groin length/#� �I
Bulkhead/ Riprap length"' .
Avg distance offshore
Breakwater/Sill
Max distance/ length .
Basin, channel —
Cubic yards"— �n
(/
Boat ramp
Boathouse/ r
Beach Bulldozing
Other .[�tiW X AJ
j3
l ❑ TAR/PAM/NEUSE/BUFFER (circle one)
L/Y ❑ See note on back regarding River Basin rules
❑ See add itiona��s/conditions on back
)a°11-fyo

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:
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

N.C.DIVISION OFCOASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be COD1Dle|eU by owner Cxtheir agent)
Name mProperty Owner: Flowers
Address of Property.
|m 16. 0^eanview, 1323 pmmStreet, oeaufowNC. 28518
Mailing Address nfOwner: 300 Friendly Road, Morehead City, NC 28551'
Owner's email: FSLandAndM@nne@grna0 com Owner'sPhune#.- 252
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owne
| hereby certify that | own property adjacent bothe 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
descr letter
/ X/ |DONOT have objections k>this proposal. |DUhave objections brthis 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) 808-280& 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 boset back a minimum distance of 15'frorn my area of riparian access unless waived by me
(this does not apply tobulkheads ornprepn»vmmen(m) (if you wish <owaive the setback, you must si_qn
the appropriate blank below)
| DO wish tuwaive some/all ofthe 15' se
tback im]
Signature of Adjacent Riparian Propetty Owner
I do not wish to waive the 15'setback requirement (initial the blank)
Signature ofAdjacent Riparian Property Owner: \4n` t>*�\
Typed/Printed name ufARPO: Peter mWniams
Mailing Address ofARpO: 33O9Felton Place
ARpD'memaU: pwmiame*gm»fcvrg 4RpO'aphone#: g1n-ean4rr3
/z/15i2, *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021