Ketner, Kelli 84708C

Atoasry CAhM DREDGE FILL 7 A B 01D
PERMIT
Previous permit
Al GENE r 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 _'1 _ ❑ Rules attached. kJ General Permit Rules available at the following link: www.deo.nc.gov/CAMArules
Oil
Authorized Agent "4rA
Project Location (County):
Street Address/ tare Road Lot #(s
Ciibdivisio v7 ZIP
City
Affected CW EW PTA �Es PTS Adj. Wtc Body at! /unk)
r
AEC(s): OEA IHA UW SPIMA PWS Closest Maj. Wtr. Body AP
ORW:0no PNA: yes/0 I
Type of Project/ Activity
(Scale -
Shoreline Length
Access Length
Pier (dock) length— _
Fixed Platform(s)
Floating Platform(s)
Finger pler(s)
Total Platform area
Groin ength/#
Bulkhea / Riprap length b to X
Avg distance offshore (Q 1
Breakwater/Sill ----
Max distance/length
Basin, channel `—••*
Cubic yards---_....
Boat rampn
Boathouse/ Boatiitt
Beach Bulldozing
Other
SAV observed: yes
Moratorium: n/a yes o
Site Photos: yes
Riparian Waiver Attached: yes C.
A building permit/zoning permit may be rregL
Permit Conditions j) &W1 hp'er4.G
by:
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS
read compilfnce statement on back
Feels)
THAT APPLY WTHIS PROJECT AND REV
Permit
S
permit— Inat!
Check #/Money order ngg
1,2
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
re
Expiration (late

,o1*gjW `r4, CAMA DREDGE & FILL NQ 84708 A B CID,
s = GENERAL PERMIT Date previous Ipermit issued
J
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:
T115A NCAC 14' u C6 ❑ Rules attached. J!( � General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
AEC(s):
ORW:Ono
Type of Project/ Activity
❑ PTA
❑ UW
PNA: yes/0
Closest Maj. Wtr. Body
/ (Scale:1�c
Shoreline Length
Access Length
Pier (dock) length —
Fixed Platform(s)
Floating Platform(s) I IV' ,
Finger pier(s) t�
Total Platform area
Groin length/# --'
Bulkhea / Riprap length
Avg distance offshore t�
Breakwater/Sill ' /✓ Vim/
Max distance/ length `� v
Basin, channel '— )�
Cubic yards --
Boat ramp —_
Boathouse/ Boatlift
Beach Bulldozing 1
Other 1
SAV observed: yes o
Moratorium: n/a yes o
Site Photos: yes
Riparian Waiver Attached: yes o
A building permit/zoning permit may be requ' ed by:
P r m i t Conditions L1/ ❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
1 �
❑ See additional notes/conditions on back
I AM AWARE OF STATUTf.$, CRC RULES AND CONDITIONS THAT APPLY TATHIS PROJECT AND REVIEW OMPLIA A E (P ase?nitial)
6
A ent or App scant P INTED Name Permit O r s E e
v nature ** q)e read compliance statement on back f permit** nature
�'-U(11 ==60 � 1 D
Application Fee(s) Check #/Money Order Is ng Da I Expiration ate

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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: KELLI KETNER
Mailing Address: �LUyiP�1n) �Uc�
Phone Number: 919-880-1428
Email Address:
I certify that I have authorized DENNIS 8, SONS MARINE CONSTRUCTION, LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following
INSTALLATION 0
joposed development:
1►0
OF BULKHEAD
at my property located at 171 SALTY SHORES POINT ROAD NEWPORT, NC
in CARTERET
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:
Signat re
A - k1j-'[RL V
---
Print or Type Name
Title
Date
This certification is valid through 12 1 31 / 2021

v `�
t,
i,
�`..

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HA_ ND pELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: .KELLI KETNER
Address of Property: 171 SALTY SHORES POINT ROAD NEWPORT NC 28670
Mailing Address of Owner: _242 BAYVIEW BLVD. ATLANTIC BEACH, NC 28512
Owner's email:
Owner's Phone#: _919-880-1428
Agent's Name: DENNIS & SONS MARINE CONSTRUCTION, LLC
Agent Phone: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom_portion_to be_comoleted 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. 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 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. ACM 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
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: `JOHN ROSENPAUM JR. /
Mailing Address of ARPO: m175 SALTY SHORES POINT ROAD NEWPORT, NC 28570
ARPO's email:
ARPO's Phone#: [phone]
Date: y1' 15 _ Z ( *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTE-D or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: KELLI KETNER
Address of Property: 171 SALTY SHORES POINT ROAD NEWPORT NC 28570 - ---
Mailing Address of Owner: _242 BAYVIEW BLVD.. ATLANTIC BEACH, NC 28512
Owner's email: Owner's Phone#: _919-880-1428______-__._._-
Agent's Name: DENNIS & SONS MARINE CONSTRUCTION, LLC
Agent Phone: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATIONer
(Bottom_Por#ion.to_be completed by the Adjacent Prop_ertY_ - _ )
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-
desc�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.
pro osed, you must notify the N.C. Division of Coas at !
if you have objections to what is being p p
f this ntice. Correspondence should be
Management (DCM) In AtVe., Morehead City, NC 28557. DCM epresentati es can also be contacted
mailed to 400 Commercea ,
at [phone]. No response is considered the same as no objection if you have been notified y
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 mf area of rtto wa ve the setback, you ustsign
(this does not apply to bulkheads or riprap revetmentsaccess unless waived by me
). ( you wish
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)
Signature of Adjacent Riparian Property Owner: G-
Typed/Printed name of ARPO: _,_GAYLE RIVERS
Mailing Address of ARPO: _165 SALTY SHORES POINT ROAD NEWPORT, NC 28570
ARPO's email:
ARPO's Phone#: [phone]
Date: _ _— *waiver is valid for up to one year from ARPO's Signature"
Revised May 2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: KELLIKETNER
Mailing Address: -FnklyieyJ��y('1
Phone Number: 919-880-1428
Email Address:
certify that I have authorized DENNIS & SONS MARINE CONSTRUCTION, LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
INSTALLATION OF 70' OF BULKHEAD
at my property located at 171 SALTY SHORES POINT ROAD NEWPORT, NC
In CARTERET
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: yo�
/ / Sign at rre
A /
1 ��-� ' V RECEIVED
Print or Type Name
SEP 0 8 20?1
Title
t CM-MHD CITY
Date
This certification is valid through 12 / 31 / 2021

N,C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND ELIUEFZED
DOD l
v05._..
(if At accnt Ri Marian Property Owner
\dtlf, ,
City, Stale Zil) I
fo Whom It May Concern:
fills con:;pondcncc is to notify you as a riparian property owner that I am applying for a CA,MA Minor pu nrtt 10
rn IM property at
-
» County, which is adjacent to your property. A copy of the application anti project.
draN, ing is attached/enclosed for your revlew,
I; cou hay e no objecttons to the proposed activity, please mark the appropriate statement below and return to me as soon
.I, po;;,ble. I1 no comments are received within IO days of receipt of this notice, it will be considered that you have no
%:01111110ti or objections regarding this project.
It" ou Imp < ob;ccuon> or Comments, please mark the appropriate statement below and send your correspondence to:
,I (r: `;I I'I-RMH 01,110ER. NAME OF LOCAL. GOVERNMEN1 MAILING ADDRESS CITY, STATE, ZIP COM.")
I! ,,qu ha% c anv Llucsttons about the project, please do not hesitate to contact me at my address ntunbcr listed below, or
contact t l.00AI IIFRMIT OFFICER) at IN IONF NUMBER), or by email at: (LPO EMAIL).
Sincerer,
Property Uwt is Name 'Telephone dumber
1ddre;� City 5laie /u?
A _ I hai,c no objection to the project described in this correspondence
I h,ne ohtccuonls) to the pngcct described in this correspondence.
,'i,; R,p., I. n Yi-wj nr
RFICEIVED
`.�2D'2�
0 8 2021
TvWcfs
CM
. ,�-,u�;a�tavv.�+�'•:�+a:��ar:,^.u�.at.ssswi��as�s7�s€;vaa=�s
_ rSR�K.831`SSL'YZa]BH.+�Tai.-'1':a.K � -t:-a

--own"
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RI�TUf�N RECEIPT RE UESTEQ or HANp pELIVERED
Date
Namc ot'Adiacent Riparian Property Owner
Address
i
City, stf to Zip---/
1'0 \Thom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a LAMA Minor permit to
Oil my )property at 1 f Y 1�
i❑�� County, which is adjacent to your property. A copy of the application and project
i
drawing is attached/enclosed fo►• your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact ( LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
-Property Owl is Name Telephone Num cr
Address City State zi1)
I have no objection to the project described ill this correspondence.
I have objcction(s) to the project described in this correspondence.
RECEIVED:
Date SEP 0 8 2021
Adja cnl Riparian Stu aturc -
Print or'rype Name Telephone Number
Address
City State Zip
Revised July 20.?

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RESIDENTIAL PURCHASE LETTER OF INTENT
Effective Date: April 16, 2021
RE: Intent to Purchase Residential Property
This residential purchase letter of intent (the "Letter of Intent") represents the basic terms for an
agreement between the Buyer and Seller. After this Letter of Intent has been made, a formal
agreement may be constructed to the benefit of the Parties involved.
I. The Buyer: Mark and Keili Ketner gI°I-SPED-14Zf�
II. The Seller: Harry and Gayle Rivers
Ili. Property Address: 171 Salty Shores Newport NC 28570
IV. Purchase Price: The Buyer shall purchase the Property for $249,000 (the "Purchase
Price").
V. Purchase Terms: Payment of the Purchase Price shall be made in the following manner:
$10,000 down payment will be paid on April 16, 2021,
VI. Bank Financing: The Buyer has made it known that their ability to purchase the Property is
❑ conditional X : not conditional on their ability to obtain financing.
VII. Closing: The Closing shall occur on July 15, 2021, or earlier by mutual agreement (the
"Closing"). Any extension to the Closing must be agreed upon in writing by the Buyer and Seller.
Vlll. Closing Costs: All costs associated with the Closing shall be the responsibility of
X the Buyer ❑ the Seller ❑ both Parties bearing their own expenses.
IX. Possession: Possession of the Property shall be given on July 15, 2021, or earlier by
mutual agreement (the "Possession"). Any extension to the Possession must be agreed upon in
writing by the Buyer and Seller.
X. Property Inspection: After a binding Purchase Agreement has been made, the Buyer shall
hold the right to have the condition of the Property inspected by a person of their choosing. The
inspection shall occur no later than days after a Purchase Agreement has been made,
After the Property has been inspected, the Buyer shall have an additional days to report
any new disclosures to the Seller in writing. If the Buyer and Seller cannot reach a mutual
agreement within days after delivery of the written disclosures, the Purchase Agreement
shall be terminated with any earnest money being returned to the Buyer.
XI. Binding Effect: This Letter of Intent shall be considered: (Initial and Check)
Page 1 of 2

_ G

- ❑ Binding — Therefore, the Parties acknowledge that remedies at law will be inadequate
for any breach of this Letter of Intent and consequently agree that this Letter of Intent shall be
enforceable by specific performance. The remedy of specific performance shall be cumulative of
all of the rights at law or in equity of the Parties under this Letter of Intent.
- ❑ Non -Binding — Therefore, the Parties acknowledge that this Letter of Intent is not
enforceable by any Party. The terms outlined herein are solely for the purposes of reaching an
agreement in the future, of which the Buyer and Seller are not bound.
XII. Standstill Agreement: Following the execution of this Letter of Intent, and until the Closing,
the Seller shall not engage in negotiations for the sale of the Property with any other party
unless either the Buyer and Seller agree in writing to terminate this Letter of Intent, or the Buyer
and Seller fail to sign a Purchase Agreement by July 15, 2021
XIII. Additional Provisions:
XIV. Currency: All mentions of currency or the usage of the I" icon shall be known as referring
to the US Dollar.
XV. Governing Law: This Letter of Intent shall be governed under the laws of the State of North
Carolina.
XVI. Acceptance: If you are agreeable to the aforementioned terms, please sign and return a
duplicate copy of this Letter of Intent by no later than April 23, 2021.
BUYER
Buyer's Sigr
Print Name
Buyer's Sigi
SELLER
Date
Date Lc;�l
Seller's Signatur i � `fir Date 1 v .2/
Print Name/��Xq
Seller's Signatur �z. Le. J V
zl Datea
Print Name rs-llwc
Page 2 of 2
b

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: KELLI KETNER
Mailing Address: --2 r2?--h V V i ew Tj � v
Phone Number: 919-880-1428
Email Address: LC, e-r
I certify that I have authorized DENNIS & SONS MARINE CONSTRUCTION, LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
INSTALLATION OF 70' OF BULKHEAD
at my property located at 171 SALTY SHORES POINT ROAD NEWPORT, NC
in cARTERET County.
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.
Property Owner Information:
Signat re
1 eyAt Il1°4ttLV
Print or Type Name
Title
TI`I aL
Date
This certification is valid through 12 / 31 / 2021
4hy,

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Namte' LtacentRiTarian Pro Owner
Addr s
e o
City, State Zi
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am
a
Date
for a CAMA Minor permit to
County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and sendd your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
�i-F—�—
Property Own 's ame Telephone Number
Address
City
State Zip
I have no objection to the project described in this correspondence.
_ I have objection(s) to the project described in this correspondence.
_._
ent Riparian Si ature
- � 1_e_
Print or'Type Name
Date
_2 -7a
Telephone :Number
Address City State Zip
Rev;.sed Ally 20211

N.G. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
NaiIcL Vas
mc nF A jacent Ri avian Pope Owtr.
ryAdd es.ac)
City, State Zip {
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL. PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
4�4)-
Property Ow is game
Address
City
Telephone Nun, er
State Zip
1 have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
,� _ cent Riparian Sign re
(c 1-e `T. V�u 's
Pn it or') yl.r Main:
� 20 Z 1 _
Date:
_ 2152- ZZ
telephone Number
Address City State
Lip
devised luiv 211,' i

ADJACENT N.C. DIVISION OF COASTAL MANAGEMENT MINOR PERMIT)
RIPARIAN PROPERTY OWNER NOTIFICATION
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of 11TT �q5 �h1 t>i4 v r�� J
Adjacent Riparian Prope Own r
Address
City, State Zip
To Whom It May Concern:
This correspondence is to notify vn„ ne n ,.,.,....h, mvnPr that I am
County, which is adjacent to your property
drawing is attached/enclosed for your review.
Date
for a CAMA Minor permit to
A copy of the application and project
If you have no objections to the proposed
ro osed activity,ease mark the appropriate statement below and return to me as soon
as possible. If no comments are re eived within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
�'4Property Own s ame Telephone Number
Address
City
State
I have no objection to the project described in this correspondence.
—1 have o ction(s to the project described in this correspondence.
Adjacent IUparian SAghature
Print or Type Name
0 �—�- -2(
Date
ego — 7c Z Z—
Telephone Number
Zip
Address
City
State
Zip

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
�.�� 4 s__„� ,L -► ---- Date
Nance of Adjacent Riparian Property Owner
Address
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City, St to Zip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am annlving for a CAMA Minor hermit to
in L. 3LVt!e V&A County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely, n
Property Owi ,r's Name ---��� Telephone I n er
Address
k
City
State
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian
Print or Type Name
Address
City
7- el
Date
Telephone Number
State
Zip
Zip
Revised July 2021