Cooper, A. B. 84357C

0 1°F`°""'1 CAMA ❑ DREDGE & FILL N9 84357 A B �D
y G E N E RAL PERMIT Previous permit
Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized y the Statt of N rth Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC �T� Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name 17ra�
Address
City
Phone # +WcUo---
Email
Affected ❑ cW
AEC(s): ❑ OEA
ORW: yes/�
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
EW
I HA
Total Platform area
Groin length/#
Bulkhead/ Riprap length �—
Avg distance offshore
Breakwater/Sill
Max distance/ leng'b—
Basin, channels--1
Cubic yards -----_--
Boat ramp
Boathouse/ o tli
Beach Bulldozing/��
Other 1QAZ, J V AAl IAA Vr-
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zop 6
Permit Conditions II
yes
yes
yes
yes
PTA
UW
0
no
0
n
y_be required by:
ZIP
❑ ES ❑ PTS
❑ SPIMA ❑ PWS
I A AWARE OF STATUTES, RC RULi
'Agemt or Applicant PRI ED Name
ture **P r d compliance statement on back of permit
Application Fee(s) Check #/Money Or(
Authorized Agent :&lIProject
Location
i — -
Street
I
. �>rl. A
...'
Adj. Wtr. Body
Closest Maj. Wtr. Body
. � J
irQ �'�LA n T ❑ TAWPAM/NEUSE/BUFFER (circle one)
�1��-- El See note on back regarding River Basin rules
❑ See additional notes/conditions on back

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 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)
http://portal.ncdenr.org/web/cm/dcm-home
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)
Revised 6/01/2021

Styron, Heather M.
From: Andre Webb <[e-mail]>
Sent: Friday, December 3, 2021 7:25 AM
To: Styron, Heather M.
Subject: Re: [External] Question
Attachments: 318 north shore drive 1.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hey Heather,
This paperwork has been a nightmare. I have attached all the forms from the correct people. We are putting it
back in the same footprint as the 2015 picture.
Ruth Ireland gave permission via voice mail to Mr. Reynolds (the resident at 318) for her name to be signed on
the form. I am going to send that in a seperate email
just in case you need it. Please let me know if you need anything else. Address is 318 North Shore Drive 1,
Atlantic Beach
On Thu, Nov 18, 2021 at 11:59 AM Styron, Heather M. <heather.m.styron a,.ncdenr.gov> wrote:
correct
-----Original Message -----
From: webbddcrgmail.com [mailto:webbddc�.gmail.com]
Sent: Thursday, November 18, 2021 11:58 AM
To: Styron, Heather M. <heather. m. styrong,ncdenr.,Qov>
Subject: Re: [External] Question
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious
email as an attachment to Report Spam.<mailto:report. spamLg ic.gov>
Just to make sure. The agent authorization form needs to be signed by AB Coopers office correct?
Sent from my iPhone
> On Nov 18, 2021, at 11:47 AM, Styron, Heather M. <heather.m.styrong,ncdenr.gov> wrote:

> Thank you.
> -----Original Message -----
> From: webbddc(a7gmail.com [mailto:webbddci �gmail.com]
> Sent: Thursday, November 18, 2021 11:39 AM
> To: Styron, Heather M. <heather.m.stvron awricderingov>
> Subject: Re: [External] Question
> CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious
email as an attachment to Report Spam.<mailto:report. sparn@nc. &ov>
> Ok I will get it straight
> Sent from my iPhone
>> On Nov 18, 2021, at 10:53 AM, Styron, Heather M. <heather.m.styronnncdenr.gov> wrote:
>> They received the wrong signatures and did not get an agent form from the park manager. They notified the
adjacent trailers and not the adjacent land owners next to the north shore property. I am waiting for this.
>> -----Original Message -----
>> From: webbddcTcr,,gmail.com [mailto:webbddc(_q—,gmail.com]
>> Sent: Wednesday, November 17, 2021 5:22 PM
>> To: Styron, Heather M. <heather.m.styronL.ncdenr.gov>
>> Subject: [External] Question
>> CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious
email as an attachment to Report Spam. <mailto:report.spam@,nc.gov>
>> This guy says he paid for a permit for a boat lift and that Chad from Carolina Shores turned it in for him.
He asked me if I could find out if it's ready. Can you tell me??
>> Stacey Wade Reynolds
>> 318 N Shore 1 Dr
>> Atlantic Beach, NC
>> Thanks

>> Andre
>> Sent from my iPhone

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:�'�'4
Phone Number:
Email Address:
I certify that I have authorized X&Vge-
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: -Poex �` 10/ /
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at my property located at
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in Con-rc2&-/' County.
1 furthermore certify that l 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.
Owner Information:
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Pnnt or Type
Title
2.3 / 2_--Z�7 -
Date
This certification is valid through t I

6
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion
sn to be completed by owner or their agent)
Name of Property Owner: iJ S`" ti ► `�
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Address of Property:
Mailing Address of Owner:
Owner's email: Owner's Phone#:
/�
AgenI's Name: A VIM �Agent Phone#:
Agent's Email: Neb40c«
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4i �
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. A
descnotion or drawing with dimensions must be provided with this letter.
C:-+p-<.•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 sign
the appropriate blank below.)
1 DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) C'k-�
Signature of Adjacent Riparian Property OwneC& Llq/
Typed/Printed name of ARPO: ����[ T�s��8 y �J�''jjo'
Mailing Address of ARPO:
ARPO'semail: �Ah�. .Cv ARPO'sPhone#: 1. -7-4-k F-7L..
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p. ?. 7 q (o
Date: `waiver is valid for up to one year from ARPO's Signature`
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT ID MAIRIARETUOPERTY OWNER RN RECEIIPT REOUESTEDAorIOM
C HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:l �'` a '� ` ►
Address of Property:
t� � rr. 5��r �. ci'rr. l—�a'C � � ! L
Mailing Address of Owner:
Owner's email:-caa.e.ci, Owner's Phone#'
Agent's Name: l! tjt7�� �" �� � ~ Agent Phone#: r
ZS2 "�S ~ �j 78
Agent's Email: AolC i>g
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom portion to be completed by the Adjacent Pro a 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.
1 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 nprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive someiall 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:
TypedlPrinted name of ARPO: 2y7w ,:;�96641vp
Mailing Address of ARPO: // T/�p �' F2F 1,e/vE 6�14opar)C
ARPO's email: ARPO's Phone#: ZS Z' 00 -- 8 �b
Date: / 2 - 3 20Z / _*waiver is valid for up to one year from ARPO's Signature`
Revised May 2021

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AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: '� 'Z�, `
Phone Number: I--7)--`,.D -
Email Address: -� �'r-1 C,"'`�``�'
I certify that I have authorized WF156
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: �`GP�°�� �Fr°CNnx
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at my property located at
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in CA 121'C261'**' 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:
Print or Type
Title
2--S 12_` ;Z l
Date
This certification is valid through l

6
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: iJ f� • �``` ? `M1 y.it`1
Address of Property:
Mailing Address of Owner.,
Owner's email: `, r.-.�r^�. �v e c �'�'� • Owner's Phone#: 2. ''a 2 • Z LLo
Agent's Name: 1^1012F Wei Agent Phone#:
Agent's Emait:
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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. A
description or drawing with dimensions must be provided with this letter,
C--�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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) Ck-�
Signature of Adjacent Riparian Property Owne�� `
Typed/Printed name of ARPO: Q" T"If- J?A-�
Mailing Address of ARPO: 9 s- jy ,ew67-1
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ARPO's email: Q R-p r w ,u ,C' o n� r ARPO's Phone#:
car ray tsvl cv►r '7t.`a`� 7i�(o !v'1ST�..
Date:*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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: � `` Z.""-F
Address of Property: l
Mailing Address of Owner.
Owner's email: 1"`� Owners Phone#:
Agent's Name: A17JU A/&g Agent Phone#:
Agent's Email' h/ehhofc,(G
ad, Cd^
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
pen -nit 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.
2A 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 sign
the appropriate blank below.)
100 wish to waive someiall of the 15' setback
Signature of Adjacent Rrparian 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: 2�`7% �961-11ND
Mailing Address of ARPO: ZZ T,oNpor,,o ZE 719/vE .41-4ar-ri6
ARPO's email: ARPO's Phone#: Zsz'�%� 1pcg�6
Date: / Z - 3 " 20Z / -waiver is valid for up to one year from ARPO's Signature`
Revised May 2021

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AGENT &THORIZATION FORM FOR PERMIT APPLICATIONS
I
Name of Property Owner Applying for Permit: �%
Mailing address
Telephone Number
I certify that I have authorized
to act on my behalf, for the purp
necessary for
the proposed
a �?, ocu `kb b oo-4\i
at my property Ibcated at
This certification is Valid 1
(Property Owner inform ation)
IC1,
signature
cis
P ' t or Type Name
Title, co. owl or trustee for prope
Date
yu q - gc;_�L - ��o
Telephone Number
,-Ad
mail Addres
r (agent/contractor),
ning all
Cj
Z
(date).
MAY 2 6 NZI
mM-MILD CITY

ADJACENT' RIPARIAN PROPER,NER STATEME T
1 hereby certify that I own propgrty a0jacent to Wa(`e­ 'ZQ ^X't� is
(Name of Property Owner)
property located at 3 i S� �D Ihoc c- t
(Address, Lot,
on , in
(Waterbody)
N.C.
The applicanj�has described to me, as shown below, the development proposed at the above
- � ��
focatio
✓' �I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Se c aA-�-- C"
,Af-a"o`0C�I
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (if you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Pro Owner information)--,
(Property Owner Information)
Sign e Signatureeve �,
Print or Type Name
Mailin ddre s tint or
Mailing Addres 7 d
i' CAA
City S ata2ip City/stataop
7ele have Numbs//r Telephone Number
Date Dote RECEIVED
(Revised 611812012) ? p 2 i
DI-• (-I D CITY

ADJAQENI. RIPARIAN PROPERTY gWNERATATEMENT
I hereby certify that I own propgrty adjacent to L-Ja, c,e— td� s
(Name of Property Owner)
property located at B 1 T :'54wc c.. 1
(Address, Lot,
on , in 4
(Waterbody)
N.C.
The applicant has described to me, as shown below, the development proposed at the above
location.
ev' D I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
A- a1_00 AJ<�S I
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner information) (Adjacent Property Owner Information)
Vale
ViLe,� f�
cal G; S ►� �
City/State2lp
vo
Telephone Number
Date IIV
(Revised 6/18/2012)
MAY 2 6 zo
t)(;M-MHD CITY

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W,
Gvl�
ILo
RECEIVED
MAY 2 6 Z021
DCM-MHD CITY

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