84372C - Starling, Ken

+mar CgMq D DOE & FILL N0 84372 A 6
ENE PERMIT Previous permit
Data previous pwrrdt issued
New (]Mod on ❑ Complete Reissue ❑ Pardal Reissue
As authorized by the State of North partment of Envlronrnantal Quality and the Coastal Resources Commission In on arm of environmental concem pursuvnt to:
I SA NCAC Rules attached. V-Ganaral Permit Rules W M" at the folowing link:
AppMant Name A I Authorized Agent
Project ration (County):
Chi' Staa ZIP Street Add to d/lot * a)
Phone N ( _
Email Subdhd
City p
Alfwad ❑ CW EW PTA is Ad). Mr. Body nay k)
AEC(s): OEA INA uw NSMMA © pre Q PINS Cloaaat hW, vVtr. Body
offt yes/0 PNA: Ves/
ryjBa of Protect/ Adivky
Floating Platform(s)
Finger piers)
Total Platform area
GrNn N ��
I a Riprap length
Avg distance attshom
Breakwater/Sill,
Max distance/length ---
Basin, channel
Cubic yards --
Boat ranp�--�^
Boathouse/ Soatkft �—
Beach Bulldozing
Other
-- i
SAV observed: yes o
Moratorium: n/a yes o
Site Photos: yY�yt��
Riparian VAlverAttached: �./ no
A building permh/zcn)rlapermlt r inv be rep
TAKIRAPVNEUSE/BUFFER (ckrle one)
See note on back regarding River Basin rules
See additional rwtes/condlflons on back

j1*1COPST4, + CAMA DREDGE & FILL Na 84372 -_A B
y ENE L PERMIT Previous permit
Date previous permit issued
'(New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized
by the Staat/e�o,�f�Nor�th�(C�arolin Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC0! 4 I) 004 t-J` O I ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
I I I N/
Authorized Agent 1 W
AddreCID
Project Location (County):
City
State
ZIP
Street Address/State ad/Lot #(s)
Phone #
Email
Subdivision
City ZIP
Affected ❑ CW
EW PTA
�Uw
ES ❑ PTS
Adj. Wtr. Body
(nat/ an/u k)
AEC(s): ❑ OEA
❑ IHA
j SPIMA PWS
LJ ❑
Closest Maj. Wtr. Body
I Y
ORW: yes/®
PNA: yes/�
n _
Type of Project/ Activity
Shoreline Length �5-
Access Length
Pier(dock)length
Fixed Platforms)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin I gth/#
ulk ea Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards -
Boat ramp —
Boathouse/ Boatlift �—
Beach Bulldozing
Other
SAV observed:
yes o
Moratorium: n/a
yes no
Site Photos:
y o
Riparian Waiver Attached:
es no
A building permit/zoni perrmitt y be/requuir(�ed1 by:
Permit Conditions I) Yi (AA )vim
WA
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REV
2
A�Vnt or Applicant PRINTED Name Permit
Si ature **Ple red compliance statement on back of permit** Si )at,
Apr iati con Feels) Check #/Money rder Issuing
7
(Scale•
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
ENT. VPleake Initia

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 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

9
uw
OCD MR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Fat McCrory Division
C. Davis
Governor Director
®ate
Applicant Name
i
,r itic �:
Mailing Address �� Z?'n
Z
John E. Skvarla, III
Secretary
o� �"02
I certify that I have authorized (agent) G c ��/�J 3 �% ? -7�
to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
at (location)
Iv
This certification is valid thiru (date)�-
Signature
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity1 Affirmative Action Employer
DEC 2 9 2021
DCM-MHD CITY
One .>
N thCarolina
A404*

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMIAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: 2 �/ l /'
Address of Property: �/ Q� yr e, �� �� c�ly Il J /�"�,
Mailing Address of Owner:
Owner's email:
' �I Owner's Phone#:
Agent's Name: �trr c� ����� Agent Phone#C=7
Agent's Email: �' /ram --,,--
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Properly 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
pnanage,.,,erot rnrta) ;,, ruritsn.; 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 not
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
n
Signatur of Adjacen Riparian Property Ow er
o
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: tr
Typed/Printed name of ARPO:
Mailing Address of ARPO: y�) Hi1lcl64'/r CPC
ARPO's email:
Date: /d/ 71?
ARPO's Phone#: /
-] C7 s! a 'T `t C 9
*waiver is valid for up to one year from ARPO's Signature* REC IVED
Revised May 2 1
DEC 2 9 2021
DCM-MHD 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:
Address of Property: ,%C'
Mailing Address of Owner:
r,j,�d�
Owner's email: t a� �Qr 1 Owner's Phone#: 9 9 b� 9 ��
Agent's Name: /,�e cz�i Agent Phone#: -S�
Agent's Email:
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.
. I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to ghat is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 90 days of receipt of this notice. Correspondence should be
rrlallGd]+!U 6iUli CUIIIII/Cll i Ave., iu°,irClicau —,ty, ,eC 28,:5'. ✓CWA representatives can ?Icn be rp�ttaC P[l
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
Signatur of Adj cent Riparian Pro, erty Owner
•a
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: L4k r-C2�
Mailing Address of ARPO:
ARPO's email:
n
ARPO's Phone#:.si—,� 3-1�
Date: �lr���l� � J *waiver is valid for up to one year from ARPO's Signature*
Y Revised ggyf—D
DEC 29 2021
DCM-MHD CITY

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