Randolph, T. & Adams, Barbara 88327C

IN\ j (OAST4, OCAMA El DREDGE & FILL N9 88327 A B C D
GENERAL PERMIT Previous permit
I R r)nto nravini ic nPrmit iccl ]Pei
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 —F-] Rules attached. General Permit Rules available at the following link: www.deq.nc.goy/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone #
Email
Subdivision
City —
Affected F1cW rl EW F1PTA FIES FIPTS Adj. Wtr. Body (nat/man/unk)
AEC(s): F—] OEA 11 lHA DUW EISPIMA 1:1 PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yeS/ho
Type of Project/ Activity
(Scale:
Access Length
Pier (dock) length
. ...... . ..
Fixed Platform(s) .
Floating Platform(s)
Finger pier(s)
- -----
41
—4—
-
. ...
.........
:'l
... .... -
17K
-
Total Platform area
Groin length/#
-r-
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
J
k,
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/(oat(ft
f
cr
... . I-.. Beach Bulldozing_
Other
71
SAV observed: Y12S no
Moratorium: n/a yes no
Site Photos: no
Riparian Waiver Attaed: es no
tt
:5
e ay be required I
.y
A building permit/zo i g�
Permit Conditions
TAR/PAM/NEUSE/BUFFER (circle one)
ElSee note on back regarding River Basin rules
ElSee additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
plicati Fe Check #/Money Order Issuing Date Expiration Date
6u)—

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

ti,1°1`°""4, ❑CAMA ❑ DREDGE & FILL N4 88327 A B C D
Previy 41 GENERAL PERMIT Date r permit
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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State ZIP
Affected ❑ cW ❑ EW
❑ PTA
AEC(s): ❑ OEA ❑ IHA
❑ UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
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
Boat house/,goatIift
Beach Bulldozing
Other i .k s, Ill
SAV observed: yes no -
Moratorium: n/a yes no
Site Photos: yes no - s-- -
Riparian Waiver Attached: j yes no ,
A building permit/zoning permit may be required by: _
Permit Conditions
ES ❑ PTS
❑ SPIMA ❑ PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Adj. Wtr. Body (nat/man/unk)
Closest Maj. Wtr. Body
(Scale:
I P"
'^ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Fee(s), Check #/Money Order
Permit Officer's PRINTED Name
Signature
:.
Issuing Date Expiration Date �~

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 F-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 Manaeement 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 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: <s
Address of Property:
.� Mailing Address of Owner: _
Owner's email: _
O J C
Agent's Name:
Agent's Email:
ers �6 4" ��� l�7
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(bottom portion to be completed bV 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 proposal.
If you have objections to what is being proposed, you must notify the C. Division of Coastal
Management (DCM) in avritivg within 10 days of receipt of this notice. Co:'respondence should be
mailed to 400 Commerce Ave., Morehead City, NC 2855!. DCM representatives can also be contacted
at [phone]. No response is considered the same as no objection if;rou 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 revetm ts). (If you wish to vaive the setback, you rveust sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
of Adjacent Riparian
-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:
Mailing Address of ARPO:
ARPO's email:
Date:
F-CE%VED
JUN 0 6 202z
ARPO's Phone#:
�CMwMHC� CITY
*waiver is valid for up to one year from ARPO's Signature
Revised May 2021
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of property Owner: 2&f"
Address of Property:
Mailing Address of Owner: Z:6 ��/ tr ­�, / . -�,2 6 6"q ) l
Owner's email:
Owner's Phone#: s J��'7-� v
Agent's Name: _ Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Proper y Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
V I DO NOT have objections to this proposal. __ I DO have objections to this proposal
!f you have objections to what is being proposed, you m, st notify the 1N.C- Division of Coastal
Management (DCM) in writing within 90 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--2808. No response is considered the same as no objection if you have been notified b;f
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 y!! §1g
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
ish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of PaRPO:
Mailing Address of ARPO:
ARPO's email:
Date: ^.
ARPO's Rhone#:
waiver is valid for up to one year frorn ARPO's Signature`
R E C F IVED
JUN 0 6 2022
DCM-MHD CITY
Revised May 2021

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°``°"r"kN❑CAMA q DREDGE & FILL N9 88327 A B C D
GENER/ /� Previous permit
AL PERMIT Date previous permit issued
New ❑ Modification El Complete Reissue ❑ Partial Reissue
As authorized by the St e of orth Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
1
I SA NCAC Ii ❑ Rules attached. ❑ General Permit Rules available at the following link: wwvvdeq.nagov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # ( ) i � i J
Email Subdivision
City ZIP
Affected ❑ CW EW s� PTA d ES ❑ pTS Adj. Wtr. Body (nat .an/upk)
AEC(s): ❑IHA ❑UW ❑SPIMA ❑ PWS Closest Maj. .\f
❑ j. Wtr. Body
ORW: yes/nod PNA: yes/yn
I
Type of Project/ Activity
(Scale: )
�
�
Access Length - - =
k
'
-�-I
--
_
-�—
—
Pier (dock)length
--
Fixed Platform(s)
Floating Platform(§) ------
Finger pier(s)
Total Platform area
Groin length/M
—
t--T--
'-fC
-
Bulkhead/ Riprap length li�l:
---
-
s
--
-
-
Avg distance offshore r
-
—
-$
------
--
--i
'
--)—
Breakwater/Sill
\
Max distance/ length �----
- `�
�
I
"`
_
'--'�
i
li
Basin, channel
i
I
Cubicyards --
Boat rampI-
Boathouse/ Boatlik
!
I
Beach Bulldozing
Other
—
SAV observed: yes no
I
i
Moratorium: n/a yes no
•-"I"
"
�..
i
Site Photos: es no
--j
I
`
_
J
_
J
I
I—
Riparian Waiver Attached: yes no
_
A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND ROVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Appjicant PRINTED Name Permit Officers PRINTED Name.
Signature -*Please read compliance statement on back of permit" Sign ture
Application Fee(s) Check Jt/Money Order Issuing Date Expiration Date

o1*00AR11N❑CAMA \❑ DREDGE & FILL N9 88327 A B C D
GENERAL PERMIT Date Previouspermit
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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City
Phone #
Email
State
Authorized Agent
Project Location (County):
Street Address/State Road/Lot
Subdivision
City
Affected ❑ CW - © EW ❑ PTA \) ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Ck—H .e 1—,oa
(Scale: f )
■
H
■■■■■■■■■■■
■
Avg distance ..
xBrea
distance/ length
M.
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A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLYTO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature **Please read compliance statement on back of permit**
Permit Officer's PRINTED Name
Sign ture
Issuing Date Expiration Date
Application Feels) Check H/Money Order

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
` kor>1aS Terrell
Name of Adjacent Riparian Property Owner
�(� ,1-W n uiKS Lh
Address
/G���� 1� . IU, c . 2.Y5 70
City, State Zip
To Whom It May Concern:
Date
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
C,e b�l1kA V(U�k tiecuk
on my property at i LA T w v vk o a k S 6 vilVecyee,'.J A/, e , 185 7c�
in Ca � k re i- County, which is adjacent to your property. A copy of the application and project
drawing is attacbedlenclosed 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,
TUVh I�clne�ol�ti
Property Owner's Nkme
City
Telephone Number
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 Signature
Prim or Type Name
Im
Telephone Number
Zip
Address City State Zip
Revised July 2021

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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
Date
Name of Adjacent Riparian Pr pe% Owner
Lo � ly jWu�� view �nr,�
A dress
Pw(oaf1i/V C-76)
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
(�e hui\ \ hulk hest
on myproportyat �8y tw,h aakS Ln
in Car cr c- 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,
I-C)M (Can d of ph
Property Owner's Name
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.
f / - /3-,??
Adjacent Rip an Signature Date
Print or Type Name f / / Telephone Number
Cgrn/oc,/d
Address City State Zip
Revised July 2021