DuBose, Will 88343C

COW,,
❑CAMA ❑ DREDGE & FILL N9 88343 A s C D
3� Previous permit
4. GENERAL PERMIT Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized y the Sgte of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC (21 ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwdeq.nc.gov/CAMArules
City-
Phone
Ems
Street Address/State Road/Lot #(s)
it Subdivision
City ZIP
Affected ❑ CW ,❑/ EW PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑l'UW SPIMA ❑PINS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/nod`
Type of Project/ Activity
(Scale:
i
--
-
-
-
-
Access Length
(
/
Pier (dock) length
"
Fixed Platform(s)
j
_
I
1
_
�
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/tt
IN
Bulkhead/ Ri ra length iy
1
-
--
Avg distance offshore-i-
Breakwater/Sill `-- `-�-
--
-1 t
-�
-
i
-
---:
-
-
--
Max distance/ length
__.
Basin, channel
Cubic yards
f
1
Boat ramp _�
I
F
Boathouse/8oatlift
Beach Bulldozing
Other
FTSAY
F
_
observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: ayes; no
A building permit/
Permit Conditions
OF
permit may be required by:
i AND CONDITIONS THAT,
Agent or Applicant PRINTEDName/ %
Signature *"Please read compliance statement on back of permit"/ ..
I t
J
Application Feels) Check M/Money Order
I'
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Officer's PRINTED Name
Signature
Issuing Date Expiration Date

ocouru ❑CAMA [I DREDGE & FILL N9 88343 A B C D
ous permt
GENERAL PERMIT Date pre i uslpermitissued
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: wwwdeq_nc.gov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
Authorized Agent
Project Location (County):
State t ZIP Street Address/State Road/Lot #(s)
City ZIP
Affected ❑ CW ❑ E W ❑ PTA ❑ Es ❑ PTS Adj. Wtr. Body
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:
anoreune
Access Length414
Pier (dock) length
Fixed Platform(s)
I
Floating Platform(s)
i
Finger pier(s) )fit/
Total Platform area-
i
Groin length/#
-
Bulkhead/Riprap length-
Avgdistanceoffshore
Breakwater/Sill
Max distance/ length
j'-
Basin,channel
Cubic yards
Boat ramp "�-
!_
Boathouse/ Boatliff
1
Beach Bulldozing
Other
SAV observed: yes no
n a yes no
u
v
SlterPhotom:
yes no
�
Riparian Waiver Attached: es no
t
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 REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Na e , Permit Officer's PRINTED Name
r7"A. t/,.".
Signature '*Please read Compliance statement on back of permit** Signature
Application Feels) Check #/Money Order Issuing Date Expiration Date

Styron, Heather M.
From: Derek smith <[e-mail]>
Sent: Friday, February 25, 2022 2:42 PM
To: Styron, Heather M.
Subject: [External] 2 new applications.
Attachments: Billy Wooten forms to Heather 2-25-22.pdf, William DuBose to Heather for CAMA
permit 2-25-22.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
YAY !!!
I'm sure that is what you said when you saw this email ..... lol
I have 2 more for you besides the one you have and Littlewoods ( I'm still waiting on initials for it )
Lemme know what you need.
Have a great weekend!!!
Kim

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: � � l 7 cis Jo-)e.
Mailing Address: P,:' P>, 'au ` ') I
Phone Number: 3 3 � - 6 6 9- 5 6,) 4
Email Address: 5wiw�cQ �y./)c
I certify that I have authorized
Agent! Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: cu:LJ. �ntvcc �^� +
at my property located at 11u'1 SL k 1 Gw j S 1
in 6-+e cf 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
yOwner
(Information.
Signature
dt_,k k)..A3a-s
Print or Type Name
Title
i Y I ��
Date
This certification is valid through e a l 5 0 1 ,) 6-

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL RETURN REGElPT B QE UESTED or HAND DELIVERY
(Top portion to he completed by owner or their agent)
Name of Property Owner: G
Address of Property: 5 S G
Meiling Address of Owner. 7 2 ry S ` O 411 60OIL
Owners email: i,Uc(l„i�,ttrr'J,SWh�lJ;.,n�,l1e-Owners Phone#: E6-6C 7-54�`l
Agent's Name: �af<-/ J.,,...'lI, Agent Phone#:___n25a
Agent's Email:I
ADJACENT RIPARIAN, PROPERTY OWNER'S CERTIFICA71ON
(Bottom nortton to be concreted by the Adjacent Property owner)
I hereby certify that I own property adjacentto the above referenced property. The individual applying forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. 0
descd bon r e Ins ust bavldad.aft thislettsr.
I DO NOT have. objections to this proposal. _I DO have objections to this proposal.
i
you have objecdons to what is being.propo5e yoYOUmost notify file N.C. Division of Coeato/
Mtfanagement (DCMJ to writing withfnjl0 daysofreceipt of this notkv. Correspondence should be
malted to400 Commerce Ave., Morehead City, NO 28557. DOM representatives can also be contacted
at [phone], Me response is considered the same as no objection If you have been notifled by
Cadillac! 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 dlstence,Of 1a from my area of riparian access unlese waived by me
(this does not apply to bulkheads Or('prap revetments). (if you wish to waive the setback; youmust slam
the appropriate blank below.)
I DO wish to waive sometall of the 15 setback
-OR-
Signature ofAdfacentRips rf®n Proparty Owner
I do not wish to waive the 15' setback. requirement (initial the blank) wGS
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:_`��/>/�I"VA'I C-
Melling Address of ARPO:
ARPO's email: 5m 1 y 4& roan n r n
263�9, tX0A J_ A/C z ?b 19--06y
ARPO's Phone{t: Sty — boz -0 y 3
Date: *waiver is valid for up to one year from.ARPO'9 Signature-
Rawaad May £OCf

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY QWNWt NOTIFIGATIONM/AIVER FORM
(Top portion to be completed by owner or their agent)
Name of Property Owner,_ I _ V It 2 �, t
Address of Property. lip q SiA4")r�
Melling Addrsss of Owner. U N ' O 411 W(- uu
Owner's small: Sj2cB,JoJeC�stdh�ID;n�J.li�OwnersPhone#. i?b-6d1-
Agent'e Name: ir.rek J.v . h Agent J S
Agent's Email: s@ �h oti °} i 0`oi a^4t i I Cvrw
a10asaasw
ADJACrENT RIPARIAN. PROPERTY OWNERS CFRTIPICATION
( ottom o rtton ba eo otated by the Adlaoent Prntiarty Owned
I hereby certify, that I own property adjacent to the above referenced property, The Individual applying for this
pahmit has described to me, as shown on the attached .d, rawhg, the development they are proposing, g
✓1100 NOT have objeotone.to INpa proposal. -i DO have objentlona to this proposal.
I understand that any proposed.pler, doxk mooting plitrigs.:boat ramp, breakwater, boathouse, lift, or
groin must be set book a minfmium dl®tanoe hf 1 W from my'an* oF,tfpetlan soceli§ On! . s Waived by me
(this dose, not sooty io biiljcheads or riprap ►eVed7tenis). (It you wlali tbwhiva titi'setbaolt you utlttl gj8t
the approptiate blank tf&Ipw.)
I DO wish to waive somelall of the 1G setback -\ 1
ha .OR-
reofAdjacent .F?WrbmPer mpeity
I do not wish to waive the I& setback requfremept (Initial the bfank)
Signature of Adjacent Riparian Property
Typod/Printod name of ARM _ " y
Melling Address of ARPO:
ARPO's email: ARRO'.a Phone#: i �r (mod
Date: 'wa ar la vaild.for up ib one year from ARPO's Signature" to
no.roaa n.ray Boer

�� Vti plc fog St
Pro f U5�L-
�' x 1J52, L
a 10,
Ito'
dpvJrJ pill,
to�� 5r�
L-1 a
o{ oV l-
41b�
m � Fl . L',