84674C - Jones, Ryan

(CewAMA ®DREDGE & FILL Nn84674 A BInD
ENERAL PERMIT Previous permit
Date previous permit Issued
❑Modification []Complete Reissue ❑Partial Reissue
As authorized by the�cSytat�eJof�N(orth Carol/in�a�Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC _ b i •y I OCy ❑ Rules attached. General Permit Rules available at the following link: w wrdea.nc.gov/CAMArules
Appl4cantNme, cJ Authorized Agent �' rMAddrProject Location (County):
CityStaZIPStreet Address/State Road/Lot #(s)
hon/ 2 �•� to 5 1S
Affected ❑CW
AEC(s): ❑OEA
Shoreline Length
Access Length _
Pier (dock) lengtl
Fixed platformis)
. ®EW
❑ IHA
LJ
PTA
UW
❑ ES ❑ PTS
❑SPIMA ❑PWS
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
Floating Platforms) ( )
Finger piers)
Total Platform area .11,._
Groin length
Bulkhea Rip-ap length
Avg dis shore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: " n
Riparian Waiver Attached: /yes o
A building permlt/zoning perpyt m;y be re
by:
4RE OF STATUTES, CRC RULES
-AND CONDITIONS THAT AF
—:17i 1VTMY `1 t>FiT�
pplicant PRIN a�9e
Q 14LP,2 e
•//•,,P,,,,le,zars�e rea mpliance statement on back of permit•`
n Feels) Chei
Permit Officer's
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Date

f�`°"'[CAMA ®DREDGE & FILL JQ N9 84674 A B�D
Previous perm
3 GENERAL PERMIT Date previous 1permit issued
ew ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the Sgtate ofjNjorth Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCACy 7 �1 *I
❑ Rules attached. KGeneral Permit Rules available at the following link: wwwdegnc.gov/CAMArules
ApplW
Addr
City Phon
Email
V 5 Authorized Agent J t /Yl/lt / 7
r/�_�Q Project Location (County):
State ZIP 9_l.'1'_ 1_ Street Address/State Road/Lot #(s)
City
Affected ❑ CW RtW PTA ❑ ES ❑ PTS Adj. Wtr. Body �r,�nKI n an/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UUW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
OR .yes/ PNA: yesdhd/
Shoreline Length.
Access Length
Pier (dock) length
Fixed Platform(s),
Floating
Finger piers)
Total Platform area
Groin length It
Bulkhea Rip a length
Avg dist shore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: ZYye.sso
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zoning perinjt may be n
IAM
`1 i tM1'1M
Applicant PRINTED
by:
AND REVIEWED
Permit Officer's
� ,� �F70!
v
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Sig re'aase read_compliance statement on back of permit" 141
Feels) Check #/Money Order Issuing Datr/ / Expiratjon Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: I \\\
uI On n "c �e5
Mailing Address: IC)17 (::kaV rnolnt -Dr
Phone Number: 91 L) 0 5 �1g
Email Address: r I h & e 6�1SoV4k - feet
I certify that I have authorized Jtrnrr\ J AN2 r/C r }2(e '1 [k. Re,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 111 S4a' \ (--I Q CN T
S+Ors d� .bO��R 0V SU Wu 11
at my property located at
in Lr\r+kret County.
1 51 P
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:
Signature
_K.tm JORES
Print or Type Name
\Nl r\ .(—
Title
3 /9/ Qa
Date
This certification is valid through

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 Owners n l/e)A
Address of Property: et71E (lc a r6\ a Dr�p� ram, I I sl a d Ut QW4
Mailing Address of Owner. 4 ��,.,, ppT hr Nt Q ,4 NC Z� Si4
Owner'semail rjh4jQbdACAa#r\_rLL# Owner's Phone#. 4l4_ 4�1 05321
J
Agent's Name Carteret Marine Services Agent Phone#. [phone]
Agent's Email [e-mail]
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.
100 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.) II 1rII
I DO wish to waive some/all of the 15' setback / //n _ P I /�
Signaturbaf Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: p
Typed/Printed name ofARPO: C142\SjoP14i,2 P.
Mailing Address ofARPO: ZS Dd✓G H4Ri� Q21V£ LINCdL,) U AJ6tSliJ 1135-?
ARPO's email: CP1%11352 a JJWc0-00Y\ ARPO's Phone#: 3uZ- S'L I - 3y I Fl
Date: 3 I21) 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 NOTIFICATIONIWAIVER 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:
Mailing Address of Owner:
Owner's email: 1r -
Agent's Name: Carteret Marine Services
Agent's Email: [e-mail]
Agent Phone#: [phone]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adlacent 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.
1X__ I DO NOT have objections to this proposal. I DO have objections to this proposal.
rr you nave 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 Mall.
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 sinn
the appropriate blank below.)
100 wish to waive some/all of the 15' setback _
-OR-
' Signature ofA cenitVRip ian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: KP-v(il V-kA U1 / RGi.}ii K eAt v
Mailing Address ofARPO:_ e,beC �#.• i/�,-LuLQyi a,)Jp,�
ARPO'semail: OCUKj014orc6a? AL,2:tcORPO'sPhone#: 5`11
Date: 01, oq *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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