87345C - Tillman, Jerry

AMA ❑ DREDGE & FILL
ENERAL PERMIT
A B CQD
Previous permit
Date previous permit issued'"'"' —
W 87345
_i C$New ❑Modification ❑Complete Reissue
As authorized by 5 arse of Islprth Caroli , Department of Environmental Quality and
ISA NCAC TI"11" ((/� Rules attached.
Applicant
City _
Phone
Affected ❑CW EW VPTA DES ❑PTS
AEC(s): ❑OEA IHA W ❑SPIMA ❑PWS
ORW: yes/ttb \ ) PNA: yes/ng17D
Shoreline Length '1Q% W AO
Access Length
Pier (dock) length
Fixed Platformis) `
Floating Platform(s)
Fingerpler(s)
Total Platform are_
Groin length/A-----------
Bulkhead/Ripraplength
CWe�ri,�tP�
Avg distance offshore
Breakwater/sill a —'
Max distance/leng —
/� �y•
6`.rs�nSfAlao
Basin, channel r--r V
Cubic yards
Boat ramp — 0 _A /
Boathouse/ Boatlift � 0T "i
Beach Butldozin
Other Nqu 1]1C1JlV 1
t .—nl—T37�. n . r
SAV obse(ved: (t 0 ) yes
Moratorium: n yes
Site Photos: yes
Riparian Waiver Attached: yes
A building permit/zoniQg pgrmf[
❑ Partial Reissue
Coastal Resources Commission In an area of environmental concern pursuant to:
Genemi Permit Rules available at the
Authorized Agent
Project Location (County)
Street Address/State Ryad/Lot #(s) _
City lslor
Gry (��i
Adj. Wtr. Body
Closest Mal. Wtr. Body f , a
I
�V
ijjil�;iold
0 ��..ttrr
V plry
❑ TAWPAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules

EDGE & FILL 44 40) Ind ""�t5/
'GENERAL PERMIT 519"� 3
New ❑Modification []Complete Reissue
As authorized by the Sta of rth Caroll!t�a,, Department of Environmental Quality and
15A NCAC a' 9 t ❑ Rules attached.
Applicant Name
Address 10
`slim
IN
Email
ZIP
Affected ❑ cW EW PTA ❑ ES ❑ PTS
AEC(s): ❑OEA IHA W SPIMA ❑PWS
ORW: yes/r( ) PNA: yes/nc���
Tyle'f Project/ Activity ' l /
A II _I n . —A .. 4n — �i
Shoreline Length ymX
Access Length ___J
Pier (dock) length=
Fixed Platform(s)
Floating Platform(s)
Finger pler(s)
Total Platform arg`�
Groin length/#�
Bulkhead/ Riprap length
Avg distance offshow—_.�
Breakwater/Sill e '
D
Max distance/ Iengtl;,�
Basin, channel
Cubic yards �---�
Boat ramp
yr
Boathouse/ Boatlift�
Beach Bulldozins-_-�--�
Other ��.L] A )
SAV observed: (' 1
Moratorium: n J
Site Photos:
Riparian Waiver Attached:
N?I
[]Partial Reissue
N° 87345 A s CQD
Previous permit
Date previous permit issued --
Coastal Resources Commission in an area of environmental concern pursuant to:
General Permit Rules available at the following link:
Authorized Agent _ (_ L (7. ( aj4
Project Location (County): �Y "�
Street Address/State Road/Lot #(s)
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
^/'fin/
�v I�De -04 &'o I
rlA) �\
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules

Styron, Heather M.
From:
David Anderson <[e-mail]>
Sent:
Friday, April 15, 2022 9:34 AM
To:
Styron, Heather M.
Subject:
[External] 5243 Webb Ct., MHC
Attachments:
2022-04-15_092627.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good morning, Heather!
Permit application attached. The plan is to remove a portion of the dock for a final 3'
width, and still pylons for the slip (proposed pylons are highlighted).
Let me know if you have any questions or need anything further.
Have a great weekend!
- Ashley
EZDock Solutions/Nauti Metal
5568 US-70, Suite C
Newport, NC 28570
Office: 252-773-0793
Cell: 252-764-1234
Fax: [phone]
www.ezdocksolutions.com
www.nautimetal.com

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jerry Tillman
Mailing Address: 140 Quail Craft Dr
Goldsboro NC 27534
Phone Number: [phone]
Email Address: _ _ [e-mail]
I certify that I have authorized EZ Dock Solution,
Agent t Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Dock work / removal to enlarge
90-s- ng slip and installation of ovlons
at my property located at 5243 Webb Ct., Morehead City,
in Carteret County.
I 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:
a
Signature
ecr1 C T rnar�
Print or Type Name
----,-Owner
Title
Title
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 Owner: Jerry Tillman
Address of Property: 5243 Webb Court, Morehead City, NC 28557
Mailing Address of Owner; 140 Quail Craft Drive, Goldsboro, NC 27534
Owner's email: jmtiilman140@hotmaiLcom Owner's Phone#:
Agent's Name:
919-222-3116
EZOOCKSOLUTIONS Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(nonom portion to b cow maleted by the Adjacent Property Ownor)
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 noury me rv.�.
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC 28405.3845, 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 slon
the appropriate blank below.)
I DO wish to waive some/all 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:
Mailing AddressofARPO:�� J�
ARPO's emall:C� •� �� � ARPO's Phone#:l � 2 .LLB
Data: �k i, *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: Jerry Tillman
Address of Property: 5243 Webb Court, Morehead City, NC 26557
Mailing Address of Owner: 140 Quail Craft Drive, Goldsboro, NC 27534
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: EZDOCKSOLUTIONS
Agent's Email: [e-mail]
Agent Phone#: [phone]
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
WE I DO NOT have objections to this proposal, I DO have objections to this proposal,
n 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 127 Cardinal Drive ,Ext., Wilmington, NC 28405.3845. 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 slan
the appropriate blank below.)
100 wish to waive some/all of the 15' setback -OR-
ter:
Signature of Adjacent iparian®opertyOwner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner;
Typed/Printed name of ARPO: �_,St-Il 42
Mailing Address of"A�R�PaO:
ARPO's email: _i f(ilc_ _ C� iCCiV(I �(/fIFrARPO's Phone#: /l - ? D - SDna-
Date: 3��D 2 a _'waiver is valid for up to one year from ARPO's Signature`
Revised May 2021

AGENT AUTHORIZATION FOR CAMA EERMI.T APPLICATION
Name of Property Owner Requesting Permit: Jerry Tillman
Mailing Address: 140 Quail Craft Dr
Goldsboro, NG 27534
Phone Number: [phone]
Email Address: [e-mail]
I certify that I have authorized EZ Dock Solutions ,
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Dock work i removal to enlarge
-existina sliu and installation of pylons
at my property located at 5243 Webb Ct., Morehead City ,
in Carteret 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:
Signature
Ixer -,
Print or Type Name
Owner
Title
DK I l K I a�a 2
Date
This certification is valid through /_

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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: Jerry Tillman —
Address of Property: 5243 Webb Court, Morehead City, NC 28557
Mailing Address of Owner: 140 Quail Craft Drive, Goldsboro, NC 27534
mmanOwners one [e-mail] ' Ph#: 919-222-3116
Owner's email: j
Agent's Name:
EZDOCKSOLUTIONS Agent Phone#: [phone]
Agent's Email: [e-mail]
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 forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
,with this latter.
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 musr nonry cne rv.�.•-
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC 28405.3845, 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 15from 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 shin
the appropriate blank below.)
I DO wish to waive some/all of the IF 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:
:ptnv\e7Mk ( 5Y__
Typed/Printed name of ARPO: ✓ `yvc �w
Mailing Addresst�
of ARPO: "e, Oij, CAkti t-� 15
ARPO's emall:l(� 2k &W\54\ - n ARPO's Phone#:l_��
Date: �k t � -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: Jerry Tillman
Address of Property: 5243 Webb Court, Morehead City, NC 28557
Mailing Address of Owner: 140 Quail Craft Drive, Goldsboro, NC 27534
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: EZDOCKSOLUTIONS
Agent Phone#: [phone]
Agent's Email: [e-mail]
giaaawgwaaazaaaw
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.
IT 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 127 Cardinal Drive Ext., Wilmington, NC 28405.3845. 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 riprep revetments). (If you wish to waive the setback, you must slon
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature-of Adjaconiparian bperty Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: �/ � 5
Typed/Printed name of ARPO: ii Gh Qr'�42
Mailing Address of__ARPP����O: _ , 1YX Webb in..i-.
ARPO's email: j'1CiK�(kfgAn4RPO's Phone#:
Date: 03'a" *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021