83902A - NCDOT

�IYCAMA / L?�DREDGE & FILL N9 83902 A C D
GENERAL P E R 11 I T Previous permit # �R �
FINew Modification �Complcte Reissue CjPartlal Reissue Date previous permit issued 1
As authorized by the State of North Carolina, Department of Environmental Quality 1 ��
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �7 i'i
Rules attached.
Applicant Name NcooT Project Location: County AIDE
Address t 13 �j � QoQ. i D Its _ Street Address/ State Road/ Lot #(s) F j OD t-,, 5T�
City—. NTIDAI -- State 1M-ZIP- 11 %�i�0%�_ � F-4q If<eY5EcTt,rj__WITI
Phone # (, ) =1��a -- E-Mail Subdivision M
Authorized Agent qr"f- YRowEtL City E 14A _ ----- _. _— ZIPsm
Affected ./Cw ❑ suit 41PTA ❑ Es ❑ PTS Phone # (_) �' _ River Basin
OEA C HHF E IN C URA -1 WA Adj. Wtr. Bo
AEC(s): dy LAN1'fa1�2GQKK Cog�junlmj
PWs: p
ORW: yes /Q PNA yes / no Closest Maj. Wtr. Body - —1 AL* %C0 50uND
pType of Project/ Activity EX1S1oa )(L CAP w i-M ExN Si 1h & A.w(-i,-dtT
1Ro%5� �iP P�Lts���o.a N�S�S�DE wt� t,nsG STI ,►t.t-zA41o,,j GP3 OX&I®`. (Scale:
Pier (dock) length '. _ - _ __ r -
FixedPlatform(s)!^-- iI I O�
t���P�p�`�LAw�
Floating Plaorms)
Finger pier(s) 07.1A�
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Groin length
number ---= -- i
Bulkhead/ BIRM kngti,
avg distance offshore1 1
max distance offshore : .-
Basin, channel
cubic yards
7 ...
Boat ramp
Boathouse! Boatlift
Beach Bulldozing _ — I • t
Other
Shoreline Length-
SAV: not sure yes no - - l
Moratorium: n/a yes no • V01V- el�lL 10101(TFD i"y7f Cl E.V 09ts DA-1mt;
Photos: es i AQ� r j
v fi [
Waiver Attached: yes no _ — ----- --1 — .- -- - --�-- i
A building permit may be required by: note on back regarding River Basin rules.
( Note Local Planning Jurisdiction) t! r
Notes/ Special Conditions i't � �IIF Sa��S�o htS'i��1ltJ 5 FF b) rA &y-1 AT CC�1 �F2b5►C P-j tI(bG )MQL 9ML. ft 95D
AT -dE c>tTr-C�J 9,P (LAF--,AALl_ RIE FJZK- AgaM Lo05E.DICi rO- 67TdC9- foU.UTAP ->(3) -5 `4C-►4lT_a6F5_
Age I Pr
Signature •Please read compliance st tementonback ofperntit� -
sq,QQ�clo a6.1 s 1 _
Application Fee(s) Check
Permit Officers Printed Icarus -
Signature
4hi I a,,za Lillr al
Issuing Date Expiration Date

STA
RECEIVED
MAR 2 9 2922.
D C n V t n_ E C STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
March 28, 2022
Greg Daisy
NC Division of Coastal Management
401 S. Griffin St., Ste. 300
Elizabeth City, NC 27909
J. ERIC BOYETTE
SECRETARY
Subject: Request for reissuance of CAMA General Permit .2300 for culvert pipe
replacement on SR 1100, Hill Street, in Engelhard, Hyde County, North
Carolina.
Dear Mr. Daisey,
The North Carolina Department of Transportation requests reissuance of a
General Permit .2300 for a culvert pipe replacement on SR 1100, Hill Street, in
Engelhard, Hyde County, North Carolina. This pipe conveys surface water in a man-
made canal off Far Creek crossed by SR 1100 and is failing. CAMA/Dredge and Fill
General permit no. 68624-B issued January 18, 2018, authorized this pipe replacement,
and expired on January 18, 2020. This pipe replacement is expected to completed as
soon as possible within the next 30 days.
The Division of Coastal Management considers the project area to be within an AEC that
requires authorization for the pipe replacement. Included with this request are a location
map, updated adjacent landowner notice, permit drawings depicting the proposed work
and applicable application forms. Also included in this permit package is a March 28
email from DMF staff Mr. Jimmy Harrison granting moratorium relief during April 2022.
The permit fee can be charged to WBS # 1.2028111
If any additional information is needed, please contact me at [e-mail] or
[phone].
Sincerely,
Sterling Baker, P.E.
Divisi O ngi e
Steve Trowell
Division One Environmental Specialist II
MadingAddress: Telephone: [phone] Location:
NC DEPARTMENT OF TRANSPORTATION Fax: [phone] AIRPORT DRIVE, SUITE 100
DIVISION ONE Customer Service: 1-877-368-4968 EDENTON, NC 27932
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932 Website: www.ncdot.gov

Pipe Replacement on SR 1100
Hill Street
Hyde County Quad Name Engelhard East
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DCM-E 1
13-
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Existing 24" x40' CMP ;t
4,e Proposed 36"x40' CAP
y 35.510557'
-75.994553'
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I I I I I I I I

From: Harrison. James A
To: Trowell. Steve J
Cc: Proctor. Michael; Gibbs. Charles J; Williams. Paul C; Castello, Robert C; Daisev. Grea; Barnes. Kyle W SAW;
Ward. Garay
Subject: Re: Estuarine Fishery Moratorium Relief for Culvert Pipe Replacement
Date: Monday, March 28, 2022 10:39:13 AM
Attachments: 0 utlook-a I in2xii. ona
Good morning Steve,
DMF has reviewed the moratorium relief request associated with the culvert replacement
along SR-1100 (Hill Street) in Engelhard. Taking into consideration the scope of work and as
long as the turbidity curtains are left in place for at least 72 hours as proposed, DMF is
amenable to granting this one-time relief for the work to be completed.
If there's anything else I can do, feel free to reach out. Thanks Steve!
Jimmy
Jimmy Harrison
Habitat and Enhancement jection
NC Division of Marine risheries
[e-mail]
252-948-3835 (Office)
757-272-3230 (Mo6ile)
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
REC I V E D
MAR 2 9 2022
DCM-EC
From: Trowell, Steve J <[e-mail]>
Sent: Monday, March 28, 2022 09:29
To: Harrison, James A <[e-mail]>
Cc: Proctor, Michael <m proctor@ n cdot.gov>; Gibbs, Charles J <[e-mail]>; Williams, Paul C
<[e-mail]>; Castello, Robert C <[e-mail]>; Daisey, Greg
<[e-mail]>; Barnes, Kyle W SAW <[e-mail]>; Ward, Garcy
<garcy.ward @ncden r.gov>
Subject: Estuarine Fishery Moratorium Relief for Culvert Pipe Replacement
Jimmy:
NCDOT maintenance forces have contacted me regarding the replacement of an existing 24" x 40'
corrugated metal pipe (CMP) with a 36" x 40' corrugate aluminum pipe (CAP) located on the SR 1100
(Hill Street) crossing of a man-made canal off Far Creek in the Town of Engelhard, Hyde County,

North Carolina. NCDOT has learned of the proposed use of the Seafood Industrial Park property as a
stockpile area for a large amount of granite stone to be used as oyster cultch and desires to replace
this pipe ahead of the trucking operations delivering the riprap material.
To replace the pipe will require closure of the road, most likely to be done overnight to avoid as little
disruption to traffic as possible. The in -water work will be completed within 12 hours and the road
will be closed for less than a day. An overhead powerline on the north side of the road prevents the
driving of sheet pile which would facilitate the pipe replacement "in the dry'. A turbidity curtain will
be deployed on the upstream and downstream ends of the pipe to contain any turbidity and will be
left in place no longer that 72 hrs. to allow settling of suspended sediments.
By this email NCDOT is requesting moratorium relief to replace the pipe during April of this year.
NCDOT Maintenance forces are poised to undertake this work. Your granting of moratorium relief
by response to this email will be included in the documentation for permitting to the regulatory
agencies who are copied with this email. If you wish to discuss this pipe replacement, please do not
hesitate to contact me using my cell phone number. Thank you for your time responding to this
request.
Steve J. Trowel
Division Environmental Specialist
Division One
NC Department of Transportation
[phone] office
[phone] mobile
[phone] fax
51trowell ncdot.gov
113 Airport Dr.
Suite 100
Edenton, NC 27932
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

men N!-1
RECEIVED
NPUCATION for
Maier lovelopmont Pormft
(last revised 12/27/06)
MAR 2 9 2022
DCM-EC
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
N.C. Department Of Transportation
Project Name (if applicable)
SR 1100 Hill Street - Pipe replacement
Applicant 1: First Name
Paul
MI
C
Last Name
Williams
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
113 Airport Road, Suite 100
PO Box
City
Edenton
State
NC
ZIP
27932
Country
Phone No.
252 - 482 - 1861 ext.
FAX No.
252 - 482 - 8722
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
/ n
2. AgenbContractor Information
Business Name
Agent/ Contractor 1: First Name
MI
Last Name
Agents Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
ext.
Phone No. 2
ext.
FAX No.
Contractor #
Street Address (if different from above)
City
State
ZIP
Email
<Form continues on back>
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Form DCM MP-1 (Page 2 of 4) RECEIVED APPLICATION for
Major Development Permit
MAR 2 9 2022
3. Project Location
County (can be multiple)
Street Address s
State Rd. #
Hyde
Hill St., 200 ft. from US 264
SR 1100
Subdivision Name
City
State
Zip
Engelhard
NC
27824 -
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - ext.
, I I ,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Tar -Pamlico
UT (Canal) to Far Creek
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
❑Natural ®Manmade ❑Unknown
Pamlico Sound
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
®Yes ❑No
work falls within.
Hyde County
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
100,
5,000 sq. ft.
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level)
(if many lot sizes, please attach additional page with a list)
2' ®NHW or ❑NWL
e. Vegetation on tract
Various roadside grasses on the maintained road shoulder, wax myrtle, spartina patens
f. Man-made features and uses now on tract
SR 1100 Hill St.
g. Identify and describe the existing land uses adjacent to the proposed project site.
Residential, Vacant, Coastal Marsh
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
Residential and Vacant
(Attach zoning compliance certificate, if applicable)
❑Yes ❑No ®NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes ®No
k. Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes ®No ❑NA
If yes, by whom?
I. Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes ®No ❑NA
National Register listed or eligible property?
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Form DCM MP-1 (Page 3 of 4)
APPLICATION for
Major Development Permit
m. (i) Are there wetlands on the site?
®Yes []No
(ii) Are there coastal wetlands on the site?
®Yes ❑No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted?
®Yes [:]No
(Attach documentation, if available)
n. Describe existing wastewater treatment facilities.
none
RECEIVF D
o. Describe existing drinking water supply source.
none
p. Describe existing storm water management or treatment systems.
none
5. Activities and Impacts
a.
Will the project be for commercial, public, or private use? ❑Commercial ®Public/Government
❑Private/Community
b.
Give a brief description of purpose, use, and daily operations of the project when complete.
This project will allow the continuance of safe transportation along SR 1100 by replacing the existing damaged culvert. Once
the culvert is replaced, the roadway facility will continue to provide connectivity and safe access for the traveling public and
the residents of Engelhard.
c.
Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
The culvert will be replaced using NCDOT best management practices and construction techniques for culvert replacements.
The culvert will be replaced on the existing alignment. The culvert will be installed using an excavator, dumptrucks, and
various other types of equipment.
d.
List all development activities you propose.
The culvert will be entirely removed using NCDOT guidelines for pipe removal. The existing 24" X 40' CMP will be replaced
by a 36" X 40' CAP, as shown in the provided permit drawings. Once the culvert in place and back filled, a new roadway
surface and grassed shoulder will be established. The banks will be stabilized following NCDOT erosion control bmp's.
e.
Are the proposed activities maintenance of an existing project, new work, or both? maintenance
f.
What is the approximate total disturbed land area resulting from the proposed project? 1,000 ®Sq.Ft or ❑Acres
g.
Will the proposed project encroach on any public easement, public accessway or other area ❑Yes ❑No ®NA
that the public has established use of?
h.
Describe location and type of existing and proposed discharges to waters of the state.
Surface runoff from SR 1100. This runoff is not concentrated and generally runs through the grassed shoulder in a diffuse
manor.
i.
Will wastewater or stormwater be discharged into a wetland? ❑Yes ®No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ❑No ❑NA
j.
Is there any mitigation proposed? ❑Yes ®No ❑NA
If yes, attach a mitigation proposal.
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Form DCM MP-1 (Page 4 of 4)
APPLICATION for
Major Development Permit
6. Additional Information
In addition to this completed application form, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (0 are always applicable to any major development application. Please consult the application
instruction booklet on how to property prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name Gibbs Development Properties, LLC Phone No.
Address PO Box 39, Engelhard, NC 27824
Name NC Seafod Industry Park Authority Phone No.
Address 1321 Mail Service Center, Raleigh, NC 27699-1321
Name Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
7. Certification and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowI dde.
Date _March 28, 2022 Print Name StevoTro rc I z---�
Signature R
ECEIVcD
Please indicate application attachments pertaining to your proposed project.
❑DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information
MAR 2 9 2022
DCM-EC
252-808-2808 .. 1-888-4RCOAST .. www.nccoastalmanagement.net

RECEIVE
Form 00YN15
BRIDGES and CULVERTS
MAR 2 9 2022
DCM-E C
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. BRIDGES ®This section not applicable
a. Is the proposed bridge:
❑Commercial ❑Public/Government ❑Private/Community
C. Type of bridge (construction material):
b. Water body to be crossed by bridge:
d. Water depth at the proposed crossing at NLW or NWL:
e. (i) Will proposed bridge replace an existing bridge? []Yes ❑No
f. (i) Will proposed bridge replace an existing culvert? ❑Yes ❑No
If yes,
If yes,
(ii) Length of existing bridge:
(ii) Length of existing culvert:
(iii) Width of existing bridge:
(iii) Width of existing culvert:
(iv) Navigation clearance underneath existing bridge:
(iv) Height of the top of the existing culvert above the NHW or
(v) Will all, or a part of, the existing bridge be removed?
NWL:
(Explain)
(v) Will all, or a part of, the existing culvert be removed?
(Explain)
g. Length of proposed bridge:
h. Width of proposed bridge:
i. Will the proposed bridge affect existing water flow? ❑Yes ❑No
j. Will the proposed bridge affect navigation by reducing or
If yes, explain:
increasing the existing navigable opening? ❑Yes [-]No
If yes, explain:
k. Navigation clearance underneath proposed bridge:
I. Have you contacted the U.S. Coast Guard concerning their
approval? [-]Yes ❑No
If yes, explain:
m. Will the proposed bridge cross wetlands containing no navigable
n. Height of proposed bridge above wetlands:
waters? ❑Yes ❑No
If yes, explain:
2. CULVERTS ❑This section not applicable
a. Number of culverts proposed: 1 b. Water body in which the culvert is to be placed:
UT (Canal) to Far Creek
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Forrh DCM MP-5 (Bridges and Culverts, Page 2 of 4)
c. Type of culvert (construction material):
Corrugated Aluminum Pipe
d. (i) Will proposed culvert replace an existing bridge?
❑Yes ®No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge:
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
f. Length of proposed culvert: 40'
h. Height of the top of the proposed culvert above the NHW or NWL.
-1.5
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
e. (i) Will proposed culvert replace an existing culvert?
®Yes []No
If yes,
(ii) Length of existing culvert(s): 40'
(iii) Width of existing culvert(s): 24"
(iv) Height of the top of the existing culvert above the NHW or
NWL: -1
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All
g. Width of proposed culvert: 36"
i. Depth of culvert to be buried below existing bottom contour.
12"
k. Will the proposed culvert affect existing water flow?
®Yes []No
If yes, explain: design will increase hydraulic flow
3. EXCAVATION and FILL El This section not applicable
a
C.
(i) Will the placement of the proposed bridge or culvert require any
excavation below the NHW or NWL? ®Yes [-]No
If yes,
(ii) Avg. length of area to be excavated: 10'
(iii) Avg. width of area to be excavated: 5'
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: 3_7
(i) Will the placement of the proposed bridge or culvert require any
high -ground excavation? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: 30'
(iii) Avg. width of area to be excavated: 5'
(iv) Avg. depth of area to be excavated: 7'
(v) Amount of material to be excavated in cubic yards: 38.9
b. (i) Will the placement of the proposed bridge or culvert require any
excavation within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
❑CW ❑SAV ❑SB
OWL ®None
(ii) Describe the purpose of the excavation in these areas:
EC 'M
MAR 2 9 2022
DCM-EC
252-808-2808 :: 1-888.4RCOAST :: wwwnccoastalmanagement.net revised:10/26l06

Form DCM MP-5 (Bridges and Culverts, Page 3 of 4)
d. If the placement of the bridge or culvert involves any excavation, please complete the following:
(i) Location of the spoil disposal area: NCDOT approved waste area site.
(ii) Dimensions of the spoil disposal area: N/A
(iii) Do you claim title to the disposal area? ®Yes []No (If no, attach a letter granting permission from the owner.)
(iv) Will the disposal area be available for future maintenance? ®Yes ❑No
(v) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell
bottom (SB)?
❑CW ❑SAV OWL ❑SB ®None
If any boxes are checked, give dimensions if different from (ii) above.
(vi) Does the disposal area include any area below the NHW or NWL? ? ❑Yes ®No
If yes, give dimensions if different from (ii) above.
e. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ❑Yes ®No
If yes,
(ii) Avg. length of area to be filled:
(iii) Avg. width of area to be filled:
(iv) Purpose of fill:
(i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
❑CW ❑SAV ❑SB
❑WL ®None
(ii) Describe the purpose of the excavation in these areas:
g. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed on high -ground? ❑Yes ®No If yes, ' `E C E I `� 1»r-�
„ D
(ii) Avg. length of area to be filled:
(iii) Avg. width of area to be filled: MAR 2 9 2022
(iv) Purpose of fill:
DCM-EC
a. Will the proposed project require the relocation of any existing b. Will the proposed project require the construction of any temporary
utility lines? ❑Yes ®No detour structures? ❑Yes ®No
If yes, explain: If yes, explain:
If this portion of the proposed project has already received
approval from local authorities, please attach a copy of the
approval or certification.
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Form DCM MP-5 (Bridges and Culverts, Page 4 of 4)
c. Will the proposed project require any work channels?
❑Yes ®No
If yes, complete Form DCM-MP-2.
e. What type of construction equipment will be used (for example,
dragline, backhoe, or hydraulic dredge)?
tracked excavator, dumptruck, backhoe
g. Will the placement of the proposed bridge or culvert require any
shoreline stabilization? ❑Yes ®No
If yes, complete form MP-2, Section 3 for Shoreline
Stabilization only.
d. How will excavated or fill material be kept on site and erosion
controlled?
Using NCDOT best management practices for erosion and
sediment control.
f. Will wetlands be crossed in transporting equipment to project site?
❑Yes ®No
If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
March 28, 2022
Date
SR 1100 Hill Street - Pipe replacement
Project Name
Steve Trowell for NCDOT"
Applicant a R E C E NE D
Applicant Signature MAR 2 9 2022
252-808-2808 :: 1-888-4RCOAST :: www.ncco;Llstaimana-qement.net revised: 10/26/06

M-
RECED
N.C. DIVISION OF COASTAL MANAGEMENT
MAR 2 9 2022 ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
DCM-EC (Top portion to be completed by owner or their agent)
Name of Property owner: North Carolina Department of Transportation (NCDOT)
Address of Property: SR 1100 Hill Street Engelhard, North Carolina
Mailing Address of Owner: 113 Airport Road Suite 100, Edenton, north Carolina 27932
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Steve Trowel
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 forthis
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 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 943 Washington Square Mall, Washington, NC 27889. 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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setb ockL�C' lac
-OR-
Sig)qz1oF6 of A facent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:, �G/ / /c�7/? vim-
Typed/Printed name of ARPO: Gibbs Development Properties LLC
Mailing Address of ARPO: P.O. BOX 39, Engelhard, N.C. 27824
ARPO's email: darkwoodswildlife@yahoo.1k;M,s Phone#: [phone]
Date: "waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

RECEIVED N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
MAR 2 9 2022 CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
DCM
��1 C (Top portion to be completed by owner or their agent)
®I.�IVIName of
m o Property Owner: North Carolina Department of Transportation (NCDOT)
Address of Property: SR 1100 Hill Street Engelhard, North Carolina
Mailing Address of Owner: 113 Airport Road Suite 100, Edenton, north Carolina 27932
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Steve Trowell
Agent's Email: [e-mail]
Agent Phone#: [phone]
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
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
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 943 Washington Square Mall, Washington, NC 27889. 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
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
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the bla
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Wanchese Industrial Park C/O Mr. Bob Peele
Mailing Address of ARPO: P.O. BOX 549, Wanchese, N.C. 27981
ARPO's email: [e-mail]'s Phone#: [phone]
Date: 3 ' 2 Z 2DZz
*waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

E: VE N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
MAR 2 9 2022 CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
�n (Top portion to be completed by owner or their agent)
DCM
Name of Property Owner: North Carolina Department of Transportation (NCDOT)
Address of Property: SR 1100 Hill Street Engelhard, North Carolina
Mailing Address of Owner: 113 Airport Road Suite 100, Edenton, north Carolina 27932
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Steve Trowell
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
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
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 943 Washington Square Mail, Washington, NC 27889. 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.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank
Signature of Adjacent Riparian Property Owner:
TypediPrinted name of ARPO: Wanchese Industrial Park C/O Mr. Bob Peele
Mailing Address of ARPO: P.O. BOX 549, Wanchese, N.C. 27981
ARPO's email: bpeele [e-mail]'s Phone#: [phone]
Date: 3 _ Z Z. r ZD7-Z *waiver is valid for up to one year from ARPO's Signature*
,Revised July 2021