87360C - Randles, Adam

1* COASTgT& EICAMA ❑ DREDGE & FILL N° a g c D
GENERAL PERMIT Previous permit
Date previous permit issued
F-INew ❑ 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 Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
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
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed:
yes m
Moratorium: n/a
yes ni
Site Photos:
yes m
Riparian Waiver Attached:
yes ni
A building permit/zoning permit may bi
Permit Conditions
(Scale: i"l_ jj )
U TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1 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"
Application Fee(s) Check #/Money Order
Signature
Issuing Date Expiration Date

1°F`°"Sr41% ❑ CAMA ❑ DREDGE & FILL 9 87360 A B C D
GENERAL PERMIT Previous 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:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMAruies
Applicant Name _
Address
City
Phone # (_ )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
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
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: )'
❑ 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 Name
Permit Officer's PRINTED Name
Application Fee(s)
Signature "Please read compliance statement on back of permit"
Check #/Money Order
Signature
Issuing Date Expiration Date

Styron, Heather M.
From: Adam Randles <[e-mail]>
Sent: Monday, April 25, 2022 5:09 PM
To: Styron, Heather M.
Subject: [External] General permit
Attachments: 4-25-22 A Randles.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
I'm attaching the drawing and the paperwork of the two neighbors, NCDOT and 103 River Drive (owned by
myself)
Looking to get a general permit to do a rip rap wall a handful of pilings and less than 100 yd.' of dredging
Thanks Adam
[phone]
Adam Randles, DC
The finest compliment we may ever receive is a referral from our friends and patients. Thank you!
Our Doctors of Chiropractic:
Sarah Randles, DC
Adam Randles, DC
Contact Information:
1

301Jones Avenue
Beaufort, NC 28516
252.838.8810 (phone)
252.364.4631 (fax)
www.CoastalDCs.com (web)
Coastal DCs(cD-gmaiLcom (email)
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(Top portion to be completed by owner or their agent)
Name of Property Owner: Adam Randles
Address of Property-,
101 River Drive Beaufort, NC 28516
Mailing Address of Owner: 110 River Drive Beaufort, NC 28516
Owner's email: dradamrandies@gmail,com Owner's Phone#: [phone]
Agent's Name- N/A
Agent's Email: N - !A
alumm=
N/A
70 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.
X I DO NOT have objections to this proposal, _ I DO have objections to this proposal,
# you have objections to what isbeingproposed, 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.)
I DO wish to waive somet'all of the 15'setback
-OR- Signature of Adjacent Riparian Property Owner
— D5
I do not wish to waive the 15' setback requirement (initial the blank) _f
Signature of Adjacent Riparian Property Owner: L_L9,,41 L-_7,
Typed/Printed name of ARPO: Robby L. Taylo�db&t'girict Engineer
Mailing Address of ARPO: 209 South Glenburnie Road New Bern, NC 28560
ARPO's email: rlllaylor@ncdot,gov ARPO's Phone#: [phone]
Date: 04/25//2022 *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 NOTIPICATIONlWAIVER FORM
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their went)
Name of Property Owner:
N
Address of Property: l01 ut-C
LC ---
Mailing Address of Owner:
Owner's email: tt€C� _ eq!k?d_ owner's Phone +_c.-?-
Agent's dame:Ow Anent Phone#: �—
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be c©r eted by the Adiacent Property Own!;r)
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 ter drawing, with diTens# _must be provided with this letter.
I DLL NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you roust notify the N.C. Division of Coastal
Management (DCM,) in writing within 10 clays of receipt of this notice. Correspondence should be
railed 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 nay area of riparian access unless waived by me
(this dues 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 someiali of the 15' setbacEsr
griature of Adjacent Riparian Property) Owne
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:
• �lirlc�C-`,�tit�l1* ���;'���i�t/ r t,t* " ' � • "f:. �►
Date: *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: Adam Randles
Address of Property: 101 River Drive Beaufort, NC 28516
Mailing Address of Owner 111) River Drive Beaufort, NC 28516
Owner's email: [e-mail] Owner's Phone#. [phone]
Agent's Name: N/A
Agent's Email: ---. N !A
Agent Phone#: NIA
PU7 70 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 drawina, with dimensions, must be provided with this letter,
X I DO NOT have objections to this proposal, ­. I DO have objections to this proposal,
If yott have _objecttons ­Fowhat is berm proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within f 0 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'frorn my area of riparian access unless waived by file
(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:
TypedlPrinted name of ARPO; Robby L. T
Engineer
Mailing Address of ARPO: 209 South Glenburnie Road New Bern, NC 28560
ARPO's email, [e-mail] ARPO's Phone#: [phone]
Date: 04/2511/2022 *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 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:
Address of Property: /01 Rt Ut ir, C
Marling Address of Owner: _ D .'a)c ... — '... C 287
Owner's email:Ci"t%CLe_5__'n,Lis Phonec-r).a._
Agent's Game: Agent Phone#:*
Agent's Email _...._.._.
/o5 . v C (—
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
14!gg2m portion to be completed by the Adjacent Pica e.. rt r,O ner)
I hereby certify that I sawn 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.
Ades try on_ r drawing, with dimensions. Mqu be rovided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal_
if you have obfections 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. £)CM 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 ripply to bulkheads or riprap revetments;. (if you wish to wa Ne the setback, you must sign
the appropriate blank below.) /
I DO wish to waive sorne all of the 15' setbacV1
Signature of Adjacent Riparian Properly Owner
DID
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: twu1if2�
Mailing Address of ARPO:
ARPO's email:
Date:*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 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:
Address of Property:
Dr
Mailing Address of Owner: 0 _2C
Owner's email:ot'
Owner " F- I ful -12-
Agent's Name: Agent Phone#:
Agent's Email:
R'l ve-c D r ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Lt ,-� I N C (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.
X 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 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 MMaLljo
the appropriate blank below.)
I DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Property Okn
-OR-
q�
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 'S
Mailing Address of ARPO: 1510 PQOL-�QL CC2�00C, tJL
(" coill
11 ARPO's Phone#:_Al q, t 5- q q,78
ARPO's email: Timwl
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

M