Curtiss, Rodger 76373C

-,. AMA / ❑ DREDGE & FILL No. 76373 A B C D
ENERAL PERMIT Previous permit #
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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.
Applicant Name qtUd<-CtProject Location: County Ce
J -'2
Address / /
CityStatW ZIP
Phone # [)
b�dE-Mail
Authorized Agent
T O g V
�W'1
A ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no)
PNA yes no
Type of Project/ Activity
Pier (dock) le—k
Fixed Platforr
Floating Platfc
Finger pier(s)
Groin length
number
Bulkhead/ Rip
avg distz
max dist
Basin, channe
cubic ya
Boat ramp _
Boathouse/ B,
Beach Bulldo;
Other
Shoreline Len
SAV: n
Moratorium:
Photos:
Waiver Attacl
A building pe
( Note Local Planning jurisdiction)
Notes/ Special Conditions _
Agent or Applicant Printed Name
Si re "Please read compliance statement onba4offmit**
cation Fee(s) Check #
Street Address/�State Root #(s)
J U'C'-1
Subdivision
City �� VcPif ZIP
Phone # O River Basio
Adj. Wtr. Body t �� (Y at Jman unkn
Closest Maj. Wtr. Body
PermitOfficerAlFrint1d Name
(Scale y A� )
Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL [MANAGEMENT
ADJACENT RIRARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, City & County) '
I2�6S"sl�
Agent's Name #:j (__A-S LMailing Address:
Agent's phone #: _�° S - 7 �. - O 13 2—
I hereby certify that l 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
g �.�'�*. :" wYi �''4'
they are proposing. A�descrrptiohor drawrriguSih<drmer�s�ans m:st be.provtced �r►tf;t.is.letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the 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 (252) 808-
2808, No response is considered the same as no objection ifyou have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Propg yner Irkformati
Signature(/
Print or Ty#47 Name
� / h
M /, b e
Mailing Address
� N��1
qityt1S"tate1Zip
33( - Lf56 S36
Telephone Number
14
tt 'ZdZ,a
Date
(Adjacent Property Owner Information)
Signature
F- R.
Print or Type Name
Mailing Address
��,
City/State ip
. %5 - 2A D I
Telephone Number ----RECEIVED
c APR 15 2020
Date
Revised U-SIMI-ID CITY

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner:
Address of Property:
1,56
.2 9,5r'/ 4.
(Lot or Street #, Street or Road, City & County)
Agents NameMailing Address
Agent's phone #: 5�� ? l i d l3 Z N C- 2 SS .3
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
a P.r':!
1
they are proposing. Acd�soriptronarsdrawngwihd�rnensiart rnusfbe ptavted with. lais4letfer.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 90 days of receipt of this notice. Correspondence should be mailed to 400
Commerce A ve., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808-
2808. No response is considered the same as no objection ifLou have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop rat Owner Information)
SignatV
Print or ype Name ' j�
i/ err'
Mailing Address
NG 70�c/
City/State Zip
Telephone Number
tk- ).oxo
Date
(Adjacent Property Owner Information)
Signature
Print or Type Name
�Y'
Mailing Address
City/StatelZip
DSA ',1a% 3a I � FIV1#
Telephone Number
A 'k OR 15 Z020
Date Revised / 0 3 y5MH CITY

AGENT AUTHORIZATION FOR CAMA PERMIT. APPLICATION
Name of Property Owner Requesting Permit: ek—
Mailing Address:
Phone Number:
Email Address:
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: r c _
d _
at my property located at S® Yje-k.P �r e_e,- A-"
in --� ev'� County.
I furthermore certify that l 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:
47 Signature
J?Qc-PP-- (�a 1=/i Sf
Print or Type Name
n4) OL)eP-
Title
Date
RECEIVED
This certification is valid through l�( _I Zv M-o
APR 15 ZO