84698C - Vandersea, Brian

td—mtiv OCAMA I� DREDGE & FILL N9 84698 A s O D
Previous permit
WGENERAL PERMIT Date previous permit Issued
JNfNevv [:]Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coas I Resources Commission in an area of environmental concern pursuant to:
ISANCAC Q A150J/❑Rules attached. General Permit Rules available at the folic Mng link: deo nc,2w/CAMAruIe
Applicant
Address
Phone # ( -�UJ
Authorized Agent 1�
Project Location (County):
Street Address/State RoaNLot #(a)
City
nat/ a® k
Adi. Wcr. Body CA ( )
Affected ❑ TA DES ❑PTS I�ary s4
AEC(s): �❑OEOEA IHA ❑UW ❑SPIMA ❑PWS Gosest Ma). W4 "''Th N!!z%. . �
ORW: ye61- PNA: ye rl
Type ofaPPrrroject/ Activity
Shoreline Leni
Access Length
Pier dock) let
Fixed Piatforn
Finger
Total Platform are _
Groin length/#
Bulkhead/ R' aplenl
Avg distance offshore
Breakwater/5111_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAY observed: yes no
Moratorlum: n/a yes no
Site Photos:
Riparian Waiver Attached: yes no
A building permit/zoging.permlt may, be is
by:
.,w Q �5
�oQQQQo[[�t�At�
�y }(o0
❑ TAR/PAh1/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditio, n _son back

DREDGE & FILL
J9v,(-- N9 84698
A B O D,
o
GENERAL PERMIT
Previous permit
Date previous permit issued
New ❑Modification ❑ Complete Reissue
❑ Partial Reissue
As authorized by the State of
CN�o/rth Carolina, Department of Environmental Quality and
0�
the Coaz I Resources Commission in an area of environmental concern pursuant to:
15A NCAC + I ✓ 1/B ❑ Rules attached.
General Permit Rules available at the following link: wwwdeg nc gov/CAMArules
Applicant Name
Authorized Agent "�
Address
Project Location (County):
n
/�
City State ZIP jL�
Street Address/State Road/Lot #(s)
Phone # ( �'
ffflii
Email <�-
Subdivision
��tt
City
Affected ❑ CW PTA ❑ ES ❑ PTs
Adj. Wtr. Body
(naU an k)
AEC(s): ❑OEA IHA ❑UW ❑SPIMA ❑PWS
Closest Maj. Wtr. Body
ORW: yes7nA� PNA: ye /r
lV/
Type of Project/ ActivityP�bparyoA
i
C
f
Shoreline Length.
Access Length
Pier (dock) length
Fixed Platform(sY
Floating
Total Platform are _
Groin length/#
Bulkhead/ R rap lent
Avg distance offshore
Boat ramp
Boathouse/ Boatlift _
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos:
Riparian Waiver Attached: yes no
A building permit/zoging.permit may, be re
Agent
by:
/vim \ 1 (� Cam
f pt�
PcoPo
j�cttjl tgemAtZ
1 J�
/ v —
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Initial)
C# T(Df

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: Brian A. Vandersea
Address of Property: 169 Loblolly Dr Pine Knoll Shores, NC 28512
Mailing Address of owner: 105 Chimeneas Place, Chapel Hill, NC 27517
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name:
Agent's Email:
Agent
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.
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.)
I DO wish to waive some/all of the 15' setback
A 'i�/
Signal re 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:
Typed/Printed name of ARPO: Nan Gildner
Mailing Address of ARPO: 171 Loblolly Dr Pine Knoll Shores, NC 28512 C7`�v)
ARPO's email: [e-mail]'s Phone#: [phone] WLL-0? -
Date: 'waiver is valid for up to one year from ARPO's Signature* RECEIVED
Revised July 2021
MAY 13 2022
DCM-Mt-ID CITY

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONANAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Brian A. Vandersea
Address of Property: 169 Loblolly Dr Pine Knoll Shores, NC 28512
Mailing Address of owner: 105 Chimeneas Place, Chapel Hill, NC 27517
owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by tho Adjacent 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 at is being proposed, you must notify the N.C. Dlvisfon 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 some/all of the 15' setback �J
SignatuteforAdjacent Riparian Property O net
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Michel Boyle t (/
Mailing Address of ARPO: 167 Loblolly Dr Pine Knoll Shores, NC 28512
ARPO's email: �✓� Rr ARPO's Phone#:�-254 I K
Date: waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
MAY 13 2022
DCM-MHD CITY

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MAY 13 2022
DCM-MHD CITY