Robertson, Janice 88518C

°�`°"�'"� c❑CAMA ElDREDGE & FILL 88518 A B c
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GENERAL PERMIT Previous permit
J 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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City
Phone # (_ )
Email
Authorized Agent
Project Location (County):
State ZIP Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW
❑ PTA ❑ ES
❑ PTS
Adj. Wtr. Body
(0t/man/unk)
AEC(s): ❑ OEA ❑ IHA
❑ UW ❑ SPIMA
❑ PWS
Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale.'
Shoreline Length
Access Lengthy
- --.
—
. j .. .......
- - -- - -
Pier (dock) length
Fixed Platform(s)�
I
i
i---
i
Floating Platform(s)
_ 1
-
Finger pier(s)
- 1 —
-
Total Platform area
Groin length/#
Bulkhead/ Riprap length
_ I
---------
Avg)distance offshore—
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
-
... —
Boat ramp
Boathouse/ Boatlift
i
Beach Bulldozing
J /
Other
- m
SAV observed: yes
Moratorium:
no;
P !
3"
n/a yes
no i
Site Photos: yes
no
Riparian Waiver Attached: yes
no�
w
A building permit/zoning permit may be required by t, f rSi,''
❑ TAR/PAM/NEUSE/BUFIFER (circle one)
Permit Conditions
ElSee 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
Signature "Please read compliance statement on back of permit"
Signature.
Application Fee(s)
Check #/Money
Order
Issuing Date
Expiration Date

1°�`°ASr'1 LN❑CAMA ❑ DREDGE & FILL N9 88518 A B C D
2—ok
Previous GENERAL 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:
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- i
l mm
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 j.
Moratorium: n/a yes no't
Site Photos: yes no -
I
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
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" Signature,
Application Fee(s) Check #/Money Order Issuing Date
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPFRTY OWNER NOTIFICATIONIWAIVER FORM
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(T nh I)oIllon to I►r+ coml►hald by nwnr!r rrr fhr!it tic)nnf)
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/q1n'i1't
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AI).►AGCN7 R119ARIAW 11ROPIJITY OW1r1:11'!i CERTIFICATTIOPI
1?c`ttc` cn_1v Lie tenjp!eted U.y_Ifts. jflc9nl Ptvy�_
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DO h=rfe Ohsrrtnr , to th+� V'DOO4 II
►.fiat IS boincl proposed, )•ou must notify the ii.0 Orii;ton of•Co;!
ia:. A:git•/IrL,:�: ,:7 vi ..: «:.:.; a N,iii.lr iQ da,'s 0-1 rGecipt Of this rz.,j:a- vv:: e�j•viSCi.717.^... ..,•vLw
NC Z8557. DCM rorosontatiyos can also
be
►nsi►ntf ro 4!4"' Comme+rty A►ro . A1orvhoad Gty, pcontact
nt ("i;?i 11t)b ; p'
NDF No rosonso is considered the sumo as no objoctlon if you have Daon notified
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WAIVER SECTION
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Mot': o+o! :I;I,N, 1: t,.11►,',ca:.`: o' +i;trtip rtrra.ments) (Y4 1
;t{�{y;,rri:Ut tlla'lf :rc•I:i,n /"j��, /
told is, sell bt
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►I•
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+ TyI►trdil'rullt+d nnnle Of AKPO:
MwllulU Addivb-b Of AItPO
r AftFG'b
pr11i1) 1 1 a 1�1' 1 ut._i.ii_► t 4"PO'* Phone$; ��1-►��_t_� l� ___� 1
1'" •a'11YMf is Y#i1d for up 10 on@ year tiom ARPO's Signature'
+Aiala: jl� f �I-:LL Revised May
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N.C. DIVISION OF COASTAL MANAGEMENT �c
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
/1 rr'f T l r I r"n en A, !! nr-rI Inr.� r nr nrr11 lrnrrf'+ JII RlI'1 ��! !l /l=L�l/
VC1� i I�iCiJ iVi!-�iL i�C iyRi�i IrCt=1� I RCI.tUCv i Cu lir ! if�ivv uL.�! v L!� i
(Top portion to be completed by owner or their agent)
Name of Property Owner:
A JAr-s, ou� f f7r...-,nr4�r.
ruu�a - i it p 11y.
Mailing Address of Owner: 1 10 S - 2av Dri CX, &C(.C( rt, Itl C Z_7�
Owner's email: q U Lb 4apwners Phone#: ��� -,6&- 17-19
i wt(
AgpnF'z i4I.
Agent's Email:
An?-t Oh-neff,
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.
If you have objections to what is being proposed, you must notify the N.C. Division or Coastai
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.
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.)
n,) +. ,;, tl }r i i ,ai\!� =,roil �+;.qEs nt the l h' �."}.ti}nrk,
Signature of Adjacent Riparian Property Owner
-OR-
y kA
I do not wish to waive the 15' setback requirement (initial the blank) °VCJ AL�QQ
--- -__.- -- --- ''jjam�
Signature of Adjacent Riparian Property Owner: /1L�
Typed/Printed name of ARPO: Wl J t i Arm C ,
Mailing Address of ARPO: 1320 k, A,, J_s l✓ v �� �� IV C U4- J`S^
ARPO's email: �a�,�►y /.L(�SO1i�9_ ARPO's Phone#: Cyr/� ✓��� ���
/ hcv. r�^, C o �
Date: S(�S 2,02-1- `waiver is valid for up to one year from ARPO's Signature"
PF7 Revised May 2021
>022
CITY

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NAM
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GENERAL POWER OFATTORNEY
I, William C. Stainback, residing at Fiesta Way, Raleigh, North Carolina 27615, hereby
appoint Wilma Jackson of j Knight's Way, Raleigh, North Carolina 27615, as my
attorney -in -fact ("Agent") to(exercise the powers and discretion described below.
`j Q%k/a Ta,mr�i ��c,titcn
I hereby revoke any and all general powers of attorney and special powers of attorney that
previously have been signed by me. However, the preceding sentence shall not have the
effect of revoking any powers of attorney that are directly related to my health care that
previously have been signed by me.
My Agent shall have full power and authority to act on my behalf. This power and
authority shall authorize my Agent to manage and conduct all of my affairs and to
exercise all of my legal rights and powers, including all rights and powers that I may
acquire in the future. My Agents powers shall include, but not be limited to, the power
to:.
1. Open, maintain or close bank accounts (including, but not limited to, checking
accounts, savings accounts, and certificates of deposit), brokerage accounts,
retirement plan accounts, and other similar accounts with financial institutions.
a. Conduct any business with any banking or financial institution with respect
to any of my accounts, including, but not limited to, making deposits and
withdrawals, negotiating or endorsing any checks or other instruments with
respect to any such accounts, obtaining bank statements, passbooks, drafts,
money orders, warrants, and certificates or vouchers payable to me by any
person, firm, corporation or political entity.
b. Perform any act necessary to deposit, negotiate, sell or transfer any note,
security, or draft of the United States of America, including U.S. Treasury
Securities.
c. Have access to any safe deposit box that I might own, including its contents.
2. Sell, exchange, buy, invest, or reinvest any assets or property owned by me. Such
assets or property may include income producing or non -income producing assets and
property.
3. Purchase and/or maintain insurance and annuity contracts, including life insurance
upon my life. or the life of any other appropriate person.
RECEI E0 M:E COUNTY, NC 329
CHARLES P. GILLIAM
REGISTER OF DEEDS.
MAY 17 7 PRESENTED & RECORDED ON
.L2?27?2018 15:97:02
F3 a 4 K n 9 hts w a y DCM-10 H U :.; iTv
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