Yenner, Dan & Skinner, Sandy 87396C

oa01COAST4 ❑CAMA ❑ DREDGE & FILL 87396 A s C' D
y 2 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/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 no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be rE
Permit Conditions
(Scale:,,
U 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
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s)
Check #/Money Order Issuing Date Expiration Date

o�0,C-0-R41 ❑CAMA ❑ DREDGE & FILL NO. 87396 A B C D
2 9 Previous permit
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 _
Address
City
Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Affected ❑ CW ❑ EW ❑ PTA `.Ae, 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 requirea uy:
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
Signature "Please read compliance statement on back of permit" ,{ Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

Styron, Heather M.
From: Mail Notification Team <[e-mail]>
Sent: Tuesday, May 24, 2022 4:24 PM
To: Styron, Heather M.
Subject: [External] Signed Adjacent Property Forms
Attachments: 001.jpg; 002jpg; 003 jpg; 004.jpg; 005 jpg
CAUTION- External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Thank you
Ricky Sprouse

W
...... ......
c,,,nc n
Name of Property Owner Requesting Permit:
hL
Mailing Address:
Phone Numboil er'.f.
E
Email Address: 5 n Q e K t
I certify that I have authorized V), -1:V-11V�i 511
I Agent Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits;
necessary for the following proposed development:
at my property located at
in
County.
I furthermore certify that / 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.
Signature
,,-J Print or Typi9 Name
Pr L� (tAu t; wra, r
Title
it
I
Date
This certification is valid through

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner 0-YA 0 V
Address of Property:
Mailing Address of Owner: 6X
owner's email, 4-A�`C)ner'sPhoneft:
'17 ('7
Agent's Name* T- ex �U,-5 fft raj� OAgent Phone# �
Agent's Email: -n Q 1( 0 WCt VVZ VNVQoj t no-�
ADJACENT RIPARIAN PROPERTY OWNER'$ CERTIFICATION
(Boftom portion to be completed 0 >,
)f,the A0jaaentPro p art yOwner')
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
with this letter.
1) fHU I DO NOT have objections to this proposal. I DO have objections to this proposal.
Ifrou #gave objections to what i being proposed, Yoo mosf nvtifY t#re ion of Coastal
nce should be
o be contacted
been ,notified by
Cerfffied 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 dprap revetments). (if you wish to waive the setback, you My§Lsi9n
the appropriate blank below.)
I DO wish to waive somelall of the 15, setback
Signature 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'. L
tA
Typed/Printed name of ARPO:
FG
L ?)
Mailing Address of ARPO: 9�,W
J� 9,0 ARPO's Phone#: S ;_R
ARMS eM211: "Lis
Date: *waiver is valid for up to one year from ARPO's Signature
Revised July 2021

N', DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
{.ERTIFIEQNIAII ES-IL-D or BAND _f)F-LIVFRY
(Top portion to be completed by owner or ttieIr agent.)
T,
0
Name of ProPertY Owner
Address, of Property
!W
Mailing Address of Owner•, . ..... .........
�,Owner's Pnone#, --J
Owner's, email,
J
Agent's Name: IL Agent PhOne#.—,-----:�
Agent's Email.
ADJACENT RIPARIAN PROPERTY OWNSR'S CERTIFICATION
Bottorn-portion to be oo Ad ace #pro291t 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 develoPMeAt they arC proposirlo,
Drovided with t er,
I DO NOT have objections to this proposal, _ I DO have objections to this proposal.
If- —Objections 10 —waleing purposed, m
-bji—you must notify N.C. Vivision of COastal
,h10anagement (DChl) in writing within 10 days of receipt of this notice. Correspondence should be
morehead City, NC 28557, DCM representatives can also be contacted
maijed to 400 Commerce Ave., ave been notified by
at (252) 808-28o$. No response i-5 considere-d the same as no objection if You h
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 distan� Of 15, from my area of riparian mess unless waived by me
(this does not apply to bulkheads or riprap revetments). (if you wish to waive the setback, you must -----Vq—n
the appropriate blank below.)
I DO wish to %vajve somelall of the 1 S* setback
Signature of Adjacent Wpatian Property Owner
-OR-
do not wish to waive e
15, setback requirement (initial the blank)
th
Signature of Adjacent Riparian Property Owner,
TypedlPrinted name of ARPO:.
Mailing Address of ARPO-J—
ARPO's em3il' ills A, L X, ARPO's Phone#:
"a� ni
Date �215;� waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
.1 . .... ........ . .... . ............ . .