87708D - Rooks

AMA L _I DREDGE & FILL No 87708 A B CLT
Previous permit
GENERAL PERMIT Date previous ptxmitissued
Vew rlModification j ICoin plete Reissue ❑Partial Reissue LF �1"ZZ
As authorized by the State of North Carolina. Depar'towns of Environmental Quality and the Coastal Resources Commission in an area of emironmentai concem pursuant to
I SA NCAC _ _- 2-Ct> Rules attached. �_ 7 Genoral Permit Rules available at the following link: wow then nc gov/CAN(V ks
APPHUM Name
ph f1 WIN)
Email
ZIP
Authorized Agent N A.-
Project Location (County): __..--_--
SereetAddress/State Road/Lux
Subdivision
City ZIP _
Affected new L/SEW A �ES �PTS Adi. Wis.Body My i 4.�/ (tu4ff5A1k'
AEC(s): [ ]OEA L]INA UW ❑SMMA ❑PWS Closest Mai. Wis. Body S�UI "�hVSCL
ORW ye no PHA: ye40
Type of Project/ Activity
Shoreline L ngth ' r " I W _
Access Length
Pier (dock) length
Fixed Platforms)
Floating Platform(s) _
Finger pleds)-__
Tolaltlatform area
Groin le h/g _
Bulkhead/Ri lengths
Avg distance offish
Breakwater/Sill _
Max distance/ lengt,
Basin, channel
Cubic yards
Boat ramp._ _
BOdtRf1U atli
Beach Bull zing _.
Other
SAV observed: yes o
Moratorium: n/a yes
Site Photos: X�/v
Riparian Waiver Attached:
A building permit/toning permit may he required by
Permit Conditions
or
Feels)
/ /� (ScaleM s )
Mill, / I
N6W LILT
7 '-\'
i
read compliance statement on back of permit'
Issuing Date
i �EOLA'G�
✓v�'v
nnEV • i
TvJ�—
19'p
Name
u TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
(please
r/r•72--
Date

UCAMA ❑ DREDGE & FILL N9 87708 A B C D
x GENERAL PERMIT Date Previous permit
previous ousp
Date permit issued
[RNew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the St�at�e {of�North Carolina, Departmem of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC �'T 1 c ! �' > ❑Rules attached. ❑ General Permit Rules available at the following link: w deci.nc.gov/CAMAmles
Applicant Name
City f1 InAit
Phone # (racy) )
Affected ❑ cW
AEC(s): ❑OEA
ORW: yes/no
123EW JZ1PfA
❑IHA ❑UW
PI yes1g)
Type of Project/ Activity
ZIP
❑ ES ❑ Prs
❑SPIMA ❑PWs
Authorized Agent
Project Location (County): e*
Street Address/State
Subdivision
city 4
Adj. Wtr. Body
Closest Maj. War. Body � QV SG 1
Is"10s11 i/.e
Pier (dock) length
Fixed Platform(s)
NOVA
Finger pier(s) HI
ii®ii
11 MINIMUM
-li
all lmlr�41410,0
ii■■i■i
■
Illfr■II�■ ■�■■■11�1■■■
I -� � ■ ,�
iiiBeach
ii=l
BoathousrfBoatlift o�■
■■■E■.��►i
Bull�dczii
i
SAV observed: yes no
A
®Mi
:
oi1111how.iiniiiiiiiMEMO
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
'�t"' •I.";' 1,1 Al V -
i
Agent or Applicant PRINTED Name
1'4l44 (1-0 cv
Permit Officer's PRINTED Name
❑ TARfPAWNEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please
Signature "'Please read compliance statement on back of permit Signature
Dr's I/n f<
Application Feels) Check p/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar - Pamlico River Basin Buffer Rules El Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven —south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

Locality Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Name i.JAYA111 4 R ©&K-1
Address 10 Ll K M4 L L A f? V 817'e /Q O � /� n? n
City (-1/ #0S'rCAjn State ^/G Zi yy3Phone .9$ /( 99 f J ( 2,
Email Ll/I¢YAd/S A06Kr dL Y,4M®0. 00M
AUTHORIZED AGENT
Name IVA
Address
City State Zip Phone
Email
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
/0L/4 M/¢lL/}IP►� l��Y l'QI) 1 IV,$ %710C;_f1#V Z,5Y143
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) TN474L L 4 Al
PvL K. Qon r [. ll=f/ MOyt Pit LALq Z"tvS>*le 40.yGJ52
SIZE OF LOT/PARCEL: square feet acres
PROPOSED USE: Residential [r (Single-family O'M.Iti-family []) Commercial/Industrial Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: Q square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT., Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES ' NO Of
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
✓n owner or record title, Title is vested in name of W hYNg A iR 60 ks
see Deed Book Yd 2 ! page VX in the 1rre_A/y&R County Registry of Deeds.
_an owner by virtue of inheritance. Applicant is an heir to the estate of
; probate was in
County.
_if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) RopAMY SlAfrXI1Ml 103L( 1W*Lit4* &y lt0
(2) SuXAM CA1AJ 1511 150'r6 f CRE61C AD
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I 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.
This the 7 day of /�/� , 20 '1�2
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a checkfor $100.00 made payable to the locality and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.

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: W%� `�lV Rd Q K-f
Address of Property: /D yG/ 1041Z ARb 9A �f • l f D - . 4. /1A�'I/ —Smon
Mailing Address of Owner. %Bqz/ SY%41 aft &Y tAl,
Owner's email: AIA VA16# R6W&r41/00,d"wner's Phone#: .2*1- T 77 - 73 7 2
Agent's Name: XIA Agent Phone#: iY4. s
Agents, Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
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
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
malted to 400 Commerce Ave Morehead City, NC 28567. DCM representatives can also be contacted at
[phone]: No response Is considered the same as no objection if you have been notified by
Ceirdfr"ed Mail.
WAIVER SECTION
1 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 mgm Sinn
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of -Adjacent Riparfaff Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: k V NI dA, /� L �C..��_
Typed/Printed name of ARPO: , �fJ`S"/1.N f�i4 A
Mailing Address of ARPO: fs�7yT�l'� Ci%%/%fC , �%/Zi?Z"Td�✓ .-2 y�%
ARPO's email:. .444 ARPO's Phone#: -S4 y2.
Date: -� fiver is valid for up to one year from ARPO's Signature''
Revised May 2021

N.C. DIVISION OF COASTAL. MANAGEMENT .
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL •'RETURN RECEIPT REQUESTED or. HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: J%.,1A YV H ROOKS
Address of Property: 0 yy M)? LL 14 1?12 J" i % -1)
Mailing Address of owner:
Owner's.email:(a9MXA�R00/d1gri%4W-00Mner'sPhon6 ..28,':?19-7.372
Agent's Name: �.# Agent Phone#: N�
Agent's Email: /P,*
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be Completed by the Adiaaent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applyingfor 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. .1 DO have objections to this proposal.
N 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 repiesentedves.can also be contacted at
[phone]. No response Is considered the same as no objecfion.if you have been nodfred by
Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings; boat ramp, breakwater, boathouse, lift, or
groin .must beset back a minimum distance of 15' .from my area of riparian access unless waived by me
.(this does not apply to bulkheads or riprap.revetme.nts.). (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
co
Signature of Adjacer Riparian Ffroperty Owner
-OR-
I.do not wish to waive the 15' setback requirement (ir'ftial the blank)
Signature of Adjacent Riparian Property Owner. y
Typed/Printed, name of ARPO: e
Mailing Address of ARPO:,
ARPO's email: d/, /� ARPO's Phone#::.V16 6
97
Date: C�3�2 z *walver is valid for up to one.year from ARPO's Signature*
Revised May 2021

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Vl/i4 Yti15' A- 806 k S 's
(Name of Property Owner)
property located at /0.4/�1 ��cCRap 1��'�IPaL o i io-�ser/vv ,
Address, Lot, Block, Road, etc.)
on 1V4Z1-ARV 44CrR 14t— in N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
r
Sign ture
Print or Type Name
1-a-
Telephone Number
Dath-

Receipts for
Certified Mail
(Staple Here)
'2 ??-
Date
S U S A" C-4 1AJ
Adjacent Property Owner
15 10 12vrc W C►2CEt?� R D
Mailing Address 2194111
i—, h *i Ni ib A . A/ C,
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, OAYMc 4 K (00K S have applied for a CAMA Minor
Property Owner
Permit on my property at 10W 64 � XP *4^0977,Ab , in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at Z 8 11 - 7 7 7 - 73 7 Z ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
4,1.4 ya.9 AiQoors
Property Owner
Mzlil /"W L #Rb E4 Y RP
Mailing Address
7-64 V . NC 2814413
City, State, Zip Code

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to r/l/A YA10 /- lQ D b k $ 's
(Name of Property Owner)
property located at 10'4/-"11W1ULAgQ J9AY IPPL 4 7` /O-e �'hL'i'/d4/ R ,
Address, Lot, Block, Road, etc.)
on IV4ZL-IWV MY r—A.A i— , in 1?— , N.C.
(Waterbody), (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)

Receipts for
Certified Mail
(Staple Here)
6-
J 10 IJ-2,
Date
Rows y S 1 Al fk 149 I�
Adjacent Property Owner
I0Jq MAtLAiM
iling Address
VAMPS IE-40_ NZ, 2VqT
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, UA` At X- #4 KOd KT have applied for a CAMA Minor
Property Owner
Permit on my property at lwel-gey 64 � /p0 *4A1°97W,4h , in COUNTY
Property Address
County. As -required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at Z 8 ' 7 ' 73 7 4 ,or by mail at the address listed below. If you wish to
Applicants Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL.GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
4,1h YAM
Property Owner
14"Al 4VINLOQb 94 Y RP
Mailing Address
City, State, Zip Code

N
IN
CA
8'-o"
27 —1 1 "
12'-6" OUTSIC���
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71000# BOAT LIFT
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16' — 4" 0
0 n EXISTING FLOATING
DOCK O0 00'
Oci
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WALKWAY i z
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COMMON COMMUNITY CANAL
W WW WWWWWWWWWW WWWWWWWWWWWitWW WWWWW WW W W W �--1
W
47'-B"
WW
WWI
1 12'-6" CENTERS
WI
W o J
tz
W1 °' ¢
i o m
N ^ O D
N 1 O
N O
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I O
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BOAT SHED
12' BY 24'
22'-3"
100'-0" LOT WIDTH
0
c
CORNER�o� RNER
_ � I
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1
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I
PRIVATE BOAT BASIN
10'-1" 1 15'-4"
o ICONCRETE
BOAT RAMP
DRAWING LEGEND
DRAWING SCALE
PROJECT DESCRIPTION FOR PERMIT
WAYNE ROOKS, OWNER
— - - — PROPERTY LINES
ONE INCH EQUALS TWELVE FEET
1. INSTALL NEW 7,000# BOAT LIFT ON 4 NEW PILINGS.
1044 MALLARD BAY RD
NEW PERMIT ITEMS
2. RELOCATE TWO EXISTING PILINGS OUTWARD FOR LONGER FLOATING DOCK.
HAMPSTEAD, NC 28443
EXISTING ITEMS
3. REMOVE EXISTING 8'X76'-4" DOCK TO REPLACE WITH 8'X20' DOCK.
PHONE [phone]

Check
Date ReceNed
Date Deaosded
Check Fran Nama)
Name of Permit Nokler
Vendor
Check number
amount
Permit Number/Comments
Recelat or Refund/RWIwated
Column!
6/8/2022
Co1umn2
6/9/2022
Calumny
Jerry G Mills Builders
Column6
Hager
Co1umn5
First Bank
Calumny
1208
Column?
$ 200.00
COlam19
GP #85924D
Co1umn9
BB rct. 18004
6/8/2022
6l9/2022
Patriot Boat Lift & Dock Maint,LLC
Sigman
Aquesta Bank
1206
$ 200.00
GP #87714D
BB rct. 18002
6/8/2022
6/912022
B & K Marine Construction
Smith
BB&T
1727
$ 200.00
GP #85972D
BB rot. 18003
6/8/2022
6/9/2022
JJ, LLC
same
First Bank -
1760
$ 200.00
GP #87723D
PA rct. 17645
6/812022
6/9/2022
Lighthouse Marine Construction Inc
Don Jordan
Coastal Bank & Trust
4274
$ 200.00
GP #85963D
JD rct. 17681
6/8/2022
6/9/2022
Luco, LLC
Milne
United Bank
5280
$ 200.00
GP #85996D
PA rct. 18027
6/8/2022
619/2022
Robert Layne
same
Truist
2002
$ 200.00
GP #87735D
PA rct. 18032
6/8/2022
6/9/2022
Richard Chilton
same
BB&T _ _
_ 5737
$ 200.00
GP #87734D
PA rot. 18031
6/8/2022
6/9/2022
Sea Dog Marine Construction
_
JR Huntley Homes LLC
First Bank
1770
$ 200.00
GP #87732D
PA rct. 18033
_
6/8/2022
6/9/2022
Wa ne Rooks
same
Afly Bank
1265
$ 200.00
GP #87708D
TP for JD rct. 17537