Grigalis, Edgar 88521C

❑CAMA ❑ DREDGE & FILL N9 88521 A B C D
° Previous permit
GENERAL PERMIT Date previous permit issued
New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State o� North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. 0 General Permit Rules available at the following link: wwwdea nc eov/CAMArules
Applicant Name '.M k Authorized Agent
Address { f i L4 A eJ Project Location (County):
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City , n State ziP / ':-y- Street Address/State Road/Lot #(s)
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Phone # (f// /) �:
Email Subdivision
City ZIP
Affected ❑ cW ❑ EW ❑ PTA M ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
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Type of Project/ Activity
(Scale;
.............. —,..
Access Length
—
TJ
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I
Pier(dock) length
Fixed Platform(s)
---
FR
—
Floating Platform(s)
��
_
—
_
_
Finger pier(s)
Total Platform area
Groin length/ri
Bulkhead/Riprap length
Avg distance offshore
—
-
-
—
_
-
Breakwater/Sill-
Maxdistance/length`
I
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlih
Beach Bulldozing
Other
_
y—
—
-
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T
SAV observed: yes no '—
Moratorium: n/a yes no
Site Photos: yes no --i
RioarianWaiverAttached: yes no
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_
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A building permit/zoning permit may be required by: `+ wI (,L i
Permit Conditions /ice
❑ 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"
Application Feels) Check #/Money Order
Signature
Issuing Date
Expiration Date

&Ote"r" ❑CAMA ❑ DREDGE & FILL N9 88521 A B C D
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: wwwdeq nc %ro CAMArules
Applicant Name
Address
1!
City r, State ZIP
t
Phone # Qi/ --)
Email
Affected ❑ cw ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
ORW: yet/no.) PNA: yes/no
Type of Project/ Activity
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
(Scale:-',
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.
®�■
11
�9:
SIN
.
Other
SAV o
......,
, ;yes
...._
A building permit/zoning permit maybe required by:
Permit Conditions
TARMAM/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 i
/
Application Feels) Check N/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Edgar & Diane Grigalis
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
219 Sailaway Court
Havelock, NC 28532
[phone]
[e-mail]
Riverfront Docks, LLC
Acent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: install wood beach staircase
at my property located at 219 Sailaway Court Havelock, NC 28532
in Craven County.
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.
Property Owngr Information:
l
-1 Signature
Edgar / Diane Grigalis
Print or Type Name
Owner
Date
This certification is valid through 5 I 31 / 2023
L

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: Edgar & Diane Grigalis
Address of Property: 219 Sailaway Court Havelock, NC 28532
Mailing Address of Owner: 219 Sailaway Court Havelock, NC 28532
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: John Gudaitis, Riverfront Docks Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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
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
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) (C_.
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Charlie & Jsoon Hwang Cha
Mailing Address of ARPO: 1913 Stratford Drive Conover, NC 28613
ARPO's email: �TZS OUn®gma' �' COARPO's Phone#: lt" 3 ?—Z 0 06 J 6
Date: '�� *waiver 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: Edgar & Diane Grigalis
Address of Property: 219 Sailaway Court Havelock, NC 28532
Mailing Address of Owner: 219 Sailaway Court Havelock, NC 28532
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: John Gudaitis, Riverfront Docks Agent Phone#: [phone]
Agent's Email:
[e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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,
xI 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
Signature of Adjacent
K912
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Richard & Petra Slesinski
Property Owner
Mailing Address of ARPO: 217 Sailaway Court Havelock, NC 28532
ARPO's email: ARPO's Phone#:
Date: �? 2— *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

arigalis
Way Court
Havelock, NC 28532
IVERFRONT
OCKS
3614 Old Cherry Point Road
New Bern, NC 28560
[phone]
Rive rfrontDocks.com