Salt Creek Holdings, LLC 88534C

1* °j COAST41 &EICAMA El DREDGE & FILL N9 88534 A B C D
Previous permit
GENERAL PERMIT Date previous permit issued
[_1 New F Modification F] Complete Reissue F-1 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 F-1 Rules attached. ❑ General Permit Rules available at the following link: www.c1eq.nc.goy/CAMAruIes
Applicant Name
Address
City State ZIP
Phone #
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected El cW FIEW EIPTA FIES 1-1 PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): F] OEA F]IHA ouw El SPIMA D PWS Closest Maj. Wtr. Body
CIRW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:
Shoreline Length — — — -- — — — —
A
Access Length
-
Pier(dock)length
V
Fixed Platform(s)
-----... -- ----- —
---
Floating Platform(s)
Finger pier(s) _7_1
Total Platform area
Groin length/#
-- -- ----- -- .... .. . .... ...... . .........
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill 4
KI L
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift J k,.
Beach Bulldozing
M-T
Other
rTli` I ' f .., —...._
SAV observed: yes no
Moratorium: n/a ye no
Site Photos: Yes no
Riparian Waiver Attached: ye
s no V, I
A building permit/zoning permit may be required by:
Permit Conditions J TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
ElSee 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

`°MT4,I%FICAMA ❑ DREDGE & FILL N9 88534 A B C 'D
Previ0
y GENERAL PERMIT Date r 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 ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtc Body (nat/man/unk)
AEC(s): ❑ IDEA ❑ 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
"1.7
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) `
Total Platform area
Groin length/#
Bulkhead/ Riprap length
}---
--
Avg distance offshore
--
j--
I
Breakwater/Sill
Max distance/ length
�I
Basin, channel
Cubic yards
.-
-
Boat ramp r
Boathouse/ Boatlift_
j
Beach Bulldozing
Other .
--
---
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
r
-
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required
by:
Permit Conditions
(Scale j
d
17
❑ 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

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Mr

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
BRAXTON DAVIS
Director
June 21, 2022
Mr./Mrs. Braxton Brooks
250 Henderson Road
Newport, NC 28570
Dear Mr./Mrs. Brooks:
NORTH CAROLINA
Environmental Quality
This letter is in response to your letter dated May 19, 2022 regarding your concerns about the
proposal by Salt Creek Holdings, LLC to install a pier, platform and boatlifts located within
Broad Creek at 180 Henderson Drive in Newport, Carteret County. The proposed project has
been determined to comply with the Rules of the Coastal Resources Commission (7H. 1200), and
as such, a permit has been issued to authorize the development. I have enclosed a copy of the
permit, as well as the relevant statutes.
If you wish to contest our decision to issue this permit, you may file a request for a Third
Party Hearing. The request for a hearing will be considered by the Chairman of the Coastal
Resources Commission. The hearing request must be filed with the Director, Division of
Coastal Management, in writing and must be received within twenty (20) days after the
disputed permit decision is made. I have enclosed the applicable forms and instructions
that must be filed prior to that deadline. Please contact me at [phone], if you have
any questions, or if I can provide any additional information.
Sincerel,Y,
Heather Styron
District Manager
aroanm�t m r �omma��ni �D-E!
-Q, -` A
North Carolina Department of Environmental Quality I Division of Coastal Management
Morehead City Office 1 400 Commerce Avenue I Morehead City, North Carolina 28557
252.515.5400

CAMA THIRD PARTY
HEARING REQUEST FORM
PETITIONER'S NAME
DCM FORM 5
DCM FILE No:
COUNTY WHERE THE DEVELOPMENT IS PROPOSED
PLEASE TAKE NOTE that the undersigned, a person affected by the decision of (check one): .
a Local Permit Officer acting on a CAMA Minor Development Permit application; or
the Division of Coastal Management acting on a CAMA Permit application
hereby requests permission from the Coastal Resources Commission (CRC) to file an appeal pursuant
to N.C.G.S. § 113A-121.1(b) and 15A N.C.A.C. 07J .0301. (Please attach a copy of the permit. If you
cannot obtain a copy of the permit, please provide the name of the permittee, the project location, and
the permit number) Requests are reviewed and determined by the chairman of the CRC to determine
whether a hearing should be granted. 15A N.C.A.C. 07J .0301(b). Approval of a Third Parry Hearing
Request allows a petitioner to file a contested case petition with the Office of Administrative Hearings
within twenty (20) days of receipt of the CRC's Order. N.C.G.S. § 113A-121.1(b). Denial of a Third
Party Hearing Request is a final agency decision which may be appealed to Superior Court under
N.C.G.S. § 113A-121.1(b) and Chapter 15013, Article 4.
For this application to be complete, the Petitioner must address each of the three factors listed below.
The CRC's chairman's decision to grant a hearing will be based on whether the Petitioner:
(1) Has alleged that the decision is contrary to a statute or rule [N.C.G.S. § I I3A-121.1(b)(1)];
(Please cite the statute or regulation allegedly violated by the permit decision.)
(2) Is directly affected by the decision [N.C.G.S. § 113A-121.1(b)(2)]; and
(Please describe how you are directly affected by the permit decision. Persons directly
affected by a decision often include, but are not limited to, owners of real property in the
vicinity of the proposed development who can show that it is likely to have a significant
adverse effect on the value and enjoyment of their property, or persons who can
demonstrate a history of substantial use of public resources in the area directly affected
by the development.)
(3) Has alleged facts or made legal arguments that demonstrate that the request for the
hearing is not frivolous [N.C.G.S. § 113A-121.1.(b)(3)]. (Summarize the evidence and
arguments you would present at a hearing in support of your appeal explaining why the permit
was improperly issued.)
Please answer these questions on a separate piece of paper and attach it to this form.

The Commission notes that there are some opinions of the State Bar which indicate that non -attorneys may not
represent others at quasi-judicial proceedings such as this Third Party Hearing Request before the Commission.
These opinions note that the practice of non -lawyer professionals, such as engineers, surveyors or contractors,
representing others in quasi-judicial proceedings through written argument may be considered the practice of
law. Before you proceed with this hearing request, you may wish to seek the advice of counsel before having a
non -lawyer represent your interests through preparation of this Petition.
DELIVERY OF THIS HEARING REQUEST
This request must be received by the Division of Coastal Management (DCM) within twenty (20) days
of the date of the disputed permit decision. N.C.G.S. § 113A-121.1(b). Failure to do so constitutes
waiver of the right to request a hearing. A copy of this request must also be sent to the Attorney
General's Office, Environmental Division. 15A N.C.A.C. 07J .0301(b).
Contact Information for DCM
By mail, express mail or hand delivery:
Director
Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
By Fax:
[phone]
By Email:
Check DCM website for the email
address of the current DCM Director
www.nccoastalmanagement.net
Contact Information for Attorney General's Office:
By U.S. mail:
Environmental Division
9001 Mail Service Center
Raleigh, NC 27699-9001
By express mail:
Environmental Division
114 W. Edenton Street
Raleigh, NC 27603
By Fax:
[phone]
Based on the attached responses to the above factors, the undersigned hereby requests a third party
hearing.
Signature of Petitioner or Attorney
Printed Name of Petitioner or Attorney
Mailing Address
City State Zip
Updated: February 2011
Date
Email address of Petitioner or Attorney
Telephone number of Petitioner or Attorney
Fax number of Petitioner or Attorney

SECTION .1200 - GENERAL PERMIT FOR CONSTRUCTION OF PIERS AND DOCKING FACILITIES:
IN ESTUARINE AND PUBLIC TRUST WATERS AND OCEAN HAZARD AREAS
15A NCAC 07H .1201 PURPOSE
A permit under this. Section shall allow the construction of piers and docking facilities, including pile supported or
floating, in the Estuarine and Public Trust Waters AECs and construction of piers and docks within Coastal Wetland
AECs according to the authority provided in Subchapter 07J A 100 and according to the rules in this Section. This
permit shall not apply to oceanfront shorelines or to waters and shorelines adjacent to the Ocean Hazard AEC with
the exception of those shorelines that feature characteristics of the Estuarine Shoreline AEC. Such features include
the presence of wetland vegetation, lower wave energy, and lower erosion rates than the adjacent Ocean Erodible
Area.
- - - - - - - - -
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. July 1, 2009; April 1, 2003;
Readopted Eff. December 1, 2021.
15A NCAC 07H .1202 APPROVAL PROCEDURES
(a) An applicant for a General Permit under this Subchapter shall contact the Division of Coastal Management and
request approval for development.
(b) The applicant shall provide:
(1) the site location, dimensions of the project area and name, and his or her address; and
(2) confirmation that a written statement has been obtained signed by the adjacent riparian property
owners indicating that they have no objections to the proposed work; or
(3) confirmation that the adjacent riparian property owners have been notified by certified mail of the
proposed work. The notice shall instruct adjacent property owners to provide any comments on the
proposed development in writing for consideration by permitting officials to the Division of
Coastal Management within 10 days of receipt of the notice and indicate that no response will be
interpreted as no objection. Division staff shall review all continents and determine, based on their
relevance to the potential impacts of the proposed project, if the proposed project can be approved
by a General Permit. If Division staff finds that the comments are worthy of more in-depth review,
the Division shall notify the applicant that he or she must submit an application fora major
development permit.
(c) No work shall begin until an on -site meeting is held with the applicant and a Division of Coastal Management
representative to review the proposed development. A permit to to proceed with the proposed development shall be
issued if the Division representative finds that the application meets all the requirements of this Subchapter.
Construction shall be completed within 120 days of the issuance of the general permit or the authorization shall
expire and it shall be necessary to re-examine the proposed development to determine if the general permit may be
reissued.
(d) Any modification or addition to the permitted project shall require prior approval from the Division of Coastal
Management.
HistoryNote: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. October 1, 2007; August 1, 1998; January 1, 1990;
Readopted Eff. December 1, 2021.
15A NCAC 07H .1203 PERMIT FEE
The applicant shall pay a permit fee of two hundred dollars ($200.00) by check or money order payable to the
Department.
History Note: Authority G.S. 113A-107; 113A-113(b); 113A-118.1; 113A-119; 113-119.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. September 1, 2006; August 1, 2000; March 1, 1991;
Readopted Eff. December 1, 2021.

15A NCAC 0711.1204 GENERAL CONDITIONS
(a) Piers and docking facilities authorized by the general permit set forth in this Section shall be for the exclusive
use of the land owner or occupant and shall not be leased, rented, or used for any commercial purpose. Piers and
docking facilities shall provide docking space for no more than two boats. Docking facilities providing docking
space for more than two boats shall be reviewed through the major permitting process due to their greater potential
for adverse impacts and, therefore, are not authorized by this general permit, excluding the exceptions described in
Rule .1205 of this Section.
(b) Individuals shall allow representatives of the Department of Environmental Quality to make inspections at any
time in order to ensure that the activity being performed under the authority of the general permit set forth in this
Section is in accordance with the terms and conditions prescribed herein.
(c) There shall be no interference with navigation or use of the waters by the public through the existence of piers
and docking facilities.
(d) The permit set forth in this Section shall not be applicable to proposed construction where the Department
determines that the proposed activity will endanger adjoining properties or significantly affect historic, cultural,
scenic, conservation or recreation values, identified in G.S. 113A-102 and G.S. 1 13A-1 13(b)(4).
(e) The permit set forth in this Section does not eliminate the need to obtain any other required State, local, or
federal authorization.
(f) Development carried out under the permit set forth in this Section shall be consistent with all State, federal, local
requirements, and local land use plans current at the time of authorization.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); II3A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. May 1, 1990;
RRC Objection due to ambiguity Eff. May 19, 1994;
Amended Eff. August 1, 2014; July 1, 2009; August 1, 1998; July 1, 1994;
Readopted Eff. December 1, 2021.
15A NCAC 07H .1205 SPECIFIC CONDITIONS
(a) Piers and docking facilities may extend or be located up to a maximum of 400 feet waterward from the normal
high water line or the normal water level, whichever is applicable.
(b) Piers and docking facilities shall not extend beyond the established pier length along the same shoreline for
similar use. This restriction shall not apply to piers and docking facilities 100 feet or less in length unless necessary
to avoid interference with navigation or other uses of the waters by the public such as blocking established
navigation routes or interfering with access to adjoining properties as determined by the Division of Coastal
Management. The length of piers and docking facilities shall be measured from the waterward edge of any wetlands
that border the water body.
(c) Piers and docking facilities longer than 200 feet shall be permitted only if the proposed length gives access to
deeper water at a rate of at least one foot at each 100 foot increment of pier length longer than 200 feet, or if the
additional length is necessary to span some obstruction to navigation. Measurements to determine pier and docking
facility lengths shall be made from the waterward edge of any coastal wetland vegetation that borders the water
body.
(d) Piers shall be no wider than six feet and shall be elevated at least three feet above any coastal wetland substrate
as measured from the bottom of the decking.
(e) The total square footage of shaded impact for docks and mooring facilities (excluding the pier) allowed shall be
8 square feet per linear foot of shoreline with a maximum of 800 square feet. In calculating the shaded impact,
uncovered open water slips shall not be counted in the total.
(f) The maximum size of any individual component of the docking facility authorized by this general permit shall
not exceed 400 square feet.
(g) Docking facilities shall not be constructed in a designated Primary Nursery Area with less than two feet of water
at normal low water level or normal water level under the general permit set forth in this Section without prior
approval from the Division of Marine Fisheries or the Wildlife Resources Commission.
(h) Piers and docking facilities located over shellfish beds or submerged aquatic vegetation as defined by the
Marine Fisheries Commission may be constructed without prior consultation from the Division of Marine Fisheries
or the Wildlife Resources Commission if the following two conditions are met:
(1) Water depth at the docking facility location is equal to or greater than two feet of water at normal
low water level or normal water level; and

(2) The pier and docking facility is located to minimize the area of submerged aquatic vegetation or
shellfish beds under the structure as determined by the Division of Coastal Management.
(i) Floating piers and floating docking facilities located in Primary Nursery Areas, over shellfish beds, or over
submerged aquatic vegetation shall be allowed if the water depth between the bottom of the proposed structure and
the substrate is at least 18 inches at normal low water level or normal water level.
0) Docking facilities shall have no more than six feet of any dimension extending over coastal wetlands and shall
be elevated at least three feet above any coastal wetland substrate as measured from the bottom of the decking.
(k) The width requirements established in Paragraph (d) of this Rule shall not apply to pier structures in existence
on or before July 1, 2001 when structural modifications are needed to prevent or minimize storm damage. In these
cases, pilings and cross bracing may be used to provide structural support as long as they do not extend more than
two feet on either side of the principal structure. Thesemodifications shall not be used to expand the floor decking
of platforms and piers.
(1) Boathouses shall not exceed a combined total of 400 square feet and shall have sides extending no further than
one-half the height of the walls as measured in a downward direction from the top wall plate or header and only
covering the top half of the walls. Measurements of square footage shall be taken of the greatest exterior
dimensions. Boathouses shall not be allowed on lots with less than 75 linear feet of shoreline.
(m) The area enclosed by a boat lift shall not exceed 400 square feet.
(n) Piers and docking facilities shall be single story. They may be roofed but shall not allow second story use.
(o) Pier and docking facility alignments along federally maintained channels shall also meet Corps of Engineers
regulations for construction pursuant to Section 10 of the Rivers and Harbors Act of 1899 (33 U.S.C. 403).
(p) Piers and docking facilities shall in no case extend more than 1/4 the width of a natural water body, human -
made canal, or basin. Measurements to determine widths of the water body, human -made canals, or basins shall be
made from the waterward edge of any coastal wetland vegetation which borders the water body. The 1/4 length
limitation shall not apply when the proposed pier and docking facility is located between longer structures within
200 feet of the applicant's property. However, the proposed pier and docking facility shall not be longer than the pier
head line established by the adjacent piers and docking facilities nor longer than 1/3 the width of the water body.
(q) Piers and docking facilities shall not interfere with the access to any riparian property, and shall have a
minimum setback of 15 feet between any part of the pier and docking facility and the adjacent property lines
extended into the water at the points that they intersect the shoreline. The minimum setbacks provided in this
Paragraph may be waived by the written agreement of the adjacent riparian owner(s), or when two adjoining riparian
owners are co -applicants. Should the adjacent property be sold. before construction of the pier commences, the
applicant shall obtain a written agreement with the new owner waiving the minimum setback and submit it to the
Division of Coastal Management prior to initiating any development of the pier or docking facility. The line of
division of areas of riparian access shall be established by drawing a line along the channel or deep water in front of
the property, then drawing a line perpendicular to the line of the channel so that it intersects with the shore at the
point the upland property line meets the water's edge. Application of this Rule may be aided by reference to the
diagram in Paragraph (t) of this Rule illustrating the Rule as applied to various shoreline configurations. Copies of
the diagram may be obtained from the Division of Coastal Management website at
http://www.nccoastahnanagement.net.When shoreline configuration is such that a perpendicular alignment cannot
be achieved, the pier or docking facility shall be aligned to meet the intent of this Rule to the maximum extent
practicable.
(r) Piers and docking facilities shall provide docking space for no more than two boats, as defined in 15A NCAC
07M .0602(a), except when stored on a platform that has already been accounted for within the shading impacts
condition of this general permit. Boats stored on floating or fixed platforms shall not count as docking spaces.
(s) Applicants for authorization to construct a pier or docking facility shall provide notice of the permit application
to the owner of any part of a shellfish franchise or lease over which the proposed pier or docking facility would
extend. The applicant shall allow the lease holder the opportunity to mark a navigation route from the pier to the
edge of the lease.
(t) The diagram shown below illustrates various shoreline configurations:

EXAMPLES
RIPARIAN ACCESS AREAS
PROJECT AREA
Et)cE Ot CHANNEL OR
6
DEEP WATER
PROPERTY LINE
RIPARIAN LIMIT
MEAN ! ICH WATER
WATER
(u) Shared piers or docking facilities shall be allowed, provided that in addition to complying with Paragraphs (a)
through (t) of this Rule the following shall also apply:
(1) The shared pier or docking facility shall be confined to two adjacent riparian property owners and
the landward point of origination of the structure shall overlap the shared property line.
(2) Shared piers and docking facilities shall be designed to provide docking space for no more than
four boats.
(3) The total square footage of shaded impact for docks and mooring facilities shall be calculated
using Paragraph (e) of this Rule and in addition shall allow for combined shoreline of both
properties.
(4) The property owners of the shared pier shall not be required to obtain a 15-foot waiver from each
other as described in Paragraph (q) of this Rule as is applies to the shared riparian line for any
work associated with the shared pier, provided that the title owners of both properties have
executed a shared pier agreement that has become a part of the permit file.
(5) The construction of a second access pier or docking facility not associated with the shared pier
shall not be authorized under the general permit set forth in this Section.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. December 1, 1991; May 1, 1990; March 1, 1990;
RRC Objection due to ambiguity Eff. March 18, 1993;
Amended Eff. August 1, 1998; April 23, 1993;
Temporary Amendment Eff. December 20, 2001;

Amended Eff. August 1, 2014; July 1, 2009; April 1, 2003;
Readopted Eff. December 1, 2021.

Braxton & Marion Brooks
250 Henderson Road
Newport, NC 28570
[phone]
- May 19, 2022 - - - - - - - -
V
NC Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
RE: Salt Creek Holdings LLC Permit for Dock
Dear Sir/Madam:
We are writing to you today in response to the correspondence we received froze your office
regarding Salt Creels Holdings LLC wanting to install a dock with a gazebo and two boat slips
on Broad Creek. I would like to express my ongoing concerns to your office regarding issues
surrounding this developments disregard to the health and safety of the creek. During
development we watched countless tons of silt poor into the creek. We also save what appeared
to be concrete dumped into the drainage ditches. The drainage in the subdivision continues to
be a source of great concern. The drainage ditches are filled with silt and plant material. There is
a section just before the intersection of Henderson Drive &t Salt Meadow Drive which appears
to be some sort of temporary solution. The drainage ditch on the other side of the street is no
better, maybe worse.
When the developer began grading and putting in the paved roads silt poured into the creek.
We reported this to your office as well as CAMA. We still have vrideo shoving the creek
turning white from the silt. Even now, when there are heavy rails, silt continues to flow into the
creek.
Prior to the development of Salt Creek, we had a pair of breeding otters living in the creek. For
six years we watched them raise their young, feed, and play in the creek. About the time the silt
began flowing into the creek the otters disappeared. We didn't see them for ahnost two years.
This spring, back in early March, they reappeared with two new pups. A welcome site indeed.
There is also a pair of. Eagles who live and nest on the creels. They also seemed to disappear for a
time. To this day we don't see them as frequently as we once did
Our first concern is protecting the creek, and the wild life whose lives depend on the health, and
wellbeing of the creels for their survival. Our other concerns are having our view obscured by a
dock running over the top of the marsh, not to mention the gazebo. Based on what we've
witnessed throughout the development of Salt Creek, we worry that their dock will extend out
into the channel, therefore, blocking our access to Bogue Sound.

We appreciate your consideration in this sensitive matter. Please feel free to contact me,
Braxton Brooks, at the phone number listed above if you have questions or need additional
information.
Thank you,
& X'j - v 'OLM"
Braxton & Marion Brooks

N.C. DIVISION OF COASTAL_ MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL_ • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:h.GLL
Address of Properly: _ O lAeA DEZ; • ^ 1 ^2 Al& MEZE�----
Mailing Address of Owner; ,`jQ5 B�(l �0��>�__' , 111—�1�zv
Owner's email: GA(A ram,/,r lk��r ��t (� , Owner's Phone#: %S7- 7zs-)ZZC�
Agent's Name: Agent Phone#: 7r, 7- 7Z5--- l?�
Agent's Email: - ,s
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 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
I do not wish to waive the 15' setback requirement (initial the blank) "
Signature of Adjacent Riparian Property Owner 1w U
Typed/Printed name of ARPO:X,Z 0n-1L
Mailing Address of ARPO: 7 `re'lPE2:5d�s)��
ARPO's email: na►t � rya •«RPO's Phone* (Z,52)(��S �2 GI
Date: df�- t t!q � 2,,Z-_*waiver is valid for up to one year froth ARPO's Signature*
Revised July 2021

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