86683A - Thomas, Mark

MCAMA ❑ DREDGE & FILL �� � `i0O"� 3 (0 9) B C D
I GENERAL PERMIT Previous permit
Date previous permit issued
0 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 1 BUG Rules attached. 1Z General Permit Rules available at the following link: www.dgq.nc.gov/CAMArules
Applicant Name _ M ci r-- \ _ I: . Tk a rhw S _
Address 1 O '� cgs S Si'.
City f'1 0 `a L {L State N zip a -+ct S I?
Phone#(15.1) 435-- ay3ti
Email r1uv V . ZCd N c- W L..-,-
Authorized Agent ( 0j . ! , .c r Lc v CA,,ic 4N
Project Location (County):
Street Address/State Road/Lot #(s) 1 O - - Rc;, S i 5
Lv '� * I t-I IZ
Subdivision Tt, \1" Ray Ca lv. y
City p- o tJ L IL _zip
Affected ❑ CW E W K PTA ❑ ES ❑ PTS Adj. Wtr. Body C.,..- ,,,�) � � � T 1 s� �S � 12 r V-c / (nat/�[Junk)
AEC(s): IDEA IHA ❑ UW t SPIMA Cj PWS Closest Mal. Wtr. Body s r Imo- SO t�
ORW: yes/6 PNA: yes/ o
Type of Project/ Activity 1 .� , 1*2,
(Scale:1`� 3o' )
Shoreline Length SO
Access Length
Pier(dock)len--A
gth
Fixed Platform(s)
.0-
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
Boathous oatlift
Beach Bulldozing
Other
61 L
11 1 1 t t t t (l I l l t t t E x t'S' Y-►-tc. d �J
Xn. wL .\_\_\\_\ex oo�K\_\\ \\ Eli fSvtkti��
Ill l tt It1 I % N 1t\ Itl (ti �aaraiwelK 0% k I % lrt tit 111 IA A
L
SAV observed: yes I
Moratorium: n/y ` s no
Site Photos: (a, no
Riparian Waiver Attached: <ig) no
A building permit/zoning permit may be required by:
Permit Conditions •it i*;. r • T T c �" �. i i� ►. Vic, to ><ccl ��y t
CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT
Applicant PRINTED Name
Permit Officers PRINTED
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
E STATEMENT. (Please
%,J J (
Sig—nftW •'Please read compliance statement on back of permit•' Signature i�
Application Feels) Check #/Money Order Issuing Oate Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date /
Name of Property Owner Applying for Permit:
Jnf o-t c, E. i4 o ity-+ s
Mailing Address:
/V10 V
I certify that I have authorized (agent) Lauren Berry Burch
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) install Boatlift
at (my property located at) I 0 7 t ; ,sj j 1- t1kV j! C)C
This certification is valid thru (date)
Property Owner Signature
Date

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: Ayf*�Al-r— 64A4 A S
Address of Property: 0 -:2 B i-' S 4—
Mailing Address of Owner: C-) /SL4. -(; 6 -�- a 1) -en e
�. .�
Owner's email mm, ? K-J1.4aara 5 ' C&wner's Phone#
Agent's Name:
Agent's Email:
Agent Phone#:
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
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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`%
wgnarure Of Aa/acenr trtparran rropeny uwnu
on
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 11­re ip' e, A,
Mailing Address of ARPO: ! b (%
ARPO's email: � It ARPO's Phone#:
Date: J `" 3 r *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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: Im �� E f (40 � T r
Address of Property: % 0 � 42 � C'
Mailing Address of Owner: C) -7 `' ��{ �� �` t� �U C�
a7y.5,
Owner's emaili='-naysfKG1Ta�rOwner's Phone#:
Agent's Name
Agent's Email:
Agent Phone#:
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.
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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), you wish to waive a setback, you must sign
the appropriate blank below.) 4Adihtnt
I DO wish to waive some/all of the 15'setb cSignature Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: OLn r) (} C) U e_,S, , t
Mailing Address of AR�cP1O:CAL=-
ARPO's email: / Y / ARPO's Phone#: 7 ' o
1 P to one Y ' *waiver is valid for u year from ARPOs
Date: �`I � ? "- � Signature*
Revised July 2021

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Renaldi, Ronald
From: capsmarine <[e-mail]>
Sent: Tuesday, July 26, 2022 8:04 PM
To: Renaldi, Ronald
Subject: [External] RE: Dropped off check
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
I think I may have forgotten Bass was already paid for. Please shredd the check.
The dimensions for the boat lift is 12x12.
Thanks
Lauren
Sent from my Verizon, Samsung Galaxy smartphone
-------- Original message --------
From: "Renaldi, Ronald" <[e-mail]>
Date: 7/26/22 3:42 PM (GMT-05:00)
To: capsmarine <[e-mail]>
Subject: Dropped off check
Lauren,
What is this check for? Wayne dropped off a check yesterday for the 113 White Heron (Masie)
renewal and I already have a check for 107 Bass St. I don't think I have anything else for you
guys.
I still need to know the piling dimensions for the Bass St. boatlift and I need the signed copy of
the issued permit for Masie that I emailed yesterday.
Thanks,
1

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