88093B - George, Chris & Katheryn

,00cw6r"'NDCAMA III DREDGE & FILL �'GS N° 88093 A B C D
G E N E RAL PERMIT nn 11 0 8 3 Previous permit
1J 4 �/ Date previous permit issued
I I New Modification n Complete Reissue I I Partial Reissue
1
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: !:
I5A NCAC -I . n Rules attached. n General Permit Rules available at the following link:www.deq.nc.gov/CAMArvles
Applicant Name ','V ' `. ' )/•- Authorized Agent -\,. ,- , -
Address 7 Y ' } ; St Project Location(County): r c+4,
City •�: ,, State J- ' ZIP Street Address/State Road/Lot#(s)
Phone#(_,LO `-- !.-
1
Email Subdivision
City ZIP
Affected CW I I EW I I PTA ES n PTS Adj.Wtr.Body (Hallman/unk)
AEC(s): n OEA IHA I I uw n SPIMA I I PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity •
•"7i,)4 (k E 4 12,,,,L eke L �C.47- I< .i 4-ei,,,,.5czrJ Mt) ICJ: i-X-1-k (Scale:
Shoreline Length -t 1 (/4/ ' — �G N` Iv
Access Length --
Y !4
Pier(dock)length t , _ _ l � L 1c
r
Fixed Platform(s)
o ad �J r — r
Floating Platform(s) ( '
Finger pier(s) „,. a;- , l' \ i ( t 2._
Total Platform area
i j I j I
Groin length/# — -____
Bulkhead/Riprap length - 1.fir.-..-- ..-. -,--
Avg distance offshore et. ` - ,,?._.. �_..._.
Breakwater/Sill I
Max distance/length r
Basin,channel
Cubic yards
'
Boat ramp ' ,. .
Boathouse/Boatlift
Beach Bulldozing `1 W » —__ ij J,/,... .
Other .!i'z!fl,C —+ �P
a
i
SAV observed: yes no
_ tr , <•; '(lc-'
Moratorium: n/a yes no. -.a J 7 i
I 7'6 444Y 4c -
i
Site Photos: yes no ` —,
Riparian Waiver Attached: yes no ,
A building permit/zoning permit may be required by: 10l f $'i
Permit Conditions ✓' l 1 5-
n TAR/PAM/NEUSE/BUFFER(circle one)
!/; ' 'r' ' t j �,_ (Co!'� i,+.' 1� Y`Graan :- 1 n See note on back regarding River Basin rules
f' L r- n 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)
Aic "k
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
) rf(;( I t /
Signature"Please read compliance statement on back of permit** Signal e Application Fee(s) Check#/Money Order Issui Date E iratio1,,V
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:
Tar- Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St.Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden,Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

it ow, CAMA DREDGE & FILL No. 88093 A BCD
i
GENERAL PERMIT Previous permit
Date previous permit issued
New Modification I Complete Reissue I I 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 I-I Rules attached. I I 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 I I CW EW E PTA ES [ I PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): IDEA I I IHA UW I SPIMA PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
�)k Q c. . (Scale: )
Shoreline Length - ....i-jo j�k� w it`t
,
Access Length Pier(dock)length — a t I{ Ii ;
. _�...—.-
Fixed Platform(s) ._ -_._
T-- ,--t--•-._,,_. I
r-'
Floating Platforms) l �_ 1
1
Finger pier(s) --
t ' I l
Total Platform area •
Groin len/hP P length ! —_�
gt /
Bulkhead Ri ra 1 l
Avg distance offshore --i--- J- i _ I „act _
Breakwater/Sill I ; i
Max distance/length I •. I i
Basin,channel
i I
Cubic yards I i _ 1
Boat ramp I 1 l—�� j
Boathouse/Boatlift ' I I (L
Beach Bulldozing i 1 i F. •^--.."'�"`'' * 'ir
L'
Other J �,..l''• ctr'
� i
SAV observed: yes no ,IL, F t t I {.
Moratorium: n/a yes no ,.t -,- 4. I ��
Site Photos: yes no " `.,r._:t‘Y 1 I --- — — I I .
Riparian Waiver Attached: yes no 1 T I I I l - I i I ' -
I
/^ /
A building permit/zoning permit may be required by:
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions • li
II 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

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:
Tar- Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden,Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

ROY COOPER
t Governor
MICHAEL S. REGAN
.. Seoetmy
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY
DOn.lur
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 028.0233 & .0259. The
Division of Coastal Management(DCM), through a Memorandum of Understanding with the Division of Water •
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation. •
i. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees) unless otherwise approved by DCM.The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials:All reasonable measures shall be taken to ensure the access way is made of pervious
materials Like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width:The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This
drawing will be used to aid in compliance and monitoring efforts.
• Pre- oject site cond)tions: Lo f r s /l'► 1.ec) /a'"n
W a deli( 'h-a<
By your signature below you agree to be held responsible for meeting all of the co ditions listed a ve and verify
thatA41form/tJon1ed, fomPI
ete and accurate.
C/9
e o A licant Pri ed N e Permit� fficer's Si nature
i`7/ — — D 22_
gen r Applicant Signature Issue Date
CAMA GENERAL PERMIT#: U OC 1.
State of North Carolina I Environmental Quality{Coastal Management
Washington Office i 94.3 Washington Square Mall Washington.NC 27889 1252-946-6481
Wilmington Office: 127 Cardinal Drive Ext.Wilmington,NC 28405-3&45 1910-796--T215
Morehead City Office 400 Commemre Avenue Morehead City.NC 28557 1252-808-2808

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. Afflho ized Agent Consent Agreement I I .
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g' w • oP r )) ,herby authorize Tobin,Tay Tetterton o - I
MJ's Marin; Construction,LLC to act on my behalf in obtammg CARIA permits oil
the location '.ted below.
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PROPER ADDRESS: 1
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PROP '4: OWNER'S MAILING ADDRESS:
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PROPER. • OWNER'S SIGNATURE: If P .
AIJTHO• VA ' AGENT SIGNATURE: ,, /Ll7 j I -
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TOWN OF BATH
BATH, NORTH CAROLINA 08/ DATE
BOOK NO. PERMIT FEE PERMIT No.
APPLICATION FOR: BUILDING PERMIT( ) ZONING COMPLIANCE CERTIFICATE (/ )
Name & License No. Address;
Phone No.:
/OWNER I )1e,' /C1 -is
1
nCONTRACTORTu 'iC � ' JL i
DESIGNER
SURVEYOR
ELECTRICAL
PLUMBING
TYPE OF IMPROVEMENT
NEW ( ) ADDITION ( ) ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE ( )
OUTSIDE( ) OUTSIDE ( ) LOCATE ( )
Lot No. Block No. Building located at
betwee !/ and ft// G Streets. Buildin to be used as
. Type Construction M
Number of off street parking spaces . Contains rooms
and bath(s).
Total square feet of building . Electric Service
Type of heat
. No. of plumbing fixtures . Foundation block caps
4"( ) 8"( ). Corner bracing: Plywood ( ) other . Insulation: Floor
Walls , Ceiling . Windows: Storm ( )Thermal
( ). How many exterior doors
. Water Heater: Gas ( ) Electric ( ) Other
Roof Ventilation: Gable ( ) Eaves ( ) Louvers ( ) Other
. Ventilation
crawl space, number of feet apart . Height of crawispace under house: 18"( ) 24"
Other , Zone ( )
Water and Sewer Tap: Paid ( ) N/A ( ) Size water tap
Size sewer tap: . Total Estimated Cost
Flood elevation

BUILDING INSPECTION DEPARTMENT COMMENTS:
GofUST7ZUGT7 -1 ' CTa F 2�
I ""6 OdT L I FT— O N.kru Sr D p c L-jc/5ry&iC !'rC r_
I •6 OAT- I-{-o uS aSN Sp urx cr DE OF PC°2--
C6A1S7 G.7--)a•✓ L(.; PL. 7 'i ,4-GG6,GD i 6 Ta
G. 7 .-PPRo1/64 By ) Gi41K1.4 /76z-su
GENERAL COMMENTS• ( ls- G!c—V;Zi‘v 4:71 � T/G4-{,f ,. e=G>` / 74"-
CITY LICENSE NUMBER' J � �
Contractor/AC Electrician Plumber/Heating
Application approved by: G/3/2-7.—
The owner of this building and the undersigned agree to conform to all applicable laws of the Town of
:. •, ►" rth Carglir j
Signature of Applicaht
Effective 8/10/04, there is a $50.00 filing fee for all permits, including zoning compliance application,
Any construction that requires installation of water or wastewater services may:
A) Be installed by owners, contactors or
B) Be installed by Town of Bath Utilities Department
All components must be compatible with existing water/wastewater materials, including Myers pumps.
Bath Utilities Department must inspect all construction prior to services becoming operational. Inspection
fee is $100.00.

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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. l , CC jn e__... i
{ I
Address of Property: a ��
,i,II- 0 //4,s,9 7OPe,-
Mailing Address of Owner 7 1, t
•
3,0
Owner's email: C /a�6,,'l . I -1Own rs Phoneft(5 /- �� c
Agent's Name: • . 00r7st Z14.e7- Agent Phone#:c.if d- g J—e f� '
Agent's Email:nbloikr.Sn i re.
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION 11. •(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 a I in for
permit has escribed to me, as shown on the attached drawing, the develo PP y o tills
descri ti or drawin with dimensions must be rovided with this letter. pment they are proposing.A
I DO NOT have objections to this proposal. I DO have objections to this proposal.
Ifif you have objections to is being proposed, you must notify the N.C. Division of Coastal I
Management(DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also tie
contacted at(252) 946-6481. No response is considered the same as no objection if you have been
notified by Certified Mail.
I understand that an WAIVER SECTION
y 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 i
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback,you must siari
the appropriate blank below.)
•
I DO wish to waive some/all of the 15'setback - I
x
-uf. .
-OR- -Signet re of Adjace t R" avian Property Owner
I do not wish to waive the 15'setback requirement(initial the blank)
•
Signature of Adjacent Riparian Property Owner• `
TypedwPrinted name of ARPO: A" / s
Mailing Address of ARPO: £ 7. 0
ARPO's omaiI ARPO's Phone#: 356 ",.26 'i- ES4% '8
Date: ?_ *waiver is valid for up to one year from ARPO's Signature*
r i
Fevrsed July 2021

Grandy, Ashley
From: CenturyLink Customer <[e-mail]>
Sent: Wednesday, June 29, 2022 9:21 AM
To: Grandy,Ashley
Subject: [External] Re: George Project
CAUTION:External email. Do not click links or open attachments unless you verify.Send all suspicious email as an attachment to
Report Spam.
Per our telephone conversation the change is ok with us
From: "Grandy, Ashley" <[e-mail]>
To: [e-mail]
Sent: Tuesday, June 28, 2022 4:01:00 PM
Subject: George Project rr /1/ P k
b (�Ci� s12 Z et/t� 4S1Pc� e
Ashley Grandy
Field Representative, Division of Coastal Management I! 4,0,,Cd hawct
North Carolina Department of Environmental Quality - 1j� (rC&jc
c
252 946-6481 office ( h, Co7i77er we-r
252 948 3854 direct office rnQ UI 17
ashley.grandy aancdenr.gov r_ t p,t 4-i 2c 1L( f
943 Washington Square Mall ' if pi-fr ��"`
4 J"
Washington, North Carolina 27889
fejt'. 8
-' "Nothing Compares
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
1

•
•
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• ' I
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWANER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion•to be completed by owner or their agent)
Name of Property Owner. 4 14 ,.i Or • 0 to e.—
Address of Property: J /J
J 1�,lti� � � C� ad7ld,P—
Mailing Address
/o-en} dD(9,O tt
f Owner A: /W ���'' / �u�/
Owners email:` / %%pi,`t 4�14Wner'sPhone#(col/-4E/c/okio /T
Agent's Name: / r/ .// q/ .k e tag5r../CC Agent Phan ek02/c9- 11-2-t 71
Agents Email: vi'n/ j^ n ��
'
ADJACENT RIPARIAN PROPERTY OWNER'$CERTIFICATION
(Bottom portion to be completed'by the Adjacent Property Owner)
•
(hereby rtr'Fithat own property adjacenttathe above referenced property.TheindividuaI applying fors
permit h s desorrbed to,me,as shownon the attached drawing; the'development they are proposing.A
esc' I or drawin with dimensions must be rovided with this letter.
[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 Coast!
Management(DCMJ in writing within 10 days of receipt' this notice;. Correspondence should e •
(nailed to 943 Washington Square Mall, Washington,NC 27889.DCM representatives can also qe
contacted at(252)946-6481,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 rI
(this does not apply to bulkheads or riprap revetments).(If you wish to waive the setback,you.must sieri
the appropriateblank below.)
I DO wish to waive some/all of the 15'setback 724 ' •
OR- - S%gnature of Adjacent P,ipadan P perry Owner I�
1 do not wish to waive the 15''setback.requirement(initial the blank)
•
Signature of Adjacent Riparian Property Owner_. "l"G'a•€C 14424147
cie
Typed/Printed name of ARPO: Nlr / r•r1PU N„
Mailing Address of ARPO: /31 Coo 'PojtttRoad Ed,. &f h NC 27 808
ARPO'c email_ Y1141nMN9•W4 eJrtryryaj•t RPO'o Phones: 175'G2/-*SZ
Date: 5 Zg __2Z 'waiver is valid forup to one-year from ARPO's Signature*
Revised July2021
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Grandy, Ashley
From: Michael Manning <[e-mail]>
Sent: Thursday, June 30, 2022 2:46 PM
To: Grandy, Ashley
Subject: [External] Re: George Project
CAUTION:External email. Do not click links or open attachments unless you verify.Send all suspicious email as an attachment to
Report Spam.
Dear Mr. Grandy,
I did receive your message. I have no objection to Mr.George moving his covered boat lift to the right hand side of his
dock. If you require anything else please do not hesitate to contact me.
Best wishes,
Mike Manning
On Jun 30, 2022, at 2:41 PM, Grandy,Ashley<[e-mail]>wrote:
Mr. Manning,
I wanted to follow up on the email I sent yesterday concerning your response to Mr. George's proposal
of moving his new covered boatlift from one side of the pier to the other side. If you have a moment to
respond that you have no objections to this per our conversation yesterday I can move forward with his
permit. Thank you for your time.
Ashley Grandy
Field Representative, Division of Coastal Management
North Carolina Department of Environmental Quality
252 946-6481 office
252 948 3854 direct office
ashley.grandy(a.ncdenr.gov
943 Washington Square Mall
Washington, North Carolina 27889
<image001.png>
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
1

N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER WOTIFICATIONIWAIVER FORM
, . CERTIFIED MAIL- RETURN RECEIPT'REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
)14
Name of Property Owner to j 8 er--_
ZDO�j/� �p�()i7,{i�a l co
Address of Property: 4 /Q�� E�f '`aiyi Ale d er .•
.
Mairmg Address of owner-. Ante/ /J$f b ejoy&a C! I . 35/if .
Owner's email r,`/c-Ownefs Phon 54/+v 57 — rc
Agents Name: !J� ` a Zhe Agent Phonek:&.J4" 14&-es-7r • .
Agents Emelt bi11 i PSnct e iv
1 /_
/ ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
.s (Bottom portion to be completed by the Adjacent Property Owner) -
T
'4
9 I hereby ceR6y that tottmproperty adjacenttofheabovereferenced property.The individualapplying for this
permit has described to me,as shown on the attached drawing,the development they are proposing. A
"P4-7 tfi description or drawing,with dimensions,must be provided with this letter.
v� ">>
70 70 I DO NOT have objections to this proposaL I DO have objections to this proposal.
ii
L If you have objections to what is being proposed, you must notify the M.C..Division of Coastal
Management(DCMJ In writing within 10 days of receipt of this notice. Correspondence should be
mailed ta 943 Washington Square Mall, Washington,MC 27889-DCM representatives can also be
67 contacted at(252J 946-E481.No response Is considered the sante as no objection if you have been
a'' notified by Gentled Mall.
} WAIVER SECTION
I understand that any proposed pier,dock,mooring pangs,boat ramp,breakwater,boathouse,IR,or
+"+ groin must be set back a minimum distance of 15'from my area of riparian access unless waived by me
li (this does not apply to bulkheads or riprap revetments)-(If you with to waive the setback,you must sign
the appropriate blank bekrw.)
' '44 I DO wish to waive some/all of the 15'setback
Signature offldiamniRiparian Properly Owner
8 -OR- -
c �'A�'A
i do not wish to waive the 15'setback requirement(initial the bblank) //L r/G
,...7 Signature of Adjacent Riparian Property Owner ' l""`det R.Nu
Typed/printedi name of AP.PQ- Michael R. Manning
cf
Mailing Address ofARPO: 131 Cool Point Road Fact., Bath, NC 27808
r5 • - ARPO's email:[e-mail]'sPtrone#k 575 621 4052
sat June 1, 2022 *waiver is valid for up to one year from ARPO's Signature'
`°=•�``. • Revised July2021

N.C.DIVISION OF COASTAL MANAGEMENT
AMCOR RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
- XRTIPLED MAIL-RETURN RECEIPT REQUESTED or HAvDEUVERY
(Top porfion to be completed by oviner or their agent)
Naive of Pt.+.perty Owner � d 1/rd 3 Y71'1#Q i rColl
Aldigies of PriliPerlY: irlarrArNrififf7IMArAq' A/4 ore'd . :
Meirnc •. i AA
owner's watt IOt 1', +g+elf l' - P#,oc�a& _b —ft f'» i .
Agent's He r . ,,d e.Pellet Phonesk(REY;;;7 : 1fr
_74.S_
Agent's Email: t 4 s
ADJACENT RIPARIAN PROPERTY OWNER'S CERTWI ,,TKI)
(Bottom oortio n to be comoleteo by the Admit Property Owner)
i (thereby oertilif the town property adacenf to the above referenced pry.The individual
limit tzar gibed to me, as shown on the attached raw the p t
d v , ter. or s}iris lttg,
with d�rrtert ►c trs must be provided wl h this totter.
I DO T have objections t his Pry. MO have objections ions to this proposal.
if you have objections to what is-being proposed, you must notify the N Division of Coastal
Management(DM in writing witirhr 10 days of receipt of this notice. Correspondence shook(be
mailed to 943 Washington Square 101811, Washington,NC 27889.DCM representatives can also be
contacted at(252)9.46-848/.No response Is censfderect the same as no Objection if your have haen
not:Med/3y Certifier,Malt.
YtAIVER SECTION
1 understand that any proposed Imo,docAc,mooring pilings,boat i to f 1p breakwater,boethouse,lift,or
groin must besot back a minimum distance of le from my area of riparian access urn waived by me
(this does not apply to bulkheads or trap revetments)..(If you wish to waive the sett:you musteirin
the appropriate blank below_)
gift %.
t DO wish to waive some/elf of the 15'setback
Sigiififilia of Adjacent - ion Properly Owner
-OR-
do not wish to waive the 15'setback requirement
g nat�.re of ALljr't.cent Riparian P operljr£}otter`
: Typed/Printet name at ARPO: >1 c 14• .• 1t+•P/% .. .
Mailing AddrGsotARPQ• 6 .c �,Z- —� 7r3
ARPO'sG'rr3all ,C.Ao.yljdedon4r.AYKr
- t. •r44 d�;.�v r 40 ARPO's Phone: 336 - 26 f�$—'
- „date:_ 6 "" % " -2- waiver Is valid for up to one year from ARPQ's.Si9rlature*
Revised My2t12f

L