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NZI ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management • BRAXTON DAVIS
ENVIRONMENTAL.QUALITY
Dft er-or
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 02B.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.
a. 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-project site conditions: ! -e°/ 15 j ..4 ,Z„,._.../f
4, 111 1 see_ -frei.5
By your signature below you agree to be held responsible for meeting all of the conditions isted a ve and verify
that all information provided is complete and accurate.
V(//ii- RY.6(A) 1-f •
Agent or Applicant Name it Offic ignature
Agent or Applicant Signature 2 2.
ueD e
CAMA GENERAL PERMIT#: g 7r/62
State of North Carolina i Environmental Quality Coastal Management
Washington Office!443 Washington Square Mall Washington.NC 27889 252-94o-5481
Wilmington Office 127 Cardinal Drive Ext.Wilmington,NC 28405-3845 910-796-7215
Morehead City Office 400 Commerce Avenue Morehead City.NC 28557 252-808-2808
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: r v. Co , L L- c-.• ��� (, 1 c_
"
Address of Property: 2-3 ( << CZ v•&_r lam_u t s 2 , 5, I\---t c.rr•
Mailing Address of Owner: 12- > tom -
Cc
Owner's email: 6N-ck-\-%AA.11 Owner's Phone#: Z } 1,7 5 . 1 1 1 L.
Agent's Name: Agent Phone#:
Agent's Email:
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.
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(252) 808-2808. 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) - P
Signature of Adjacent Riparian Property Owner: �� �.N��
J
� Typed/Printed name of ARPO: 1ALI I l) V'h(i' 1
\, Mailing Address of ARPO: yS 13A11`(7, � /I'. R1 / yl/c. ��5
ARPO's email: ARPO's Phone#: /J y'/
Date: Sp2 /;.L),11 *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: -7 bi e..k L 0.v.S- Lb , L.I.,t. 'lb O,i;t4 On el t,
Address of Property: 1-3v 1-3o- !2 r St,bre-j (ZJ , . Mr/G? 5", r.) L
Mailing Address of Owner: 11- S,-y,,,t1-. Le.e- lark.. (\J t,,,, 9 s-r.,.I Jut: Th lc j U) b
LDA.
Owner's email: c.-1 t '�'fe~L .L-1-'1 j.,LQ r, Owner's Phone#: Z-T'z-• /J ) 5. ) 1`j
Agent's Name: Agent Phone#:
Agents Email:
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.
V 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(252)808-2808. 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-
• Ail do not wish to waive the 15'setback requirement(initial the blank) ,
Signature of Adjacent Riparian Property Owner: 2 c4 Jpp a
Typed/Printed name of ARPO:- J j` (V\a (-AA p
A Mailing Address of ARPO: 2 3 \B ( ` 'A 9 c'� (\i t La\-_.t 1 ) R Chia ,
7(ARPO's email: Pas(�O -I- 'U�C�- ARPO's Phone#: C\co 5 4 0 0cia N c a' �1
cJ 9Ma.*`1 • C_o ram(
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue,Governor James H. Gregson, Director Dee Freeman,Secretary
Date -S '-•Nis -2-B r 2 c 7-1-
Name of Property Owner Applying for Permit:
1 _ ... L. A.-.a La r.-. a..0 ) L L C.--.
Mailing Address: 1
T. 0 , b1 3 61__
ft-Awl -f5 3-e M1.o, t.J L '2- S24
I certify that I have authorized (agent)T 12-. Pr1S(-4"- M►•n►,$C Co ".• to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) `V l 4- fi—
at S L"t-K l 4 A D �; �tiTF'r.
(my property located at) 23 if, rra-1 R•vs.r 51,..c r Ls. t2-k• 5 semi-L .
This certification is valid thru (date) 1 'L / 3 1 / '•4--0 7- .2-- .
.ti (4,. t 8. -1--1—
Property-Owner Signature Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer-50%Recycled 1 10%Post Consumer Paper