Pham, Beverly 88667C

LAMA ❑ DREDGE & FILL N9 88667 A B D
A
Previous permit
GENERAL PERMIT Date previous permit Issued
" leW ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the 5 to of North Carolina, Department of Environmental Quality and the Coastal Resources Commission In an area of environmental concern pursuant to:
ISA NCAC ❑ Rules attached. General Permit Rules available at the following link
.t rsr onv/C'_gMArules
Authorized Agent
Applicant Name
Address y Project Location (Cotmtyl. '
City tare ZIP
�.� Street Address/State Road/Lot #(s)
Phone #
PAdj.'?,1:1
Email
ZIP
Affected ❑CW PTA rES ❑PTS na a k)
AEC(s): ❑ OEA IHA uW A ❑ PWS tr. Body
OR W: yes/ o PNA: yes4p
C ,
Type of Project/Activity P(1/2S7r4
(Scale• /,Q �
Shoreline Length
Access Length ,
Pier(dock)length jV
Fixed Platforms) I �/ ((��((}},� ���� ,,..,,,,
FloatingPlatform(s) �(� �trJ�)J\I,t�
Finger pier(s)
Total Platform area
Groin length/k
Bulkhead/ Riprap length n �\ \ ✓l /
Avg distance offshore t^�`
Breakwater/Sill-
Max distance/ length
Basin, channel
Cubic yardsC /
Boat ramp c� l
,
Boathous oa
Beach Bull in Other i
SAV observed: yes o
Moratorium: n/a yes no
Site Photos:
Riparian Waiver Attached:, s no (�
A building permit/ion' g pe It maybe required by: ` ❑ TARIPAMINEUSEIBUFFER (circle one)
r
Per it nditi ns - ^
❑See note on back regarding River Basin rt:
�� rc7� ,� ❑ See additional notes/conditions on back
I AM AWARE OF STA7UT 5, CRC RULES CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. ` 1P1ease Initial)
Permit 0(ficei's PJR�Ep Na
Si ature "PI se lead compliance statement on back of permit • �f i Jissi
' �h�pon Date
App (cation Fee(s)"'"/Money Orderate

KCAMA El DREDGE & FILL\V
Na 88667 A B ® D
GENERAL PERMIT Previous permit
Date previous permit issued
6Nleww ❑ Modification [:]Complete Reissue ❑ Partial Reissue
As authorized by the%S to of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NC AC �Ta (c7 � ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent 4A
r p
Address Project Location (County):
City State zip Street Address/State Road/Lot #(s)
Phone #"7! v
Email
Subdivision
City
Affected ❑ CW W jW PTA ES ❑ PTS
❑ Adj. Wtr. Body an (na k)
AEC(s): OEA IHA ❑'c' UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
Y
ORW: yes/0 PNA: yes
C
Type of Project/ Activity t7VC2005M AOCK,-(
em)
Shoreline Length (Scale• ,s j®
Access Length
Pier(dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#i
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Beach Bull U- In ,
Other ��y'
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached
A building permit/zo�g
Perrait GonditiQns C
yes ,rho
yes // no
//_ no
may be required by:
-T
1-42
-`ice ` , A � u�
f 'may y
1
❑ TAR/PAM/NEUSE/BUFFER (circle one)
140- ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AWARE OF STATUTK CRC RULES &NQCONDITIONS THAT APPLY TO THIS
Agent or 4 icar)t PRINTMName Permit
ENT. JPlease Initial)
liaturease�ead compliance statement on back of permit*Application Fees) C/�#I /Money Order Issui Date
Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: j 01 ] M-0 S 'A 1--V
Phone Number:
Email Address: Xi�n �G rcL-c3v cl i ' Goyim
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in
County.
1 furthermore certify that 1 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 Owner Information:
ignature
Print or Type Name
Title
tl 2- Z-
Date
This certification is valid through / 1
JUN 1 0 2022.
D-MHO CITY

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: L2iC-- Uy�% I CLSZ
Address of Property
►.A!ram C 7-
too r, r—S
Mailing Address of Owner: F��..�.d''uiY' V` S ✓l'r
Owner's email:Owner's Phone#:
Agent's Name:
Aqent's Email.
Agent Phone#:
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
descrigtion,or drawinq, 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 paria operty Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) G
Signature of Adjacent Riparian Property Owner: C J
Typed/Printed name of ARPO:
Mailing Address of ARPO: /0 7
ARPO's email: /1/r/Lcoyc'� �cJs��rO ARPO's Phone#:
Date: �/� /� *waiver is valid for up to one year from ARPO's Signature* RECEIVED
Revised May 2021
JUN 10 Z02Z
DCM-MHO CITY

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Pine Knoll Association, inc.
Post Office Box 905 Atlantic Beach, NC 28512
[phone] pkabox905Cc_gmail.com
PKA ARCHITECTURAL CONTROL COMMITTEE (ACC)
PROJECT REVIEW
Owner: �CW.e2lI? PKA Address: __LtD
Phones: _ t - Q / Mail Address: dtiC 2. �s,,S'I 2-
Email: G
Date Received by PKA: 2-;Z 7 Z Date Reviewed by ACC: -1-2
Project: ❑Neer home []Addition ❑Fence ❑wall ❑Driveway F7Deck Dock 216oatlift El _
❑ Project APPROVED for CONSTRUCTION AS PER PLAN (circle one): (iR
Comments/Conditions: Wa�Iole 1 / A WI,1,II 14' a�¢< d���Xr �t
6 e
/c.ao Axle
.. ,E] Project NOT APPROVED for CONSTRUCTION. Reasons:
PKA 4CC�Xetnbers
NO
'40d4�6/W'S;
7�S v c a �1 f .
^ONST,RU :TION AGREEMENT: Approval by the PKA ACC does ne4 the Mart i approved by the
Town of PKS or takes the place of required Town permits. You should consult with the PKS Town Inspector
and obtain the necessary permits before proceeding with any new construction or changes to your property.
When the PKS Town Ordinances are more restrictive than the PKA Covenants, as in the case of fences for
example, the more restrictive Town Ordinances will take precedence over the PKA Covenants.
Please sign and return this Agreement to Pine Knoll Association, Inc. PO Box 905, Atlantic Beach, NC 28512.
By signing this Construction Agreement, you specifically acknowledge your responsibility to do the following:
a. Consult with the PKS Building Inspector and obtain appropriate permits, if any.
b. Construct your dwelling or project in accordance with the plans approved with conditions, if any, by the
Architectural Control Committee of Fine Knoll Association, Inc.
c. Submit any proposed changes in said plans to Pine Knoll Association, Inc. and the PKS Building
\Insp or for recon ideration and approval.
Propert \Ow ner's Signature Date Signed
(rev. May 2019)

7/29/22, 12:06 PM
Gmail - PKA Project application
Gmail
PKA Project application
Ngoc Pham <[e-mail]>
To: Scott Rideout <[e-mail]>
Here's the pictures. I've cleared a path to the post
ii
OF (AivAL—
Scott Rideout <[e-mail]>
marked the property line, deck width.
W pi Utz WA 7 C¢t �-
Wed, Jul 27, 2022 at 9:48 PM
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