Straight, Ben 88619C

,o1*01`0,4S'41 ❑CAMA ❑ DREDGE & FILL NO.88619 A B C D
y 2 GENERAL PERMIT Previous 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
Addressd ,1 e..
City State ZIP
Phone # ( )
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
IP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity ►
Scale:,
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
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
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed:
yes no
Moratorium: n/a
yes no
Site Photos:
yes no
Riparian Waiver Attached:
yes no
A building permit/zoning permit may be re
Permit Conditions
❑ 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
Signature "Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
Application Fee(s)
Check #/Money Order Issuing Date
Expiration Date

WASt4l ❑CAMA ❑ DREDGE & FILL NO 8861.9 A B C D
h
J.G E N E RAL PERMIT Previous 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: vvww.deq.nc.,zov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State
ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
at/man/unk)
Type of Project/ Activity
i
(Scale:` d )
Shoreline Length _
Access Length _
Pier (dock) length
Fixed Platform(s) "
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
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be n
Permit Conditions
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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"
Application Fee(s)
Signature
Check #/Money Order Issuing Date
Expiration 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:e
Address of Property
Mailing Address of Owner: Owner's email: �_Q . ``
v �� - Owner's Phone#-.
9 '
Agent's Name: e`� �. f, Agent Phone#: < d
Agent's Email: e N 0�� �bv E �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.
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 [phone]. No response is considered the same as no objection if you have been notified by
Certified Mail.
WAIVER SECTION
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.) o
I DO wish to waive some/all of the 15' setback
Signature of Adjacent arian roperty Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
i
Typed/Printed name of ARPO: , 'A- -
Mailing Address of ARPO: ) Ao — �=� `��� )S . 11
ARPO's email: ARPO's Phone#:
Date: 7_ *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 7 k-A V1Z
Name of Property Owner Applying for Permit:
C", �, � Q. , � Nr cc CAI.,
Mailing Address:
I certify that I have authorized (agent) zdl o to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) �'•'k .... �. + ��r -i; ,
atyrro property located at) ...� �' \oJ r ,
r �
This certification is valid thru (date)��. 3 olG2Z .
Property Owner Signature
Date

14
HIDDEN HARBOR POA
APPLICATION FOR ARCHITECTURA CHANGE � � �►*"
Date Submitted to Board
ft.ard Signature
Datei-1
- - -

am no
dh
JACOB01's
CONSTRUCTION �T
LLC
252.269.6387
[e-mail]
216 Ajitioch l+`d New Reria> NC 28560
'We propose hereby to furnish material and labor -- complete in accordance with the above specifications for the sum of:
Dollars
with payments to be made as follows:_
Any alteration or deviait on #into above speettieattons involving extra coats will be
execuled only upon written order, and will become an extra rharge over and
aWve the estimate, All agreements contingent upon .Arikes, accidents, or belays
beyom our Wntrol.
Respectfully
Note — this prnposal may be withdrawn by us it not accnptt=ti within
creptanct of rOP+o 41
Thra above prices, 3086fiCalions and conditions are satisfactory and are ;signature
hereby accepted. You ate authorized to do the work as specified.
Payments will be made as outlined above, �
r
Date of Acceptance _ Signature
NC3819 MADE IN VISA