RBBS Properties LLC 84482C

coAsrgz ❑CAMA ElDREDGE & FILL 448 A B C D
'
y =� 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
Address
City State ZIP
Phone # ( )
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
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
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 required by:
Permit Conditions
(Scale:J".. )
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) Check #/Money Order
Signature
Issuing Date i Expiration Date

1+olCOM41 ❑CAMA El DREDGE & FILL NO 84482 A B C D
.o
z = GPrevious permit
GENERAL 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 _
Address
City
Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
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
Shoreline Length
Access Length
Pier (dock) length _
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
1
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
t
t
Basin, channel i
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 required by:
Permit Conditions
(Scale: )
❑ 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" Signature
Application Feels) Check #/Money Order Issuing Date Expiration Date

ADJACENT. �
hereby certify PARIA111 PROPERTYI that I o OWNER STATEMENT
wn Pr°pe,-ty adjacent to
Property located at . S C
an L(/ Jt�,s, (N of roperty ner)
�� (Address,
(Waterbo y) in ck, Road, tc.)
the aPPHCant has (Clty/ own a /or County)
loc wth
'on. described to rtte as -
shown belo, e development proposed at the above
I have no obiPr-tirt., f,. ��
�e&tlQr�t2ttti5_pCQp.0��1.�.______
(b7diiidual l�1=SGRIPTIOi\{ ANQ10R DP.AUi►1NCs OF PROPOSE®
P-rOPOsing dalfel6 DEVE' ©PMEM 1
erne t � F1l in descdptllon below or attach a site drawing)
Bps
too e Q.+
,
M �
-Drop ro Ljl,.A)
that
a - - - wA,'E R SECTIONs,-
[ .understand that a ier, mooring pilings, breakwater, boathouse, lift, or groin must be set
P. dock,
back a minimum distance of 15' from my'area of riparian access unless wary by e. you
wish to waive the setback, you must initial the appropriate FP Ariate blank below.) 6T
C- I do wish to waive the 15' setback requirement
. I do not wish to waive the 15 setback requirement.
Property Owner information) ( acan' a Owner in edon,
Lt _
ant or Type Name Pint or Ty ie Name
91
ilingyA d ss' i Ad ss
01
., -.
phone Number Telep one Dumber
Date -
(Revised 6tiW012)

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: VAp & E"Ie-kIS&e —
Mailing Address: %. /�.�'e� i r(f C.��>�f�.'Li7c-
Phone Number: 7aLl 7-FV(
Email Address: l--�gty.�,,,c
1 certify that I have authorized r' w.v. LA-w,^ense- .e
Agent ! Contractor
to act on my behalf, for the purpose of applying for and obtaining all CANIA permits
necessary for the following proposed development: 'IAd6i-u-
at my property located ate�ittl.`f+ey'-r-4r!�-C
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 Cfficer and their agents to enter
on the aforementioned 'lands in connection with evaluating information related to this
permit application.
I
nfor ation:
or
Signature
Print or Type dame
c� 4,;W ee
Title
A l `',,I, l ,? Z--
Qate
This certification is valid through I I_

DiACr-N 3 RiPAPRiAN PROPERTY OWNER STA-TEMENT
I hereby certify that I own proner'ty ad_jaceni to LA .11 A44- P s
- - �N y Ci l Propebi wrier)
_
proper(v located at J-4.,vp e C gr
', / ;Address, X4111
, Road, etc.)
on �� in d
.C-
,���'atePi;P©-
he applicant has described to me, as shown below, the development proposed at the above
loca"jJ�on.
I have no objection io this proposal.
haveLobjzctiorts to_�his_pCopos.aL-_____
DR21SCRiPTION ANDIOR DRAWING Jt- PROPOSED' DEVELOPMEN
(€ eliS�, gad �o ova c� eir�le� e� t m�usz� fillip desc?ption badow oY atrach as ite drawij?' 71I
I understand that a pjer, dock, mooring pilings, breakwater, boathouse, {iff, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you sous. initia� the appropriate blank belov<<.)
1 do wish to waive the 15' setback requiremen-L
I do noc wish to waive the 15' setback requirement
OdU spin
SiQnai .re Si _re
Print or Type Nae mPrint or Type Name
A/1 I Add ess . Ad ss
CiiyJStatenp itv t i
Telephone Number Telep one Number
l�ai2
Dace -
(Revised G/i 8/2092)

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top poftrvto, bPc,p t 'A by owner or their agent)
e
Name of Property Owner:
Address of Property:
Mailing Address of Owner. tJ►���
Owner's email:
Owner's Phone#: '°20!5� 1 L,5� Wx i
Agent's Name: it S (�G
Agent's Email:
Agent Phone#: d,2 ,1- — ® 13 2.
--- =A -CENT RIPARIA PROPERTY-OWNEWS-CMtfl=='PtM --
(Bottom portion to be completed by the Adjacent Pro a 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.
1 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
Signaturle of Adja nt Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owrier:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
j?,v s a � h lcq�ll c " / -
ARPO's Phone#: _701/,23 g 3mcl gp
Date: waiver is valid for up to one year from ARPO's Signature*
Revised May 2021