88459C - Smith, Trisha

1Ao(mt" LAMA ❑ DREDGE & FILL Nr ) 88459 A B QD
+ GENERAL PERMIT Previous permit
��__ // Date previous permit issued
F24ew El Modification El Complete Reissue El Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Com I Resources Commission in an area of environmental concern pursuant to:
ISA NCAC �! i 0 ❑ Rules attached. 7Generai Permit Rules available at the following link: wxw.deo nc gov/CAMAn Ix
Applicant Name _{ rA s('t
Phone #
Email )I(ChaL; 44,Y11
Affected �CW PEW [S�P1e
AEC(s): []OEA EIIHA DUW
ORW: vgr.-.,7 nueA:ai0" .
Type of Project/ Activity
Shoreline Length /
Access Length
Pier (dock) length /
Fixed Platform(s)
Floating Platform(s) Z
Finger pier(s)
Total Platform area '
fth/#
praplength
s
Avg distance offshore
Breakwater/Sill
Max distance/length
Rusin, channel i
Cubic _�.."
Boa
Boat ramp /
Boathouse/ Boatlift
Beach Bulldozing
Other
m observed:
yes
moratorium: n/a
yes
Site Photos_
es
ZIP
Project Location (County): _,,,_AA
Street Address/State Road/Lot #(s)
SubdMsion
City ZIP��
L_JLD u pTS Adj. Wir. Body _,'
DSPIMA ElPWs closest Maj. Wtr" Body
NAE
H.
—ram!
100 14ovel<r,( �f,
ot v
TARIPAMINEUSEIBUFFER (circle one)
ElSee note on back regarding River Basin rules
I J See additional notes/conditions on back
12,
JAM AWARE Of$TATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWEDCOMPLIANCESTATEMENT (Please Initial) 1'
Applicant
statement on back of permit"
Feels) r Check #§Aonev Order

a&dco `r"`NV CAMA ❑ DREDGE & FILL N9 88459 A B O D
GENERAL PERMIT Previous permit /
� Date previous permit issued
Ne 'w ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorizedby the State of Nort'hh^>Carrololina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC O ` , 1 V C.l ❑ Rules attached. General Permit Rules available at the following link: wwwdecinc gov/CAMArules
Applicant Name
Cityr`j K'�C
Phone}#��q�W-
Email 11( C fix0— t r—M I
Authorized Agent C-4 V K,(_
[[�� \\ Project Location (County): �] \f
ZIP 9D (0V Street Address/State Road/Lot#(s)
Subdivision _
City �`� ZIP
LQ�e/ t
Affected C�W W S ❑ PTS Adj. Wtr. Body loot/ an/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body 1y v
ORW:y no P o
Type of Project/ Activity t2
Shoreline Length.
Access Length _
Pier (dock) length
Fixed Platform(s).
Floating Platform(s)
Finger pier(s)
Total Platform area
Gr ' en h/1f
Bulkhea prop length
Avg distance offshore
Breakwater/Sill .i
Max distance/ length
Basin, channel
Cubic yards
Boa[ ramp /
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed:
yes rfSj
Moratorium: n/a
yes 'cff_ l
Site Photos:
es
Riparian Waiver Attached:
no
A building permit/z�o\nin`g permit \may�beyrequ�ir`ed
Permit Conditions 11 l
byy:,_
JEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please
Agent or Applicant PRINTED Name Per It Officer's P INTf{ EljplaJite�
Signature **Please read compliance statement on back of permit** S\ ure V1
�� I� �����
Application Feels) CheckA oney Order IssDate Ex vatio Dale

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �, sha Sm_l+�
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: F5 t J CQ WQ l l
at my property located at _ I
in I)Y)61 0 (1) County.
I furthermore certify that I 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:
�isha Sm��h
Signature '`�. ^�-Y/`
JPrint or Type Name
)ne-r
c Title
"'I I 10 I'A0,120
Date
This certification is valid through I I

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL. • RETURN R9C91PT REQUESTED or HAND DELIVEgy
(Top portion to be completed by owner or their agent)
Name of property Owner:
Address of Property:
C V—
Mailing AddressofOwner. � )QI")11✓
PI
Owners emau:7yi5%1CStl1iii,5 QilMlI Owner's Phone#:_ 1�U 'az78-Q778
Agents Name: �P�tL QYI n (�CLUG�14�Agent Phone#:_�1/�' ��j- ail �75
Agent's Email: ram,:/ A
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom cordon to ba cornoFatnd by HSy qdj� • o �„ �v Owrwri
\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
t v dOBVIDtion or drawing with dimensions must be provided ma this letter. they are proposing. 6
HB I DO NOT have objections to this proposal. 1 DO have objections to this proposal.
fl you have objections to what /s being proposed, you must now the N.C. Division ol_ SulManagement (OCM) in writing within 10 days of receipt of this notice. Correa msfied to 4W Commerce Ave., Morehead C11% NC 28567. DCM reprssent8Uves can so be contacted
Co(Z52) Meg808. No response is considered the some as no objection M you have been no~ by
WAIVER SECTION
I understand that any
proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
t CQ 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
O� 5 t L4 the appropriate blank below.)
J I DO wish to waive some/all of the 16 setback
OR Signature oiAdjacent Riparian property Owner
I do not wish to waive the 16 setback requirement (initial the blank Helen Basden(HB)
signature of Adiacent Riparian Property Owner: Helen Basden
TYPed/Printed name of ARPO: Helen Basden
1
Melling Address of ARPO: 1219 Quinn store rd Beu avl e
5 ARPO'a email:
cbasdentruckingllc@gmal .coO's Phone#: ("-1W ?s44-9750
Date: 09-15-2022 •watver Is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be Completed by owner or their agent)
Name of Property Owner:
Address of Property:
Mailing Address of Owner: 5Arne Owners small:{1i4lQimifh5ftmail.64wner'sPhone#: q10-9 00-97%8
Agent's Name: F/1 P�}�j[� rl a clQa,5T -tjC,�tVjAgent Phone#:JILOZ-3415
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER% CERTIFICATION
(3m portion to W gomplatod ky the Adjacent Proaertv 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.
i ' _ I DO NOT have objections to this proposal. I DO have objections to this proposal.
n you nave 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 N you have been notified by
CerMed Mail.
WAIVER SECTION
\ I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
(A groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
�►M (this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.) - /
J I DO wish to waive some/ail of the IV setba
I � C//
-OR-
1gn1 f Adjacerit RloarlsTPmpedyowner
I do not wish to waive the 16 setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 027
k bt\ Mailing Address of ARPO: l (CrS er, AjC (t ()
5�
ARPO's email: / i P v u r tr..o[�. �iAvr ARPO's hone#: ( 11 V 1)3 '? �3 "J-6�f
"waiver Is valid for up to one year from ARPO's Signature"
Revised July 2021
9

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