Groff, James 88469C

❑ CAMA ❑ DREDGE & FILL
GENERAL PERMIT
[?New ❑ Modification []Complete Reissue ❑ Partial Reissue
N° 88469
Previous permit
Date previous permit issued
r_Q.�r�
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concem pursuant to:
1 SA NCAC ❑ Rules attached. E3 General Permit Rules available at the following link: www.deq.nc.gcv/CAMArules
ApplicantName _. \ t i < : i !
Address 1
City �'�. State_
Phone # ( %
Email
Authorized Agent ,r" i'7 / % / c/ FC
Project Location (County): .j
Street Address/State Road/Lot #(s) _
10)5 VQ It f7I I-
Subdivision
City ZIP
Affected �CW ErEW E]PfA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ INA ❑ uW ❑ SPIMA ❑ PWS Closest Maj. Weir. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity J 4 C r
(Scale0 s )
C F...elt..n 1 nnrwF
._
Access Length -" z / _.-'
Pier (dock) length /2 z
I
�
_ ......
I
Fixed Platform(s) /(` ✓ .'. '..�' -"
,
Floating Platform(s) /
Finger pier(s)
i
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length "
1
Basin, channel
Cubic yards
!
_
--
Boat ramp
Boathouse/ Boauift
Beach Bulldozing
j
Other
i
SAV observed: yes no --.
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
I
_
_
A building permit/zoning permit may be required by:
Permit Conditions
Agent or Applicant PRINTED Name
l
P!n""Wofficer's PRINTED Name
❑ TAWPAM/NEUSE/BUFFER (circle one)
z-❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please
Signature "Please read compliance statement on back of permit•'
I1;-11
Application Feels) Check #/Money Order
Yigmatute
Issuing Date Expiration ate

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar - Pamlico River Basin Buffer Rules 1-1 Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Manaeement Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven —south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

❑CAMA ❑ DREDGE & FILL N9 88469 A B c D
GENERAL PERMIT Previous permit
i Date previous permit issued
❑ New ❑ Modification ElComplete 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
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: )
ch,Aine l eneth
Access length
Pier (dock) length
'.
Fixed Platform(s)
i
Floating Platform(s)
.-t
I
i t
Finger piers))
I
t
T
t
T )
Total Platform area
('
Groin length/&
!
Bulkhead/ Riprap length
Avg distance offshore
--- --
-r-
--
-( - ---
4---
j
-'-
Breakwater/Sill
I
Max distance/length
I
I I
I
Basin, channel
Cubic yards__..
T'- _
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
f
-
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
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ 5ee 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
PRINTED Name
Signature "Please read compliance statement on back of permit•'
Signature
Application Feels) Check p/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar - Pamlico River Basin Buffer Rules
1-1 Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

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N.C. DIVISION OF C
ADJACENT RIPARIAN PROPERTY
(Top portion to be completed, by owneror their agent)
Name of Property Owne
r
Address of Property:
Mailing Address of Owner, S 5M
Owner'semail:MUS4611990aiLtipm Owners P'llwonet. % (Y MA, ZL6 -q6O I
FORM
Agents Name:
Agent's Email:
AgemPhonek.
ADJACENT RI;:::=,0WN ERTIFICATIQN
rn Dortion 0 Adieeent
#66i;'8`iiW b vi n a r)
I hereby certify that I own property adjacent to the above referenced property. The ,l ndividual applying forthis
permit has described to n -- A ,g,.the devoopmpnt they
are proposinu a
M. M7 with-thla letter.
with
me, as attached. drawl
dagagn or draw! mM0 be provided
I DO NOT have objections to, this proposal. I DO have objections to this Proposal.
9 YOU nave 0ofeCU0115 10 WnSt IS Dafng PrOPOS66, YOU Must notfry Me N.C. DIM(qn of, Co"M
Manggement (DCM) In writing within 10 4qA.,of racqlp snotf;p. C9"s I da'ne'e-shouldfie
t qf.!kt por;
InaHo to 127 . Carqpal Drfvb Ext, Wimbigt" I cen ISO bi
MC 284664W. Wfifna' - 'qp!.!?s�m _ ves
ses 06'qb If ypu have Contacted at [phone].N6 ra6p6rrio Is tieei
notified by Cordfled hib'11.
I understand t
groin must be
(this does not
the appropriat
I DO wish to waive some/all of the I 5'setback
-OR- Signatureof Adjacent Ripa#an Pipperly Owner
I do not wish to waive the 1 W setback requirement (initial the blank),
Signature of Adjacent Riparian Prop" Owner.
TypedlPrinted name of ARPO- 1 J--VtIr>J r--13 el U -N I f-11 H
Mailing Address of ARPO: qoiLle- Pr! r1 -0
ARPO's email: 9 i
u—"ta4N �%M ARPO's Phone#:
U V
Date: 1 -9,4vKwalver is valid for up to one year from ARPO's Signature`
Revised July 2021

N.C. DI'
ADJACENT RIPARIAN
(Top portion to be completed by owner or their agent)
Name of Property Owns
Address of Property:
FORM
Mailing Address of Owner. S�Jr{`i�lUtSIf1t)1A0.t lvacS(OYl Pt,1�kh
Ownersemail: tfldCSy�o1_ CORM -CuribwneesPhone#. Jkq 1-�Lisol
Agent's Name:
Agent Phone#:
Agent's Emil:
ADJACENT RIPARIAN P/;OPERTY OWNER'S CERTIFICATION
(Bottom portbn to b® completed by the Adiecent Property Owner)
I hereby certify that I own property adjacent to the above r
permit has described to me, as shown on the attached
The individualapplying for this
30ment they are proposing. A
100 NOT have objections to this proposal. 1 DO have objections to thisproposal.
H you have objections to what is being proposed, you must notify the N.C. Dlvis(•on of Ca
Management (DCN) in wddng within 90,days of receipt of this notice, .CormsponclBece shoal
mailed to 927 Ceidlna/ Drive Ezt, Wilmingtoh, NC; 05-�W DCM representaf va• canals
contacted at (910j 796.7215. No response Is considered thesame a§ no objesfion if you have I
nodBed by Cerdfied Mail.
WAIVER SECTION
1 understand that any proposed pier, dock, moonng 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 dprap revetments). (If you wish to waive the setback, you must Stan
the appropriate blank below.)
1 DO wish to waive some/all of the 15' setback
Signature,of Adjacent Riparian Properly
_OR_ ,
I do not wish to waive the 16 setback requirement (initial the'blank)
Signature of Adjacent Riparian Property Owner.
TypedlPrinted name of ARPO:
Mailing Address of ARPO:
ARPO's email:
ARPO's Phone#:
Date: -*waiver Is valid for up to one year from ARPO's Signature*
Revised July 2021

TIPS -FOR ADJACENT RIPARIAN OWN NOTIFICATION 8.WAI10FER FORMS
CAMA Regulations require notice of proposed development to the / djacent Riparian Property Owners (15A
NCAC 710204(b)(5)). Proof of actual notice (a sign -of by the owner on this form) or certified mail return
receipts (showing delivery of notice) are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM an opportunity to consider:these comments/objections before a permit decision is made.
"Permisslon" of adjacent property owners Is normal rec 1 for DCM to Issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15''setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal. -.
Who Is an Adjacent Riparian Property Owner?
what Is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary Tine with the site of proposed deyebprent;,AND
• A property that fronts a nature) ormsnmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a rrianmade basin.
• Easement holders? Yes, Ifthe easement could be impacted by the.proposed development.
• Streets/Roods? Only If the street/road could be impacted by the proposed development. This
Might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands cialaWsti4sh franchises.
What.ls Riparian?
Do the boundaries of the adjacent properly`1eg81ly intersect" with the water. at mean high tide? If there is a
question, about whether an adjacent properly Is considered 'riparian," please reach out to.DCM Staff -
especially on the oceanfront beach where there may be untleveioped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals (or families) send notice to the address listed on the tax card.,lf the property 1s owned
by an Inc. or LLC, please send notice to`the;person listed as the.regntered agent on the NC Secretary of
State's Corporations Look. Up sde hops:/h ".sosnc.eov/seamhrndeu/coro. For _ condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What Is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign thisibirn and return it to DCM; OR
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope);,OR .
• You can mail this forth by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
cerfified mail package number on USPS.GOV's online tracking system, and provide the tracking
printout as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
�� S�e�retisorl '�ona\d � k�e�cs
L GV A0ABeA Benson
%arclen C'kkg N� \\szo -sa 4
Revised July 2021

Betty Bullock
From:
Betty Bullock
Sent:
Friday, September 30, 2022 2:36 PM
To:
[e-mail]
Cc:
[e-mail]
Subject:
James & Marilyn Groff - Pier/Dock/Mooring Plan
Attachments:
scan9008.pdf; doc20220930142751.pdf
Ms. Martin,
On behalf of our client we would like to request a permit for a pier, dock and boat lift. We have
attached a copy of the survey plan for Lot 136 Blk. Chadwick Shores along with documentation
of previously submitted "Adjacent Riparian Property Owner Notifications/Waiver Form, proof
of certified mail sent and certified mail receipt. Should you need any additional information to
grant this request, please give us a call or email us . Thank you in advance for your help with
this permitting.
Betty
Betty Bullock, Office Manager
John L. Pierce & Associates, P.A.
P.O. Box 1695
405 Johnson Blvd. (28540)
Jacksonville, NC28541
[phone] Fax [phone]
E-mail: [e-mail]

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT -RIPARIAN PROPERTY OWNER NOTIFICATION/
(Top portiori to be completed by owner or their agent)'
Name.of:Ptoperty Owner
Addre'ss.of, Property: ,
Mo
Mailing Address of,Owner., _6lUl5.kah "Wj; - UaNQ6 RA .Al 556'
Owner's emailc M� Ala i400.rutaiUzipn Owner s'Phone#:' �1 �1- •221� ySO ►
Agents Name:y - Agent Phone# .
. l .+, '.l IIYIO\QYY�4110 /4YIY4C11{1'{VYQIIY'VNIIQ,/
I hereby eer ify that l own property adjaosnf to the atiove referenced property. The individual applying forthis
permit has described to me, as shown on'the attached drawing, the development they are.propcsing."A
description or drawing withh dimensions must be Provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to th(s'proposal.
if you have objections to whahis being proposed; you must notify the N.C. D/vlslon of Coastal
Management (DCM)'!n wi ing within 10 days of receipt of this notice., Correspondence should'be
mailed to 127,Cardinal Drive Ecf, IMlmington, NC 28405.3845. DCM representa8ves can also be
contacted at (910);79&7215:'No response !s considered the same es no objection lr you have been
notified by certHled INa1L'
WAIVER SECTION '
('understand that any proposed pier, dock; mooring pilings, bdat ramp, breakwater, boathcuse; lift, or `
groin must be 'set back a minimum distance of t5' froin myarea, of riparian access unless walved`by me
(thisdoes not apply io bulkheads or dprap revetments). (If you wish,to waive the setback,, you must elan-
tha approp'riate.blank below.)
1•DO.wish to waive some/all of•the,15' set6eck
J _
SlgnaluoofAdjecentfflpar/an,PmperfyOwner '
I do not wish;to waive the 15' setback requirement (initial the blank),
Signature of Adjaoent Riparian Property flamer.
TypedlPrioted name of ARPO:. J 1? ��_ i� L
s. L
Malling Address of ARPO: ZoyM.%,
ARPO's emallPhone#: '_J1 f 1, (r 7 i J'�
Date: aiver.Is valid t»rup to oneyear from ARPO'a Signature
Revised Jidy.2021

N.C. DIVISION OF COASTAL MANAGEMENT
'ARIAN PROPERTY OWNER'NOTIFICAATIONIINAIVER FORM
"(top portion to'be completed by -owner or.iheir'agaii!).
Name of.P-roperty Owner
Address of Property: ,
Mailing Address of Owner. 55h9,- t si,risorl}tnl�i_ .�YdcVirn P� "1'ISFb . .
Owner's email:_ -Mal 5UnI `IW2A-Codbwnees' hone* i'll22to AS;0I
Agent's Name: Agent Phone#:
_Agent's Email:
ADJACENT. RIPARIAN PROPERTY OWNER'S CERTIFICATION j
.!(Bottom Portion to be completed by the Adlecent Pranerfv Owner) ,
i hereby certify tfiai i own property adjacent_6 the above referenced property. The,individual applying for this
permit has described tome, as shown on the attached drawing; the development they are proposing. A
description ar drawing. with dimensions. must'be provided with this letter:
I DO NOT have objections to this proposal', I"DO have objections to th'iis proposal:
H you have objections to what is: being proposed, you must notHy the N.C. Division of -Coastal
Management (DCM) in wirift within 10 days of receipt of this notice.. Coriaspondence should be
mailed to' 127 Cardlnal,Ddve Exi, Wilmington, NC'28405-3845., DCM representatives can -also be
contacted at [phone]: No response Is considered the same as no objection ifyou have been
notW/ed by Ceitified Mail. , ' - - -
WAIVER SECTION ;
I understand that any'proposed pier, dock, mooringpilings„ boat ramp, breakwater, boathouse;,ltit, 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,ripiap revetments). (If you wish to waive the setback, you must slan
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 tha blank)
Signature of'Adjac6nt Riparian Properly Owner:
TypedlPrinted name of ARPO:
Mailing Address of ARPO:
ARPO's email:
ARPO'6'Phone#:
Date: *waiver Is valid for up to one year from ARPO's Signature'
Revised July 2021
),N(00
I

_. 11'r
TIPS F.OR ADJACENT RIPARIAN OWNER NOTIFICATION &IWAIVER,FORMS .
CAMA Regulations requlre'notice of proposed development to gie-Adlacent Riparian Property Owners(15A
NCAC 710204(b)(5))., Proof of actual• notice (a. sign -off by the;owner on•this.form),or certified -mail return
receipts'(showing delivery of notice);ahe needed.
The purpose of this notice is to make adjacent ripariari properly ownersaware of the proposed"development
so that theyhave an.oppoitunityto'provide comments (or potentially objeclto),the proposed,development
and'to,give.DCM anopportunity to:consider these comments/objections before a permit decision is•made.
peririisslon" of adiacent r e owners is not nece4•a�io required for DCM'to issue a permit; however,
permission'mustbeobtainedforcertaintypesofproposeddevelopmentsiftheyfillWithina 6setbackarea
along the riparian access area of the adjacent property, as determined solely by DCM. if sin the applicant's
best interest to provide comprehensive and accurate notice%so that any.concems or-6biecti6ns can;be
resolved,earlyin the permit review process. In addition, if the adjacent riparian property owner appeals'the
permit deoilion, insufficient notide cbuld be a basis for granfing'such an appeal .;
Whwis an Adjacent,Riparian Property Owner?---'- _:___ _ . _ _ .
What Is Adjacent? (Note DCM+reads this broadlii to ensure commentbv potentially impacted neiahtuirs)
• A property that shares a -boundary line A' O the slid of proposed development; AND
A property ttiatfront6 a natural or manmade iiaterbbdythat ts 6onnected6`6oastal waters:and
can support some form of navigation,.even a kayak or canoe including a common oanal'systemi -
oramanmadebasin. ' ' ' - - - _
o' 'Easemenfholders?Yes;rftheeasementcorild,6aimpacied.bythe-proposeddeveiopment. ;
• Sir eets/Roads7 Onfy:if the,streebroad could-be'impacted by the proposed developmehL This' -.''
,mlghtinclude street -ends which might be used for parking and beach access••
Holdersof recognized submerged lands claims/shellfish-franchises.'
Do tdeaoundanes'ofaie adjacentproperty;legalty`intersect with the water.at rtiean high tide? If there is a
question about whether an adjacent, property ls-considered °riparian," piease;reach out to DCM Staff -
especially on the oceanfronftreach whore there may be undeveloped parcels on,the beach or m the iW4.
WhoivVhat Is: a`Property Ownefl •
For private individuals,(orfamilies);sendnoY" -
by an inc. or_LLC; please send notice;......
States' Corporations 'Look, , `site: httoi
neighbo"oods'with'an'owners' association
corporation, for which you' end notice to its
What Is'Nottee, and how do I eosure)t Is
. a Youraitmeetwith vouradiacentnr
a
and
agent).
er, provide a•description or'drawing of the
his form 'and•retum;itto DCM OR -
onbrdrawing,'and,ask.your neighbor to return it to
p4eloipe); OR'
print-out as;proof of deliveryto,DGM "" - -
Ifyou.have any-4uestions'about this,'pro' please h6dchf out to DCM Staff and DCM Legal,Counsel
and we will work to answeryour questions -
Revised Jgly 2021

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7I29J22, 11:47 AM
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Juyk=22,11:18am - ----__-.-.-
Delivered, Left with Individual
GARDEN CITY, NY 11530
Your Rem was delivered to an individual at the address at 11:16 am on July 8, 2022 in GARDEN CITY, -'NY 11530.
July B. 2022, 8a0 am
Out for Delivery
GARDEN CITY, NY 11530
July 8, 2022, 8:39 am
Arrived at Post Office
GARDEN CITY, NY 11530
htyrsJAools.usps.comlgarrreckConfirmActlon9qtc_O.abels1=70212720000135035472 113

7122122,11:47 AM
July 7.2022, 822 pm
,Departed USPS Regional Facility
GARDEN CITY NY DISTRIBUTION CENTER
July 7, 2022,103D am
Arrived at USPS Regional Destination Facility
GARDEN CITY NY DISTRIBUTION CENTER
July e, 2022,11:36 pm
Arrived at USPS Regional Origin Facility
HARRISBURG PA DISTRIBUTION CENTER
July 6, 2022, 431 pm
Departed Post Office
EAST EARL, PA 17519
Juy 6, 2M. 23D pm
USPS,In Possession of item
FAST EARL, PA 17519
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� ADDRESS:
1,055 CHADWICK SHORES DRIVE
REFERENCES: �o•MsN /
M9: 19. PG: 25-26
09:5499. PG-339
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MAP -
THIS IS TO CER, Y THAT THIS MAP -IS A TRUE
REPRESENTAIICN OF 1. E PROPERTY HEREON AS
COMPILED BY ACTUAL SURVEY OF THE PREMISES
AND THAT THERE _ NO ENCROACHMENTS ACCORD-
ING TO THE 9ESE OF MY KNCWLEDGE, EXCEPT AS
SHOWN. THE RATIO OF PRECISION IS I: 10.00D+.
JOHN L.
- CSES�
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1pm NFO. MAT 4 TAKEIN FROM
FLY' MA r034 288K WITH PN
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BOUNDARY, WETLANDS & COASTAL WIFTE-NGS SURVEY &
PIER, DOCK, & MOORING -PLAN
SHOVING
LOT 136 BLOCK A
CHADWICK SHORES
PREPARED FOR
MARILYN J. GROFF & HUSBAND,
JAMES GROFF (OWNERS)
STUMP SOUND TOIANSHIP. ONSLOW COUNTY, NO
PREPARED By
JOHN L. PIERCE & ASSOCIATES, P.A.
NORTH CAROLINA LICENSE .NO. C-1888
409 JOHNSON 81 VOL JACKSONVILLE, NO 28540
PHONE: [phone] DATE:OCT. 12, 2022
SCALE: 1'= 50' P.B. 930, PG. 7
JOB #2022-637
GRAPHIC SCALE
50 0 25 50 100 200
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1 i ch = 50 fL