87889_Alonzo Rogers_20221005

oC0ANt,1 1CAMA DREDGE & FILL 1 5 No 87889 ABCD
i GENERAL PERMIT ID t 145b Previous permit
it Date previous permit issued
nNew nModification Complete Reissue I I 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:
I5A NCAC I I Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name t';E _. Authorized Agent
Address f; Project Location(County):
City •''-e k-'v ' I'e State • ZIP Street Address/State Road/Lot#(s) -
Phone#( i S 3 'II 2 - c•.
Email -i"1'•C+rcA.0 l k' c 7:..
Subdivision
City ZIP - '
i
Affected n cw n tW PTA n ES n PTS Adj.Wtr.Body I''x7 ,('nat/man/unk)
AEC(s): n OEA n IHA n UW n SPIMA I I PWS Closest Maj.Wtr.Body "'//,' <•' rr ) -'r-
ORW:yes/no PNA:yes/no
Type of Project/Activity -`r ~�. 1 ,,- ' �� ,, .-� - L...c:,'v� 4...,ft 'o-s 6, ,- Ik0<\<::r J1,::',;i(_ ' ,:..1, ;_.>�.-1-. `f r /(o
1.er. CL,; �:.,/rak ...,.•,r • p(-+L- .--• v- L If—t7' c��.J'.. J r. f-? ,
Shoreline Length !� •
' �27 'x,<:_- S u.' c- j:'t,a., c l . L.4 $ .
Access Length -- i 1 ` ' l (/ t l( r ., i . ��: r ( ,..7
r1 1 i I I BMW -- p -�._�y! a
Pier(dock)length —` + $i 1
Fixed Platform(s) . ' �`' I , si ' a s �� �w r'
7 y, ;.4iar. • -_... i .. q-i. "S').................._ J"�k.tl }l0 4—._CSC_-.. ",-1 '
Floating Platform(s) I ' r n�3 j { - {
1
ripli 4,,,---Hr-,,I,lc, i i,r,-.2t,--c-.._ F. 7,.-ci, I--
Finger pier(s) ) '.----iE. L ' j ' _ .�-�
w_. _. - �.__
i
Total Platform area
' „ •ry:'( I
Groin length/# ( '••� ;.4, y i II I
Bulkhead/Riprap length —..—�_ ._.._..... , —T,---i. } —1—r. I {
—
Avg distance offshore 00 ( ! L..--- __._-I
id .
Breakwater/Sill ( I- Q ��
.,per Maxf
distance/length ! -1 awgr C J . c. o, MP , ' .,
Basin,channel '; +1 / �, 7. T
Cubic yards , �. z� -.. , r. r—� Pp
Boat ramp /./ ' -.''Al 4. i, C /_ f f .„-__.__
Boathouse/Boatlift ' I I
/
4- -.._ ' ��/(ir' .
Beach Bulldozing �;,i �' r�.
r ! I
Other-.- = i- • ljY _
f y 1 µ .0.+- k I I k I � ti� ,_
j• P
SAV observed: yes no 1Z -i- �' .,,
Moratorium: n/a yes no ( { G; .- ) ' « Yy ' �' , `•r
Site Photos: yes no • I �- ' _�■� E
Riparian Waiver Attached: yes no �i eu�t� v' I I:. I';'-----..,..„.-,
•
A building permit/zoning permit may be required by: 11115 , '
j. / N."n--AR/PAM/NEQSDBUFFER(circle one)
Permit Conditions '?
;-�1 1-1-.fee note on back regarding River Basin rules
" ,•, n 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 Fee(s) Check#/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:
Tar- Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie,Camden, Chowan,Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

,o�°�`°"'k CAMA I I DREDGE & FILL � 'j No 87889 A BCD
GENERAL PERMIT -ID* 1 144)(0 Previous permit
Date previous permit issued
n New n Modification n Complete Reissue n 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 n Rules attached. ❑ General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP { 4 Street Address/State Road/Lot#(s) .
Phone#( )
Email t"' Subdivision
City ZIP '
Affected CW EW PTA n ES ❑PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA n IHA n UW n SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length
Access Length ^ .. 1.. -_-`" . —4 ._
Pier(dock)length ,� H f i,• *}1LIIII I III
Fixed Platform(s)
Floating Platform(s) ii
Finger pier(s) + i I "'- • �. ,
i
Total Platform area
Groin length/# f
Bulkhead/Riprap length 1 li
IIIIMI j _
Avg distance offshore ____.-?--- II III
I air'
Breakwater/Sill
Max distance/length
Basin,channel iiH!!!!!pii1IpI
Cubic yards ■ �.. ■
Boat ramp • r4■ � Mil■ ■■
IliiiiIIIIIrririerm '�i � "n,
Bulld _
Other ■■ i_. iaa•_ ,.;• r f ■
�UWI `' ■■ �
y i St= r. 1 I �IIIiIIIIII
SAV observed: es no # I I �
Moratorium: n/a yes no ! M4^).: Tig
1
Site Photos: yes no --
Riparian Waiver Attached: yes no ' i i i ° ` i 44 <F i
A building permit/zoning permit may be required by: (ta1S -
Permit Conditions .....•TARIPAM EUSE_ BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee 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 Fee(s) Check#/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 Basi ules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules 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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

. R.OY COOPER.
co►ernor
MICHAEL S. REGAN
sway
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Director
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico&
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 02B.0233 & .0259.The
Division of Coastal Management(DCM),through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below.Failure to
comply with this Buffer Authorization may subject the property owner and the party(contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per day per violation.
>_. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly(which is defined as between 75 and 105 degrees)unless otherwise approved by DCM.The
alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials:All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width:The width of the pier or docking facility access way shall be limited to six(6) feet.
4. Project Drawing:The drawing on the CAMA General Permit is considered the project drawing of your •
property indicating the relative location of the pier or docking facility and any requested access way.This
drawing will be used to aid in complianceL.6
and monitoring efforts.
• Pre-pr j ct site conditions: ,‘
!-S GJc)d�i � �G'� "-I
Wi bee Gl wG 0). -
By your signature below you agree to be held responsible for meeting all of the . di `•ns isted above a / eri
that all information provided is complete and accurate. I
ni'4._ (‘-t. S ,"c:,
Agent or Applicant Printed Name 'ermit Officer' Si:Jr"
Agent orA lica�ure Issue Date
g PP g
CAMA GENERAL PERMIT it: 5'...q VCtcnQ
State of North Carolina I Environmental Quality f Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 278891252-946-6481
Wilmington Office(127 Cardinal Drive Ext.Wilmington.NC 28405-3845'910-796-7215
Morehead City Office i 400 Commerce Avenue Morehead City.NC 2855?1252-808-2808

N.C. DMSiON OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOT1FICATIONIWAIVER FORM --7
E F1ED Maw, RETURN RECEIPT REQUESTED or HAND DELIVERY (div 7q! .AC 0 1
(Top portion to be completed by owner or their agent) P
_er A Le 4 Zit!, 14)*A er-5:
Ns 01 Protaertr�V+w"
I � at 5 Wq/1(
of Igo �� ft' /'��i�t' _ ._ _�1...__
r� r thalweg ress of Owner 7S' AIM S �.or)51-/'aa i�i.017 . ffY71411€
=g errail Terra n ' `� n el
A/R on e# 7 C'.2 , , / 2
{fir -, - 0 7,e)I C., a78.3 if
Ara,ti - Agent Phone#
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
• {Bottom portion to be completed by the Adjacent Property Owner)
I tit that I own property adjacent to the above referenced property The individual applying for
this poet too described to me, as shown on the attached drawing, the development they are proposing
• 6 r drawing,with dimensions. must be provided with this letter.
Lions to this proposal I DO have objections to tits proposa:
t DC�NOT have ot>}ec
d you hues objections to what is being proposed, you must notify the N.C. Division of Coastal
or Illansgstsent(DM in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 1143 Washington Square Mall. Washington, NC 27889. DCM representatives can also be
b4tl al j 948-8481. No response Is considered the same as no objection if you have been
tiodiled by Ce tdlit d Mail.
WAIVER SECTION
tfinditsiOnd Mel any
Imposed pier, dock. mooring pilings, boat ramp brkNekw.iter boathouse. hft. or
t is a mit►irnurrt distance of 15'horn my area of np.ri meat access rank?ss weuva' t*y rsu>
,..,`peampFapixa t.f,f Bacai.cstt�
114rtk or nprap revetments (II you wish to waive Y��+.,moat aedq�
.)
. i Do ohmic*ilia'O+nadd1l of the 15' setback i `
Segfature o A,d ricer Ripar an Property Owr
isk -_•e>r+ ' waive the 15' setback requirement jinihei the blanks .__ ' ._.

/441 l
Mailing Address of ARPfO:n 63 I rant, i& / 1 i �J L"7f 3v
rcz
ARPO's email: JJPieietFel3POrtZ?Of(ARPO'aPhone": ale it" S r-'l am- �
Date: dr f o"y 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021
TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION&WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(ISA
NCAC 7J.0204(b)(b)), Proof of actual notice(a sign-ofi by the owner on this form)or certified mail return
tin.cipts(shaming 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 0CM an opportunity to consider these comments:objections before a permit decision is made,
•Pfirmission'of adjacent property own rs is not necessarily required for 0CM to Issue a permit; however.
permission must be obtained for certain types of proposed developments it they fait wtmin a 15'setbac<
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 npartn 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 Near*to ensure comment by potentially impacted neighbors)
• A property that shares a boundary tine with the site of proposed development;AND
• A property that fronts a natural or manmade 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
m-rnmade basin
• Easement hotdeis?Yes,if the easement could be impacted by the proposed development.
• Streets/Roads?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 ciairns/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide?If there is a
question about whether an adjacent property is considered-riparian,' please reach out to DCM Still-
aspeciaQy on the oceanfront beach where there may be undeveloped Parcels on the beach or lathe water
Who/What is a Property Owner?
For private individuals (or families), send notice to the address fisted on the tax card. It the property is
owned by an Inc. or LLC• please send notice to the person listed as the registered agent on the NC
Secretary of Slate's Corporations LOOK Up site: Fer
Condomeiutm or neighborhoods with an omen'association(HONPOA),send notice to the association
(which is usually a corporation,for which you send notice to its registered agent)
What is Nodes,end how do I ensure it Is received?
• You can meet with your adjacent properly owner,provide a description or drawing of the proposed
development and ask thorn to sign this farm and return it to DCM;OR
• You can hand-delver this form and a description or drawing,and ask your neighbor to retu •
DCM(consider providing them with a stamped envelope):OR r_1
• You can mail this form by LISPS Certified Mail,return receipt requested(me Green Cam , ,
choose this option.you must provide either the signed&returned green and OR track the -

J.
N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONAMAIVER FORM
(_{RTtI=11.0 MAIL RI Tt;RN RE kIRT REQUESTED or HAND OF_LIV$Y
(Top pOft n o b coxmpleedby r or then agent) ft 4/Q/79//1a/
Nana or Property Owner,/ l 1 l/ !CJ 1
Andress d Property ! l e 1, 1 c %�"�'a/( --�/ ..
Wive";Address ofOwa. 7•_- o
n �l6 �//7sttocf+/'or2 RdG vtl(
Nr q/ _l'tiV _5 / ' 67°1 ,,ic Q7834
Owner s errw17 �i y,,,,, '�
Agcn!s Name* _._ _ Agent phone*
Agent Email -_--- —
MIMMMEMOMIIIII
ADJACENT RIPARIAN PROPERTY OWNERS CERTIFICATION
(appornyortkle I compNtoA OY hitAQ.11c•_nt PKVIr!tr[9wm-rl
I here/y cer1AY OW I awn Rc o y ad went to the above neterersred property The Indrvdual appryrn9 for
Ous Woof wee dascnb d In me 75 Sion on t?w'1t2chnd Jramng the devMoomenl they are otopOyan9
6Orr4+ nadrarnrro vrttp_Orra.n•..on rr,,s!beprovnlyd with",5lot!M
Y I DO NOT have obler:burrs la Ms Prooat.lf- ._.._ 1 W have ob{eet fN tOtarn mooed 1. .•- '--
I T"ow hem oldoci no tI What N twitp proposed,you aloof malty tall IRC.Or►nsion of Coastal
lrareptwteot(Vat)in wtrtttwp wwd in 10 days of ree&pt of Mrs notice. Cerrdpondrace should be
tOaili/fa e43 Washington Spuare Mak,Washington,NC 27664 Art repwntanva-w tan atso be
eontdceed at(252i 046--641l1.No response is considered the same as no oblttlgn at you bare been
nabbed by Cettr ed Malt.
WAIVER SECTION
I ardentana mat any Pxopoeod Prey dock rneann g tfrr+Ds.boat ramp.braatnrelet bo tlAousa.►tt,a
rcr:muai beset tea I mWrteath*IW be N 15 from my add 011111201110210101.5 onlep y,mr fp by me
tabs roan net apply le bottoms*Or tip►rp reeet'rwntsl(If you With la WINO IN setback you nuot*Ilan
the a@Prectkaie blank 0e1w I -
ll
I r,Y)w,sn?a ratio 50.none's a"tho I5 sE.tbaNc/J�`' //„ C —
ef
S+gr i um ct'R4,frte.rl RMaron PROW/Om of
-OR
I der woe wwh to wive the t5- schwa 70Wprenie°1 lxtdtal the blank) --
seinshait A Ad011es tt Rparry t*opc Ty/l OYMOr
Typal...i w nano at AttPO_ ,eat-urn r G

Mailing Address of ARPO: ? ,./j/finet e /��-,7�}n� C pr�
ARPO's email: Ce f „-1A)-<�� ARCP O,honaA: Ira q / ,� ^!
Date: re 1 � er is valid for up to ono year from ARPO's Signature'
�f /T Revised July 2021
TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION&WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjarent Riparian Property Owners(15A
NCAC 7J.0204(b)(5)), Proof of actual notice (a sign-off 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 properly 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 commcntsfobjectioris heroic a permit decision is made.
*Permission*of adjacent prope?h'owners is not necessarily required for DCM to issue a permit;however.
permission must be obtained for certain typeset proposed developments If they fall within a 15'setback
area along the riparian access area of the adjacent property,as determined solely by DCM. Il 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 addtibn, 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 development AND
• A property that fronts a natural ore anntadewaterbody 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
manmade basin.
• Easement holders?Yes,if the easement could be impacted by the proposed development
• StrectstRoads?Only if the sveet(read 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 clalmslshcltfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legatly intersect with the water at mean high tide?If there is a
question about whether an adjacent property is considered-ripener)? please reach.out to DCM Staff-
especiaPy on the oceanfront beach whom there may be undeveloped parcels on the beach or lit the water.
Who/What Is a Property Owner?
For private individuals (of families), send notice to the address fisted on inc tax card. Ii the property is
owned by an inc. or LLC, please send notice to the person listed as the registered agent on the NC
Secretary of Slates Corporations Look Up silts For
Condornailums or neighborhoods with an owners'association(HOAJPOA),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 drawug of the proposed
deveIOPxnerel,and ask them to sign this form and return it to DCM;OR
• You can hand•de Wer this form and a description or drawing•and ask your neighbor to return d to
DCM(consider prwiMmg them with a stamped envelope);OR ,
• You can mail this form by USPS Certified Mail,mtum receipt requested(the Green Card). It
choose this option.you must provide either the signed 5 mourned green can,OR track the c r`._1

Building inspections GIS/Land Records
Phone: [phone] Fax:[phone]tittj Phone [phone] Fax:[phone]
In an effort to provide better service to its residents,Beaufort County implemented a eountti w ide
Enhanced 9-1-1 system. 'Fliis product is designed to produce an accurate emergency dispatch
capability,which will enable a more timely response to emergency calls. Street number
assignments are based on the distance your property is from the start of the road. t i.e.; 1503 Oak
Street is about 1.5 miles from the beginning point of Oak Street). This methodology makes it
easier for first responders to find your house or business in an emergency. Addresses are not
assigned for other usage,such as identifying urotret-4 for bank/real-estate,insurance or other
similar transactions.
YOUR PROPERTY HAS BEEN ASSIGNED TIIE F(N.I,OWIN(;STREFT.ADDRESS:
2913 Mouth of The Creek Rd.
Blounts Creek, NC 27814
THIS IS AN OFFICIAL.STREET ADDRESS ASSIGNED
BY THE AUTHORITY OF BF.AIIFORT COUNTY.
To make it possible for emergency service providers or others to more easily find which structure
is yours, You Must Post Your New Address.
Listed below is a set of guidelines required by County Ordinance to aid in property identification.
All properly owners and residents arc required to display street address numbers so the location
can he easily identified.
I. The official address number must be displayed on the front of a building or al the entrance
to a building which is most clearly visible from the road during both day and night.
2. If a building is more than seventy-five(75) feet from any road, the address number shall he
displayed at the end of the driveway nearest the road which provides access to the building.
3. Numerals indicating the address number of a single-family dwelling shall be at least four
(4) inches in height and shall be posted and maintained to he legible from the road.
4. Numerals for multiple dwelling units and non-residential buildings shall be at least six((i)
inches in height and shall be placed on the front of the building faring the road or on the
end of the building nearest the road.
5. Numerals must be made from reflective material.
Page 1 of 2

AGENT AUTHORIZATION FOR CAMP' PERMIT APPLICATION
Name of Property Owner Requesting Permit i t..1 �'
Mailing Address• ,7 1' 6150215 r c.A4
'.r e crl\R t�p_.,__._ A O ((3 4 _
Phone Number: -/c5V.3.-2 i`l62?? In��,
Email Address: i,rrat10 e f
IF.--
l 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 />a ."} M n ul () vie- rK R(4
r` 13cate cnct County. Gl0(�Y i-s �r` 1 A)a-- 2-7 /q k
It rthermore certify that l 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 0' er Info ‘;
10 I 4r"" .6 ........„..—.c-r
1'7
Sign-'u e
ot? 1(5q-e_
Print or Type Nahie
0A/iHt.r
Title
,. ? i_.,2 .-....„ aoP,
Date
This certification is valid through /