Humphreys, Michael 88814C

❑LAMA ❑ DREDGE & FILL N9 8881.4 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
Phone # (_ )
Email
Authorized Agent
Project Location (County):
ZIP 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
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: Net,o C
Permit Conditions eX,nn, 4-fir»'
(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 Fee(s) Check #/Money Order Issuing Date Expiration Date

a°F`°"S'"`% EICAMA ❑ DREDGE & FILL N9 88814 A B C `' D
0
y
Previous 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 Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
ORW: yes/no PNA: yes/no
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body _
nk)
Type of Project/ Activity
(Scale: - O)
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 nol
Site Photos: yes no 3
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions w rnf:ft-k
❑ 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 Fee(s) Check #/Money Order Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Michael Humphreys
Mailing Address: 1244 Hillsborough Road
Chapel Hill, NC 27516
Phone Number: [phone]
Email Address: mhumphreysl962 [e-mail]
I certify that I have authorized Riverfront Docks, LLC
Agent / Contractor
to act on- my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
install (2) boat lifts and a dock platform
at my property located at 630 Edgerton Street New Bern, NC 28560
in Craven 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 I in connection with evaluating information related to this
permit application.
Property
Michael Humphrey
Print or Type Name
Owner
Title
� 1 , 2a0,Z
Date
This certification is valid through 10 / 30 1 2023

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONUAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Michael Humphreys
Address of Property: 630 Edgerton Street New Bern, NC 28560
Mailing Address of Owner: 1244 Hillsborough Road Chapel Hill, NC 27516
Owner's email: [e-mail] Owner's Phone(/: [phone]
Agent's Name John Gudaitis, Riverfront Docks
Agents Email•. [e-mail]
Agent Phone# [phone]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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 fetter.
_T 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
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'_
C_
-OR-
Signature ofAdjacenl" iparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO: Kathryn Silver
Mailing Address of ARPO: 606 Edgerton Street New Bern, NC 28560
ARPO's email:
Date:
ARPO's Phone#:
'waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

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: Michael Humphreys
Address of Property: 630 Edgerton Street New Bern NC 28560
Mailing Address of Owner: 1244 Hillsborough Road Chapel Hill, NC 27516
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: John Gudaitis, Riverfront Docks Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owned
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 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.)
I DO wish to waive some/all of the 15' setback
•m
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) S
Signature of Adjacent Riparian Property Owner;
Typed/Printed name of ARPO: Sara & Ward Zimme
Mailing Address of ARPO: 101 King Street New Bern, NC 28560
ARPO's email:
Date:
ARPO's Phone#:
`waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

NEUSE RIVER
wood dock
(existing)
7,000 lb Boat Lift
„
C C
13,000 lb Boat Lift
•
----------------
-
Lowered 11' x 5'
Swim/Kayak Platform
Michael Humphreys
630 Edgerton Street
New Bern, NC 2860
IVERFIRONT
wood dock OCKS
(existing)
3614 Old Cherry Point Road
New Bern, NC 28560
[phone]
RiverfrontDocks.com