Owens, Christopher 88447C

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❑DREDGE & FILL N9 88447 A BO D
4 GENERAL Previous permit
PERMIT
` Date previous permit issued �
[J�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 0114 , aP�w ❑ Rules attached. General Permit Rules available at the following link: www.decinc gov/CAMArules
Applicant Name (.4 111 5Z
Authorized Agent — /
Address �� Project Location (County): Z)/?,V
City 2 State ZIP Street Address/State Road/Lot #(s)
Ph #
Email Subdivision
City ZIP
Affected W Tq ES ❑ PTS Adj. Wtr. Body /p P� a man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body AZ4
ORW:y no Pq�5)/no
Type of Project/ Activity /�q_ S Ql%�.( /n S% �j/i�„J z�Y-
(Scale: I y
Shoreline Length
Access Length w ;8 o , -
Pier (dock) length /� �IV/ V („�
Fixed Platform(s)Z T �� ^ I l
� `rJlAV
Floating Platform(s) • 0
Finger pier(s) w bw I
Total Platform area
Groin length/q
Bulkhead/ Riprap leng<
Avg distance offshore / ✓ ��
Breakwater/Sill
Max distance/length_
Basin, channel
Cubic yards
Boat ramp
Boathous oatli
Beach Bulldozing
Other ".V
SAV observed: yes7(`','" I 5✓ r
Moratorium: n/a yes T�oj'��Site Photos:\
Riparian Waiver Attached: %n�
A building permit/zoning permi�y5e required
Permit Condid s Q ❑TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Agent
Name
AND CONDITIONS
PRINTED
(Please Initial)
Signature "Please read compliance statement on back of permit'" Signatr
Application Feels) Chec /Money Order Issuing

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER 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 Owne,.
Owner's email:
v
Agent's Name:Y �
Agent's Email. 01 A
Owner's Phone#: r'� loll
Agent 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
v 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 1IR-4
Signature of /a e t Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)_.
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO:
Mailing Address of ARPO:
zv�A-o
ARPO's email:&AC�L�` � il' CCM ARPO's Phone#: 1J q S -4 �"�7Z,
Date: 2af 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 NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property
Address of Property:
Mailing Address of Owne
Owner's email: ew.5 2ja2 0 Owner's Phone#: Qj� 0 • Ll'l $ G, 11
Agent's Name: Agent Phone#: Y� A
Agent's Emai
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent 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
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' setl�acJc�
Signatur J ntt iparian Property Owner
-O R-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: -9 �A��
Mailing Address of ARPO: �����y-A '..�7C �./ryp�yVgti./� �)L?�j((,,rZ�
ARPO's email �T Lr^ h iZ e"ARPO's Phone#: _q f/ % % J (d"(�
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: wG J
�n
Mailing Address:
Phone Number:
Email Address: xD
I-oeetify=4hat I have;aut
.: Agentcontractor
to act on my behalf,for; : ose of applying for and obtaining all CAMA permits
A.
necessary for thefollawlC�� proposed development: t --
y
iaFF
at my property, Iq 3 2 P M'
and do in fact grant permission to
mit Officer and their agents to enter
,aluatina information related to this
M,z,KAC
Frint or Type Name �G
NIs-z�SL-f-t}�
Date
Jff
This certification is valid th
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