Whittaker, Lee 88643C

;oNojcoAsrgz& ]CAMA ❑ DREDGE & FILL 9 88643 A B(9 D
y = GENERAL PERMIT Previous permit
J Date previous permit issued
ffilk�Nevv [-]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 �� •' Zoo❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City F���--t
Phone # Z
Email
Street Address/State Road/Lot #(s)
Subdivision
City / ZIP
Affected ❑ CW KEW �TA ❑ ES ❑ PTS Adj. tr. Body r. (n SiaTi�nk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body 90q �Q
ORW: ye no PNA: yes/0
Type of Project/ Activity
(Scale! )
Shoreline Length
Access Length
Pier(dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) ,,
Total Platform area Caa�
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards 00 _
Boat ramp
Boathou / Boatli 10'X /
Beach B zing�C�—❑
Other
$CoQ
0
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no ❑ �(��
Riparian Waiver Attached: yes P S
A building permit/zoning permit ay be required by: ' 1 ( `' ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
p� ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, C C RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE kTATEMENT. (PleasP nitial)�
c10
A t or App�liPRINTED Name / Permit XW
Name
Si ture **Pie a,�e read compliance statement on back of permit** Sign
at e AZ3/ /,20
Application Fee(s) Check #/Money Order Issu ng Dat piration ate

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ��� Lik%1b-�_6a_
Mailing Address: �0 r"LW 0�A '$LUQ-
?ia1;�' V'4u. 5�ko2c5 , l�� 2o�cZ
Phone Number: 0-02.25S-�&
Email Address: t w�L� ��� MMV4 COwt
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: NFw Zb, DOa
at my property located at tyu� ygtoq C k V9LJP-
in CAf41LZ (_' County.
l 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
t, on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
VAV-o L- Wu,u
. Print or Type Name
Title k
ZZ-
Date
This certification is valid through 6� I ) 4 1 2 02

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NO'i1FICATIONIWANER 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 Prop' rty: {J�
Mailin Address of Owner. �� Mt0�• 1 v Z%�7yL
g
Owner's email: � ��"- �l,t '�iwner°s Phone#:
��J
Agent's Name: J7/�134 PM4 Agent Phone#: Zs2 66S r / 3%$
Agent's Email:
G
2g612.-
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIMATION
(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
descn io�wZ
ith dimensions must be vid vr' this letter.
( ve objections to this proposal.
I DO have objections to this proposal•
ff you have objections to what is being Prole you must y the N.C. Division of Coastal
management (DCAI) in writing within 10 days of receipt of this notice. Corieespondence should be
►r►a ted to 400 Commerce Am, Atwohe+ad City. NC 285b7. DCU rgV"ent8ti0es can also he ca+rtacted
at [phone]. No response is considered the same as no objection M y►ou have been, noWled by
CerMW Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse. tift> or
groin must be set back a minimum distance of 15' from my area of riparian access un" waived by me
(this does not apply to bulkheads or riprap revetments). (If you to waive the setback, you mUt si n
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback
f Ad1aoe joe►iwn Owner
-ORlij
-
I do not wish to waive the 15' setback requirement (initial the blank) J
Signature of Adjacent Riparian Property Owner.
TypedlPrinted name o[ ARPO: VAV12 e65,� ' o
Mailing Address of ARPO: � t)�
E ARPO'rsermail: ARPO s Phone#:
Date: V 1'' ZOZ� -fir is valid for up to one year from ARPOe'
's SignaWf
Revised May 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 =P P 1A/ htT t �jG (f
Address of Property: _ t o 1uALIMOSC6 � +
Mailing Address of Owner: M MOSrr P 1��
Owner's email: Owner's Phone* ZSZ. 251" Mg
Agent's Name:.-1 Agent Phone#: 2JZ' g6S, -g37D
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be comoieted by the Adjacent Property Owner)
1 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. A4
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 slfan
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 the blank) Qr
t�1�I
/�� t
Signature of Adjacent Riparian Property Owner: U&114
Typed/Printed name of ARI
Mailing Address of ARPO:
ARPO's email: �18 Ula A81 eks-f&► ARPO's Phone#: ZS2.2 Ll `glfi
Date: g f i1/ 2 Z. *waiver Is valid for up to one year from ARPO's Signature*
Revised May 2021

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O rl'Uf" m 9m & CONSt. LEE **TAKER
AdChi We 104 AMA DMVE, PW KNOLL SHORM�
Ml'3 OLn AWOK "V
Ww M, NL 28562 SITE PLAN
252-665-4WO