Collins, Kathleen 88830C

�1*000`r'v&❑CAMA ❑ DREDGE & FILL
GENERAL PERMIT
No 88830 A B C D
Previous permit
Date previous permit issued
F-71New ❑ 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 ' ` J ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwdeq.nc Rov/CAMArules
Applicant Name
Address
City State ZIP %
Phone # (_ )
Emailt-,
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IRA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale: '"
-
Access Length /�
,-
--
I.
-
L_
_
Pier (dock) length
Fixed Platforms)
Tri
7
r
{
I
I
1�_
_i
Floating Platform(s) i
Finger pier(s)
Total Platform area
�_.J
_.�_
!
Groin length/#
—
-
Bulkhead/Riprap lengthI
Avg distance offshore
Breakwater/Sillall
`
Max distance/ len h /
Basin, channel
Cubic yards /
-'
(
-F-
T
-
-
-
--
r
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J
...
__
_.--
n
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-_
W
Boat ram
-
I�
-
-
<
Boathouse/ BoatlifF ` .J /�) 71
i
r
}
_f
o Beach Bulldozing
Other / J
-
-
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: f ,\w.w U iew-, cA -
_�1,. ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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
Agent or Applicant PRINTED Name
Signature ""Please read compliance statement on back of permit*"
Permit Officer's PRINTED Name
Signature
Feels) Check#/Money Order Issuifig Date Expiration Date

+d(MU` ❑CAMA ❑ DREDGE & FILL N9 88830 A B C D
o
GENERAL PERMIT Previous permit
❑ New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue Date previous permit issued
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 goy/CAMArules
Applicant Name - Authorized Agent 6'l/l f'.V II
Address Project Location (County): J �.%� i`.I Q' 11
City State ZIP t:' i.�,7 (.L Street Address/State Road/Lot#(s) ' j'i ,I,'ii UYC l!ttC
Phone#O yy�`EJJ
Email 4- 11{'- Subdivision 1j(,yzl.r\('.1
CityiN` C W
Affected ❑ CW ❑ E W ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body 1 1' f
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body CJ
ORW: yes/fib PNA: yes/no
Type of Project/ Activity
Shoreline Length I i i
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
i'
Max distance/ length
Basin, channel
/
Cubic yards
Boat ramp
Boathouse/ Boatlih
Beach Bulldozing
Other
SAY observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zoning(
Permit Conditions r.l
(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) r
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name.
Signature **Please read compliance statement on backof permit** Signature
Application Feels) Check#/Money Order Issuing e Expiration a Datte

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Kathleen Collins
Mailing Address: 644 Winona Road
Center Harbor, NH 03226
Phone Number: [phone]
Email Address: [e-mail]
I certify that I have authorized John Gudaitis, Riverfront Docks
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 boat lift
at my property located at 282 Shoreline Drive New Bern, NC 28562
in Craven County.
I furthermore 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 Owner Informatio
Sig
e
Owner
Title
Date
This certification is valid through 11 / 3 I 2023

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: _ Kathleen Collins
Address of Property: 282 Shoreline Drive New Bern, NC 28562
Mailing Address of Owner: 282 Shoreline Drive New Bern, NC 28562
Owner's email, [e-mail] Owner's Phone#: [phone]
Agent's Name: John Gudaill 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 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, NC28557. DCM representatives can also be contacted
at [phone]. No response is considered the same as no objection U 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.) n /,�, / , /�)
I DO wish to waive some/all of the 15'
M
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner(
Typed/Printed name of ARPO: Elizabeth
Mailing Address of ARPO: 284 Shoreline Drive New Bern NC 28562
ARPO's email: tL/ ij��,%tgmz ( a ARPO's Phone#:,QsJ- &-zz)-0/�r,
Date: -/ ___•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 NOTIFICATIONIWAIVER 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:
Kathleen Collins
282 Shoreline Drive New Bern, NC 28562
Mailing Address of Owner: 282 Shoreline Drive New Bern, NC 28562
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: John Gudaitis, Riverfront Docks Agent Phone#: [phone]
Agent's Email: salesCriverfrontdocks.com
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 forthis
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 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, NC28557. 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 Sian
the appropriate blank below.)
DO wish to waive some/all of the 15' setback a
-OR-
Signature of Adjacent Riparian rt ro Owner �L-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owne2-�C✓.rig ;A- - O 714,1(
Typed/Printed name of ARPO: Lewis & Joyce Frazier v
Mailing Address of ARPO: 280 Shoreline Drive New Bern NC 28562
ARPO's small:ARPO's Phone#:
Date: II O *waiver Is valid for up to one year from ARPO's Signature`
Revised May 2021

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Malting Address: !-O.
�✓bo�o 7 SSG
Phone Number: oLJ a - 513
Email Address: y✓`lG/f/kq fa
I certify that I have authorized ABenl/,PS 4441d-/ -". �rlf-
Contra for
to act on my behalf, for the purpose of applying for and obtaining all
allll CCAAM�-A permits
necessary for the following proposed development: A l f By kke
at my property located at /6/1 rfaw 'Arc,-�—
in 4Z—k/LT 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 lands In connection with evaluating information related to this
permit application.
Property Owner Information:
r/ l�✓.i/1 r/'
Title
i/ � 1��
Date
This certification is valid through
Fki:_l it -T TI% T i-1