Gallop, Marshall 88912C

J
coast ..� o8 _ �`
'� CAMA ❑ DREDGE & FILL
❑ s A B C D
y
Previous permit
GENERAL PERMIT i permit issued
Date previous pe s
F New F Modification F 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 F Rules attached. F General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State
ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected F]CW 1-1 EW 1-1 PTA 1-1 ES ❑ PTS Adj. Wtr. Body
AEC(s): ❑ OEA I IHA El UW ❑ SPIMA R 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)
'i
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:
Permit Conditions
ZIP
(nat/man/unk)
(Scale: )
,.t
n TAR/PAM/NFLJSF/RUFFFR (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"
Application Fee(s)
Signature
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
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 6/01/2021

NO88912
°i`°MrA1 ❑ CAMA ❑ DREDGE & FILL A B C , D
3 Previous permit
z - G E N E RAL PERMIT Date previous permit issued
R New R Modification ❑ Complete Reissue R 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 R Rules attached. F-1 General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State
ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected F-1 CW FIEW FIPTA FIES FIPTS Adj. Wtr. Body
AEC(s): ❑ OEA FIIIHA El UW FISPIMA F I Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
horelineLen h '" „ S rNl ,//!///✓/.V///r/NVN/ /N/N//N///NN/NNr NN ,NN / ///!/NNN/N//N!N/N/ /rNN N,NNNN/NN/////N/HN Nr% rN///N,/N/lrNJINNNN/NN /N///N///NN/N% rrrr///H%N///NN///qNNrNlr/llrrrlrrrl,/r/N///////N////////N///////N/H/N/N/d/ry/N///N/NN//N/NrrllN�r!!r!/!!lrl�,/% N/////////NNNNN(NrrlN/rr,Nf/N,rNN//N/////N////N////iV//
� //N £ // ' y' / f / : # ?
'
s s" i
s t i s s i J 5 ,
• 5 # t
t
t #
t
y - t # ,
t
t :
• t , t
t
S
S
S
t
AccessLength .,.... .. ....... ...... ...... ...... b ....... ....... .... ....... 5.............y. .... ,
, s � N 's, 3 / # i 'ss
...................i',,,...,......f. ,,,,,,,",,,L,,,,,,,,,,,,h ",,,,",,,,,,,,,5,,,,,,,,,,,,,,",,,""„i'„ro,,,,.,,,,s,,,,,".,,,,,.� ,,,,,,,ro,,;i,,,,,,",,,,s'„u,,,,,"�/,,,,,,,,,,,�,,,,,,,,,,,,,,,,,,",,,.iy",,,,,,,,,,s,,,, ,",,.,,s' ,,,,,,,,,,,fy,,,, , / r ,,,,, "„v", r / r i r
Pier (dock) length # _ 5 s t = L" y
i #
,, .........i:......... "., ro ro .. ","., ✓ro....ro 3yroro",,, ,5 hj ,,,,,,.,,,;v,,,,.,.,, ""„iy,,,,, ,, ,,,,,,,, G,,,,,, ..,,i, ,, .,,,,. ,;i,,,,.,y. 4..,. ,,,.,. �,,,,,,,,,,,,,,,,,,,,,,,,, ,,..,,:,:,..,, .........f/,,,,, ,,,4',ro
Fixed Platform(s)"�"� t
y � t t t t
,
t .
y..........................:.............'y............b............/............,.............L..........,,,y..,,,..-,....,.,.,.......b....,,,...,.,y,..,,.......b�,..,,...,,.i.,,.......,..t...,..•......y..........,..;............,y...................,.......,...n........y .................. .........;,., „�,, ..�.. '�S
ys. # S S � h'�• # # t' '.S y
# r
�.:-ll,,,. ,.i;, „",,,,�''�.,,"N,,,,,s/ ,,,N"„✓� ",,,,, roq,"„%l�w+f ..,,,," „�,,,,,,,,,�.�.�i�N„ 5�,,,, , v S y ,�„ 3,,,.�r.,, i ! y' !'
Floating Platform(s) s # _
t y 3 t # t t
t 3 # t t t
t
t
t t
t
y
t
t
t
t
Finger r t # : t # # # # # _.. ".,
g p O
#
',,,,.,,,,.,".......... ............i,..,.,.,,,ro/,.,,,ro.,,.%,,.,..,,.,...5,..,:,,,,,:a..>,-,,,,-,,,,,,t3i,,,,,,,,,.,5/i,,...",.,."353. ..,,..iuii,,,,,.,,,,,,,..,,,,,,.,,,,3,,,,,",,,,,,iy,"
i
s 4 # '4 5 #
, t t t s t S
t ,..�:' s, # i # . ;s ' # i s i , t y s s s
s
s i ,
#
ss � i s
s ' t
s t
i
' 5.......... /. . 4..........64' t. ............, j b............/............o............ /............./,............ i..,.........i.........................,...,,.......4............/............. '............i...,........ �.........., y.., ..
"s'.f' 1 # t s s
oe
% Ni NNiNi............. ! INNi%riiii NNI,N/ NNh,N r
Total Platform area
;N� H/ /rN,,,NI,N,N,,,,u NN,,,, /N!„1,,,,,,;/N„NNd;I,NNN,% iiNNNN%Niel s i%lNiNi N/ryl wNi /�,iNiNi%iiNa A.;
s r ft y
s s
y +' ....., ..%,i.,i../.i,..i.....ihro,..,iii...%,..i .,. ,,.3...
Groin length/# ...................."...."..,....".. ......."........, ,",.. .,,,, , ,.. ".,..£.." �.. ."�., ,�....�... , . ., ,'- - ' ; ' _ _ ' y
s is # : s /' „,
t
#
,' y � t
s
Bulkhead/ Riprap length t s � � r; _ # s # _ s
s s
s
t
# t s #♦ y
- s
i • y s
t
i
, t
3 r s
y . t
Avg distance offshore ............
.........................y............y,...........i.....,....../............a............,:,............;s..........y... �r t" i y
t y t
s , s:.. , a �,. y - f
t•
#
P.. C t
" "„s', ,�,,,,,, " ,,,,
.., ,..w,,, ..�.........,b..,,...,..,i./..........5.......,.,..i....,.,,.../',..,:.,,,,,.....,,....s.. .,�... s/.,...ro.....isr.,. /,.,....,.,.,.�, .t....,+N: / 't"dS.., p... / i '�...,. �. i../' /' ;/ /
Breakwater/Sill ~�- 3 t€ t """"" y"" s r
l # S s t ro # i # ,� { t t #
tf y 5 t y
,,,,3.,,, ,.,,..%....,......i,ro........,s .,.,.,
„ ,..,✓�..,, ,y ,,,,,.,,�;,.�.,. /„ ,,i � „s,,, /,,,,,, . / / , ,,,r1,,, t i srT
Max distance length f"` t
/ a" „t„ s ,,y�g'
i # t
.,.,,ro,.,ro,..3.,,ro, ,..i..,,,.,,,,,,i:,i .. ,,...,..,.i.,,.,....,.,ti...,.,.,,,,,!
,,,,,,, ,.... .,,,,,,,.i,,,,,,.,,.,i' .,. ,...,....%..... .../........,.,,.i......,.
.,. .,......%.. ,.......'.,..,...." ru...w.,,,z...,.......ii,.Y .:it.........,v/.,. .,..% r %. .... ...,. ...ii„h .,/..,....... .. / �p
f ,, y.t;; ; j,: ro.,, , /„ �+;, ":., ,:,,,,,,.:."g,,,,,,,,; ,,,,,,,,,,ice ,,,,,,,,,.31,,,, , i,,",.,,,,,. ; E,,, i s i y s
Basin, channel
r s , g }�
t
t
+
t
s ;
#
t
t
' t t , s
t
t
Cubic yards'` s s
t Si
t
t
t
,t
t
t
t
t
t .,
��
t
t
#
t.........y ,.......,:.
. t
Boat ramp r g
,....,..."".G.....".,i,Ny...i....i...%.." ,.,%... , . ...i"..i.....H..i.,.%/.lri......,.q...xi..i"xG,.... ' "„ii.,,�iii.,..i....iiii.."..,. �...i....i„N....imv//.,..ii...../N,..."..."h,.ri .,. .........,, , / / 3' ; ,i%.i . / i
F �.' �'" y . dCroroy..,...,ro.
Boathouse/ Boatlift z_ �` d 33 j 5 t #.. _
y # i / vuNu lNNiii/
i� C r irlr,,,,NNrrv,Nab NNi N,N,,ilNllrN,% I,NfNNiNUNii Ni
j!!/N/N //NN//!,N% /�IIA,NNNN////N/✓//N// /N�/ ////N%%If/f%!N%aNNNN,%r/r/I/(////NI/NNN,NN/%/ Nar �/N/rNr///// %/Na %��,YIN//I//N//.9//N�%//a/N%�r//NN/NI/�NNN/N/I%/NN/N/NNS '// aN�/////N/� NN�///,///N�/N / /
Beach Bulldozing s s '4fti *. 5 s s F :'�. s
p t ,
`............ g ,...._., t"............."....,...... .
.... ....,.. ...... .. .y ... .. irororororo./. Hp....... /. ... ...,."........%y........,w j............J............. ........H.�........ .,.h/i.......:...i,.. .'y... ..G... � ..G.... / , y , y ..j... ,
. S
%
y : ;
t
Other � # s # _� - #
O y
t s t t
. t
t % t
.. ... y
�........................... s•.. ......,.......... ............,,.......................,.............y. ......../...... ......,4 .......,,...........r....,...................., ..........................z ...............3,...........,y............i........................y............5,............ - ...�.... .. .:.Sy... ...s...
t ft A`.
................ro.//"r...�ro ....�...., ..........i,,........:%#.ro H...... , %y... ro 4 / ! S S
.,V .. • ...¢... 'S, t # Ile
..r.,«w y�. t? y
... 4
,.., ..... " ..... ...."�,..,. .,....x.%...i.......y......,.. .i....%.. .ro% .i..."i%"....✓i......i...../..i.,.......ii..........q........i..✓....i..,...././.".,....,ro%..,...iifi%J�tnw+�M.W+'ybltr...,i/y.........../i...........(.'1iroi. �,...irori%/' % / y /..
SAV observed: es no µgiro # r - y
Y ,�.�..•_ t., t ,,�;,, t ro # j r s i' t, t .....
rvii /Ni r ,N%ri,NNNi% /NiNr
Moratorium: n a yes n o �//% NrN//!Nr ' rlNrrN%�Hl,/N/N/I/N/d/ u'////Nri Nh%liiraN/,NN/!/iN%NNN�NN%�NNIi
/r ,... ............
Site Photos: yes no
y t A' s:. s 5 'S
i
s
s
4
s
s
s
s
s
s
Riparian Waiver Attached: es no 1,,,,„,�,NN,NNNs,,,N,,,NN,,,,,,,,;,,,,,,,,,,,,,,,,,,,,,,,,,,NN,,,,,N„N,�,,,,,,,,Na,N,,,N„N,.,,,N,,,,�iarlrlrN% NiiiNiNf,N„",NN N,,,,,,,,,,,NN„N„N,N,,,N, ;
A building permit/zoning permit may be required by:
Permit Conditions
ZIP
(nat/man/unk)
(Scale: )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
F]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

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
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 6/01/2021

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: Marshall Gallop
A r• Arnr-e- of Drr%^^ f?y
I \V LtIVVV VI 1 I%fpV1 {�y:
2108 Emerald Dr., Emerald Isle, ND
Mailing Address of Owner: PO Box 7100, Rocky Mount, NC 27804
Owner's email: [e-mail]
Owner's Phone#: [phone]
9
Agent's Name: Stephen Perry/Dynamic East Agent Phone##; 252-883-9585 (M)/252-773-4116 (0)
Aaent's Email: step henperry1ive.com
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
description or drawing,..r.with dimensions,
must be provided with this letter. PING Lift mounted on existing dock pe
.�a....r,.r uw.wwrw.«.-..mow M • w.. ■ . • . i . i i i . i i i •
kk—\
I DO NOT have objections to this proposal. I DO have objections to this proposal. attached plan.
If you have objections to wham is being proposed, you must notify the N.G. Division of Coastal
Management (DCM) in writing within 70 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.
vvAiaEFri. 5E� 1rOft IN
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 1 5` from my area of riparian access unless waived by me
(this does not apply to bulkheads or Nprap revetments). (If you wish to waive the setback, you must s
the appropriate blank below.)
I DSO wish to waive somelall of the 15' setback
Signature of Rdiacent Ribanan Proioefty Owner
-0R-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner,
T ed/Printed name of ARPO: Debbie Mackie
too(
Mailing Address of ARPO: fH Cedarhurst Dr., Raleigh, NC 27509
ARPO's email: au ntbh aol. com
ARPO's Phone#: [phone]
DEC 4 12022
Epcm,mmHo CITY
Date: 11 130 1017-- '*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 (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 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 DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15' setback 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 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 line 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 manmade basin.
• Easement holders? 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 claims/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 Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. If 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
State's Corporations Look Up site: https://www.sosnc.gov/search/index/corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), 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 drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Re vise Jul y �' 21
OEC 0.12022
v�M_MHO o

LI-ILt--�
T
3Z /314
I fl ,1ta
olft,
F, C.- v E Le
DEC 0 1 ZOZ2
oCM.MHK) cITY

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT PJPAR AN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVER`
(Top portion to be competed by owner or their agent)
Name of Property Owner: Marshall Gallop
Adder of Property:
2108 Emerald Dr., Emerald Isle, NC
Mailing Address of Owner: PO Box 71009 Rooky Mount, NC 27804
Owner's email: mgallop�bwswsoom
Owner's Phone#: [phone]
Agent's Nate: Stephen Perry/Dynamic East Agent Phone#: [phone] (M)/252-773-4116 (0)
Agent's Email. stephenperry@live,com
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Battam cgrtion to 6e c=aleted by the Adiaunt Pronerty owner)
I hereby certify that I own Propel 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
dewfiMn or dr
swing, M&h OiM20jions, must be er. PWC Lift mounted on existing dock per
I DO NOT have objections to this proposal. l DO have objections to this proposal. attached plan,
ff you hie objections to what Is being proposed, you must notify the N.C. Dh4sion of Coasted
Management (CCU) In wring min 10 Mays of receipt of this notice. Convspondence should be
tiled to 400 Commwre Ave., Morehead City, PVC 28557. DCU rspresenftdves can also be conUct
at [phone]. No response Is considered the some as no objection #you have been notified by
Cer~ Jail.
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 16 from my area of riparian access unless waived by rite
(this does not apply to bulkheads or riprap revetments). (if you wish to waive the seek, you must 111911,
the appropriate bank below.)
Sound Navigation, LLC
1 DO wish to waive some/all of the 15' setback By. ana ,
g
Signature of Ad ac+en ipadan Pro rty Owner
-OR-
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 Staub, Manager
Mailing Address of ARPO: 2210 St. Marys Street, Raleigh, NC 27608
ARPo'e small: [e-mail] ARPo`s Phone#: [phone]
k- �-i -, x , o� M
M .r
• November 30 202 f 0 � ��OTT
Date: waiver is valid for up to one year from ARPo s Signature*
Revised July 2021

!' tip, :� - _-

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations rewire notice of proposed development to the Adjacent Riparian Property ors (15AA
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 Hulce 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 DCM an opportunity to consider these comments/objections before a permit decision is made.
"Pe i nt owners is nat n sa r it for DCM to issue a permit; r,
permission must be obtained for certain types of proposed developments if they fall within a 15' setback 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 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? N this.bagdly to ensure comment by 2QLqnW1yh
• A property that shares a boundary line with the site of proposed development; AND
* A property that fronts a natural or manmade watetbody 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.
• Streets/Roads? Only if the streetiroad could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• folders of recognized submerged lams claims/shellfish franchises.
What Is Riparian?
Do the boundaries of the adjacent property pally 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 Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
wholwhat Is a Property Owner?
For private individuals (or families), send notice to the address listed can the tax card. If 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
State's Corporations Look Up site: https:/h .sosnc. qovlsearch/index/corp. For Condominiums or
neighborhoods with an owners' association (HOAIPCA), 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 drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hard -deliver this form and a description or draming, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by LISPS Certified flail, return receipt requested (the Green Card). if you
choose this option, you must provide either the signed & returned green card OR track the
certify mail package number on USPS.GOVs online tracking system, and provide the tracking
printout as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
DEC Q 12022
Revised Jury 2021

�,�y�p .
km
12R, ."ZOA�\��
: � �� �ƒ
Ind

:21oe L'm1vr,/�,G'Vv
&9.e 14 - 'e
DEC 01
DCM-MHD CITY

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: /4A v S � a r � t4'
Mailing Address: f3 d Y 7 / 069
0 lot s, /V 7f 9
Phone Number: '� s2L/NkNOW -ANA
l
Email Address: i'� � a � 1 °��? 6 w-----------------
s c� • f o N�
certify that I have authorized Stephen Perry /Dynamic East Construction
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
L i � "�j•p� o c �C
at my property located at Z ;0" p✓oV IV OVOT
in eoty�ev C I`
County.
1 furthermore certify that 1 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:
Signature
Ati,, t4 A II off,, J—V
Prins or Type Name
C%tNNe✓
Title
Z.
Date
�ECEl!/E�
This certification is valid through OW7/ 3 t � 13 DEC 0 12022

SEQAMA' / ❑ DREDGE & FILL
c
GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Applicant Name
Address
Ci'.-3 ^.
s
State ZIPS
Phone #
Fax #
Authorized Agent
rc4
Affected ❑ CW
❑ EW ❑ PTA ❑ ES C] PTS
AEC(s): ❑ OEA
❑ HHF ❑
IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes / no
Previous permit #
Date previous permit issued
❑ Rules attached.
Project Location: County_ ,._
Street Address/ State Road/ Lot #(s)
Subdivision
---- City-._ -- --- -- ZiP- �..
P
T
Phone # �� ),` -` iii River Basin -• r
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier ength
Platf
Fing
Groi
Bulk
Basin
Boat
Boat
Beac
Othe
ShorelineLength
SAV:
,, notsure yes no
Sand not sure yes no
Mortlorium: rVa yes no
Phot
Waiv
A buildingpermit may be required b :
P Y q Yregarding
Notes/ Special Conditions
MM
rL
Lk
f.
Ell See note on back re
E fi4er
din River
Basin rules.
IN
agent or Applicant Printed Name
Signature Please read compliance statement on back of perrr;i„ ,
Application Fee(s) Check #

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific 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 I) 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 or certified mail return receipt has been obtained from the adjacent riparian
landowners).
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 F-10ther:
❑ 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 Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-648 1) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleieh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910- 796- 7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

I
Applicant: Marshall Gallop
Date: 11 /9/10
Permit #: 56957C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount
Open Water
Dredge 0 Fill ❑ Both ❑ Other Fx-1
138
138
Dredge ❑ Fill Z Both ❑ Other []
Dredge [] Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both [] Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
riev F,e'd" 02/031 0

I PTA
------------
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date _ ?J/ a ) / D
FLIED
Name of Property Owner Applying for Permit:
IoAy6helli JV.
Mailing Address:
® Z30X 710
f2 7e
I certify that I have authorized (a ent) 044J e. I-Ve 4 cj/6 'L/- o &4j• to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) D tx �. �' � � c
v� c e s40
V -
at (my property located at) 0Z 0 p G � cV ``lj, '9v . Z; cv4lj 4A
This certification is valid thru (date) (/L1�&'i a / Z o/ L
Property owner Signature
Date
400 Commerce Avenue, Forehead City, North Carolina 28557
Phone; 252-808-28081 FAX: [phone] Internet; www.nccoastalmanagement.net
An Equal opportunity 1 Affirmative Acton Employer — 50% Recycled 110% Post Consumer Paper

5EF -13 - 201. 0 13 : 04 From : FAX AREA 1252937e 100 T o : 1919963662 2 P . 2' 3
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A. ME&MOONNG P11_JNG B0A7'LIFT1B0.47' 0USE)
at t4�
berehy certify that z owrm property dla;
(Name of property owner) =j
property located at ;/04F
(Lot, Block, .Road, etc,)
on60�1"eo" &4 inzi�?t�� .� /,tt" N.C.
atecbody) (Town andlor County)
Applicant's phone #: 9S_Z ~ �" W "ad Mailing Address: . & 00
X0 CkV Ae44 b-'-i1 ,4l4f Z APOf/
He has described to rm., as shown below, the development be !s proposmg a1 that locx6on, and, I
have no objemions to his proposal. I understand that a pier/mooring piles / boat ift f boathouse
must be sot back; a winjmwn► distance of fifteen feet (15) f -am my arm of riparian: mess unless
waived by zone. (If you wish to ware the setback, you most 'Initial the appropIriate blank
below.)
i do -not %ish to waive
r
4Z 0W I do wish to waive that setback regWrenient,
�r�w �sb�•r s.. r.--� ����,..�.�.-,a.`..-.....�.�r..�.��.�rAr w������rr��r����+��r��r�r+.r�...���..���..s�r�+����r��r�R ��. ��.r�...��� bAr�w.s.����.r��r.r i►
DIESCRIPTION AND/OR DRAVVUNG OF PROPOSED DEVELOPMENT:
(To bead by lnd Wdual pro
posing development)
_r
2X��
!-,��R_ cQoc k
d
Q f"f"wcli!
(Infarmatiion for Property owner Apply ina
for Pendi'l./W A ef
hoo 13S)e 7/�
Mailing Address
City/State7Zip
PXZ10737--2Zoo
T one Ni b
/3,�
Signat we Date
(Riparian Property Owner Information)
A,-Ja-v-� 0 -Ty�_Vaeu)
Si afore
ask K4 ej 6r. Altkt*. C J'w .1 y/" OD it
Print or Type Larne
i I-f'ism- A ip/ 3. W 9~ 8/J— -,? 0 -?
Telephone Number
�.// .31!6
.Z l 147 4.W r,,.a / A' 0 V. Dare
eve 41 A/ C

SEP-13-2010 13:09 From:FAX AREA
12529378100 To:ROC P-3--3
19 - be, 4,oO'.4;9 es F oftv

f
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING FILING'SIBOA TLIFTIBOA 7-H' O USE)
I herebycertify that I own roe adjacent to `�'��' /�� '
� property �' J s
(Name of Property Owner)
propertyI o cated at 1
0V
(Lot, Block, Road, etc.)
on 60 43 u e 3 o k H X , in
tl (Waterbody)
✓w J X rs /L' , N.C.
(Town and/or County)
Applicant's phone #: ZS Z ' i o3 � �/oa6 Mailing Address: /" Z) Jq `X 710 0
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individualproposing deiyelopneeiat)
/� " � o cQ � t" i • C a ]� i` c� Yl � � e i� / � .S � ir /f a �
hoa % /d-L f /Iev R )(-�At e A e X ec,'��9 vgwt .
0
-------------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
fo ermit)
ke S A 4 // /4. � a% Tie#,
060Y 710 0 YV
Mailing Address Signature
�ocA/ok�f', AlC Z7rPo1z V �/e4tjk"+6
City/State/Zip Print or Tylpe Name
,�52-`%37-22da��.� 2-qo3 •�/�o6(C.� i/9-701--6zZ5 . 1S'z-35c/-eljlJ_
Tel e Number � Telephone Number
Signature Date 1 r11/4$ ov Date
/v'K, e,. a t e� *Cc le� A,, C

e -
o"'O'e-lerid city I)CM

ConnectGIS
Page I of I
1:25 feet
ihttn•//r.artPrPt r•.nnnPntaic rnm/Mqn/PrintWinrlmxr onnnpotrtic onm/nronic 1 1 /S/7()1 ()

ConnectG I S
page 1 of 1
1: 25 feet
25
f.
on
http://carteret.connectgis.comJMapIPrintWindow.aspx?Map=http://carteret.connect is.coml � arcizis... 1 ll5/2010

Np�g(Pp_p_o
IfiF
soft.—
lkm,
jN.-
IN
if
Ti-
- - -----------
4"1
i.

F- CAMA LJ DREDGE & FILL
GENER, AL PERMIT Previous permit #
UNew F'] Modification (I Complete Reissue El Partial Reissue Date previous permit issued.
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name
Address
City State ZIP
i.
Phone # Fax #
Authorized Agent
Affected El Cw [I EW El PTA El ES D PTS
AEC(s): El OEA El HHIF El 1H El UBA El N/A
El PWS: El FC:
ORW: yes/ no PNA yes / no Crit.Hab. yes / no
Project Location: County____.
Street Address/ State Road/ Lot #(s)' i
Subdivision
City
ZIP
Phone# River Basin il r
Adj. Wtr. Body, (nat /man /unkp)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
L
Finger pier(s)
....... ...
r
Groin length
number
F
Bulk
Basin
Boat
Boat
head/ Riprap length
avg distance offshore
4
max distance offshore
, channel
-A
cubic yards
L------ -------- ------
ramp
house/ Boatlift 7
L-L
-------- --
Beach Bulldozing
Othe
Shor
SAV:
Sand
Mor
Phot
r
eline Length f Y
not sure yes no�
Y -A.
bags: not sure yes n - - - - - - - - - - - - -
IJ
atorium: n/a yes
no
os: yes A
Waiver Attached: yes, no
A building permit may be required by: See note on back regarding River Basin rules.
Notes/ Special Conditio
ns
:j 'r= -. .�
,4-r
-4-
Issuing Date Expiration Date
- �_..
:�
_:,�:
�
-
—
—
-��
-....._.��. �_._
_.
€
_.�
....
�
�
�.
�
i
�
. �
i i
{
�
_�_ _ �
_
�
t
�
� �
_ _
� �
�
__._._..
�
�
t
f
�—_ ��—
i
�
;--_ , y —__
_.._ �__-__�—_
---_---_.f__-
_�...._.#.__
- �;
------1--�
s---
, ---�-____-
,
�
_--�..__._.-�.__
_--�-'
- ___ _
-----�-- �.-----;---
i--------, --
----�-�-_.�___--�-_--------
�
'
_
� j
�
� _
� � '� :�
i � �
�
�
}ast
-....
_._ '
_..
�
�
�
� �.___
�-
f
4
►
it _
._. i.- I
:
-�...--.--
.._._. r�.�_-...._.
i
.�L_.«.
1__._...�___
_. _----
_-- _ _-_-_
__ __-
��f__
__
�
�I----
; t
� �
, "_"T"__"
�i
�---�— r
i
i —> —
I � �
-
� _4_.._._.._..._-..._
�
�_ �
i�
� i _
� ' i
� ..
� :..----�— �--�
_ _ i
4.
�o `
1__. � y.- .._.. .1.-. .. i .. . _._
____ .�._
..�. -. ._-_ _._..
__.
_� �_ __ � __ __.
_.. _..._ - _..__ _ ._...
....
T. - - ..T .._ - _._
.. _T __- ......
__....A -. _. -.... , -.. ._. _
._.. ... ....�_ -
Agent or Applicant Printed Name., PermitOfficer's Signature
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
■
Local Planning
Jurisdiction
Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific 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 or certified mail return receipt has been obtained from the adjacent riparian
landowners).
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:
F-1 Tar- Pamlico River Basin Buffer Rules F-1 Other:
El 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 Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-648 I) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

Clop
Iry rp.
00
�10
Nlo�firpl
n a n
Depairtmell'L of Envil ul ImC;
ioorth
'1 41
eS J c n -e s D i r WHIi;2m G. RcSlq Jr.
4 ;Z
AppjlJf-,a-An.,fL, Nai've
Al a �sG�� � I ,� � a I I ��� , J V
s—�_ yo6�(A«. ���
937' �2, 0 —3
v-
e
Ithat I ha-ve autbo,Hze-ci (agent / /A
10
b ehal', Ile i- th ior and
purpo-,�e o' app`�-in,(,T obtaining all CAN.L�,, Permits necessary to
4. n zn
A aj 0 1 /1,
Instal'", or Const
CO V) ;I Ck 4^ V. 0 C) 14 .'�Lv
e:';vNev-k fev ex / cp LA
Tc, )y 3 z oc)r A
This Cert-,175canon. is
IS 'A ED a I- U T -e

APkIt-28-2008 12:03 From:
T o: 912529378100 9 0097 Paqe.2-"E
APR -EB-20RB 11:20 Frum;FAQ; AREA
t
i2'S"?937910e To:* p Y p 0 P. 212
A rEN1T­4
IL
.� , j J. •.tea-�..''S1 ,� S� ._,Y't� t'�rr�' i'' t��f� �^1'j� -p
Ont T f7f
UH
-It V (� �?`i �i �, J a � � � P �1 � �� � l 1 � 1 -•� it .
rA )0P
t,; V e
zM
0 n (30 1A e OCR) Road, etc,) IAl.
bo Y) ­_1 Lei W [oL
TmaadD/ Court) A1He IG to MC
I
2,
.cadcn, and
(he dev u
, QcDjecdons
I _tznd
MUR be 5et bac. P unde
I L LA
'Lill M u m dis ag ;j
W;tved bvnlp- fro n. my jarea 0
d
Wish (Q waive
rvfto
that setback
6
D ES C PE M 0.N,- ..... . .
A,N-D/C)R DRwZi jG OF jRC)
&
19 /1 #K ey aft d0j
j ex AMP
IA K% Yoolo.44.. e ,,
solo,
4,r
Pj ey, r4
LIN
V
wbwo M 0 MVQ6L_
I j1j
14
Y?d
1,eo 4i01 e 140 W
VA lef T4,00(9 Ao'?6
q ~ fi r
V
572

4
�.% / - ..� �. • �. �. 1 ` 1 1 1 I . i . i C-i ' - 1 -/ '' 1 -mil t r-Road L
i
1
4
C, t� i'r 1 \ I� C, O I )~, �M r... V - r
.C%' , �lG l ,oj�r'�,(1G�► L i�1C. !S �i C)C0S-Lq
a'
!cY��� �n a-nd 1 ��tr ��to nr '
-' � � �•I......�!� � rC �`��� p+.-���J<<:�.. � �'il �� 3 �1�"/I�nc�o�:rr��1~ n
_ C
r!1.,,.(I r ��l�l�--vil, Iwr I` ! � � 'l�'li Li
bv
ai
���c�� _ _
�] Q L `,'" S 11 ! o cr,�, 1 ^ ' �-LJ C t,. r '� t„ _ alll a fir
do wj-h [_Q lac S�2cback -� ►, ��
/1_-___-------..--..----.�_..O�A��
D E
) C P,=
0 R D
G O F' PR O ?05 ED D E - E T Q Per
.. 0 be : !2 or i
14
(K s
ku
IL
V