Grafinger, Mike 88910C

0
8
o�pFCOAS4,41- ❑ CAMA ElDREDGE & FILL ' '� ^ A B C D
y ti GENERAL PERMIT Previous permit
Date previous permit issued
El 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 0 1 0 • I � ' ' ❑Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name'«�i .k, $;2
Address
City State ZIP
Phone # ( T )
Email ,.:r}..
Affected ❑ CW
AEC(s): ❑ OEA
ORW: yes/no
❑EW ❑PTA
❑ IHA ❑ UW
PNA: yes/no
ES ❑ PTS
❑ SPIMA ❑ PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Adj. Wtr. Body
Closest Maj. Wtr. Body
nat/man/unk)
Type of Project/ Activity
c ,
(Scale:
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 re
Permit Conditions
6
a
L_j imrs/rHr-i/rvr=uar/aurrr m tcircie 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) Check #/Money Order
Signature p f
Issuing Date Expiration Date

0A5T41 y ❑CAMA ❑ DREDGE & FILL NO 88910 A B C' D
9 Previous permit
GENERAL PERMIT
y 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 L ( j1 � I C-1 C" ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name'` t'•
Address
City State I'` 1 it ZIP
Phone #
Email ' L l,
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
CityT." r ZIP
Affected ❑ CW ❑ EWEll 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 1 , ,rt, 1r"= `''i A" i
(Scale:
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 A� i
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 n
Permit Conditions i "�. " wt'1 4^► "1.
❑ IAK/F'AM/NtUJt/I3Ufl-tK (circle one)
±� V
❑ See note on back regarding River Basin rules
X.
❑ 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) Check #/Money Order
Signature
Issuing Date Expiration Date

AGENT AVT'HORLZ-ATI . FQR CAM.A PFRWIT APPI ICATION
7,
N,
I I kol It e s s
CerONN Ttat I ha-.e autvtonzad
Agunt., ConlYidw
act on my bwhalf, tot the purpose of applying for and obtaining all CAMA petmits
-�ecossjrN for the following proposed development q
at my property located at
in if7*-County
i furtherrnote certify that I am authorized to grant. and do it) fact grant permisswri to
D"nwon of Coastal Management staff. the Local Pemut Officer and thou agents to enter
on the aforementioned lands in connection with evaluating informabc)n related to this
perrrvi application
Property
Ire
Print or rypo Names
ra/V

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:�c_�
Address of Property: niq I EzQy- - ST, f' ) '�', I� C
Mailing Address of Owner: Z.t �� i l'4�� r ti( VK, ?,ALr,- I6i 4 74C VWI-o
Owner's email: GVAV.gC_W-C�-& to 1t_ w>vlOwner's Phone#: 4
Agent's Name:
Agent's Email:
Agent Phone#:
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.
M 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 nodfled 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.)
100 wish to waive some/all of the 15' setback �/ /,r/ //
-OR.
Signature of Adjacent Riparian 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: IAM L 1' iEDL W
Mailing Address of ARPO: ?A d 7EC2AJa-CgL\1 M !A AJr7 � [y ,
ARPO's email: MAMCJJfMUk1a CAT%)OARPO'.'s Phone#: 4 (q -` 6*Z-3d22(o
Date:
C� r
r AA
*waiver is valid for up to one year from ARPO's Signature`
Revised Jury 2021

N.C. DIVISION .OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PR6PERTY- OWNER NOTIFICATIdNMAiVER F001
CERTIFIED MAIL • RETURN RgCEI_PTj— EQU STE or HM'D�EkY
(Top portion t - o e complete(!complete(!A owner. or their. agent}
Name of Properly Owner:
�ilk
Address of Property:
Mailing. Address: of,_0,wner.
or/ �
Owner's email: 1V4qr'f/•
Agen#'s'Name:
Agents Email:
Phone#' 2l 36)— ZCOO
Agent Phone#:
ADJACENT RIPARIAN *PROPERTY OWNERS :OERTIFICATION
(SQttom aotuon.to hg-!LMpteteLbv:the Adlac-ent-fonerty__MmO
I hereby certify that I own property adjacent to the above referenced property. The Individual applying fof this
permtt:has describeclAo me, as shown on the attached'Oawing,:the development they aM prop6sing..8
description,dr dtawln& withclim6rislons, must be: RELvided ah -this: e
I DO NOT have objections to this proposal. , I DO have objections-to-thle:w9posal.
rt you nave ;ppipmons -to wfiatis`:batng, proposed,. you Mq#. notffy-,tr.'e- MG
M�anaggm�ent�.{pCMj in.wrldng-within..10 days of r+acelpt of`ihls:rroilc°e. Corse;
nialleil to ;COlnnre�ce AVe�, MOr�ehcead Cftycr:NC.28W-.`DC�M1,MPresentadves;
ai�(�8j:61r56400: No rtesponse,ls.co�skfer�ea(ttie same as=roitectFicn;lfyou
CertlfledMall: .
WAIVER ,8E MON
I understand that any proposed pier, dock; mocrtrtgtlirigs,.boat ramp, breakwater.,. boathouse, -lift, or
groln must beset back a minimum distance of 15' from my area df riparlan aoom.untess waived by.me
(thts does not apply 'to bulkheads or riprap revetmente). (If you h.-to' walve.the;setbgCK ydo-Mma jolan.
the.appropriate blank- Mow.)
I DO wish to waive sometall of the 15' si
-OR-
'I do not wish to waive -the 15' setback requirement (Initial -the blank)
Signature -of Adjacent Rlparlan Property Owner,,,ne
TvoedMrinted name of ARM 146A
Maiting.Addrnss-of:-ARP.O: v2lo� /Av 0ai�t
ARPO's email: 10 n<'. f7- '�ARP0 s Phone#: _ ���� /+`'
r
Date: ��-� *waiver is valid for up to one year from:ARPO's Signature"
Revised-May;202.1

Jr-
e-^ A i

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 7,11
r or their agent)
Name of Property Owner: 14 1 ��- 60�,�
Address of Property:
f -7
f roe�4-
'e -
Mailing Address of Owne : �f�'i' /1C dl /�/ 2' �v
r i�1
Owner's email: �►'rY �2c-�" �5 ,�� Owner's Phone#: ,�t**I.
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that l 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,
V I DO NOT have objections to this proposal. 1 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 some as no objection if you have been notified by
Certit7ed 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
Si
-OR-
gnatuie of Adjacent Riparian 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:
Mailing Address of ARPO: -7
z
ARPO's email: t" . , �.�, r s, :1. ARPO's Phone#: 9 / r, ri-t i 913
Date: _ 1 64? z *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021