Davis, Robert 88867C

1* ,=FjO �41 FICAMA ❑ DREDGE & FILL N9 88867 A B c D
y GENERAL PERMIT Previous permit
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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_ )
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. 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)
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
(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)
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

�11jOAS t4l —ICAMA ❑ DREDGE & FILL N9 88867 A B C D
y GENERAL PERMIT Previous permit
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 ❑ Rules attached. ❑ 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 ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ 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)
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 n
Permit Conditions
(Scale: )
U 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)
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

Styron, Heather M.
From: Kari Taylor <[e-mail]>
Sent: Wednesday, December 28, 2022 10:38 AM
To: Styron, Heather M.
Subject: [External] 107 Intracoastal Dr, Beaufort
Attachments: CAMA Docs.pdf; Map Sketch.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to wort Spam.
Hi Heather,
Please find the attached documents for 107 Intracoastal Dr, Beaufort. Please let me know if you have
any questions or concerns.
Thank you,
Kari Taylor
Executive Vice President
C,-252-571-7282
e.r e
CARTERET MARINE

0
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Robe-rT DoLu/S
Mailing Address: I Ul JLN I KhLUH-) I d L Vr-
'�
3eau -Foerr
Phone Number: ZQ-691?�624 -ar--JS2.(P?0 0'a30
Email Address: =U)QqVfSA-H6-( mck(l' Coln
I certify that I have authorized 117-iorto--r Mamf-
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: (C)0J ON
at my property located at INTRKOSTAL J)r' 8ext4; YT N.C- -
in b rTer 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:
14 � mr1apim
This certification is valid through -/ 1

x
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:_. R&E'rT L , DauI 5
Mailing Address of Owner 107 Z1VVaeQd5-TAL D
Owners email:MQW ��S RdT' fr1G;bwner's Phone#: -,fit 7- r �5 q
agent's Name: Carteret Marine Services 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
description or drawing, with dimensions, must be provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal,
If you have objections to ghat is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 90 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 mupA sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
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:
Mailing Addrous of ARPO: _ ....
AR.PO'e email: `,� n ARPO's Phoe#:
Gals: "walvor Is valid for up to one year from ARPO's Signature'
l ovisotl 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: 'R&e- L - DqU15
AddressofProp": lorl T.1yUfA0C2,9SJ4L of
Mailing Address of Owner'. 107 LV—K14eQ65TAL- d-r Me— 2S'-16
Owner's email: > W (fT ft;/Dwner's Phone#: Za - T 02(95--q
Cory%
Agent's Name: Carteret Marine Services Agent Phone#: [phone]
ON Agent's Email: [e-mail]
10*
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
L (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.
DOCK , description or drawing, with dimensions, must be provided with this letter.
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.
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
grain must be set back a minimum distance of 15'from my 0 riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments). h to waive the setback, you must sign
the appropriate blank below.)
1 00 wish to waive somelall of the 15'setback
1-11 / - . ,
-OR-
I do not wish to waive the 15' setback requirement (initial the nk)
Signature of Adjacent Riparian Property Owner. _
TypedlPrinted name of ARPO:
Mailing Address of ARPO:
ARPO's email:
Date:
°-,ARPO's Phone*:
..waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

TIRT-1- PIP,
v —•
Q —a
a x_
O
O
�
r .
AD
r
a �!J
I tl
. s !' f } Y ��'- f+ d.s• � 9t F ��,� r ' ���r !��' d ,mac ^ d � -
4r41
ov
FI a® (3{n iy rd }' t � � p L.: '� �aA.��i� r4 •' . a'
x 1
}rf ir+ 1 !. t ,, r •d` S.0 yy.-ry"i�F•w YYy h
rile-����L•�'r� 'f�T ! V- it�� 9, � �'~ +1
rk 4 r
, .fi 71 � of LAY Y�i
v€y t ski..
ol