86784A - Ross, Alan

�DA❑ DREDGE & FILL '' N9 86784 C B C D
GENERAL PERMIT Previous permit
y Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by theStatepursuant ate of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuato:
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I SA NCAC r A • I'aag ❑ Rules attached. ® General Permit Rules available at the following link: www.dea.nr g CAMAnlles
Applicant Name C'V%
_
Authorized Agent {
Address �Z C3� o� FivCa SkttYC.
W�
Project Location (County): f �iS �t f v . j(
City - r- . State
W L!
ZIP 1'7 cf G-1
Street Address/State Road/Lot #(s)
Phone # (W) 33� :
`_ yy�� --pp
209 a _k' W Y_s kd-Ye. F-Co
Email
Subdivision
city ZIP 19 9
Affected ❑ CW EW
® PTA
❑ ES ❑ PTS
'a (_ tan tnk)
Adi, W.. Body N YI
AEC(s): ❑ OEA ❑ IHA
❑ UW
❑ SPIMA ❑ PWS
Closest Mai. Wtr. Body �rsT ac°r j��►�r'
ORW: yes to PNA: yes/C
Type of Project/ Activity l h4,-,Ik
1 �t ail•
t6' x ('L' �rt'j tY�
(Scale:!! Cott)
r
--r - --"--,—fir-'._ ."" —T'_ �.,. _ ... • �_�_—r"`�Shoreline Length � a� i � , ,:. _. , _ _ 7
Access Length r - - I -
I I I I ! �. 6 I I i. i i I J I !—.i„__.i_. I V I t J I o- •i +_s—+—�—t
Pier dock length !�-*--r- -r 11� ' _ .'r - r'_, I3_
FixedPlatform(s) i_i
,�_T-' I f r I r i ' ' I , j'�.._i 'I• r. 1�,� j , I i 1 _E_J
mi
Floating Platform(s)
!
Finger pier(s)
l---i--r—_(_ —, 7..•_IT_'_f' r----___e ! .-_,—..,_._�._._! _ I ' `I 'r I I —r- I 9
Total Platform area -� 1 _ I 1 I ! I ! i 1 i
Groin len h /1f
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill � r ! 1 ,. ! ,�--� , "�`—i T 1 • � I ! i�i s- I
Max distance/ length Basin, channel -
.
Cubic yards
Boat ramp
Boathouse/ems+" 10 lc(7-' t i, i ,
_,...1_
• I
Beach Bulldozing '�--r y
Other [ N-C
�IT� _I I I I �-✓I� � t i + �" � 1� r t I 1, 1 I �� ' 1 I t '
SAV observed: yes
Moratorium: ® Yes no ,- ,--I- _ ! ! . >^;•--'--y-r_Y I---=^---r-�- _ t k -r .._I I I
Site Photos: $ no - Q --
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by: �QS� f t b
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions an back
1 AM AWARE OF STATUTES, CRC RULES AND CONDMONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Alan Koss L� "C' &h
Agent or plian�fRINTED Name Permit Ofiy er's PR^TED Name
Signature "Please read compliance statement on back of permits• Signature
Application Feels) Check fi/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION1WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: k"t1 ,
Address of Property: 7.e Z y'1Jl �' � � � cGy (r4
Mailing Address of Owner:
Owner's email: Cu t� iT"ti �f? l /Rld ' eiLlj� Owner's Phone#: ZS-Z - 7>3i -941' �
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.
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner 1 - r �y r �.�..
-OR- a . 5 xi
I do not wish to waive the 15' setback requirement (initial the blank) ,Q NOV 0 B 2022
Signature of Adjacent Riparian Property Owner: �J- r taw r ".
Typed/Printed name of ARPO:
Mailing Address of ARPO: 20 IQr✓,;iLS'NO�i: f�� �=�� 71Ac; ti r r''G 27gd°f
ARPO's email: ARPO's Phone#: 2 S 2 - 3 3 % - 20 S"Al-
Date: / // ZvZ 2 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

Alan and Lou Ross
2022 Rivershore Rd
Elizabeth City NC 27909
[date] 2022
[New North neighbors]
John and Susan Hankinson
Elizabeth City, NC
Dear Neighbors:
If you would be so kind, please sign the attached "Adjacent Riparian Property Owners'
Statement" to accompany our application for a CAMA permit to install a center piling in
the boat slip at 2022 Rivershore Rd. The location of the piling is shown in red below; it
will extend about 10' above the waterline. Thanks very much!
,r ,
GO Be-� ' ors s� P ,' ro'
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Alan Ross
PORT IC
I OT
F-GEIVED
N O V 0 8 2022
DCM—EC

RECEIVED
NO V 0 8 2022
DCM-EC

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: A_L"�t h=� i'.v SS
Address of Property: Z C- ZL-, 1 �i U i.�L 5 t <4 . t.-44,
Mailing Address of Owner: Z-0 ZZ �W. i.,�r_,, i '-C 2k
Owner's email: czibwner's Phone#: 3 59 - Cje l 5
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
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 sign
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)
Signature of Adjacent Riparian Property
Typed/Printed name of ARPO: jo, ,q✓A
RECEIVED
NOV 0 8 2022
DCM-EC
Mailing Address of ARP11O: JJ 124yO A
ARPO's email: << �1RPO's Phone#:
Date: % /UU- 0 ZZ *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

Alan and Lou Ross
2022 Rivershore Rd
Elizabeth City NC 27909
[date] 2022
[New North neighbors]
John and Susan Hankinson
Elizabeth City, NC
Dear Neighbors:
If you would be so kind, please sign the attached "Adjacent Riparian Property Owners'
Statement" to accompany our application for a CAMA permit to install a center piling in
the boat slip at 2022 Rivershore Rd. The location of the piling is shown in red below; it
will extend about 10' above the waterline. Thanks very much!
Alan Ross
P°R-TI C
_®
RECEIVED
NOV 0 8 202Z
DCM-EC

RECEIVED
NO V 0 8 2022
DCM-EC

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: �AA, -1
Address of Property:
P (� E;3 ` 9
Mailing Address of Owner:
Z�U ZZ
re Iyc�rL�l�a2(, 2�
GL►'ut13t:'t?l
Q�I
r 1L, Z--2°tcf�
Owner's email: L 61 % S' 2) U ram• Uc wl Owner's Phone#: �, S"Z 339
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
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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 sign
the aoorooriate 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)
RECEIVED
DEC 1 6 2022
DCM-EC
Signature of Adjacent Riparian Propertyr: Owner
J
Typed/Printed name of ARPO: os", ✓/) />a4!Q0-M '
Mailing Address of ARPO: 7-,V69 & /C i veRS'f-bk ( En L r T`1 NC, 2'7gO4
ARPO's email: jasyL.:;L6 ��i 9A1 ARPO's Phone#: ��? ZS-Y-61A%
Date: 15 IDE4 .2- *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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• N.C. DIVISION OF COASTAL MANAGEMENT
DECEIVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY DEC 1 6 2022
(Top portion to be completed by owner or their agent)
Name of Property Owner: At,tt-Loy DCM-EC
Address of Property: 'ZyZZ UVTL5t4L(6 0-1' C,IT _ �L. �2`lo`'j
T—
Mailing Address of Owner: (Uy prft,S11c R(; _JW1 j_14C.,
Owner's email: ) �Attvo, ac)4w Owner's Phone#: "ZS�Z S^
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
description or drawing,with dimensions, must be provided with this letter.
L,11 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
Im
I do not wish to waive the 15' setback requirement (initial the bl
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: J0(4 �j
Mailing Address of ARPO: �vz(, ✓�I�S�J�cs ��� �L, z..4,��
ARPO's email: ARPO's Phone#:
Date: I L// i 1Zv 22 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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