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fl c*"rd e"r.iRules attached.
issue f] Partial Reissue
Previous permit
Date previous permit issued
Commirrlon ln m area of envaro i€nt:l conc€m pursurnl lo:
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Breakwater/Slll
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Site Photos:
Raparian Waivcr Attach€d
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TAFVPAVNEUSE/ruFFER ((ircle on6)
See note on bacl reSardint River Bash,ules
See addi$onal notes/conditloni on badcr-\
AWARE s
A8ent.
cRc ATD COl{DITIOI{S THAT APPLY TO THIS PRO.IICT AI{O REVI€WEO
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(Please lnitial)
PRI
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Application Fee(s)
complia 3tatement on bac* of permit"
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GENERAL PERMIT
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order
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:233 Grandview Drive
Sneads Ferry, NC 28460
Phone Number:910-389-1507
Email Address:nla
I certify that I have authorized Joshua Barber/ PFL Conskuction
Aoent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
Replacing dock in its existing foot print.
at my property located at 233 Grandview Drive
in Onslow County.
I furthermore cedify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management statr, 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 lnformation:
ccrL6 ;,+L /I I -22
Signaturg
Ousby R Bryan
Pint ot Type Name
Title
tt
Date
This certificalion is valid through I I
Ousby Bryan-
necessary for the following proposed development:
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Owneds email:
Agsnt's Nams:
N.C. DIV]SION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL . RETURN RECEIPT REQUESTED oT HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property omer: duJ'/y' / Bty',tn
2?l drtn/uren Pfr '/t"/rs /errt H Lltr(4o
Mailing Addressof owner:Zl? finJf zc't /)& SrP*as /err/ /A 3f4/ /
Owner's Phone#?/a-5t1-tt-,?
Josh Barber/PFL Construction Age n1 phqne#. 91 0-330-5569
Ag enr's Emait: [e-mail]
ADJACEi'i: i,;PAiiIAN PROPERTY OWNER'S CERTIFICATION
(8qLom portion to be complatad bv the Adlacont Propertv Owner)
I hereby certify that I own property adjacent to lhe above referenced property. The individual applying for this
permit has dascribed to mo, as shown on the anached drawlng, the development they are proposing. A
descriotion or drawino. with dimsnsions. must bs orovidod with this lettor.
r' I OO NOT have objections to this proposal. _ I DO have objections to this proposal.
lf you havs oblections to what is being proposed, you must notlly aha N.C, DMlslon of Co?stal
Management (DCM) ln w ting within 10 days of racelpt of this notlce. Correspondence shoutd be
mailed to 100 Commerce Ave., Morehead Ciay, NC 28557. DCIO representatiyes caa srso be c ontacted
at (252) 80&2808. tllo response is co nslderad the same as no obJectlon lf you heve been notified by
Cettified Mail.
WAIVER SECTION
I understand that any proposad pier, dock, mooring pilings, boat ramp, braakwater, boathouse, lift, or
groin must bo set back a minimum distance of 15'from my aroa of riparian access unless waived by me
(this does not apply to bulkheads or riprap r6vetments). (lf you wish to waive the setback, you EISEIS
the appropriate blank below.)
444I DO wish to waive some/all of tho 15' sotback
Signature of Adjacent Riparian Propetty Owner
-oR-
I do noa wisir to waive tne '15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property
Typs d/Printod namo of aeeo. 'V^, r'k / 7V/t't
ARPO's emall:fo Itz/tt, n.l ARPO's Phone#:
up to one year rrom ARPO'S Signature'Date;t-')oz''*waiver is valid for
Revised May 2021
Address of Property:
MailingAddressof Aaeo: ZJ 76rz^-?u/ezO,t- frt.or" ,arr, ,'"r/P46 o
1/a't)6'rro>
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERW OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL ' RETURN RECEIPT REOUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
2 ? I 1rrr""/u /€/z/ D,r 5'hzzrt-r Fflr / // a ) i44'
.".t cltb /
Mailing Addrossof ownar ?)) (:ronlurtt/ O* ltlr*ls 1!*t/ /u'a )f /l o
Owner's email
Agent's Namo
Owner's Phone#:1/o-3t77- tt-o 7
Josh Barber/PFL Construction Age nr phone#. [phone]
Age nt,s Emait: pfl [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Boltom portlon to b6 completed bv the Adlacent Propertv Owner)
I hereby certify that I own property adiacent 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
rlaq?.ri^ti^n ^r .lrewin^ wilh rlimah m st be ^r wi.lA.l with thic lattar
I DO NOT have ob.iections to this proposal.
-
I DO have objections to this proposal
tf you have obleclions to what ls belng ptoposed, you must notw the N.C. Dlvislon of Coastal
Management (DCM) in writing wiahin 10 days of rcceipt of this notice. Correspondence should be
naiiid ?r,1C0 Co,'';;'I,Erce A;e-, lliore;;ead Cifi, NC 23557. DcL, representatlres can alsa be contacted
at [phone]. ,Vo tespotse ,s co nsldered the same as no oblecllon lf you have been no$fled by
Cedified Mail.
./ l-Qoyvish to waive some/all of the 15'
Adjacdftt Property Owner
-oR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adiacent Riparian Property
Typed/Printed name of ARPO:
a3/G ran d yict z Dr.-Ililailhg Add ress of
J.^
ARPO
]i.x:tal1A9 f
/t
IARPO's omail:ARPo's Phono#: 3 5a q a -t r', <:r <
. oajrel: la /n / eA 'waiver is valid for up to one yearfrom ARPO'S Signatur€'
Revised May 2021
Address of Property:
WAIVER SECTION
I understand that any proposod pier, dock, mooring pilings, boat ramp, breakwater, boalhouse, lift, or
groin musl be set back a minimum distance of'15'from my area of riparian acce$ unless waived by me
(this does not apply to bulkheads or riprap revetments). (lf you rvish to waive the setback, you !!Ug!-g.ig!!
the appropriate blank below.)