Tewksbury, Eric 90031C

LAMA ❑ DREDGE & FILL 0 90031 A BO D
GENERAL PERMIT Previous permit
Date previous permit issued
�iew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized
,�bbyry^the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC io�� • 27 v� ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.goy/CAMArules
Applicant Name cr► C_. -Taa- _ f ' - ` Authorized Agent -- t1�
Address nu n—%'- "d. '� +, W& �/' Project Location (County): It '
CityC �_' _States ZIP�� Street Address/State Road/Lot #(s) fp(y n/ut�112Pc
Phone # (�) �c %� 7
Email 2(7"c_..^�ewin6yi)QL:L �nilpt,,f �. ('a�+'� Subdivision
City 4" ZIP Z?
Affected ❑ CW �W �TA ❑ Es ❑ PTS Adj. Wtr. Body filzl.i� a manJunk)
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW:yese PNA:yes>
t
Type of Project/ Activity PJ2gb � ak4y - T11
i1 1
(Scale:
Shoreline Length �"'
I 1 i (-
Access Length
Pier (dock) length
Fixed Platform(s),1`-
t.
FloatingPlatform(s)
Fingerpier(s)
Total Platform area .�� _ I
Grain length/it l
Bulkhead/ Riprap length
Avg distance offshoreJ-
Breakwate Si t 1C _ ----
,
Max distance length
Basin, channel-
-..._ _ I _..1 1 . _..-I. �_ __.. i' �_ ' ---� -_- _. _ i I �...�
Cubicyards / j l I i
Boat ramp I ' I - - i - - -- ----I
fi �1
Boathouse/Boatlift ��� I
Beach Bulldozing `/
i, /tt-G-.F -
Other
- N�--,�--�--- -- -
SAV observed: yes
Moratorium: n/a yes
Site Photos:
Riparian Waiver Attached: yes no „-
_- _.:!_.. .!-.'...-..
A building permit/zoning permit may be required by: PA f a) rj 4 /yJ
Permit Conditions t) . 'J �. sII i ski. Ab+ bL atlako �� 3�` t tuc,ne nIKW TAR/PAMINFUSE/BUFFER (circle one)
1pktfti 4 5yI� '. Ikka TA �X� 112, ok6y4t- �w � S,I I si'� Alf kftu#- V ❑ See note on back regarding River Basin rules
I s t� � SIa A VW+- 1 t f %WAG �o
`�� �� V-- ❑ See additional notes/conditions on back
412 91
or
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (P;Iease IhitW)
Sarph S.Bodiri`.. �� (rNjy�Q , kgkg
Agentof Applicant PR NTED Name a limit Offlter's.ORINTED Name
Sig tu((ryye��*��*PI read compliance statement on back of permit** Signature
Application Fee(s) Check N/Money .Order Issiil Date t.Eitpiratiofr Dafe'

North Carolina p0
el
Coastal Federation
® Working Together for a Healthy Coast Q� L4 10
06 February 2023
Wayne Hall
NC Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
Re: Application for CAMA General Permit 2700
Eric Tewksbury
604 Bronna Road
Beaufort, NC
Dear Mr. Hall,
Please find attached copies of the necessary documentation to request a GP 2700 for installation of 180
linear feet (LF) of offshore sill at the above referenced property. The following is included in this packet:
Figure 1— Location Map & Site Plan
Figure 2 —Cross-Section of Proposed Offshore Sill
Figure 3 — Existing Conditions Photos
Signed Agent Authorization for CAMA Permit Application
Adjacent Riparian Property Owner Statements for adjacent landowners
• Adjacent Riparian Owner of 606 Bronna Road (New Vision Trust -Charles Smith)
waived setback.
• Adjacent Riparian Owner of Bronna Road (NCDOT-Gory Eure) did not waive setback.
Please let us know when you would like to visit the site and/or the permit is ready for signature. If you
have any questions, please feel free to contact me or Lexia Weaver. My contact information is listed
below. Lexia Weaver can be reached at 252-393-8185 ext. 501 or [e-mail].
Sincerely,
Sarah S. Bodin
Coastal Resiliency Planner and Manager
252-393-8185 ext. 503
[e-mail]
North Carolina Coastal Federation
3609 HWY 24 (Ocean)
Newport, INC 28570
252-393-818
R1=r1F_1"=D
DGM-MMU GIT°Y
Northeast Regional Office Headquarters & Central Regional Office Southeast Regional Office
637 Harbor Road, P.O. Box 276 3609 N.C. 24 ® Newport, NC 28570 309 W. Salisbury Street
Wanchese, NC 27981 252-393-8185 Wrightsville Beach, NC 28480
252-473-1607 www.nccoast.org 910-509-2838
!d

Proiect Location Ma
Proposed Living Shoreline
604 Bronna Road
Beaufort, NC
Date Prepared: 02/06/2023
Mapping Source: Google Earth Pro
7.3.6.9285
Carteret County GIs 02/06/2023
Project Description
An offshore sill is proposed to be
constructed at 604 Bronna Road, Beaufort,
NC, as shown to the left and below. The
total length of the property's shoreline is 260
feet. The offshore sill will be approximately
180 feet.
The offshore sill will be constructed parallel
to the shoreline by layering oyster shell
and/or marl bags perpendicular to the
shoreline as shown in Figure 2. Coir fiber
matting or equivalent will be placed
underneath the material to reduce settling.
The landward edge of the sill will be no more
than 30 feet waterward of normal high water
or no more than 5 feet waterward of existing
coastal wetlands, whichever distance is
greater. Overlapping gaps at least 5 feet in
width will be placed at least every 100 feet to
allow water circulation and fish passage per
permit requirements. All other applicable
specific and general conditions outlined at
15A NCAC 07H.2700 will be met.
Site Plan
Figure 1
Location Map & Site Plan
Applicant(s)
Eric Tewksbury
504 Holly Branch Drive
Holly Springs NC, 27540
r.'l a F�
of im,. Awl,.) n� I
North Carolina Coastal Federation
3609 HWY 24 (Ocean)
Newport, NC 28570
[phone]
www.nccoast.org
North Carolina
Coastal Federation
s Working Together for a HeahhyCoast

Normal High Water
/ (NHW) Sill height shall not exceed N
Maximum
12" above NHW or height of adjacent o u
I wetland substrate, whichever is higher,
Number of layers of bags may vary as 1.5 n
needed to reach desired height & slope. NHW
-
------------------------
Y Y — Oy orSholl s NLW
Spartina patens Spartina alterniflora — — — — — _ _ _ _
planting (optional) planting (optional)
Max 30 ft. from NHW or 5 ft. from existing Max 12 ft.
wetlands, whichever distance is greater
Cross Section of Oyster Shell Bag Offshore Sill
Examples of Oyster Shell Bag Offshore Sill
Proposed Living Shoreline
604 Bronna Road
Beaufort, NC
Date Prepared: 02/06/2023
Photos Taken: 2/14/2022
Existing Conditions
Figure 2
Cross -Section &
Exisiting Conditions
Applicant(s)
Eric Tewksbury
504 Holly Branch Drive
Holly Springs NC, 27540
North Carolina Coastal Federation
3609 HWY 24 (Ocean)
Newport, NC 28570
[phone]
www.nccoast.org
North Carolina
Coastal Federation
s Working Togetherfor a Healthy Coast

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Eric R. Tewksbury
Mailing Address: 504 Holly Branch Drive
Holly Springs, NC 27540
Phone Number: 919-730-1644
Email Address: [e-mail]
I certify that I have authorized North Carolina Coastal Federation ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Living Shoreline
at my property located at 604 Bronna Road, Beaufort, NC 28516
in
Carteret 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:
Signature
Print or Type Name
Title
UC\ I 2 1202.2
Date
This certification is valid through 9 / 30 / 2023
�, !.-,t°l�-sI.,9 8-1,Y

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: Eric R. Tewksbury
Address of Property: 604 Bronna Road, Beaufort, NC 28516
Mailing Address of Owner: 504 Holly Branch Drive, Holly Springs NC 27540
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: NC Coastal Federation
Agent's Email: [e-mail]
Agent Phone#: Sarah Bodin: 252-393-8185 ext 503
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.
x 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.
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) 2-c-
V
Signature of Adjacent Riparian Property Owner: B
Typed/Printed name of ARPO: Gordy Eu e
Mailing Address of ARPO:
129 Masontown Road, Newport NC
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 1-9-23
*waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
b
i%k_.-,. Ki-. P I_ j a. - F y

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.
Revised July 2021

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: Eric R. Tewksbury
Address of Property:
604 Bronna Road, Beaufort, NC 28516
Mailing Address of Owner: 504 Holly Branch Drive, Holly Springs NC 27540
Owner's email: [e-mail]
Agent's Name: NC Coastal Federation
Agent's Email: [e-mail]
Owner's Phone#: [phone]
Agent Phone#: Sarah Bodin: 252-393-8185 ext 503
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 forthis
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.
X 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.
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.)
I DO wish to waive some/all of the 15' setback Ada x- �%G�%16
Signature of Adjacent Riparian Property Owner
Ego
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: AMC& x. 0%Gl�/16
Typed/Printed name of ARPO:
Charles L. Smith (as agent for New Vision Trust)
Mailing Address of ARPO: 6635 Windyrush Rd., Charlotte, NC 28226
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 01.25.2023
"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.
Revised July 2021

North Carolina
Coastal Federation
Working Together for a Healthy Coast
06 February 2023
Wayne Hall
NC Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
Re: Application for CAMA General Permit 2700
Eric Tewksbury
604 Bronna Road
Beaufort, INC
Dear Mr. Hall,
Please find attached copies of the necessary documentation to request a GP 2700 for installation of 180
linear feet (LF) of offshore sill at the above referenced property. The following is included in this packet:
Figure 1— Location Map & Site Plan
Figure 2 — Cross -Section of Proposed Offshore Sill
Figure 3 — Existing Conditions Photos
Signed Agent Authorization for CAMA Permit Application
Adjacent Riparian Property Owner Statements for adjacent landowners
• Adjacent Riparian Owner of 606 Bronna Road (New Vision Trust -Charles Smith)
waived setback.
• Adjacent Riparian Owner of Bronna Road (NCDOT-Gory Eure) did not waive setback.
Please let us know when you would like to visit the site and/or the permit is ready for signature. If you
have any questions, please feel free to contact me or Lexia Weaver. My contact information is listed
below. Lexia Weaver can be reached at 252-393-8185 ext. 501 or [e-mail].
Sincerely,
Sarah S. Bodin
Coastal Resiliency Planner and Manager
252-393-8185 ext. 503
[e-mail]
North Carolina Coastal Federation
3609 HWY 24 (Ocean)
Newport, NC 28570
252-393-818
Northeast Regional Office Headquarters & Central Regional Office
637 Harbor Road, P.O. Box 276 3609 N.C. 24 • Newport, NC 28570
Wanchese, NC'27981 252-393-8185
252-473-1607 www.nccoast.org
ed
oi4v
Southeast Regional Office
309 W. Salisbury Street
Wrightsville Beach, NC 28480
910-509-2838

Proiect Location Map
Proposed Living Shoreline
604 Bronna Road
Beaufort, NC
Date Prepared: 02/06/2023
Mapping Source: Google Earth Pro
7.3.6.9285
Carteret County GIs 02/06/2023
Proiect Description
An offshore sill is proposed to be
constructed at 604 Bronna Road, Beaufort,
NC, as shown to the left and below. The
total length of the property's shoreline is 260
feet. The offshore sill will be approximately
180 feet.
The offshore sill will be constructed parallel
to the shoreline by layering oyster shell
and/or marl bags perpendicular to the
shoreline as shown in Figure 2. Coir fiber
matting or equivalent will be placed
underneath the material to reduce settling.
The landward edge of the sill will be no more
than 30 feet waterward of normal high water
or no more than 5 feet waterward of existing
coastal wetlands, whichever distance is
greater. Overlapping gaps at least 5 feet in
width will be placed at least every 100 feet to
allow water circulation and fish passage per
permit requirements. All other applicable
specific and general conditions outlined at
15A NCAC 07H.2700 will be met.
Site Plan
Figure 1
Location Map & Site Plan
Applicant(s)
Eric Tewksbury
504 Holly Branch Drive
Holly Springs NC, 27540
North Carolina C&Istal'Federation
3609 HWY24 (Ocean)
Newport, NC 28570
(252) 393=8185 - ='
www.nccdast.org
North Car lid
Coaftiai ederation
Working Together for a Heohhy Coast

Normal High Water
/ (NHW) Sill height shall not exceed Maximum
12" above NHW or height of adjacent o Slopa
wetland substrate. whichever is higher.
V Number of layers of bags may vary as i s n
yyneeded to reach desired height ✓; slop-. NHW
0yj6r Shell fte
NLW
Spartina patens Spartina alterniiiora — — — _ — — _ _
planting (optional) planting (optional)
Max 30 ft. from NHW or 5 ft. from existing Max 12 ft.
wetlands, whichever distance is greater
Cross Section of Oyster Shell Bag Offshore Sill
Examples of Oyster Shell Bag Offshore Sill
Proposed Living Shoreline
604 Bronna Road
Beaufort, NC
Date Prepared: 02/06/2023
Photos Taken: 2/14/2022
Existing Conditions
Figure 2
Cross -Section &
Exisiting Conditions
Applicant(s)
Eric Tewksbury
504 Holly Branch Drive
Holly Springs NC, 27540
North Carolina Coastal Federation
3609 HWY 24 (Ocean)
Newport, NC 28570
[phone]
www.nccoast.org
North Carolina
Coastal Federation
c Working Togetherfor a Healthy Coast

AGENT AUTHORIZATION... FOR CANIA—PEURWIT —APPLICATION
Name of Property Owner Requesting Permit: Eric R. Tewksbury
Mailing Address: 504 Holly Branch Drive
Holly Springs, NC 22-751!,
40
Phone Number, 919-730-1644
Email Address: EricTewksbury@gmail,com
I certify that I have authorized North Carolina Coastal Federation
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Living Shoreline
at my property located at 604 Bronna Road, Beaufort, NC 28516
in Carteret 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:
Signature
Print or Type Name
Title
Date
This certification is valid through 9 1 30 1 2023

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:
Address of Property:
Eric R. Tewksbury
604 Bronna Road, Beaufort, NC 28516
Mailing Address of owner: 504 Holly Branch Drive, Holly Springs NC 27540
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: NC Coastal Federation
Agent's Email: [e-mail]
Agent Phone#: Sarah Bodin: 252-393-8185 ext 503
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.
x 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.
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 Owner: a6li-14&
Typed/Printed name of ARPO: Gordy Eu e
Mailing Address of ARPO:
129 Masontown Road, Newport NC
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 1-9-23 *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.
Revised July 2021

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: Eric R. Tewksbu
Address of Property: 604 Bronna Road, Beaufort, NC 28516
Mailing Address of owner: 504 Holly Branch Drive, Holly Springs NC 27540
Owner's email: [e-mail]
Agent's Name: NC Coastal Federation
Agent's Email: [e-mail]
Owner's Phone#: [phone]
Agent Phone#: Sarah Bodin: 252-393-8185 ext 503
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.
X 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.
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' J11d, j
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: d1, 41 `i x - G� �
Typed/Printed name of ARPO: Charles L. Smith (as agent for New Vision Trust)
Mailing Address of ARPO: 6635 Windyrush Rd., Charlotte, NC 28226
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 01.25.2023 *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 Cnsel
and we will work to answer your questions.''
Revised, July 2021