Everette, Kip 84239C

�*1COAST4, . ❑CAMA [I DREDGE & FILL 9 .'��-:4 39 A B C D
y �v 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_
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
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 required by:
Permit Conditions
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
nat/man/unk)
(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"
y�qy
Application Feels) Check #/Money Order
Signature
Issuing Date
Expiration Date

1*°`(OAS til&❑CAMA [IDREDGE & FILL N9 84Z39 A B C D
5
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): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length _
Pier (dock) len€
Fixed Platform(
Floating Platfor
Finger pier(s) _
Total Platform
Groin length/#
Bulkhead/ Ripr
Avg distance o1
Breakwater/Sil
Max distance/
Basin, channel
Cubic yards
Boat ramp _
Boathouse/ Bo
Beach Bulldozi
Other
SAV observed:
Moratorium:
Site Photos:
Riparian Waive
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: I j)
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #/Money Order
Permit Officer's PRINTED Name
Signature
Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: K iV [V(—;" iC-i f�
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
1
r- a�-I. "
7 1
A li / A)
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 60,
�:= t- 49- C Q( S-1 v- us�l I am 0-t -
at my property loca ed at y D aIeP-
in La W e- County.
Agent / Contractor
Mm
1 furthermore certify that 1 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:
/�� g4l,
Signature
tea- <1 � ►'�
Print or Type Name
Title
Date
This certification is valid through I I

I herebycertify that I own property adjacent to l
y (Na a of Property Owner)
to, OP
property located at w a��� L-
(Address, Lot, BI ck Roa ,etc.) 0j
on cc aS in
(Waterbody) (City/Town andlor County)
The appXant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
(have obiections_o_this-prop9s_al-----------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
of OPM a site drawings
(Individual proposing.development must tilt in desctrptton �® O�� 4-
.� l3
WAJVF-R SECTION. _ _ `--..-
i understand that a pier, dock, mooring pilings, breakwater, Coatounless�wa� ed groin
by mue- (lf � st be t tV�n
back a minimum distance of 15' from my area of riparian access�.
wish to waive the setback, you must initial the appropriate blarkbelow.)
I do wish to waive the 15' setback requirement. JAN 2 '()7
* _ I do not wish to waive the 15' setback requirement_ OGM—mmo U Y
� Owner' information)
(property Owne nformation) (Adjacent o roperty
e
Sio at- re
EySign. � '�
C-rC-
Print or Type a
Print or T, e Nam ` me ✓ , —
O
C �Ma ng Address i
SY
M ling Address - �, �B � �,�rt,�ti-b
.�' r -Ke
Cipj/St e/zip ih�/State/Zip l
Telephone Number
Telephone Number,,
`2� Z gate
Date
(,Re-Osed 6/18/go12)

Ap,jAGENT RIPARIAN PROPERTY OWNER STATF-mtry 1
�� s
I hereby certify that I own property adjacent to (Na a of Property Owner)
property located at •' °�� ��
(Address, Lot BI ck, Roa , etc.)
�!�'!� ,
Ckv 'c.�
on in
N.C.
(Waterbody) - (GitylTown andlor County)
The appplfht has described to me, as shown below, the development proposed at the above
/ locati
(have no objection to this proposal.
I have obie_c-t orts_toAbJis.--Pr-o-p9sal-----------
DESCRIPTION AND/OR DRAINING OF PROPOSED DEVELOPMENT
(Individual proposing development must in description below or attach a 00C)drawing)
3 30
C �
d0v
WAIVER SECTION , ----_ - - `—..-
I understand that a pier, dock, mooring pilings, breakwater, tOathouse, lift, or groin must be set
area of riparian access
back a inimum distance of 15' from my unless waived by me. (If you P
�.
wish to aive the setback, you must initial the appropriate blank below.)
I do wish to waive 'the 15` setback requirement. JAB;,
1 do not wish to waive the 15' setback requirement.
A .d...... + ota erty Owner Information)
(Property Owner Information)
at
�;bn ` �jlie
Print or T, e I am
p r' e
iVtng address
City/St e2ip
�Vtkb
U
"'Telephone Number
Tel phone Number �
bat
7 ntp 1
iCt t Cp OJ C L% (Revised 6/18/9012)
�c tter

Board of Commissioners
John Davis, Mayor
Frank Tursi, Mayor Pro Tern
Patricia Turner, Commissioner
Harry Pugliese, Commissioner
Larry Philpott, Commissioner
Jeffrey Conaway, Commissioner
sin
Town of Swansboro
Friendly City by the Sea • Established 1783
www. swansboro-ne. ors
January 20, 2023
Kip Everette
404 Water Street
Swansboro, NC 28584
Re: Parcel 1405-62 (317 Water Street)
Dear Mr. Everette:
Town Manager
Paula W. Webb, MMC-NCCMC
[e-mail]
Town Clerk
Alissa A. Fender, CMC
afender a,ci.swansboro.nc.us
The Town of Swansboro has signed the Adjacent Riparian Statement with no
objection to your proposal. Per our understanding, the "9x9 pull out" will be
removed and added at the end of the dock as shown on the drawing as "add on."
The existing boat lift on the right side of the dock will be moved back to the end of
the dock.
Please note once you receive CAMA approval, you will need to obtain a building
permit from the Town of Swansboro.
Sincerely,
Paula W. Webb
Town Manager
cc: Andrea Correll/Planner
JA N,
601 W. Corbett Avenue 9 Swansboro, NC 28584 • Phone: [phone] Fax: [phone]