Rose, Eddie 84236C

N\°``°"St4,& ❑ CAMA ❑ DREDGE & FILL N9 84236 A B C ` D
z = Previous permit
J Date previous permit issued
GENERAL PERMIT
❑ 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 State ZIP,
Phone # (_ )
Email
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
(Scale: 1
Shoreline Length _
Access Length
Pier (dock) length _
Fixed Platform(s) _
Floating Platform(s
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap Ii
Avg distance offshc
Breakwater/Sill _
Max distance/ len@
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlif
Beach Bulldozing_
Other
SAV observed:
Moratorium: n/;
Site Photos:
Riparian Waiver At
A building permit/
Permit Conditions
u
❑ 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" Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date

;o1°1
COA tLN FI CAMA [I DREDGE & FILL N9 84236 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:
I SA 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 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 reyuueu uy:
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" Signature
Application Fee(s) Check #/Money Order Issuing Date
Expiration Date

Drawing Prep:. -ad By: C3 Scott, Inc
Date: 11 /17/22
Scale: 1 ": 20'
Proposed Work:
-Demo existing 20k boat lift
and: piles, disposing of piles
and leaving boat lift on
homeowner's property
Install eight 10"x30' piles to
support new 24k Tide Tamer
boat lift
0
5' 1 116 John L
tD 1 Hurst #Drive
Property Address
114 John L Hurst Drive
Swansboro, NC 28584
Property Owner:
Eddie Rose
- -� �►
112 John L
Hurst Drive

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: —_ ei ; C t OS
Mailing Address:
I certify that 1 have authorized
S'wpik)6�occ> NCr a es$-1
0110-330 -4MA•
c©seeo @• c� -
C3 Scott, Inc
Agent / contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: acr.AMto)
a1419 C 9 LE L;
at my property located at \-4 & 98,8 4
in n nr�_ county.
furthermore certify that l 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:
` — r� 1
Signature
Print or Type Name
Title
t_. ©3 1 0�
Date
This certification is valid through / 4 -3 / °Q
PFCFIV f
)AN t 7 2i)2'1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
I (Name of Property Owner)
property located at �_..-.._ _... _ .._ . - -- .... ...
_.
(Address, Lot,. Block, F oad, etc.)
on In �: %��a1,�i r 1>�t'w' N.C.
(Waterbody) (City/Town and/or County)
Initial ,� The capplicant has described to me, as shown below, the development proposed at the above
Here of I have no objection to this proposal.
one o
thes I have objections to this proposal.
lines
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
a
„
WAIVER SECTION
I understand that a pier, dock, m6bring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from 6iy area of riparian access unless waived by
Initial me. (if you wish to waive the setback, you must initial the appropriate: blank below.)
Here on 1 do wish to waive the 15' setback requirement.
one of ,
these j I do not wish to waive the 15' setback requirement.
lines
(Property Owner Informatio (Adjacent PropertyO-wn Information)
- ..-lam
Sl�rptillI rc .Si (t! tic
q-4
Pant . r T e Ntame L Print or Ty e Namp.
Mailing g Address Mai Address
iL �--'MterzZ City/srate%Z.ip
lr phone Number / email address Telephone Numb r 1 email address
rrlt nrrrr W CFAV
(Revised Aug. 2014,j
`Valid for one calendar year after signature"

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
4Name of Property Owner)
property located at ,
(Address, Lot,. Block, goad, etc,)
1t
on Y ' �� r'
m :1,. s �l1..t3? .,..�:__..._...------------_.__...N.C.
(Waterbody) _ (
Ci
t
y
/Tow
n and/or County)
Initial The applicant has described to me, as shown below, the development; proposed at the above
Here on . /lopa' .�
One of �, - I have no objection to this proposal.
these ! I have objections to this proposal.
lines
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum _distance of 15' from rhy area of riparian access unless waived by
Initial
me. (if y u wish to waive the setback, you must initial the appropriate blank below.)
Here on I do wish to waive the 15' setback requirement.
one of
these _ I do not wish to waive: the 15' setback requirement.
lines n
(Property Owner Informat
_.--�--
.Si L*rul.terrri
or
Ad re s/ ,
Telephone Number / ernail address
Oe
*Valid for one calendar year after signature*
Owner Inform
\ ""\. �
Print or Type Narne L ,
My line Address
City/StatelZip
Telephone Number / ernail address
(Revised Aug. 201 4)
JAN t 7 2023