Jerome L. Heard Jr. Trust 91131C

1\1OF COW414, c❑CAMA ❑ DREDGE & FILL N° 91131 A B C D
2 Previous permit
GENERAL PERMIT
y 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.deg.ncgov/CAMAruies
Applicant Name _
Address
City
Phone # (_ )
Email
Affected ❑ CW
AEC(s): ❑ OEA
ORW: yes/no
State ZIP _
❑EW ❑PTA
❑IHA ❑UW
PNA:yes/no
Type of Project/ Activity
Shoreline Length _
Access Length _
Pier (dock) length
Fixed Platform(s) _
Floating Platform(.
Finger pier(s) _
Total Platform are;
Groin length/#_
Bulkhead/ Riprap
Avg distance offish
Breakwater/Sill _
Max distance/ len
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatli
Beach Bulldozing_
Other
SAV observed:
Moratorium: n)
Site Photos:
Riparian Waiver
A building permit)
Permit Conditions
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
❑ ES ❑ PTS Adj. Wtr. Body
❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
P
k)
(Scale: ; , )
❑ 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

❑CAMA ❑ DREDGE & FILL N9 91131 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 _
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) 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 re
Permit Conditions
(Scale: )
U 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

Styron, Heather M.
From:
[e-mail]
Sent:
Monday, January 23, 2023 8:48 AM
To:
Styron, Heather M.
Cc:
'Doug Banks'
Subject:
[External] 286 Shoreline Dr. River Bend
Attachments:
CAMA Forms.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to Report Spam,
Good Morning Heather,
Please see attached paperwork for 286 Shoreline Dr River Bend. Let us know if you have any questions
or if there's anything else you need.
Thanks!
Amanda
Doug & Amanda Banks
Coastal Boat Lift Repair
252.635.8494 Doug
252.671.1196 Amanda
Visit us online www.co(istulboutlifti-epair.com
Review s� cm
LEAVE U5 A
fucebookGo gle
REVIEW"
This message may contain confidential and/or privileged information. If you are not the addressee or authorized to receive this for the
addressee, you must not use, copy, disclose, or take any action based on this message or any information herein. If you have received this
message in error, please advise the sender immediately by reply email and delete this message. Thank you for your cooperation.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jerome L Heard Jr Trust
Mailing Address: 286 Shoreline Dr
Phone Number:
Email Address:
River Bend, NC 28562
619-920-9796
[e-mail]
I certify that I have authorized Coastal Boat Lift Repair ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
of 4 boat lift r)ilin4s
Demo & rebuild dock, installation
at my property located at 286 Shoreline Dr River Bend NC ,
in Craven County.
I furthermore cortifythat 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:
— A/// T r C'-
Si na r
Print orTypeName
Title
_ ) / IUI142;�7
Date
TV ds to- —e
This certification is valid through I I

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: Jerome L Heard Jr Trust
Address of Property:
286 Shoreline Dr River Bend, NC
Mailing Address of Owner:
286 SHORELINE DR NEW BERN NC 28562
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Coastal Boat Lift Repair
Agent's Email: [e-mail]
Agent Phone#: [phone]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Ad acent 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.
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 sittn_
the appropriate blank below.)
I DO wish to waive some/all of the 15'
lA
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
— A
Typed/Printed name of ARPO:
Mauling Address of ARPO: / i t j
) f ,� d {gip
ARPO's email: �f . Jul A4,1 °� ") yy� .�`/ARPC s h ne#:
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
�C

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: Jerome L Heard Jr Trust
Address of Property: 286 Shoreline Dr River Bend, INC
Mailing Address of Owner: 286 SHORELIN5 DR NEW BERN NC 28562
Owner's email: llheardSO@gmail-com Owner's Phone#: [phone]
Agent's Name: Coastal Boat Lift Repair Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
Bottom ortion to be com leted by the Adjacent Propeft 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.
1 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
malled 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 Prop rt Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: /"o-t-z� 49
Typed/Printed name of ARPO: A 12— 1 5 17 5 N-ar i L'
Mailing Address of ARPO: 2 86 b49, t30t'LikJ I N G
ARPO's emaii: N -SPvp us% / y1�Fo° ARPO's Phone#: 252- Zed 2/4 Z
Date: '762• "waiver Is valid for up to one year from ARPO's Signature*
Revised July 2021
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