Kilpatrick, Frank Ray 90034C

wur N9 90034
°` '��,❑CAMA ❑DREDGE &FILL A B �C)D
GENERAL PERMIT Previous permit
Date previous permit issued
❑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 (7J j l JD"'1) ❑ Rules attached. N`6eneral Permit Rules available at the following link: wvrw.deq.nc.gov/CAMArules
( � r
Applicant Name Y.f OVA. �k.l?rn IL, 10h'Af!1,
t
r
Address /.t"I't-
City i r (.x., State i t l(., ZIP '- � cf.
Phone # () i .a - ITI " ( _
Authorized Agent '1 IL
Project Location (County): i r.—J. e
Street Address/State Road/Lot #(s) 1 e{ ") + d I �-
Email / „v.�•y Subdivision
City `" HfI 'i r C p
.._r-r5. r. r, L'` ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body Gopp l T�`` (nat/man/unk)
AEC(s): ❑DEA ❑IHA ❑UW ❑$PIMA ❑PWS Closest Mai. Wtr. Body
^..,., ..
__ORW: yes/ho PNA: yes/no
Type of Project/ Activity
(Scale:
Shoreline
Access Length
Pier (dock) length j a X 5, .
Fixed Platform(s) _---"
Floating Platform(s) -•
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill ..'"
Max distance/ length
Basin, channel
Boathouse/ Boatlitt
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no -_) -
RiparianWaiverAttached: .yes- no
A building permit/zoning permit may be required by.
Permit Conditions ❑ 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**
Application Feels)
Signature
Check #/Money Order Issuing Date
Expiration Date

�'4❑CAMA ❑ DREDGE & FILL
GENERAL PERMIT
ew ❑Modification []Complete Reissue ❑Partial Reissue
N9 90034 A B
Previous permit
Date previous permit issued _
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:
v
ISA NCAC 1))' -�'Y-� o ❑Rules attached. 'General Permit Rules available at the following link: www.deq.ncgov/CAMArules
Applicant Name T tGJit_ •�' - I' Or:: i :l L
Address
City State Alt, zip Y�k
Phone # (:' i.,) 9) -� - Ll 1 �5
Email
� 66_
t ) JttTT�u. 61"
J
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
Authorized Agent
Project Location (County): �,-
i
Street Address/State Road/Lot #(s)
t
Subdivision
City IV l c _ I r ( L''i.e ZIP
Adj. Wtr. Body (rep><<J ;. (nat/man/unk)
Closest Maj. Wtr. Bo
h r }..,A s
Type of Project/Activity Of,.Ni}k(4 ix ; - k_ (
v —1
(Scale:'
Shoreline Length
Access Length
i
Pier (dock) length ss
Fixed Platform(s)
Groin length/#
Bulkhead/ Riprap length
Boat ramp
Boathouse/ Boatlift /
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
yes
yes
yes
A building permit/zoning permit may be required by: °' ) `�:. t�<j,4'G�.. b l
�TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
Agent or Applicant PRINTED Name
Permit
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature -*Please read compliance statement on back of permit" Sign1ture !
Application Feels) Check #/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
( I op portion to be completed by owner or their agent)
Name of Property Owner: Frank /�Ly IAO7/)ar, lcK
Address of Property: I ` 5- bcXyiei✓ 1&✓d ATla277(, 6eri,o6 .IyL
Mailing Address of Owner: /0 3 Avis lec Ime , 6/eUovdIL l/L a% 0-9
Owner's email:
�
Owner's Phone#: a,a
W Nd3�?
Agent's Name:
Of000 col X-Ier
Agent Phone#:
95?, 793 369q
Aaent's Email:Qeyo,�7,Ooi5rer4Oo,,?ur/,com
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.
l� 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 127 Cardinal Drive EXT, Wilmington, NC 28405. 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
T 4
Sign�f Adjacent Riparian Propel Owner (ARPO)
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: X
Mailing Address of ARPO:,
ARPO's email: 4- C 1n44rl L1
Phone#: �14.�z✓�i<�
Date: a. `/ - a *waiver is valid for up to one year from ARPO's Signature*
Revised MaYZ021d v-D
Dt:;M•If HOG11IY

1/27/23, 4:33 PM
Gmail - (no subject)
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Marne of Property Owner Requesting Permit: l amk R(ky l� 1�y't-rr/C
Mailing Address: 03 QuoAc Jklwe. Grcchyi`lle /I/G �7t3S8
Phone Number:
;_mail Address:
- 1 certify that
A-iA rickCo,d 6maiy—�6H7
agent/
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary tor the following proposed development: J by S �—L
,DoLKwhy ro %he "o('Ing T-#e-ad (ok Bolo* uP)•
at my property located at/ y �- ` ,,yi et✓ blVd, 60 uc/7 /tie-
in C0.fre6Gt County.
f furthermore certify that I am authorized to grant, and do in fact grant permission to
Jnrision of Coastal Manaaement 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:
FCVo' , j2a k'0C
Print or Type Name
OW�er
Title
l�l d,oa3
VGIo
This certification is valid through
FF.R
0(;hq-MHLi (ArY

2/8/23, 8:17 AM
Gmail - (no subject)
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portipin�to be completed byowneror their agent)
Name of Property Owne lrorc -f/�
] f�
L_I T
Address of Property. I �� ba-y /ie iw ✓I ✓G( N/!�i( b
Mailing Address of Owm % �,� C' tiod e e l ahzt Orcen ✓, r/G IVl a 2 8i-d .
Owner's email: 6007 Owners Phone#9I7
_a_
Agent's Name: /)Cvr1/) //X�/5�� Agent Phone#: 2,6A 12a3.369f
Agent's Email: �Pyd/L,ci0�5�G��q%6/Ogrr,CQ�rI
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
t/CQH 100 NOT have objections to this proposal. I DO have objections to this proposal.
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
malted to 127 Cardinal Drive EXT, Wilmington, NC 28405. DCM representatives can also be contacted at
[phone]. No response is considered the same as no objection it 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 Adj< enl Riparian Property Owner (ARPO)
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
;K Signature of Adjacent Riparian Property
-*- Typed/Printed name of ARPO:
Mailing Address of ARPO: A is I1)'x � c,e- e , -Yn haro V1.>2 7S3 �
_)( ARPO's ema11:�11fiP0's Phone#:Et 19 -9,21- 2 C17
Date: a _/ _ a 3 waiver is valid for up to one year from ARPO's Signature'
Revised May 2021
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