Edentide Holdings LLC 90056C

° °"'" ❑,CAMA ❑DREDGE & FILL N° 90056 A B { 9 p
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:
I SA NCAC ❑ Rules attached. ❑'General Permit Rules available at the following link: wwwdeq nc gov/CAMArules
ry
Applicant Name1^cs S l_ C C. Authorized Agent iL. AA.. `h.�:-� �t.ti.6JA d'+
Address )'Z.4`[ (i N`✓+'t': J r` Project Location (County): l.. rt ,
City State A ) (; ZIP "Ae',1 Z. Street Address/State Road/Lot #(s) -III 13 0cl A4 6,S hC..
Phone # (_) t_ `So,n. •7..t...j •..va.
Email "j I''• i Subdivision " f
City 1 j r, I' f, `'�iE',n fIP % Y ) 2-
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body _ Fj %>c.)„cc �n.rYt t r i,t �t-(t (nat/,n9Vunk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/6 : PNA: yes/no
Type of Project/ Activity _
Shoreline
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) lo'rc/h
Finger pier(s)
Total Platform area
Groin length/# "-^"-
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length -�-
Basin, channel
Cubic yards s
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
(Scale: j" = ", )
❑ 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 Feels) Check #/Money Order Issuing Date Expiration Date

❑DREDGE & FILL N° 90056 A B 0 D
Previous permit
GENERAL 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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.dec.nc.gov/CAMArules
Applicant Name
City
Phone #(—)_
Authorized Agent (�•,d f...t. f �+.: "t:�Oa I '#-
'e. Project Location (County):
_ZIP '<Cl/. Street Address/State Road/Lot#(s) `711 1)"1 '�,l
Subdivision
City ZIP
Affected ❑ CW ❑ EW ,2 PTA ❑ ES ❑ PTS Adj. Wtr. Body +(nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/jio) PNA: yes/`
Type of Project/ Activity( x 4,1
(Scale:
Shoreline Length,
Access Length
Pier (dock) length
Fixed Platform(s).
Floating Platform(s) (. iYr11)
Finger piers)
Total Platform area 5`I p_Pf `
Groin length/A --�
Bulkhead/ Riprap length --""
Avg distance offshore
Breakwater/Sill ,...i
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 -`
❑ 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.
Agent or Applicant.PRINTED Name Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit" Signature
Application Feels) Check N/Money Order Issuing Date
(Please Initial)
Expiration Date

U
z

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 6d e, 4' �, 4 /A."tgS L L t,
Mailing Address: % p g A 1&tt -r- &O'C'A
Phone Number:
33<o-Llal0-3a30
Email Address: t%Fra 5/J n 4 0-d 5 @-ul"0��5 [+� �a ✓'�� �� n k . � ��
I certify that I have authorized �/� V -e*4j./,0 r 4—
Agent / Contr ctor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 10 4 04 1 a.wtw 6 ems'
,L t 0 4- J. i
at m/y� property located at _
in (:GW 4 C,Ce,$ 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
5w5A,rn La v"b
Print or Type Name
rw ewJb er / rn oXv &-Lo
Title
l a `4 I a s
Date
This certification is valid through

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: �Ct eyt + `ct e. 14 [/1P. r l i,( .>
Address of Property: —I O G A � I k a&f, A Cn a!, e 6 u, m
D9 AfIet,t•tct �C�� AiIttutcw enc�. hC. aR51A
Mailing Address of Owner: ��
,1� N ao- a 3 o
Owner's email: gr n 5e n, r.(ii`, � I�utrrr(u,(,'Owner's Phone#: -5
Agent's Name:
Agent's Email:
Agent Phone#:
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
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 norny me rv.L.. Urvrsrvn or i.oasiUJ
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
Srg atu f Adjacent Pipdfian Property Owner
OR -
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
MAR 0 1 :'V';
Typed/Printed name of ARPO:
12Z /� �C;tw-tutrtU t;TrY
Mailing Address of ARPO: a..J .(�ri l�V (y
ARPO's email: ARPO's Phone#: 5� 7 %i389
Date: /2 3 'waiver is valid for up to one year from ARPO's Signature`
Revised May 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: (n" 6
Address of Property:
Mailing Address of Owner: 0 I A wwuu (3+= 4A C 5 f A4
Owner's email: r a S e 0. t at 10- Owner's Phone#: 3 3(o 30
APirnar Li Lom
Agent's Name:
Agent's Email:
Agent Phone#:
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 hasAescribed to me, as shown on the attached drawing, the development they are proposing. A
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 nodry me n.L., um51013 Of wnslar
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 hprap 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
Sign of Adjacent Riparian Property Owner RFCFIvFr)
-OR-
1 do not wish to waive the 15' setback requirement (initial the blank) MAR 01 ?V3
bCAn-MH-U C ITy
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Mkt /
Mailing Address ofARPO: ((10-1 fi4fa,%,& cf, (Seatf, C6A4
ARPO's email: maf.5//,SV r- S jeo, RPO's Phone#: z5Z'
Date: O a f Ival3 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021