Thullen, Amy 90064C

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AMA ElDREDGE& FILL Nv 90064 A B ,c! D
ENERAL 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: www.deg.nc.gov/CAMArules
Applicant N
Address
City
Phone # ( _
Email
State
o:
ZIP
j(
Project Location (County): x (",A C.-t a
Street Address/State Road/Lot #(s) /.I'{O I S . ", 1, ✓ U_ ), , R_
City N 1 hx-4xe. �a o\ C'i-.- ZIP Z� S
Affected ❑ CW ❑ EW ❑ PTA 0 ES ❑ PTS Adj. Wtr. Body o-( li nnan/unk)
AEC s : OEA IHA UW ' C
❑ El ❑SPIMA ❑ PWS Closest Maj. Wtr. Body C< v.... > uvY
ORW: yes/no PNA: yes/no
Type of Project/ Activityl_
f (Scale:p S 1
Shoreline Length its: {>r� -1` -.-
i �-I
Access Length �' - - - C� (. 0 d - - — -
Pier (dock) length/` y ,;.C2t� t I
cH
Fixed Platforms) ID r!) - - - --
p4n#rn
t s z -I -_.'. __ - —
Floating Platform(s)
Finger
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Max distance/ length
Basin, channel
Cubic yards
Boathouse/ Boatlift
Beach Bulldozing _
Other
i
(n_
i
�rl if
u e... iA
L/
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
oit
❑ 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 lni[ial)ry
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature **Please read compliance statement on bac
Application Fee(s)
Signature
Check#/Money Order Issuing Date Expiration Date

��`°"" ❑CAMA ❑DREDGE & FILL N9 90064 A B LC) D
GENERAL Previous permit
PERMIT issued
� Date previous permit issued
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the
rr Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCA0 l-1 I ❑ Rules attached. I yh eneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
State zip
Authorized Agent / I '-
Project Location (County):
Street Address/State Road/Lot #(s) t/
Subdivision
City_
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body = -a - ✓ r. 1. ,(na#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 ' I U I
T ( 1
Access Length I `
Pier (dock) length s-�y L1 m-
Fixed Platform(s) P ; Llt)
i
Floating Platform(s)
Finger piers) r' Y
Total Platform area !f J Z
Groin length/# ..�-
Bulkhead/:Riprap length Zet )
Avg distance offshore /'
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other --
SAV observed: (" ye no no I
Moratorium: n/a - yes no 1
Site Photos: yes no
Riparian Waiver Attached:., yes no
A building permit/zoning permit may be required by:
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 lnitial)�__. _ r
1 1
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature '*Please read compliance statement on back of permit** Signature
i
Application Feels)
Check #/Money Order Issuing Date
Expiration Date

F

DocuSign Envelope ID: 7B553774-D983-452F-83CF-6722B1307BO8
DocuSign Envelope ID: 1ED57OF847AD-40BO-AFOE-CFD488OA8753
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Properly Owner Requesting Permit:
Amy c Thullen Estate
4300 s shore Drive
Mailing Address:
Morehead city NC 28557
Phone Number: 252 413 8162
Email Address:
[e-mail]
I certify that I have authorized A544'Ag62m45 '
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at 4-3ol Opt �E ��r✓E
in CA- ��County.
1 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:
�e..s,wdbY. z
Signature
Julia M Jones
Print or Type Name
Executor
Title
3/18/2023
1 1
Date
This certification is valid through

DocuSign Envelope ID: tE057OF8.47AD-4OB8.AFOE-CFD4880A8753
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIOWWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
Mailing Address of Owner:
Amy C Thullen Estate
D 1 50kx4 S
Dr11 vrs It/` t+C. SeS'S 7
4300 s shore Drive, Morehead City, NC 28557
Ownersemail: [e-mail] Owners Phone#: [phone]
Agent's Name: r gt J4cc� 45 Agent Phone#: Z5Z &4rt
Agents Email:
U
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 has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawino with dimensions must be provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
if you nave objections to what is nemg proposes, you musr noury me ".�. urvrsron or �Vasrar
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.)
100 wish to waive some/ail of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR- os
e- --)gL I do not wish to waive the 15' setback requirement (initial the bianr)
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO: Gene smeli k
Q.
Mailing Address of ARPO: 4305 s shore Dr, Morehead city Nc 28557
ARPO'semail: [e-mail]
ARPO's Phone#: [phone]
3/18/2023
Date: 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

DocuSign Envelope ID'. 1ED570F8-47AD-4DB8-AFOE-CFD48BOA8753
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit Amy c Thullen Estate
Mailing Address:
Phone Number:
Email Address:
4300 s shore Drive
Morehead city NC 28557
252 413 8162
[e-mail]
I certify that I have authorized / 1 >Hl/ Q2oo
Agent i Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: NG+^r /J U UK%��
#7VD FolicPL r DiLK 2'EPla4cF-.�t�/T
at my property located at 4F?O I -okT4 L� RE pet ✓E ,
in f'Fi'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:
0"Usg 4by:
—s,acnnsays,<an. Signature
Julia M Tones
Print or Type Name
Executor
3/18/2023 Tale
i t
Date
This certification is valid through 1.0- f3 1 l —2yi3

DocuSign Envelope ID: 7B553774-D983A52F-83CF-6722B1307B08
DocuSign Envelope to: B2795E2A-A993-4613-9455-SBB336CCE49A
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.
Address of Property:
Mailing Address of Owner:
Owner's email:
0 SDu.;� S ee Dizivr= Ail
Owner's Phone#:
Agent's Name: 4-51445
Agents Email: Sho%e
ZS'SS 7
Agent Phone#: Z6Z— l�4 32j2'
I ,
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.
ll� X I DO NOT have objections to this proposal. I DO have objections to this proposal.
H you have objections to what is being proposed, you must noury we rv.i . uwvis,un u,
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to400 Commerce Ave., Morehead City, NC 28567. 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 dprap 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 PtqDerty Owner
-OR-
e-19L I do not wish to waive the 15' setback requirement (initial the blanf) J l
-.e..� Signature of Adjacent Riparian Property Owner.
D.
Typed/Printed name ofARPO: Helen Aman
Mailing Address ofARPO: 4224 & 4225 s shore or, Morehead city NC 28557
hnl<nlr—il —
ARPO's email: _
3/21/2023
Date:
ARPO's Phone#:
919 618 0032
*waiver is valid for up to one year from ARPO's Signature'
Revised July 2021