Williamson, Annette 90059C

1*jWW41LNOCAMA El DREDGE & FILL ® 9����59 A B C D
'ice
Previous permit
i 3 GENERAL 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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deg.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone # (_) `�•
Email
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 lei
Avg distance offshor
Breakwater/Sill _
Max distance/ lengt
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attz
A building permit/zc _
Permit Conditions
(Scale: ?/.t) )
�iFF9 t�� ❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
4 i•
❑ 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 Fee(s) Check #/Money Order
Signature
Issuing Date
Expiration Date

a0FCOAU41 —ICAMA ❑ DREDGE & FILL Na 90059 A B C D
Previous permit
D
y GENERAL PERMIT
Date previous permit issued
F-INew ❑ 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
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,
s
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 required by:
Permit Conditions
❑ ES ❑ PTS
❑ SPIMA ❑ PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
P
(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

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: h,n e - ��L. �'j
Mailing Address:
Lo
Phone Number:
Email Address: Ckc- , w r M d Cj Y"Ci , (mil
certify that I have authorized t r�� ` - % I,- ? �i - %;;
gent / Vontractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed develo ment: Orh ,-N. r j o{, w c; kw a
�c,ctc- 40 1 -(o rrn (at) U'X L- ����,"►�� i��.lc= )`�, �3' l r{ z.e—"h
at my property located at 0 1 fi,,4 S4: J� �Pjc �' )) /
in Lr County.
1 furthermore certify that 1 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
'pl/F
Print or Type Name
Title UTY
} ��MpNIMO
Date
This certification is valid through

-
r o rc)se--
,
LIAR 00, 'f l

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: a n�- (� �,* �k4-�d tA L Okys
Mailing Address of Owner:c52_ 1/GJlct,, 0-AcLRc, (4 6A I,�D< -- �A
"nr,t4e.).a,\��-4Ms,rr. F4,rwN e
Owner's email: ors 1, L-,rm Owner's Phone#:
Agent's Name: VAv-,-n Ovr4,� Agent Phone#: �as -3a�>)
Agent's Email: �Obwx I I e hDfw-ict t 1, POY�
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
descriptiovror drawing, 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 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 sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setbacJc
Signature of Adjacefit Ripa' an Property Owner
-O R-
I do not wish to waive the 15' setback requirement (initial the blank)
`'7
Signature of Adjacent Riparian Property Owner:
—y
Typed/Printed name of ARPO: �� 4 I i!: _ CY-c:� ; i) l"'
Mailing Address ofARPO: -% 0- -- f i^(3 t
ARPO's email: ARPO's Phone#:
Date: �U Z *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CE TIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: 4"'d 0 / fC 4)I l/ /,4 tPj S o X1
Address of Property: O! o e arT A)G
Mailing Address of Owner: 1 of(
4&!7 9 (;tom i I ft., S..'s '� .
Owner's small: .c Owner's Phone#:
Agent's Name: ►'yt () 4 &- _ Agent Phone#: -� ds
Agent's Email: 6b-iym. `) i @ hu4rY1ot, canA
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(130110m portion to be comRleted by the Adjacent Property Owner)
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 notify the N.C. Division of Coastal
Management (DCIM In writing within 10 days of reeelpt of this notice. Correspondence should be
mailed to 400 Commence Ave., Morehead City, NC 28557. DCM representathres can also be contacted
at [phone]. No response is considered the some as no objection N you have been notified by
Certified Mall.
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 1 V from my area of riparian aocess unless waived by me
(this does not apply to bulkheads or dprap revelments). (If you wish to waive the setback, you must slsrn
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (Initial the blank) w n W 4,, aW
Signature of Adjacent Riparian Property Owner. iA). 71tA4-4-' k ti
[Date:
yped/Printed name of ARPO: UJ- Sd Al
ailing Address ofARPO: t744 ..a-QS1 /
e (E RPO's small: Ix iJ W i Ids 9 4 ej ARPO's Phone#:
1d�,3 'waiver is valid for up to one year from ARPO's Signature'
Rcvlacd May 2021
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Ehf\'-e— W I ( tcRM-dv-�'
Mailing Address:
Phone Number:
Email Address:
a
w lk�
rm a I
certify that I have authorized 17-, nv rti(
gent / Obntractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
a
necessary for the following proposed develo went: r"Cm,n-e o V-W
o� 3�� a
cIz �o p 1 �, (' x c-/o' 1�c1 ►�`� c�� l� 1 �`X �3 ` cl b �
at my property located at D 1 45- S4, R��✓ C �SJ,L,
in C�'4�'`� County.
1 furthermore certify that 1 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
Print or Type Name
Title
3
Date
Z 1,
This certification is valid through 1 l
RCIFIlA.Ct
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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: rrh nP7 / (E /jtJ J /� I`�f �j S o Y1
Address of Property: zo/ ZZO A S k (j e,<A,r i ItG
Mailing Address of Owner. `p ;
-211
Owner's email: I N red,., Owner's Phone#:
Agent's Name: �ti ✓' ( -
1� •�-� � Arent Phone#:
Agent's Email: I JYY1C_
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. g
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 400 Commerce Ave., Morehead City, NC 28557. DCMrepresentat/ves can also be contacted
at (252) 808-280& No response Is considered the same as no objection If you have been notified by
Certifled Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse. Ifft, or
groin must be set back a minimum distance of 16 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
d �� i i- �: cc
-OR-
�
L I_ Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) 4mw :-(06)
Signature of Adjacent Riparian Property Owner.
[Date:
yped/Printed name ofARPO:
ailing Address of ARPO: q2�
E ! e RPO's emali: IN IJ ARPO's Phone#: � (y5 6 r j
'waiver Is valid for up to one year from ARPO's Signature"
Rcvlacd May 2021
()(;hA--MHU ,,kAT `

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: _ L� A YA -� C, )
Address of Property: ' 13'o r-1 1-e e 4 L o
T
Mailing Address of Owner: Z Lr< 1 ' y 191,19 i e -oil
l,so.l.CPA 0_
Owner's small: < ; 1 o Owner's Phone#:
Agent's Name: +-1 0 t (4vv-r-- Agent Phone#:
Agent's Email: _ Vb mC
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.
`!_ 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 trust notify the N.C. Division of Coastal
Management (DCM) In wrung within 10 days of racelpt 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 soma as no objection i.` 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 M_tog slan
the appropriate blank below.)
I DO wish to waive somelall of the 15' s
-OR-
fgnature of Adjacent Rfparlan Property Owner
I do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
TypedlPrinted name of ARPO: ! i2/
Mailing Address of ARPO•
ARPO's email: f> ARPO's Phone#;
r1�4
Date: Z 3 'waiver Is valid for up to one year from ARPO's Signature'
9I'°OWFID RCV100d May 2021
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MAR 0 2 IlVi
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