88945C - Bogue Banks Water Corp

❑CAMA ❑ DREDGE & FILL
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t = GENERAL PERMIT
New []Modification [_]Complete Reissue ❑ Partial Reissue
N9 88945 A ,e ; D
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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
I SA NCAC -� 1
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❑ Rules attached.
El General Permit Rules available at the following link: wwmdeq.nc.gov/CAMArules
Applicant Name"-�U(✓
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Authorized Agent
Address
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Project Location (County):
City
State
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ZIP
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Street Address/State Road/Lot#(s) ul Vi1i t
Phone #
Email
Subdivision
City (':- : ZIP
Affected ❑ CW
❑ E W
❑ PTA
❑ ES ❑ PTS
Adj. Wtr. Body cf vt'h (. C.)y c a v. (nat/man/unk)
AEC(s):OEA
❑IHA
❑UW
❑SPIMA ❑PWS
Closest Maj. Wtr. Body
ORW: yes�S0
PNA: yes/no
Type of Project/ Activity
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(Scale: )
Access Length
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Pier (dock) length
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Fixed Platform(s) it
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Floating Platform(s)
Finger pler(s)
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Total Platform area
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Groin length/kli
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Bulkhead/Riprap length ..--
Avg distance offshore
Breakwater/Sill .�•
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Max distance/ length
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Basin, channel
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Cubic yards
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Boat ram
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Boathouse/Boatlift
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Beach Bulldozing
Other
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SAV observed: yes no
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Moratorium: n/a yes no
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Site Photos: yes no
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Riparian Waiver Attached: yes no
A building permit/zoning permit may be required
by:
1.I IJ TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions 4 �'--s"v+[-(-IVL' Y'lN\i)V E� (/sYL/
�. ' ' - v^(_(i li + r "i O(Y!t{I r, >� ❑ See note on back regarding River Basin rules
CI'vi '`'(-t t`,(( ❑ 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
Signature **Please read compliance statement on back of permit**
Application Feels) Check ft/Money Order
Permit Officer's PRINTED Name
Signature
Issuing Date
Date

�1*0(Wr4 ..' CAMA ❑ DREDGE & FILL N9 88945 A B i C D
AMIRN
t GPrevious permit
GENERAL PERMIT
Date previous permit issued
'Z 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 ' I • 1, i � , ❑ Rules attached. W�General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name -1(.R oyS my I
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Address : f
City State ZIP,Lj
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Phone # (_ )
Email
Authorized Agent
Project Location (County): T./lY j"cYr"}'
Street Address/State Road/Lot #(s)-
Subdivision
City l'.b1�, ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body! A r``� Ft C �� (P G rT (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ElPWS Closest Maj. Wtr. Body f�l'1" L1 v 1 11c
ORW: yes/no PNA: yes/no "
Type of Project/Activity'
(Scale: )
Shoreline Leneth (,.
Access Length
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A building permit/zoning permit may be required by: - ' 'e o i (, 1
Permit Conditions'.` _ ! r } _ " i`1 ._1 n_-V
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
✓.(� Cyr' 1 I. _ \•Ft, s(.
` 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 Permij Officer's PRINTED NN�ay/m,e.
Signature "Please read compliance statement on back of permit•' Signature
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it � i 1
Ap lication Feels) Check 1r/Money Order Issuing Da Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: 765!/b E-n-Imald !)rlVPi
Phone Number: 26-2-?6Li-3L12q
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 7`�st l/(/(��� d-l-iLI-® W 61
Site - Zyhrvrry a 1hroK!�h l&' n�iF�IrI,I"�y eln bo��Gl� 5}1"
at my property located at �>Lh Suet PObLike eS 1 hen/ tS&, lm J �
in W- -Or-e Ii_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 '
Mevm-t�-w R- -JAfP
Print or Type Name
GE(Z-
Title
Date MAR 27 %p3
0CM-1WHO CITY
This certification is valid through I I

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion"" tobe�/completed by owner or their agent)
Name of Property Owner: / /'I" Kr s (M6K Oen�,rfs)
Address of Property: to /3 ©ttr,n hr ✓fi , CAUv-ed J Ts It, N-C.
Mailing Address of Owner: 13tt DncfgcVtW Agr crt25ns& -S.C. oZ93Z3
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Owner's email.►ndi(yNdJkd69gm441"10MOwner'sPhone#: $e3 603'92Y7-
Agent's Name:
Agent's Email:
Agent
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
permit has described to me, as shown on the attached drawing, the develoent they are proposing. A
descriptiop,or drawing, with dimensions must be provided with this leiter. of h our OUmp lest
�jo$ue n Ks WMu- C'o�P.
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' setback
Signature of Adjacent Ripa an Property Owner ar;wttrpfy
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) MO `1, `/ ;-- / I
Signature of Adjacent Riparian Properly Owner: :2 ACC L4AIA4 17t.m-mt1U QITY
Typed/Printed name of ARPO: M wO • /G `su5
Mailing Address ofARPO: 13Y View KCr0—Chesnee, S.C. a9323
ARPO's email: tKdkA4QDild6"nu/.futVARPO's Phone#: 93 603'92411
Date: 3�23�23 "waiver Is valid for up to one year from ARPO's Signature"
Revised May 2021

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign -off by the owner on this form) or certified mall return
receipts (showing deliveryof notice) are needed, or any other method which satisfies the Local Permit Officer
(LPO) that a good faith effort has been made to provide notice.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM or the LPO an opportunity to consider these comments/objections before a permit decision
is made. "Permission" of adjacent property owners is not necessarily reguired for DCM to issue a permit;
however, permission must be obtained for certain types of proposed developments if they fall within a 15'
setback area along the riparian access area of the adjacent property, as determined solely by DCM. It is in
the applicant's best interest to provide comprehensive and accurate notice so that any concerns or objections
can be resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals
the permit decision, Insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the streettroad could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally Intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What Is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.gov/search/index/corn. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to Its registered agent).
What Is Notice, and how do I ensure It is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised May 2021
�4pr 1=1vilq)
MAR 27 2111i
0i-_M-1 iH a (ATY

Mark Kilgus, MD, PhD
From: Mark Kilgus <[e-mail]>
Sent: Wednesday, March 22, 2023 6:21 PM
To: Mark Kilgus, MD, PhD
Subject: [EXTERNAL] Fwd; BBWC 24 Hour Pump Test CAMA Notice
Attachments: 2021 Adjacent Riparian Owner Notice -Waiver Form with instructions.doc
'CAUTION: This email originated from outside the south Carolina Department of Mental Health, Qo not
click links or open attachments unless you recognize the sender and know the content is sate,
---------- Forwarded message ---------
From: shill boeuebankswater.com <[e-mail]>
Date: Wed, Mar 22, 2023 at 9:27 AM
Subject: BBWC 24 Hour Pump Test CAMA Notice
To: [e-mail] <[e-mail]>
Thank you for taking my call earlier today. Attached is the notification, Please check the'do not have
objections box and fill out the remainder of the lower portion of the form. You can return via email to me,
mail, or fax.
7412 Emerald Dr
Emerald Isle, NC 28594
[e-mail]
252-515-2563 (fax)
Thank you for your support]
Seola Hill
Executive Director
Bogue Banks Water Corp
Emerald Isle NC
ocM"I"Mu (;r ry

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:
161e, NC aBS94
Mailing Address of Owner:
i CIP.Vt16tn4
rEgpC V; llt M b
Z3,M
Owner's email:
Pnm
owner's Phone#:3(2L29q-o40,
Agent's Name:
Agent's Email:
Agent
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.
X 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.)
DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
v
Typed/Printed name of ARPO: i M\j T- H I k+f J
Mailing Address of ARPO: 7 CAeyd nd U. koai�o I It � i h aPgsb
ARPO's email: _OIC/�O r '�ctm� ,r nm ARPO's Phone#; .3GI-aqq- aqi 6
Date: 3/ hM3 --waiver is valid for up to one year from ARPO's Signature`
Revised May 2021
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