91399C - Front Street Escape LLC

r�`°"'" ❑CAMA ❑ DREDGE & FILL N9 91399 A B (0 D
a = GENERAL PERMIT Previous 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 U 00 ❑ Rules attached. p General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant
City
Phone # (
Authorized Agent
�t
I l/ d Project Location (County):
State ZIP / ! Y O Street Address/State Road/Lot #(s)
City 6 L/%1+4 /ov ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body TO 1,2 ✓ Yee h (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑$PIMA ❑PWS Closest Mal. Wtr. Body 6at L. lL
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale-.,# i )
Shoreline I cnoth
Access Length
Pier (dock) length-
Fixed Platform(s)'-"+-
--.
I
DWI
Floating Platform(s) T
Finger pier(s)
�j
Total Platform area
Groin length/# -- tit
a
Bulkhead/Riprap length 1---
,-
�
--
-
-
t
�aL
_
-
t_
(
r
J
I
j
/-
t
_
Avg distance offshore �r
Breakwater Sill
-i
_{-_
length
distance/Max gt
Basin, channel
Cubic yards
Boat ramp
i;�'.I._�
Boathouse/Boatlift •.h
ry
j
+
'�"'-•
i
Beach Bulldozing
I
yi
/..
✓r-`.
7;
_._.�
-_
Other
/
li
/
L
�
SAV observed: yes
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
a
❑ TAWPAM/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

,o��`°""❑CAMA ❑DREDGE & FILL, N9 91399 A B (Q D
GENERAL PERMIT Previous 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 0 7.1.1. +00 ❑ Rules attached. p General Permit Rules available at the following link: wwvvdeq.nc gov/CAMArules
Applicant Name Yr�GP'l t h tfC t'-
Authorized Agent J f) 1 Z t''Poo
� P"I V C
Address . O I 0i,,i : I ,� r2� �,�f
Project Location (County): � (�:
� ��t Kk
� t
City %A,¢U/1 / State /6 ZIP 9 I l.7U
Street
r:.:.
'
Address/State Road/Lot #(s)
f
:
Phone # (±d) 17 �• 9,q1
Email ( rt .% ;1 "- I'. )� ✓ G• r+ r+j ,� e\ (r +k It '1N �, 4"ubdivision ...-�•r�
City & oi" 4" 1
ZIP
3-
Affected ❑CW NEW PTA ❑ES ❑PTS
Adj. Wtr. Body- --. / (!//Yl'rA
(oatiman/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body
s+
ORW: yes/0 PNA: yes/&
Type of Project/ Activity �1.- , f a 5(�I A e, C { ✓'F � � or L rtt
i' f f
Length.
Access Length
I
�.
Pier (dock)
'
Fixed Platforms 10 o--
i
1
111
Floating Platform(s) i
—
Ti
�s�
Finger i
..,+
+e
Total Platform area
_
Groin length/#
Bulkhead/Riprap length'
Avg distance offshore
Breakwater/Sill -
-
-
—
—�—
n
Max distance/length '
--
�-
-
-
f 11
---
-J-
——
—
Basin, channel
f
Cubic yards
�
!
I_Boat
ramp ramp
BoathousekiBoatlift I J
^-
�-
�"'
-•�:
Beach Bulldozing
_jSAV
Other '
N
observed yes fi�—
-
-
yF
Moratorium: n/a yes no -
Site Photos: no
-
yes
'..
Riparian Waiver Attached: 0 no
_
_
_
—(
_
+r✓�
Y�<r
A building permit/zoning permit may be required by I>�' t ewt Y l�S+�- - .f i/' "u+lv✓ I
Permit Conditions r i"DY7 ;.I.111JS �TAR/PAM/NEUSE/BUFFER(circle one)
See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name ( _
(Please
Signature **Please read compliance statement on back of permit** Signature
Application Feels) Check #/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: �>?030 Wl r,)C)04 ILL b2IV
Phone Number: _cT -2 E FIF 7
Email Address: _(/t�'r ►r •1�)�(^ oefrcl dt�(C`yrs`1r1� C/`t f • COvu(
I certify that I have authorized / T� too ()l< S
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: CC) MirLE�-`i`. =- _
at my property located at l I —� i yzcD"jT S-riz _ G 6),,z-r
in County.
I furthermore certify that / 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
� ark--e � I�•e I I ��
Print or Type Name
"L1 ti (Z�
Title
Date
This certification is valid through 1 "7J 7-:5

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:
Address of Property: 1107 i LacwT S"r•as�^
Mailing Address of Owner: :� li_i O W I n) D M I UL nptJE� .',"04'3 � &
Owners email: 0dal118ItAQ (M&yrtlRt' w�
Agent's Name: 1QS!{L�1 (3rLdi�fLS
Aoenfs Email:
Phone#: qt 9 /VO 4 q, l
Agent Phone#:�� k4( 3ZI y
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adjacent PronaMi 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
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 iv.C. Division or coasrar
Management (DCM) In writing 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 same as no objection if you have been notified by
CeHilled Mail.
WAIVER SECTION
t understand that any proposed pier, dock, mooring pilings, twat 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 Piparian Property Owner
-OR- 4
I do not wish to waive the 15' setback requirement (initial the blank) tr I" -' -i•,
�-�--� Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: L °'^�� I �� j' • i(1,1-[",raj 'c - l"� _�l</ �-
r
Mailing Address of ARPO: 7J 'J _.�_: }__',=sy� ___.,, ,_ _�__s = • ti+
ARPO's email: Lr,..t 4/,Ji`r_-, &=.�-', I-ARPe#:O's PhonwJ > >� � y
Date; .� - f/ 7 "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 NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. 1/LC,
Address of Property: 1 (D 7 �/OA - S-rIegzy- 9&4gr09'r'
Mailing Address of Owner. Z030 Wlribli;,�ILL oPtUrc..S+Ah;�jro k� 'L73'30
�. 5.. ?
Owners email: Phonet`:d((41 -7W8Q /
Agent's Name:.�I-t'rL�! 1S Qi dDlr!S �t !? Agent Phone#: %��(s4(o -j�j�-
Agent's Email: S!"ID�GIf/�Qf�IQ fK,.p .h-[� Gf Aq(�a44
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
iBottom 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.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
b_ ,
I do not wish to waive the 15' setback requirement (initial the blank)) 1((11 � t'i 61 NG t
�-® Signature of Adjacent Riparian Property Owner.
Typed/Printed name of ARPO:
MailingAddressofARPO•
ARPO's email: �� ;r°f�l ',c G� I ARPO's Phone#: _ ;s a i 'G
Date: 3/t 7% 2 g i"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 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. F(201)TiSi"Rnet_ f_:SGtWE /ILCI
Address of Property: 0 7 BED} APT- �1
Mailing Address of Owner: _2_0 0 _Ww Dm i Gt;- Dpwrr. sl+A 2r) /i G A% F30
Owner's eme(l:
Ca rn has 0)44&t0Mb
Agent's Name:
A-5144a %
Agent's Email
_ Sh0ki�11 QNl4l
: Phone#: qrl M 6 Q8�
Agent Phone#: Z. ,e4(a 2iZj
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
---�F _�L 1 DO NOT have objections to this proposal. I DO have objections to this proposal.
It 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, twat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of I T 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
-OR-
Signature of Adjacent Riparian Property Owner
bK
I do not wish to waive the 15' setback requirement (initial the blank) G113`L 1
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
LVA�VVt3eaLR;�-i_ acu)
Mailing Address ofARPO: �'5 M00C'l4'Ze/kj�
ARPO's email: �iy_104 �CCNVdO"Y1�y V( ARPO'sPhone#:
Date: > / i 'Z 3 `waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

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