89647A - Kemp, Carole

3o+"te"rN❑CAMA ❑ DREDGE & FILL NO 89647(g A B C D
GPrevious permit
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 Pernik Rules available at the following link: www.deq.ncgov/CAMArules
Applicant Name _
Address
City
N Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Affected ❑ CW ❑ E W ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body
ORW: yes/lid; PNA: yes/no
Type of Project/ Activity
(Scale: 0 'i )
Length
.'
■
Nei■■■■
Pier ock) length
FixedAccess
Platform(s)oil
_.
�:�■■
IIIIMMMM
■■■
■
Finger pler(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
ME
OEM
..;...
Fill
Avg distance offshore
..IIIII:::
distance/ length
■..
.J/.■�i�.
E■ll.
i....■
■■■■■
::Max
:.
■
..:■■■:
:.
:.
NINE
�.:
■
■
...M.c.::■:RUM—
MOM
o::®
.
No
■:
71�.VRI�Ai
.�
.1
■..
■
...
■
.
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. (Please
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check p/Money Order Issuing Di
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date Y — 6 — -X` 3
Name of Property Owner Applying for Permit:
RbLE
Mailing Address:
130 C C61AJ61 SVCk PP,
C.0 k R I-ru c r; N -5�. a? q a°t
I certify that I have authorized (agent) 'Yokr r y YV f—Ss IN A to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 13 O-K NEAR ,
at (my property located at) 130 C , e AAJVr4S►�RC 1�
This certification is valid thru (date) Ip 3
Property Owner Signature Date

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: 5A M5
Owner's email:
Owner's Phone#: a 52 — 6/ 9 5 A
Agent's Name:�nMz SiAIA
Agent's Email: cur -el T V CCU
Agent Phone#:2�;L— 9'
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 development they are proposing. A
I DO NOT have objections to this proposal. I DO have objections to this proposal.
tf you have objections to what is being proposed, you must nomy the rv.c. urvrsron or koasral
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 �. jc � /, >c� Jj�\
Signature of Adjacent Riparian Property Owner
No
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: % �� �'• �?^ �� r>%« ` �r
ARPO's am
74N Ile,- ARPO's Phone#: 7
Date: 2 7 *waiver Is valid for up to one year from ARPO's Signature*
Revised July 2021

From: william bndteacs bndteacs(Photmail.com B
Subject: Fwd: Permit 3
Date: April 8, 2023 at 12:58 PM
To: Carole Kemp cekempQembargmail.com
Begin forwarded message:
From: William Teachey <[e-mail]>
:ublect: Permit 3
Date: April 8, 2023 at 12:58:39 PM EDT
To: bndteacs <[e-mail]
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