Beaman, Carsen - 91405C

❑DREDGE'& FILL N° 91405 A .B \C� D
a Previous permit
8 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. . Q General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name G Vt. Authorized Agent
Address ((� Project Location (County):
City Sn o,., 1: State ZIP Z 6 t)C� Street Address/State Road/Lot #(s)
Phone # (! SZ) 'I I-,
Email ( il- 6 0 'PI Subdivision���
City ZIP
Affected ❑ CW -0 EW ,❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body ! tc is I, s. t;.. (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS Closest Maj. Wtr. Body lido x-,�f 'Sn._. Ar-('
ORW: yes;p' PNA: yes/fi
Type of Project/ Activity
Shoreline I nnoth
Access Length
Pier (dock) length / J. J X (o
-
Fixed Platform(s)
I
-
-
Floating Platform(s) / 9 z N
It
Finger pier(s)-
-
Total Platform area -A(,
Groin lengt h/fJ
Bulkhead/ Riprap length
Avg distance offshore-�--
Breakwater/Sill
Max distance/ length
Basin, channellt�---
Cubic yards
Boat ramp
Boathouse/;Boatlift
Beach Bulldozing
Other
L
I
l
r
-
-
((
--
-
rt� P
_�
41
:
�
I
I
I
1
t
i
of
i
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: - yes no
RiparianWaiverAttached: yes no
-
JIl
-
A building permit/zoning permit may be required by:
Permit Conditions fur ❑TAR/PAM/NEUSE/BUFFER(circle one)
Or ❑ See note on back regarding River Basin rules
o brti a� .L%k ❑ 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
¢AIIII
Signature "Please read compliance statement on back of permit"
Signature
Fee(s) Check#/Money Order Issuing Date 'Expiration Date

��`°""a,❑CAMA ❑DREDGE & FILL
��� GENERAL PERMIT
❑New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
N° 91405
Previous permit
Date previous permit issued
A B I Cl D
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:
ISA NCAC ❑Rules attached. ❑General Permit Rules available at the following link: www.deg.nc.gov/CAMArules
Applicant Name L: n inl.i Authorized Agent
Address Project Location (County):
cityState ZIP G 6
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/po) PNA: yes/no-
Type of Project/ Activity
l
(Scale: : � )
Shoreline Leneth 1O D
Access Length
Pier .:
Floating Platform(s) •
EN
■
■■N
■■■■
■■■
MEN
■■■■
:■:
■■
■■
Finger pler(s)
Total Platform area 7 �Ul
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
■M
MEMO
■■■■
:��■■
■■■■■
■■■■
ONE
WN
M1
5
NO
�i:
■
�i�■.i::®i■i�i
ME0
ME
n
ME
PIUMMM
■
i■
■■
■■
son
i�i�i
■�.
`—'��
ii
■�iri1
�rll`��iliiiiir
ME
MSC
■ter
in:n■Si■N
M:■:n■:N:
::N
MWER
EN
A building permit/zoning permit may be required by: �� r vl `
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLYTO 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 k/Money Order Issuing Date
sj/`Z�
Expiration

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit L aVS0t\ f%, etrl lal) , 1 t ,
Mailing Address
Phone Number
Email Address: �1 1) C'Guf aj i LA% �J eJ Ir_ eC)171 k �'
I certify that I have authorized
Agent t 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 _�i 3 erml -Dr r A+ 6 eea, I\Z ,
in bil'fe L, County
l 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
�f(�nattl e
Printor Type Name
i� ne r
Title
Date
-his certification is valid through _,___t

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 Ly se-1't 13eavmul,
L V ►'-,
Address of Property: �-1� 1 a�✓Y� Yr, r+'r ��f't�G �j�D�G�Ir fV6
((, 1
Mailing Address of Owner S U z J� WY h �ltc6 br., S hUu) j ] ]l NC z�Skdl
Owner'semail: C`-CIIyNVlPAYYtA,VI ��IwiS-wnerr' Phone#: Z.S 2-`G(,2j�—tyJ�: �
Agent's Name.
Agent's Email.
Agent Phone#:
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
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 Prot rty Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
MAY 0 5 M.'3
/ 1)CM 44HD
Typed/Printed name of ARPO: `� e v ��.P �f DIY
Mailing Address
of ARPO: /`d n &L
ARPO's email: —� a®�ur/tl "RPOhone#:
Date: r cS Zn *waiver is valid for up to one year from ARPO's Signature*
Revised May 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: C A.( Si, 11 -?-� e l'11m, .I e,
�� 1
Address ty: 213 PoR+ ytd 'Dr., )�u�hc: BeeicL,, NC,
Mailing Address of Owner:
Owner's email:
Agent's Name:
Agent's Email:
z sz -D 1- k533
Agent Phone#
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Ownerl
b 1�ld
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 nave 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 nprap 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 Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
RIFCRVED
Signature of Adjacent Riparian Property Owner: C 4&6, MAY 05 M3
Typed/Printed name of ARPO: Chester Allen (-). C --MHD CITY
Mailing Address of ARPO: 816 Lakestone Drive Raleigh, NC 27609
ARPO's email: see below
Date: 5/4123
ARPO's Phone#: [phone]
'waiver Is valid for up to one year from ARPO's Signature"
[e-mail] Revised May 2021

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