Singleton, Grant - 88979C

OWMNr ❑CAMA ❑ DREDGE & FILL N° 88979 A B ;'c 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 `, ❑ Rules attached. ❑ General Permit Rules available at the following link: .d .nc. ov CAMArules
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Applicant Name U'v (r "� \% 1(` [- VJ
Address L'1 G A i `l 1'.' I'1�1
City f/I'.Wri-r'VI IIP State ��K, zip 2
Phone#(-:j CJ) (aw1Val
Email
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Authorized Agent l ,0 lyjocir dy(Ay Vy
Project Location (County): (,Glr-(cVC.i"
Street Address/State Road/Lot #(s) 21 ' � A<, qRI *LA
Subdivision
City zip <'F;eaY
Affected ❑ CW ❑ EW El PTA ❑ ES ❑ PTS Adj. Wtr. Body r - 1 f�E',TC,✓ P (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body Tit(' '--' � (r i f t <-, -
ORW: yes/no', PNAves/no
Type of Project/ Activity
Shoreline Leneth i ,
(Scale:W,f )
Access Length
Pier (dock) length
Fixed Platform(s) . = �
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A
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—
Floating Platform(s)
I{4.
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Fingerpier(s) -'
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17
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Total Platform area
Groin length/ft
Bulkhead/Riprap length
Avg distance offshore
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—
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1
-
-Breakwater/Sill
—
-
—:-
Max distance/ length
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Basin, channel--
Cubic yards
-
Boat ramp
L
Boathouse/ eoatlift
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Beach Bulldozing
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Other fr
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SAV observed: yes no
Moratorium: n/a yes no
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Site Photos: yes. no
P,
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Riparian Waiver Attached: ,yes no
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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 Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit*• Signture
Ic
Ap(iication Feels) Check q/Money Order Issuing Date
Expiration Date

*dom?".NULAMA El DREDGE & FILL N? 88979 A B C 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:
I SA NCAC II I ❑ Rules attached. N'General Permit Rules available at the following link: v .deg.nc goy/CAMArules
Applicant Name
Address r 1
City 11 (' State ZIP
Phone#(_)_. Ei. Lj- I;'(j
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yet/no
Type of Project/ Activity
(Scale:I", )
ChnrAinc I anath
Pier (dock) length
Fixed Platform(s)
E�SHE
..®III
Floating Platform(s)
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Finger pier(s)
Total Platform area
:.
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■..Bulkhead/
Riprap length
Avg distance offshore
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No
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ME
MR
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A building permit/zoning permit may be required
Permit Conditions
❑ TAR/PAM/NELISE/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.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit-' Signature
Application Fee(s) Check q/Money Order Issuing Date
(Please Initial)
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ►z n i h I „J
Mailing Address:
Phone Number:
Email Address:
I certify that 1 have authorized
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Yam, � �>♦ � ��k �'[�
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: F 0-0 4 1, (- r
at my property located at � � S 1 �w P0I i` c� C to g �� �[•�
in County.
I 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:
S. nature
Print or Type Name
Title
Date
This certification is valid through I I
���rtr�•i�
UAY ,
M

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:
2 ,:�s s Lz�-
Mailing Address of Owner: 4 0 3
Owner's email:
M
,I-11rnf- TOK1-0' N.(,
lJ r2(1 ky Va
Owner's Phone#: q j ® �� T Er--1'
Agent's Name: I/ L () g c r ,� h a-S Agent Phone#: 2S'Z 2--`i
Agent's Email: rn V J 10 c c- �-j- n c, l'~ ^"1 yh 8- t 1 .N
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 Aoso to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback
Signat Adjacent Riparian Property -OR- Owner
�C
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:(,(( �� �eGL'� W C ✓/G5
PAY I fj �0??
dck401C C/)'Y
Date: + 2 -)- Z3 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

C
RECEIVED
MAY 1812023
DCM-MHD CITY

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: G r i3-n+ i n c2.r�yl/
Address of Property: 2 %s S • 01 r1 1 -po KaC-=1 � tq• (
P II II
Malting Address of Owner: `t� C) �� Yi'1 uv-p1ty I CJ . Ilay.elge :L he j�1.C, 2$31
Owner's email: Owner's Phone#:
Agent's Name: T-e-lct r) "9 0 e IN 40-5 Agent Phone#: 2S'2- 2�
Agent's Email:
c (40 "Ma-iI ilL10
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adfacent 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. Oivisfon or Coastai
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 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 somelall of the 16 setback
Signature ofAdjacent Riparian Property Owner RECEIVED
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) MAY 18 2023
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: (, pc�j�eMailing Address of ARPO: l3 C eueCgy�
i rl
,D0
DCMAMHD CITY
ARPO's email: ARPO's Phone#:
Date:ia� ia3 'waiver is valid for up to one year from ARPO's Signature"
Revised May 2021

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C RECE-IVED
MAY 18 2023
\ DCN►`l4HD CITY