Roberson, Walt - 88987C

❑CAMA [IDREDGE & FILL N9 88987 A B 'C-' C
Previous 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 ' � • 2-r Ce ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.goy/CAMAruIes
Applicant Name 'NIA- i
Address I—Y)
City rt�bcyo State t--I Ci ZIP
Phone #(_I)
Email rryVl
Authorized Agent
Project Location (County): Cn <,I OL.1
Street Address/State Road/Lot#(s) (l
Subdivision
City G' ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body 1/\I �)i -� C 4 — Li V naUman/unk)
AEC(s): ❑OEA ❑IHA DEW ❑SPIMA ❑PWS Closest Maj. Wtr. Body V'1V', i C.�'L t. K, @�-1V-C
ORW: yes/no) PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore /
Breakwater/Sill . -
Max distance/ length �� {
Basin, channel i
Cubicyards {
Boat ramp
Boathouse/Boatlift
Beach Bulldozing t4
Other
SAV observed: yes no
Moratorium: n/a yes no L {.
Site Photos: yes_ `no
Riparian Waiver Attached: C-yesno
A building permit/zoning permit may be required by:
Permit Conditions (I2 iw �� i �'i `r 15 V 1�-�t(` •�
(Scale;\] V� )
❑ 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 Officers PRINTED Name
Signature "Please read compliance statement on back of permit** Signature
Application Feels) Check#/Money Order Issuing Date
Expiration Date

3�Dcour4 ❑CAMA ❑ DREDGE & FILL N9 88987 A B 1" .' D
Previous permit
G E N E RAL 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: www.deq.ncmtry CAMArules
Applicant Name '. i I Authorized Agent
Address 1 Project Location (County): ! ," 1 �
City - State "--kC ZIP I --I Street Address/State Road/Lot #(s)�.::� N L
Phone # (_I)
Email
Subdivision
City ��, c ZIP
Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORIN: yes/hd. PNA: yes/no
Type of Project/ Activity + fi
Shoreline Length
Access Length /
Pier (dock) length
Fixed Platform(s)
Floating Platforms)
Finger pier(s) /
Total Platform area
Groin length/R /
Bulkhead/ Riprap length /
Avg distance offshore /
Breakwater/Sill -�
Max distance/length
Basin, channel Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other 1I
SAV observed: yes no
Moratorium: n/a yes no j
Site Photos: yes no -
Riparian Waiver Attached:. yes no ' )•
A building permit/zoning permit may be required by:
Permit Conditions
❑ TAIVPAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
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 Fee(s) Check q/Money Order Issuing Date
t /
Expiradon Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting PPerr�miit:" T� .Q.IIYeLS.Q 6
Mailing Address: -Z,0 a34a kp fe
Swatnsbom NO Z1�6�}-
Phone Number: %64 —15(4 11 L+6
Email Address: WQI4r%s}YO11b2(�(1QSSpG10.�s. COtRI1
I certify that I have authorized alb
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: rf_ n Z-
at my property located at ZD, kA Vie
in !2t15D-%L---,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.
Propert 0 ner In ration:
Signature
Wal4l bersoln
Print or Type Name
Title
5 ,2�
Date
RECEIVED
This certification is valid through I 1 MAY 2 6 2023
0CM-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: �j'j(j& _&
Address of Properly: 7k2 Z,, 1n tAC Z��
Mailing Address of Owner: -,LA 10
Owner's email: ft&%W�U Owner's Phone#: r-704 7 S j0 111 ( O
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.
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.O. Olvislon or Ooastai
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 sion
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
M3
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: 1vU AaX %.tip , :W4A11F"r4 /VC// 2 `L
ARPO's/email: f A arD�� •e.ARPO's Phone#: 9& r%' p 7 /.yy
Date: tp"OCIO?Oa� -waiver is valid for up to one year from ARPO's Signature'
Revised May 2021
RECEIVED
MAY 2 6 �023

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to bco
e completed by owner or their agent)
Name of PropertyOWnor:—&{i-Qtd {QULILLp_(so-0 L` — ,�Ar 'I
Address of Property: 7.61 k�errilrn bayNe Smy,,So qC ZCI✓6
Mailing Address of Owner: a
Owner's email: m (�1)'C�Q twner'sPhone#:'ltj�-�.�0 IIrk6
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 development they are proposing. A
description or drawing with dimensions must be orovided with this letter.
ti
V I DO NOT have objections to this proposal. 1 DO have objections to this proposal.
If you have objections to what is being proposed, you must nohry me N.G. urwsion or coasrai
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead Clty, NC 28557. DCM representatives can also be contacted
at [phone]. No response is considered the same as no objection ff you have been notified by
Certified Mail.
WAIVER SECTION
1 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 revelments). (if you wish to waive the setback, you must sign
the appropriate blank below.)
100 wish to waive some/all of the 15' selbaacl���al/uL( X/ t
Sis�'t of Adjacent Riparian Property 04fier
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO: 044t r a r'1 11 e K He r n /I GI <�
Mailin Address of ARPO: a a S I�C'lr (6-1 e- U1 5 (OV( ;holt)AX- 0 7 t �f
1 yrl)vJ/Vktly 10 3a 8-V9
ARPO's email: ARPO's Phonelt:
Date: 5 2 'waiver is valid for up to one year from ARPO's Signature'
Revised May 2021
RECEIVED
MAY 2 6 a?3
0CM-MHD CI'ry

ny
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�ara�sal�
RECEIVED
MAY 2 6 2023
DCM-MHD CITY