90004C - Sheaffer, John

to,(0.'k r1CAMA DREDGE & FILL N9 90004 A B C D
GENERAL PERMIT Previous permit
Date previous permit issued
New Modification n 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:
I5A NCAC 6--)+, I€C' --' n Rules attached. 171 General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name-co IA in I i S f oin -Ye r Authorized Agent A nri i e_ t_)C.Sb
Address -337 3G iv./obi-'I" 1)(W- Project Location(County): C.,,,,i.e--(ek
City i)_G4 I Cl IN State A/FC ZIP 1-('j Z- Street Address/State Road/Lot#(s) 00 g(on/lc. Q.<-t4
Phone#( it l ) £JJ`!L — 473tol
Email -S(S ��Q '..•'t M C iii herici n C 0AM Subdivision ---"----
City EC(A LA.fe;-4- ZIP 2-k-s'2-
Affected n cw n EW n PTA 17,71 ES n PTS Adj.Wtr.Body !V o14h a\A r ,(nat/man/unk)
AEC(s): n OEA I I IHA n UW n SPIMA fl PWS Closest Maj.Wtr.Body ,/\jc?rP1 ea>er
ORW:yes/no PNA:yes/ho r
Type of Project/Activity it .fc1�( (Vt n Y 1
(Scale:{°-= 0)
Shoreline Length '
Access Length111111111111111R1111111111111111111111111111
Pier(dock)length F
Fixed Platform(s)
Floating Platform(s) r_ '
1 L. ' * r
iiiiimioE.
Finger pier(s)
l , "
114 �"
Total Platform area - 1111111_ i RRRI
Groin length/# (____.___. III w ' _ IMO IMIMIMM�a R
Bulkhead/Riprap length ' i n :.. 4 _-. — ......
Avg distance offshore
Breakwater/Sill -- '- 111111111111111111111111111111111a a
Max distance/length
Basin,channel / Eli MI iik, - "'
Cubic yards .l— 2 - ;- -
,,,,,,,,,,,, e
Boat ramp .F� v
Boathouse/Boatlift / ' MiniaMiniallanalpiiiMINIMMININIIINUIMMIZIN1 4
Beach Bulldozing / - , �r V
Other a `, IMIIIIIIIIE 1
o �2_ : -E i
,.� BERL 1
SAV observed: yes noMEin �=--
01
Moratorium: n/a yes • '""'""'
Site Photos: es i ' � t
Riparian Waiver Attached: es no ( I Midi t.�
A building permit/zoning permit may be required by: { h( 12_t- C'tn./)L1
Permit Conditions' 1.44n;A.S d CliS-i-4,,,; �. i i'v‘I'tkpck ft, 10 ( a`' ✓e` C TAR/PAM/NEUSE/BUFFER(circle one)
a„1\\.v€,C(. ?\ f,: ,1nf,A. vya 'a ( et,r cc Oil C oCr 14-'s.-( t-JC'If.' •-(S. n See note on back regarding River Basin rules
nSee 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 Fee(s) Check#/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S.Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Beale, Camden,Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

0`°'4 , 1CAMA I I DREDGE & FILL No 90004 ABCD
1 GENERAL PERMIT Previous permit
Date previous permit issued
I'New n Modification n Complete Reissue n 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 t s-,' ? n Rules attached. a General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name } ,- i Authorized Agent
Address '. 1,2(-; Ci I iy -:,, ;VI 1) Project Location(County): -City 1_'+)F 1,111 State U( ZIP - ' " I Street Address/State Road/Lot#(s) -
Phone#( i1 ) Ll/`f - El (r I
Email i £t i C tr�`: t,', 1 r€;iv-xe i,( • Subdivision
City ZIP
Affected I • I CW In EW n PTA ',.4ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n IDEA n IHA I. I UW SPIMA n PWS Closest Maj.Wtr.Body -
ORW:yes/ho PNA:yes/no
Type of Project/Activity ( I rL d ac. c ( (V, 1,y
(Scale:l`€=L 0')
Shoreline Length ,'
j
Access Length 1 ---
Pier(dock)length / (70 ,
Fixed Platform(s) / —_ ._.. I
�, t 1
Floating Platform(s)
•
i
+a
Finger pier(s) - I 1 ( (t
,.) ( ...E k ,.. .. __.. �.. f
Total Platform area I 1 t I
Groin length/# I € is I _ - I '
et i
Bulkhead/Riprap length -I —
Avg distance offshore • i t i r p I y
Breakwater/Sill -- i I ) . 1 1 t
I I 1
Max distance/length - { ( ' *
)
Basin,channel -' \- i v'''"_' ;IN \ , \ I
Cubic yards % I Z.. _,�� —' ''t- „'r r t1- uc—,- to v li,r.,cl 1\! } —
1�
Boat ramp Ai h Ni 14) "
Boathouse/Boatlift C` 1 ! Er,,A �i TY. ,-tf
I i !
Beach Bulldozing t�..€k.f� {
Other ` ` . ._...._... {.... t..._ ,._.t..... f.
vi' y- - 1 i e'r 11 1 141- 4I ' i !
1 \�F 110ti S; ,'
SAV observed: yes no-\ 1 '�` ' ' I :�_ �*
Moratorium: n/a yes now i • ; ; '°"" i ' i .
Site Photos: yes nod -1,„":„.-
_ _.._ I _ _
Riparian Waiver Attached: yes no � ±'�'�� ': ` 1
A building permit/zoning permit may be required by: f-' ,1E t S C. 4 1
11
Permit Conditions', L- ` ) n TAR/PAM/NEUSE/BUFFER(circle one)
!, .11t+,, ri ;'' p' n See note on back regarding River Basin rules
ElSee 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)
y.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
t
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

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. `S°Nr' CN/Z-IST7AN SNEAfF(
Address of Property: 6/D 3/2vivfvP 204J 3EP U Fo,¢i Ne 2�S6 Z
Mailing Address of Owner. ? Z") E 76FiflcN? 72ie/LC beg ,, .i' •Z fl it
Owner's email: 5-"e-AI7o globOClu+x-a°Owner's Phones: ,q/9` 7/4/am 9-?6/
Agent's Name: ANDU 1'JFge Agent Phoned: ZS Z ' 6G5" —e-t 7b'
Agent's Email: W ebbdo(c P p4441. Corn
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,wih dimensions, must be provided with this letter.
XI 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(252)808-2808.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 skin
the appropriate blank below.)
• .k•, I • .I . , ►•,�•• 1. , N/A
Signatre of Acfiacent Riparian Property Owner
-OR-
>*_+'•'•'�+ t,'-c :►�: -�o- ;*•• nk) N/A
Signature of Adjacent Riparian Property Owner: / ab.•a
Typed/Printed name of ARPO: Rachel Bradley Titus and Shea Bradley-Farrell
Mailing Address of ARPO4004 Ellenita Ave Tarzana CA 91356/750 Port Street Apt 631 Alexandria, VA 2231
[e-mail]
ARPO's email: sgarrisl4tulane.edu ARPO's Phone#'-$18-469-3006/504-621-4408
Date: 1217/22 'waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ILA ( Lr:S ,(;11 t�ri efr'
Mailing Address: 3 L rat,,'ivy) t�
I4,1t�, ;
Phone Number: q \ Ll
Email Address: N ( 'Lll ttY ctt, b ov1.
I certify that I have authorized lve Lh
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: JcIA
at my property located at t71LO hCIJI-1 1
in (tl County.
I 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:
cja...411'"^-
Signature
to\ S1^edt l Ci r
Print or Type Name
Li4 QNl-tr
Title
\\ / 30 / 2,017_
Date
This certification is valid through 3 / 5 I / 203

10:32 / .1 1-7
Tracking Number: Remove X
70210350000019909541
1c--1 Copy ck Add to Informed Delivery
Latest Update
Your item was delivered to an individual at the
address at 4:17 pm on December 10, 2022 in
BURLINGTON, NC 27215.
Get More Out of USPS Tracking:
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G./ Delivered
Delivered, Left with Individual
BURLINGTON, NC 27215
December 10, 2022, 4:17 pm
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 30" ( �,;:S f t(;ll S 1)r1.�, e
Mailing Address: 3 3 2 L I ,v.
U,: -11 12
Phone Number: •
I. LI 61 j G
Email Address: ,SAS N 0 L' . (b‘vl
I certify that I have authorized tlrw; - �� 7
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Set; (I.L L 1
at my property located at b t1 o P C1
in (ay-lei Z( County.
I furthermore certify that l 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:
-VY`, C rJ� C)
Signature
306 C LI.i 0-.i0\ c t11 c r
Print or Type Name
LE4 Q v�lltr
Title
1\ / 30 l Z0-Z
Date
This certification is valid through 3 / 3 f / 2.03

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICAT1ON/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: °NN CNILIS%MAN SjJ( f
Address of Property: 6/6 3/2vNIvp 12oAJ 6p v Forzt /x/X Z eS6 Z
i
Mailing Address of Owner: Z4) ePi6 /+''o iT P,/✓( R.ALF/LP t'( Z'6/Z
Owner's email: SCSL'NDO /6) ( aWEN&'Do- r"Owner's Phone# 9/9' 761- 9J6/
Agent's Name: ANDS WCgg Agent Phone# Zs Z ' 6CC -y.'78
Agent's Email: w e 66 dd c. p Q 4141. cow
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.
XI DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being prop'osec4 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(252)808-2808.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 sian
the appropriate blank below.)
bEitilberklychmeivecsamiettobtkioteciettandc N/A
-OR- Signatwe of Adjacent Riparian property Owner
ictliAlkiMilPtiFIRSIWWERPSTRINEIRILLEVIRWSlitc(MilliliffilSVIank) NIA
Signature of Adjacent Riparian Property Owner. 16--- / 045 - 11,.a.
Typed/Printed name of ARPO: Rachel Bradley Titus and Shea Bradley-Farrell
Mailing Address of ARPO''004 Ellenita Ave Tarzana CA 91356/750 Port Street Apt 631 Alexandria, VA 2231
[e-mail]
ARPO's email: sganisl@tulane_edu ARPO's Phone8:g18-469-3006/504-621-4408
Date: 12/7/22 'waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

Mail Receit :
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MAIL FROM; TRACKING & REFERENCE
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mare

1O : 32s7 . � �
Tracking Number: Remove X
70210350000019909541
Ig Copy A. Add to Informed Delivery
Latest Update
Your item was delivered to an individual at the
address at 4: 17 pm on December 10 , 2022 in
BURLINGTON , NC 27215 .
Get More Out of USPS Tracking :
Ega USPS Tracking Plus®
G Delivered
Delivered , Left with Individual
BURLINGTON , NC 27215
December 10 , 2022 , 4 : 17 pm
See All Tracking History