84296C - Sheppard, Johnnie

eo,com4 CAMA ri DREDGE & FILL N9 84296 ABCD
GENERAL PERMIT Previous permit
Date previous permit issued
n New Modification n Complete Reissue I I 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. ri General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s) '
Phone#( )
Email Subdivision
City ZIP
Affected n CW I I EW n PTA n ES PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA I I IHA n UW n SPIMA n PWS Closest Maj.Wtr.Body
ORW{yes/no PNA:yes/no
Type of Project/Activity ,;(,7 f
(Scale: /
. 7 )
Shoreline Length , -+•' t v
.L- e
Access Length t f y
Pier(dock)length I
Fixed Platform(s) ,‘ l T__ Ib,
N' ''''' ..- lk , 1---''''l ----4. r )
Floating Platform(s) '� !- I
I' 1 . ,P� aj 7 ' .
Finger pier(s) ° ( X.I . ....: ,
Total Platform area
e 1 3
Groin length/# •
Bulkhead/Riprap length ..... .. _.......,. + .- ...._........e _ __..__ .... :*�
Avg distance offshore — - \ I I
Breakwater/Sill -___ -`-" - \ , 1
Max distance/length Iti !
1
Basin,channel I i t
Cubic yards - -,::p(.'' �_ ..__ Ell
Boat ramp �1 I l -' NII
.Boathouse/Boatlift 1 ' l_ ' --
i
Beach Bulldozing
Other ) «
j j f
f' tI _ �' ,
SAV observed: yes i_ i —
Moratorium: n/a yes no i '
Site Photos: yes no -. + ' __ _-.. j.,_.___ _
Riparian Waiver Attached: yes no �I
A building permit/zoning permit may be required by: /.f "-C
Permit Conditions ?- n TAR/PAM/NEUSE/BUFFER(circle one)
nSee 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: 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

30,.�`°"'''� ( 1CAMA DREDGE & FILL No. 84296 A B C` D
54.
1 GENERAL PERMIT
I Previous permit
Date previous permit issued
New 1 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. n General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#(_)
Email Subdivision
City ZIP
Affected CW n EW n PTA n ES n PTS Adj.Wtr.Body -- (nat/man/unk)
AEC(s): OEA Ti IHA Ti uw n SPIMA Ti PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:`j)S)
Shoreline Length
j
Access Length
Pier(dock)length _ T l
Fixed Platform(s) 1 -� !
1 i
.T • )� fl f .. lL.
Floating Platform(s) s}}
t f 3 .a aj - r ,J r
_ __ i Pr tr �:
,k.
3 Ie,
Finger pier(s) ` ...... t. - i..‘.t n j_ _.. _. _._._.....__
' • •� '� I v
�
Total Platform area i
Groin length/# ~" j { +
Bulkhead/Riprap length `- - --*> ~
Avg distance offshore - �, I j
Breakwater/Sill ) 1 r i f ' i 1
�.w 1
Max distance/length 3 t/ i I i s ‘Si: /
Basin,channel I ; __ ._ /
4_•1 ----- ._.. ... �...___._ .,.._,..-
Cubic yards _ 17 �_ /
Boat ramp ..- i Y" ( mm.. .. .* -
j I
tt
yy tip' I
,Boathous�t/Boatlift k,;.v i L'
Beach Bulldozing
Other
j r A _ _
SAV observed: yes no 3 - j 1 mm -
i
Moratorium: n/a yes no I •
Site Photos: yes no -- - — �_ r
Riparian Waiver Attached: yes no e 1 �
A building permit/zoning permit may be required by:
Permit Conditions j ElTAR/PAM/NEUSE/BUFFER(circle one)
•
0 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: 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ,`cm,�'N.
p..,,,a,,,,
Mailing Address: d c . p-) 7
q;14_, \\ ) \\ 2- c?7
Phone Number: S2 ss9 .
Email Address: j \Ne__. p.,(20_ y.r\c,.;\\____o C_Civv---
,
Carolina Marine Works ,
I certify that I have authorized Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Add additional 4'x 54' dock on
existing dock. Install sundeck w/rails over existing dock and boat lift.
at my properly located at 3
u3 V-3 -C� HQ_. �� - �� ��
ins)o Lii 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. fl1�
Property Owner Information: rr r
ly
19--2C . --‘/- ( ).-- )1.- d--3 •
Signature3) i OA-i p1 po 7 %-e4 .
1A r r K-- 0 -`-7:Ae_s Q
Q ______
Print or Type Name
VW\ 'C,i V\CA' '4
w rJ ., --" :6t
Title
0Sl7Il702 ,3
Date
This certification is valid through l I

ve,
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion tolbe completed by owner or th it agent)
V
Name of Property Owner: C) ._\ '/\`R\ <� e V�
Address of Property: t ' ' —.I W Pt`"eC�1 i�
QMailing Address of Owner: 0 -- 2�� �t�l P� `1\A C. 2_ 7Z_
Owner's emailL)S\e�.0 1- Z�(o "Owner's P oh ne#: IS2 — -SS '" t 4 J"
Agent's Name: Carolina Marine Works Agent Phone#: [phone]
Agent's Email: [e-mail]
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.C. Division of Coastal
Management(DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive EXT, Wilmington,NC 28405.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 //7�
J 0t4ll
Signature o Adjacent Riparian Property Owner(ARPO)
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: C..
Typed/Printed name of ARPO: 561912 0 cro--- C,,-0 c,
J
Mailing Address of ARPO: ,� 7 pi kia)'
ARPO's email: ARPO's Phone#: ?/0 t r 'erg---
Date: (o •• ) 7-- a_3 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

. i
N.C. DIVISION OF COASTAL MANAGEMENT a
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY t
(Top portion to
to be completed by owner or their agent
Name of Property Owner: ,NYvm<__ Z, -Q-W_..,fP{ (�e f r'1 (�I cr
Address of Property: , 343 V 1-.1 A-- - r Li+n N l(Z . j Ili ePe9S T
Mailing Address of Owner: f �.,1 r) 1\�\\ �c -_ 2 FSs 77 Z O
6 0 �
Owner's email: 5��? wner's Phone* 2-5Z �SS I �7 kp ke lc,,
Agent's Name: Carolina Marine Works Agent Phone#: [phone]
Agent's Email: [e-mail]
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.C. Division of Coastal
Management(DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive EXT,Wilmington,NC 28405.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
Si na a of Adjacent Riparian Prop Own RPO)
-OR
I do not wish to waive the 15' setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner: .g.cn,
Typed/Printed name of ARPO: Q kv\t, e__ \J_
Mailing Address of ARPO:kb (C ,P-i 7 Pir' �"`k\\ /4( _az'_ ,z__
t eJ G("ACI--'COS--
ARPO's email: j < \eiVA 1-}()2 ARPO's Phone#: ?��S�;.�j lko L
Date: ,- 2 I - Zv 2owaiver is valid for up to one year from ARPO's Signature*
Revised May 2021
0`•-J '3 66H-L LO4s Gk- 34I 31--3 Q At-I-e-r LL; Qc_

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: J(( \A,R c-- e r c�(� 2S‘/
Address of Property: (3.1 I f N
Mailing Address of Owner: S 7Z_
M�,L,cc c
Owner's email:J c 9c 4U?a 0Owner's Phone#: 2 S Z ss )- /to to
Agents Name: Carolina Marine Works Agent Phone#. [phone]
Agents Email: [e-mail]
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.
x 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 127 Cardinal Drive EXT, Wilmington,NC 28405.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 b Adjacent Riparialf Property Owner(ARPO)
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Properly Owner
Typed/Printed name of ARPO: .t_Etv < s1 ti y
Mailing Address of ARPO: 7.. .Bit( l<'E �rf Za .Ksr,J J."11 e r,1 C .2 SS'/0
ARPO's email: b c,el y born,I,'U 'j.i . I ARPO's Phone#: ?I .5 ./g- a r'6
Date: f - - 2 0.2 3 .waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

343 Waterway Drive
Sneads Ferry, NC 28460
341 Waterway
Drive Riparian
line
water depth at low
tide —3ft
15'
4' < >< 12 >
Existing Boat lift in 4 �: : :::::: :::: : :: :
.
green will stay : : ::::: :: :: :::: ::: : : :•:
27' .. . . ..... .. . . . . . ..
AI
O
RS
-Project will add to existing dock ---r
and remove existing overhead 4
canopy and build new engineered •
sun deck. 27'
- Owner has waived 15' Riparian
setback at 341 Waterway. The
owner of 343 Waterway Drive also
owns 341 Waterway Drive.
Existing
Lower
deck of
dock in
blue
Existing
Lower
dock
remains

r
- ..f...,igic sok ._
-.. ... , • 4, ,
. .,...1;.. , 06soo° , .
. . , .
. ._ *.l.''... ,,. .., .........„ IA
— • . ...0411''''!,-
t 3t * •
;4 i
'4 341 e •,
0-..:.4_:"A:1*:.1l it_.-1.F--''-4...1 11--i '".'*1-:4 1`..-.1;''''.
•.t. T. ir•' :'�,{ _ ^. .''� \ Via"• 1
-T
., N ....P.'.....7"-.. ,t.s. '.7 ....-1E-.1%- • -._,.\
'.. % ' t k
4
_ 46. , . : t.-... .
.-,- ,
.., „..'1. ..e •-•'.. --71•61" . . ,
' ` i ,cam 9 4 ^+�
• til 't ;9 . �
'VA 0
-_ ... - Owner of 341 Waterway Drive
Johnnie Sheppard
Owner of 345 Waterway Drive
Brady Murphy
ft
rs
a -

Styron, Heather M.
From: Ethan Mahoney <[e-mail]>
Sent: Friday, June 16, 2023 7:07 AM
To: Styron, Heather M.; Martin, Tina R; Guthrie, Kara L
Subject: [External] RE: 343 Waterway Drive Sneads Ferry NC 28460 CAMA
permit request
Attachments: 343 Waterway Drive CAMA permit.pdf
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the
Report Message button located on your Outlook menu bar on the Home tab.
Hello Ladies,
Just want to confirm you received this permit request and if there are any questions and get an
estimated timeframe when it would be issued.
Thank You,
Ethan Mahoney, PMP
Project Manager
[e-mail]
C:[phone]
121 Garnet Lane, Jacksonville, NC 28546
CW
a km
CAROLINA CAROLINA
UTILITIES MARINE: WORKS
From: Ethan Mahoney
Sent: Wednesday,June 7, 2023 3:55 PM
To:Styron, Heather M. <[e-mail]>; Martin,Tina R<[e-mail]>
Cc: Eric Ward <[e-mail]>; Shelley Copp<[e-mail]>
Subject: 343 Waterway Drive Sneads Ferry NC 28460 CAMA permit request

Hi Heather and Tina,
Attached is a CAMA permit request for 343 Waterway Drive, Sneads Ferry 28460.
Please let me know if you have any questions.
Thank You,
Ethan Mahoney, PMP
Project Manager
[e-mail]
C: [phone]
121 Garnet Lane, Jacksonville, NC 28546
CAROLINA CAROLINA
UTILITIES MARINE WORKS
2

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Owner of 345 Waterway Drive
Brady Murphy
Oil

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION &WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return
receipts(showing delivery of notice)are needed,or any other method which satisfies the Local Permit Officer
(LPO)that a good faith effort has been made to provide notice.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM or the LPO an opportunity to consider these comments/objections before a permit decision
is made. "Permission" of adjacent property owners is not necessarily required for DCM to issue a permit;
however, permission must be obtained for certain types of proposed developments if they fall within a 15'
setback area along the riparian access area of the adjacent property, as determined solely by DCM. It is in
the applicant's best interest to provide comprehensive and accurate notice so that any concerns or objections
can be resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals
the permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders?Yes, if the easement could be impacted by the proposed development.
• Streets/Roads?Only if the street/road could be impacted by the proposed development. This
might include street-ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals(or families),send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.gov/search/index/corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand-deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed &returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised May 2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Kermit:
h<,�..c— PA ,
Mailing Address: j?a A > 1 -
"4-, \s, ; \\ _c
Phone Number: ss9
Email Address:
Carolina Marine Works
I certify that I have authorized Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits ff
Add additional x 54' dock on i
necessary for the following proposed development: 1
existing dock. Install sundeck w/rails over existing dock and boat lift. �C---
at my property located at 3
in is)o 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:
k___
Signatur ~
d‘.4,�„ 0. � Q_
Print or Type Name Q
Title
S 1 I Vow ��'
to ✓�� F��
Or,
08� O
1 �'y0
This certification is valid through _—f C>

• . __
N.C. DIVISION OF COASTAL MANAGEMENT a
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
• CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY ti
(Top portion to be completed by owner or their agent
Name of Property Owner: ),I \Y\4n\a-- Z, ���-,P�=c�,�o (}'
Address of Property: ,3' W r Dcz.. S N ePr.,Q--SG` rA N
Mailing Address of Owner. -Co0 �..1 R k. V\,`\ N L G O s 72 Z �O
G Owner's email: 5 �V\ k 'x wner's Phone#: ZSZ -SS9-9 6
Agent's Name: Carolina Marine Works Agent Phone#: [phone]
Agent's Email: [e-mail]
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.C. Division of Coastal
Management(DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive EXT,Wilmington,NC 28405.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 /( / v; l..�
l/mil/ G- /�
Si na e of Adjacent Riparian Prop Own RPO)
-OR- �_ �Q
I do not wish to waive the 15'setback requirement(initial the blank) �� r'�
0
Signature of Adjacent Riparian Property Owner: -- g2,,.. .(2)140/1,
Typed/Printed name of ARPO:T i14uqN Q_ �C) � f
Mailing Address of ARPO: () 247 2 j^` i"\ \ NI c_ 2 7Z_
(1 �J G ARPO's
Ph ne#: '1___), i�oco ARPO's email: j �� pc� �2 ARPO's Phone#: •�
Date: S• 2 al - 2)2)waiver is valid for up to one year from ARPO's Signature*
Revised May 2021
T o� ba 1 c,N-s GA- ill) 31/-3 Q A*'mo w _.

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)
I l
Name of Property Owner. Y�ry n��_ ���� 1, '� Z
Address of Property: TL1 Z) L+.1 o\'I L'
e lvt< �trt (JL
Mailing Address of Owner: ��j �� 2 1 7 1 t N F-, \\� \\ 2 7Z
Z tOw,L,cc�
Owner's email.J S1�c ��z Tv (� G Owner's Phone#: Z S Z '76�e
Agent's Name. Carolina Marine Works Agent Phone#: [phone]
Agent's Email. [e-mail]
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.
x 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 127 Cardinal Drive EXT, Wilmington,NC 28405.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
°l tpa
Signature Adjacent Rrpa Property Owner(ARPO)
-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:
Mailing Address of ARPO: 7.2-4 -�•rj 14- K� Ci Tu .Ksr-,4d:11 a r/G .2354/ci C�
ARPO's email: b �d�borne/ v�,r�4 � ARPO's Phone#: ' 4//0 5 ' g-_23/4 'j��j�
Date:_f j- ,2 C'2 3 •waiver is valid for up to one year from ARPO's Signature' O0 ��4/ cN
Revised May 20 Oor
I

343 Waterway Drive
Sneads Ferry, NC 28460
341 Waterway
Drive Riparian
line water depth at low
tide -3ft
15'
4' < >< 12 >
Existing Boat lift in , .. .. .. • ....... .. . .... .:.;.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:..
green will stay
27
.......... ........ .... ..
r
STAIRS , _
S
-Project will add to existing dock -
and remove existing overhead �,
canopy and build new engineered < �
sun deck. 27'
- Owner has waived 15' Riparian
setback at 341 Waterway. The
owner of 343 Waterway Drive also
owns 341 Waterway Drive. ,-'
O Existing
�C) Lower
deck of
dock in
6 � .4b blue
o /›?• Existing
Lower
dock
k/7 remains

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—ter
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IfiA1�r
June 19. 2023 1:500
0 0.004 0008 0.016 mi
0 0.005 0.01 0.02 km