89736A - Spivey

LAMA r DREDGE & FILL {Lid N a C D
aENE,�A` PERMIT
M ! �6lf'•T• Previous Permit _
} a Date Previous Permit issued
New [_Modification ❑Completefteissue ❑Partial Reissue T
As authorized by the State of Norch Carolina, Deportment of Environmental Quality, and the Coastal Resources Commission in an area of environmental concern pursuant to:
i5A NCAC •� ^[{_._L („ Q--_,____ `I Rules attached. General Permit (rules available at the foRwang link: yv_v�vydgy,nc egvjr—AMArulel
Applicant Name�VLI
Address�PL-_�_Z+..1i,d
State _.�� .___ ZIP __.-..G.L�-I.Gi
Phone#(�)?{' t_L�'�—�
Email C, 'I/h. pIQ G}(G UGin AA. rA KA
Authorized Agent
Project Location (County):
Street Addres0tate Road/Lot#(s)
Subdivisio{n� r I'
City ......__t.^'.L.�.ttdl U _
Affected FJCW [KEW KPTA L]ES OPTS Adj. Wtr. Body—iiirf�'
AEC(s): OfOEA r�INA � _ UW DSPIMA nPWS Closest Maj. Wer.Body—,q
—a`1—t—`
ORW: ye no Phlk ye no. N
Type of Project/ Activity \t. Gv:rzj_Lt- L, e ` J'Ii.q pj f%G{ tr-c r v .—
shornhne tent ! t_T.._WR.. (Scale:
Access Length �" •.g fk is ( i
Pier (dock] Ieng,Zb—isjFixedPlatformi5� t r
Finger pier(sJ _���� F'��+• rIi ' "`�`
—� Se
Groin length/d_
Bulkhead/Riprap length_
Avg distanceoffsho�eE`"f
Breaksveferf511! ___
Max distance/length
Basin, channel___ '__i/uy
Cubic yards _„
Boatramp �..- " —__.._ rr7f. It yt'`• a t"l .7 i--tI/,(;T Fria V'Y'1
Boathouse/Boataft
Beach Bulldozing — ----- r6, ti... •� }A .'t..
Other_-_._ '^m •,r YtJ
SAV observed: yes not :p�.� .� %i j]t
Moratorium: nlar vye!x no �k y4,\ '�' 1 S}j J
Site Photos:
8' no ..33 `t j� ,{r
Riparian Waiver Attached: o no u'"" r ssR ~" s`Y T '�/
A building permitfmning per rt may be required by:
Permit Conditions TARIPAMJNEUSE/BUFFER (circle one)
DSee note on back regarding River Basin rules
- ------`--"'_"----" ""-`-"'- u See additional notes/conditiwu on back
I(AMM AWARE
OF
S�TTATUCT'E$,ERE RULES A/N�OCONDITIDNSTHATAPPLY TOTHIs PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please lndi
Ag S Ap licant PR ED Na nE Permit Officar s PRINTED Name
Ngnature) "Plea c read complia4e s temenl an hack trt permit• Signature
—11 _le._4e _.__ —_ zd �77 ••t' w—I 1 4.-L:'+ t �,: I
Application F , j check G/Money Order Issuing Date Exp raKon Date

eatomr" 14CAMA El DREDGE & FILL N° 89736 �� B C
a� � GENERAL PERMIT Previous permit
AMDate previous permit issued
NNew ❑ 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
15A NCAC AM • I `VID ❑ Rules attached. LN General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name N&Aru bi NAal + e I�YzYY1Cl.VL1A 7(J1in 1A a Authorized Agent �Z D&CV• SQ1.4/�cOK
Address PVT Project Location (County): D%aA o, /�
city State ZIP !A -Street Address/States Road/Lot#(s) �"�LtA4S 1"t°Y1Q-1•t/�Y.(.� Dy
Phone#( ) Li4-5—�'�{'a-'I I,)i 3✓' :/!e , oh :l
Email c.l'V].✓iz gG' . blet &V-.5C? l(.'/.kDO - co VA Subdivision -!P /
City ` L 2. zip 7 44ef
Affected ❑CW NEW PTA ❑ES ❑PTS Adj. Wtr. Body 01MJ21 . M f201,44011.6i (natnan nk)
AEC(s): ❑OEA ❑IHA ❑uW ❑SPIMA ❑PWS Closest Maj. Wtr. Body AJ Z41V1 VJ,0 ! YV
ORW: ye no PNA: ye no r�
Type of Project/ Activity (Uyt°i 1A(� 0. I D' X 14' �- JV p 1 6L4 W Yv✓-
^ (Scale:r[
Shoreline Len � $i% t r. n
Access Length
Iles
Pier (dock) length
Fixed Platform(s) C -� c,• d low
tt v5
�lo-a-fin P-lays-m�)11 0AI L4
Finger pier(sCA
146 )
2 R%
Groin length/# "� S/(r44L ^ �'
Bulkhead/RipraY�1
Avg distance offshore
^r
Breakwater/Sill
Max distance/ length
Basin, channel e'yjLroL - A. L�
Cubic yards �y / +LLB' ,eel 5Y. 1(.I�IfvV1M
Boat ramp •It F
Boathouse/ Boatlif[
Beach Bulldozing E •� I YV �,
Other
SAV observed: yes
Moratorium: 0yes no
Site Photos: ���,�y++���{( no ,/•• ('fU✓wf
Riparian Waiver Attached: no T f�- { J +`
A building permit/zoning per Tit be required by: 1 L�'rN'V� /i 1 �=�1 I'lL�4U F
❑ 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 APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
d�
gen r Applicant PRINTED Name Permit Officer's er's PRINTED Ngme
Signature "Please read compliance statement on back of permit*'Signature __yE�-Dt(J
2130.00 45)1- (v1I,ZU`L Ibf(IZos'-5
Application Feels) Check Jt/Money Order Issuing Date Expiration Date

t"te"rw F]CAMA ❑ DREDGE & FILL
GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N° 89736
Previous permit
Date previous permit issued
t.l B C : 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:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwden nc Row/CAMArules
Applicant Name �'t P)Ia,,,V 1- RP4,IeI.yit4-,?T➢4,4:':{,.J. Authorized Agent E7. fi7(•lL '54(Lcq-t (�V1
Address ? )I � I Jt t Vt Project Location (County): Da_y!�J
City K`' I b I,i State jV i_ ZIP .7 Street Address/State Road/Lot #(s) 41 G el
Phone #(: ) WU-h - 1q7 I L1.. i, CLl -79
Email rij,� In .,. h I(A 1, k... 5a L.d Q, ice➢ of (0 WI
City I I i-I , I'd t.Y.t_I-)lc ZIP G.. t "f �q"
Affected ❑ CW NEW FZ-,l ❑ ES ❑ PTS Adj. Wtr. Body � 61 i/ iJJ f '"y) 0 iA," ( (nat(�I�i6n6- nk)
AEC(s): ❑ OEA ❑ IRA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body 1 ki.P. VLI f14( 11' Lt,y"Id
ORW: yes/no PNA: yes(no..)
Type of Project/ Activity (j I k 11•i' I , I '�7�%f 1 G(.;! fro v�ln,.
(Scale:( (��)
(Shoreline Length
Access Length
Pier (dock)length
Fixed Platform(s)
i
Floating Platforms) I() ,C 1'-I
/4
_
I..Jry
-
j..
�'
%O
-
J
-�_
!• _
Finger pier(s) �. _
T11
i
y
TotalPlatformarea, ILl C.(I^�•
Groin length/#
-
�_..a
i.
h
.n$.
—r
—
Bulkhead/ Riprap length
fin-
Avg distance offshore
--
-
-
----
--r
--
--r
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic as
Y
-.
p
f-
Boat
Boathouse/ Boatlifts
Beach Bulldozing
-
Other
I
SAV observed: Yes no
Moratorium: n/a yes no
i—'
W
I
-
)
=-t
Jlr➢
I,.
I
_.
...
__
Site Photos: yes no
)
(_..
-
Riparian Waiver Attached .'Yes no
_._
.__._.L,
_..
.i�-�._._L_..,
..
_ �_.
_-
.
.
._..
A building permit/zoning permit may be required
by:
1h\14i
P.
V.1
Permit Conditions
INS THAT APPLY TO THIS PROJE(
P.genOr Applicant PRINTED Name
IJ IAIVYAPI/NtUDt1bUtttR(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1D REVIEWED COMPLIANCE STATEMENT. (Please
I1,,
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Feels) ' Check #/Money Order
Signature
Issuing
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: C V O r IeS
Mailing Address: nn
_J�✓t� YIOf VV61241
i � NGtwk �N i 219 L/
Phone Number:
Email Address:
I certify that I have authorized EZ Dock Solutions
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Floating dock for jet skis.
at my property located at 3945 Pineway Rd., Kitty Hawk, NC 27949 ,
in Dare County.
t 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:
Signature
C�yn.✓I�S i�l�U�
Print or Type Name
OW V tt
Title
117 Q'L3
Date
This certification is valid through
RECEIVED
MAY 15 2023
DC M-EC

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: Charles Black
Address of Property: 3945 Pineway Dr,,Kitty Hawk NQ 27949
Mailing Address of Owner: 3945 Pineway Dr Kitty Hawk NC 27949 _
Owner's email:rharleS black Ca yahoo com Owner's Phone#:
Agent's Name: EZ Dock Solutions Agent Phone#: [phone]
Agent's Email: ezdocksolutionsra)vahoo com
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 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 nod/y the N.C. Dlvfslon 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 /� ""! - ,'� per' e
ED
Signature of Adjacent Riparian Property Owner I `�-,'t
-OR-
I do not wish to waive the 15' setback requirement (initial the blank) MAY 1 5 2023
Signature of Adjacent Riparian Property Owner: �j(GCar� /% d C -• EL
Typed/Printed name of ARPO: fLrdAilk IT 2l�ik
Mailing Address ofARPO: _110 (� (42d Prjyp �+nk- `/a- �3y3�
ARPO'semail: `1C►9�S.lTId `'-gtyIa;L(0M ARPO'sPhone#: u01 dfn4- q(iot( — CeA
Date:) 2 Mau 2'waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

DocuSign Envelope ID: 27C4131B-CBDEA43Fr936D-9A7C51F7C9E2
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Charles Black
Address of Property: 3945 Pinewav Dr., Kitty Hawk, NC 27949
Mailing Address of Owner: 3945 Pinewav Dr.. Kitty Hawk NC 27949
Owner's email: charles.black5ay o comOwner's Phone#:
Agent's Name: EZ Dock Solutions Agent Phone#: L252) 764-1234
Agent's Email: ezdocksolutions(a)yahoo.com
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.
j � %NOT have objections to this proposal, o: I C90 have objections to this proposal.
rr 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 28,557. 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
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 revetments). (if you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback No
-OR-
Signature of Adjacent Riparian Property Owner RECEIVED
do not wish to waive the 15' setback requirement (initial the blank) Ker
— MAY 1 9 2023
Signature of Adjacent Riparian Property Owner: k e[yij,�� °t q
`CGBIlbPE511N9]..
TypedlPrintedname ofARPO: Keith angers ®C MwE�Vu Mailing Address of ARPO: 4017 Tarkl e
ridge drive
ARPO's email: khawkkr@gmai iciddty hawk n s Phone#: Phone #[phone]
ARPODate: 5/19/2023 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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Loeffler, Sarah W
From: Loeffler, Sarah W
Sent: Friday, May 19, 2023 11:51 AM
To: David Anderson
Subject: RE: [External] PERMIT APPLICATION: 3945 Pineway Dr., Kitty Hawk
Good morning Ashley,
Since the address for the primary owners says "c/o Keith Rogers" and Keith Rogers is a secondary owner, I would
suggest sending the second notification attempt to the VA address listed for Keith Rogers instead of the P.O. Box.
According to the County GIS that address would appear to be:
Keith Rogers
1443 Kilmer Lane
Norfolk, VA23502
Hopefully that will be the most successful method. Thanks for checking!
Sincerely,
Sarah Loeffler
Sarah Loeffler
Field Representative
Division of Coastal Management
401 S. Griffin Street, Suite 300
Elizabeth City, NC 27909
Office: [phone] ext 232
sa ra h.loefflerCpncdenr.eov
"In all things of nature there is something of the Marvelous." — Aristotle
-0
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: David Anderson <[e-mail]>
Sent: Friday, May 19, 2023 9:52 AM
To: Loeffler, Sarah W <[e-mail]>
Subject: Re: [External] PERMIT APPLICATION: 3945 Pineway Dr., Kitty Hawk

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Loeffler, Sarah W
From: David Anderson <[e-mail]>
Sent: Monday, May 15, 2023 3:58 PM
To: Loeffler, Sarah W
Subject: [External] PERMIT APPLICATION: 3945 Pineway Dr., Kitty Hawk
Attachments: 2023-05-15_154637.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.
Good afternoon, Sarah.
We are applying for a CAMA permit at 3945 Pineway Dr. in Kitty Hawk.
I've attached the paperwork here. The floating dock will run parallel to the seawall, so
will only stick out approximately 10'.
Since we are not local, I can mail the check for the permit whenever you need me to do
SO.
Please let me know if you need anything else or have any questions.
Thank you!
- Ashley, Office Admin.
David Anderson
President
EZ Dock Solutions/Nauti Metal
5568 US-70, Suite C
Newport, NC 28570
Office: 252-773-0793
Cell: 252-764-1234
Fax: [phone]
www.ezdocksolutions.com
www.nautimetal.com

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