89922A - Celtnieks

❑CAMA R DREDGE & FILL N9 89922 A B
GENERAL PERMIT Previous permit_/C
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 ❑ Rules attached. ❑X General Permit Rules available at the following link: www.deo.nc.gov/CAMArules
Applicant Name " .-t t�
Address `-t♦"an I'7 r, ;;�1.� (.. CA-1,
City State IA 'f`) ZIP ' �-c='`•5 `K %z
Phone # ( )
Email i A r.r 0 It ,
Authorized Agent I r l l k o 1", C- c:• - C
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Project Location (County): f, 1 t r •r r i._
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW PTA W ES PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑$PIMA ❑PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/do, -
1 rr
Type` of Project/ Activity T ii aia(l I Cl �i nt r. oln r r v'i r• - i:- 1�•.t�; -I - e��
•: 1,2II. ^..JCS^1.1,1 r, nfl"rrrl A' Cctn lb wn+Efilaz , ..:41 (Stale:sn 41)
Access Length
1
-
r
-
Pier (dock) length
Fixed Platform(s)I-,1
'
-_ -
-- -•
-
-
-
--
-
-
Floating Platform(s)
ll
No
1-
Finger
piers)
!
i
Total Platform area
Groin length/JJw—
Bulkhead( itiprap�length I C) 4- i `"j
Avg distance offshore
Breakwater/Sill
Max distance/length 10
d
l
-
--',
r'y..J
t'--
�''
( / ,.
I-
1
1
_
a
r
Basin, channel
Cubic yards
-- -
-
�-
Boat ramp
Boathouse/ Boatlift
�-
k
_Jj
L_-)Y
1
t
Aj
Beach Bulldozing 1
Other
r-
- fir
T
I
1 --
4 1A r
Y
1
1
-
'i-Itr-r
't
-
—
SAV observed: yes
Moratorium: n/a yes no
Site Photos: yes no`�y1V-t.,-.lkT
_..
1
I
1-�-
4-
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
AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature *'Please read compliance statement on back of permit*"
Application Feels) Check Jr/Money Order
Permit Officer's PRINTED Name
Signature
Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Karl & Amy Celtnieks
Mailing Address: 5716 Stanbrook Lane
Gaithersburg, MD 20882
Phone Number:
Email Address: [e-mail]
I certify that I have authorized Affordable Bill's/William Eger
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
concrete waterward of existing bulkhead.
Install 105' +/- of broken
at my property located at 185 Owens Beach Road. Ext, Harbinger
in Currituck County.
l 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
Karl or Amy Celtnieks
Owner
or Type Name
Title
Date
This certification is valid through /

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: Karl & Amy Celtnieks
Address of Property: 185 Owens Beach Road. Ext,
Mailing Address of Owner: 5716 Stanbrook Lane, Gaithersburg, MD 20882
Owner's email: [e-mail]'s Phone#:
Agent's Name: Affordable Biil's/William Eger 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.
100 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. 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 Signature of Adiac nt iparian Pro erty Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: _
Typed/Printed name of ARPO: Clyde or Marylou
Mailing Address of ARPO: 181 Owens Beach Road Ext, Harbinger, NC 27941
ARPO's email: t"ti d bq x e g"I,cd "� ARPO's Phone#: G.(-L- i/ % )' I— J q3
Date:�'� �O'waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

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: Karl & Amy Celtnieks
Address of Property: 185 Owens Beach Road. Ext, Harbinger
Mailing Address of Owner: 5716 Stanbrook Lane, Gaithersburg, MD 20882
Owner's email: [e-mail]%wner's Phone#:
Agent's Name: Affordable Bill'sNVilliam Eger Agent Phone#: [phone]
Agent's Email: [e-mail]
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 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909, 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 somelall of the 15' setback
_§,�gnatuho of A r
nt Riparia roperly Owner
-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: Terry Wayne Lynn
Mailing Address of ARPO:
205 Owens Beach Road Harbinger, NC 27941
ARPO's email: ARPO's Phone#:
Date: 25Z31 *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021