89946A - Roberts

o �`°"" OCA; ❑DREDGE & FILL n N° 89946 A B C D
GENERAL PERMIT Previous permit
a Date previous permit issued
0 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. 1—^J General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name r Authorized Agent
Address f Project Location (County): C. e ) f r' 1,)C -[.-
City State ZIP - Street Address/State Road/Lot#(s) SS i'f) (J
Phone # ( ) p,/t Y-
Email fol Subdivision Y"Im,4Ac-fire,,
city , ,: [ r, i (Ct ) ZIP
Affected MCW MEW ❑PTA ❑ES ❑PTS Adj. Wtr. Body C t J a%!a: `"z:;!!v-,[( r(n-a man/unk)
AEC s: IHA UW SPIMA PWS' r I C.' r
❑ OEA ❑ ❑ ❑ ❑ Closest Maj. Wtr. Body � :.r '1 t '. ' �
ORIN: yes/nod PNA: yes/no
I
Type of Project/ Activity ,
(Scale:
Shoreline Length I I x t
Access Length s. - —i- — __ —+_------
Pier (dock) length
Fixed Platform(s) Y — - - I _ —i— — — -
Floating Platform(s) _ _ I
A
'�7fII>« d3' F ' r- a 1 — &J
Finger pier(s)_ i) s 1
u
Total Platform area
Groin length/f!
Bulkhead/ Riprap length - -- - i -- }-- i -- —
Avg distance offshore
c il' t '1, � <T sty f v C GIY'
Breakwater/Sill � � — �—
Max distance/ length '�� ��` — I"-"'
Basin, channel + ' 1 1- �
Cubicuses
Y 1 p1�
Boat ramp
I I �� �,
Boathouse/ Boatlik I )
Beach Bulldozing ) ) •Y r
Other
Site Photos: yes no
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
1 '
Signature **Please read compliance statement on back of permit** Signature
Application Feels) Check a/Money Order Issuing Date Expiration Date

AGENT AUTHO RATION FOR CAMA PERMIT APPLICATION
5
Name of Property Owner Requesting Permit
U9,34 11i fYf���O�F�`�t n
Mailing Address: Ne-t� , n ,d a
Phone dumber:
Email Address: _
I certify that I have authorized `t I
ttgent / contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Q
at
in
I furthermore certify that I am authorized to grant and do in fact grant permission ro
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:
�Srgnature
print or Type Name
[ me
; -J
Date
This certification is valid through --
Revised Mar. 2016

[e-mail]
From: Sue Outterson <[e-mail]>
Sent: Wednesday, June 7, 2023 12:02 PM
To: [e-mail]
Subject: Re: 888 Sea Ridge Dr. Monteray shores
notification
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On Jun 7, 2023, at 8:12 AM, [e-mail] wrote:

,4, 7
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(INAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner
Address of Property:
Mailing Address of Ownei
Owner's email:
Agent's Name: N CyAl r I Q -e
Agent's Emaitlulo,CpemQr-inf
Owner's Phone#: 41�0- (64- 3499- r't5
Agent Phone#:
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 drawirlcl, with dimensionsmust be Rrovided with this letter.
jz'F-lam (C2 = vrrnc�y 2C-y c .FJS�Cltnc,J p 2;y, l.(,"�� -%l� -pi e; �v ZU
_7>e- I DSAOT have objections to this proposal. I DO have ob actions to this proposal.
If you have objections to what is being proposed, you must nofffy 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 (Choose only one)
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groln 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
-OR-
Signature of Adjacent Ripal'an Property Owner
-t E
I DO NOT wish to waive the 15' setback requirement (Initial the blank) Z
2 0 2023
.-EC
Signature of Adjacent Riparian Property Owner: n
Typed/Printed name of ARPO: V / C F 11re 4 14
Mailing Address ofARPO:
ARPO's.email: v'<.en
Date: 6116 T9
:PO's Phone
*waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

PROPOSED LOT COVERAGE
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TOTAL. :•S69 - SJR +IpVTRAT slua6 = Lx
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