Loading...
HomeMy WebLinkAbout89772A - Emmons (MOD)~-~~~!E CAMA □ DREDGE & FILL : I i GENERAL PERMIT t~ N9 89772 @ s ~ Previous permit ________ _ Date previous permit~ ____ _ !19New . Modlflcadon Complete Reissue [7 Partial Reissue :..s ~ by rhe Salte o{ NQftfl CW1na. De~ of ~ Qu;ar,ty and the Coasal RM.ources ~ tn an arc of e1Mt oumera (Qt\011'!'1 putSlQClt to: ISANCAC 1H• •a~ ~ ffl.K~. ~t~ .. ~hmr, & K~ "1dNtSs l<> '-\ b\a .A e! I Emm.~ ::lty ~. ~\\,\s 51::ate N.<:.., U P ~ 7 "hone#{~ 11'1 -~21 b =-1i ~E:, Yr\nu~io} ~ LJ CYi ~EW ~,): O OEA ,....... 1M - JRW:y,e~E§) PNA:yes/(§' rn PWS ~ Permit RIJk?s ll'l'lllbilM art!'-. fo"°""'°' We~ Aud\ortz:ed.A.gent ____________ _ Pl"Cj!Kt LoGmon (County): t?e,;;;,\ ~ Sln!CtAddnlss/Sm..e ~#(,)Jet j\-~;...,.f}_..,__ ____ _ 501 W¼\o w ~. s~~~~tl\Q ~~----.--~------ City ~=-----_,Zif> 'f)..."1<j-41./ ~.Wt:.&dy ~ 9~~~ i?.M< Qoseftl'bj. wtr.Sody A!h~,e., ~ .~unk) ype of Project/ Activity _ _..;:=~~~;:.._-..::::.::...._..-_ ___,,'-=-~~..._._........,_~___,,,:i...1,c:...,r-o±-=--~lt..--:;;~;;...,:;,.~-~~ to<" l <..' ihOireffl'lel.cr,ctl, 4 /-<S I ---;---, , ; o'l\~o/vf,·, ~--~..__-:-~-t , ••-;_,~ I \a:P'.[.U,,gth __ ...... _...,.....--_.· ~ -----~ ~ ......,_ • •.. ~~---0 ...... ~ 1~'6\ v-4--: f o-(,f \ ,t;"}t\~ ,,1\,,..,._.,._, . I . \ \{) "\.\ CJ , t ·--(dock} M!fl gth <c,. lC 2J , ----~s:::Pc"""~ ~ ----: -• , . -,-----: 'ixed~c:Kmis l 76 1 x-rv · .. . {tM..--: , : · -·--j -,··--ff"---: : · ;-: ""' ----., ,. :-. '~•. -~ -, ,__..,.. + \\o -·--r· --.... ~· 'loiltll'II Plltform(i) -_ ·_ ~-\v-~--·-~•--.J-_;-~::~-~--,.:::--"1-i---t.:t:_~t -•·-· -.. :_:~. ~\. ·J ~ ! ' : ~ . ·.. . -t~tv-~ I ~ ' --------------· --·' ~ -···,-,-•' -t •-r-:-~V"-••• ·• ~ --,-------..:.---' ' ·'n . [ n i-i). ..., ' ; _,,,__,...__;__,.. . . . ..P✓· . : . . . ----... ' . , cc r"'~,, ---------.... ·~ _,.. , -·~ .... ,., --~' ..... ... . , .......... ,., ........ __ ,.... ' . ~ ; 1 ~ I ' ' , I t i • 'otal ~"Z·.s-~~ ' :--:-:-, ... ;•-•;·-~~--~~ .. :.--~---~ ... ~-, :-·-:---~-;·--- ~, :<H•q,•r: -·~ 'lrrz.t'/'l~ • • ,.., ·. -_.__.,_, -• ,. __ ,. _______ _.__ art)fn 1~• ......., ,-__ I i i . i j t , I I I ~ I . -~··•• ·-·· . ' ' . --. --: ~ ' . : .... , -. :----:--: -. . -~-.-~~·'. : ' -··-, -----~-·-~: ! -~,~-: -. ;---• --. :· ... !> '; ~,~ \_o-r--• + -.. .... t ... ---, ---t-+t!'_....:__... ' . \u lkhead/ f!,p,...p le f\1%h _____ _ \lfl distara offshc'f~ ...., • -·- 3.eakwaterM _______ _ '<\axdiStl till~ ....... ------------.i..~' ..... ~---. _---"' .... __ .; ...... J I l f . ;~,,:) l-; Wtn, dl;inncl ....., :.Ubk '(art.IS ----• • --------~--~--· . I ··-·--·'.-¼~ ,.. ,..__ _____ . ; . ... . .-;---ef~--~ : (()'?<['l./ ;r,'xtL-S-'~Lii:i'~r -: ;------.. _; ;!:1·.~ :-: .. ~--;. -~-:-,-··:··l '""\ • . , ..... -• alOC{( , -~-• '.· ,..'lj! 1 --~• · '. ,-·-.,.....-, ~Q -._--------•--.. ·--I: 1 . .,, _., __ : 1'_~---= .. -~ .. .,.,.•r·---:-... ; her , ____ 1 t,.S;.--...u , , ""·""' , -------_------=::;::===~~-=-=·;-~;;~;···-;"'r~~====='=·==a;:;;;;;;' ;:;;;·=· =::::!=-::::•;· ;i~;-:;;~;;·~·~="'-: )•:--•i · ~ t,.. -: 17 .~ 'f" i -I :· --~~--•- iAV obse:rved: @) no __ __... ~ _.-4 A ' ' '~t ·; · , ___ : : . , , 11tor.-stor1um: GlJ ~· no ·'~"""'\ . -~--:-·-.C ~"-~--··; , • • -~7"--• iitelltloms: no , ~ f~f. ·· • ·-· '-•:--· -'. : ~ ~ ' ~ ·t ·--·· · .!:l . · ~ · ·., ., • . ~ .... d . ' ~ i ' ' l ' . ~ D~. , Upa n.;u\Wa,w-rAtt3c,....-· yes ~---------__ _.._ ~ ... · • --------~---· ~ ____ L.,: _ ____,__, ,..._,,..,..,,...,,, ,., ..... ., .. _; .... "' ~H "'~-c~~ ¥.nniteondi. 'h(llh . t ) ~<t~:tmr-.~ ~ -~ ,~:~ 'h ~--ti e.t:'C,.,co~ ,~.:hb LS n p:J.C\~ ~ 0 TAA/PAM/NEUSE/9-UFFER {c::irdc one) 0 See n~ ~ bad reg;mfing Rn:er 8'3s-n rulell 0 S<:-e Jddiit'lorl<tl now/o:ind lttcni on bade AM AWARE Of STATUTES, <:Rt: RUUS ANO CONOmONS THAT AWL¥ TO THIS fl«CllECT ANO RfVll.Wft) COMPLIANCE STATEMENT. (Ple ase tr!itt.il J / :::-:;i o, , < .< '='~~-~,onf> \{,:c:c-~ ~~-r<°'~!>. mt ~~ rt /Lr.Ir /l ~ a;U~ {fl ~cJo-<93 IO/t:2///~:1 N9 89772 ® B c o Previous permit __________ _ Date previous permit issued _____ _ ~ New ~ Modification D Complete Reissue D 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 1 H · 1 ol C() □ Rules attached. !Kl General Permit Rules available at the following link : www.deq.nc .gov/CAMArules Applicant Name '&):\29,,t\ {t) K~ E (Y\1)\(;)\--iS Address -~l~C)_'i~_"I:~~._,~Q__,__T--d~_~e&~~• -------=--- C ity ~Cv--\h.. \1---\\t\s State _N~<:.,_~--ZIP ~ 1 'r'1 b Phone#(lfiJ} Jl1 -~21 Email ~¥:-e. \')\O\oC °l@ <c,mc~ \ • C:~)r, ~EW 01HA ~PTA Ouw Des □sPIMA OPTS 0Pws Affected D CW AEC(s ): □ OEA ORW :yes.@ PNA: yes/@ Acce ss Length __... Pier (dock) length Co(' 'fC Ti"lf' I Yv--ct..u..~ Fixed Platform(s) lb ( K(V (tM.r-- ...... e:-tc, ftl\,~~ Floating Platform(s) ....... -s~ Finger pier(s) ..... c-----_ Gro in length/# ____ -..,~--- Bulkhead/ Riprap length __ ...., __ _ Avg distance offshore-----,,----- Breakwater/Sill _______ _ Max distance/ length ___ ,__ __ _ Basin , channel _______ _ Cubic yards ________ _ Boat ramp ___ =,..,__________ I t C-I lf'-9-0 oatli ( C) c ?( I 'lJ )..,'1 'i: l'c~ J "nt...'ll<t.3 c.,~ Beach Bulldozing ____ ~---- Other _______ -. ___ _ Authorized Agent ___ ~,--------------- Project Location (County): Y~c ,,, \ ~ Street Address/State Road/Lot #(s) __._l.,.<::>.._.&-_...,#,.,__,Z,=-"7>ee....1..A.,__ ______ _ 5C1 Ll.Yi',,&\ ow (2d . Subdivision . ({\.O., ~br£~ City _--=-..,_=--...,_.._._,.__._,, ______ ZIP ___,;J_,~',__,C("--'4/../"-=--- Adj . Wtr. Body ~.;,;:___~L_~~'J,/..jlAJ,.rt,,-~~-~~~£_@nan/unk) Closest Maj. Wtr. Body __ (}:...,_{..._he:..::~,:ci_c---""""'d'---'-"L'""--~=-=-=--=------ ~ , t.'5 ---ti I SAV observed:~ ® no ~ ..-f -. ?1_~ Moratorium: VJJjJJ ye s no '~ """'1 .i.".:;.\yes no OYt> O ' l Site Photos: ~ \ T Riparian Waiver Attach ed: ye s ® A building permit/zoning permit may be required by : P~,(.,~· M~ c~4 Pe,mi,Coodfoos!:;:• ~•·~ ~ d~ ~~ ~-oaP-, ~I ~((\ {$ I !:1'__~~ ~c_ __ _ ( □ TAR/PAM/NEUSE/BUFFER (circle one) D See note on back regarding River Ba sin rules D See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (P lea se Initial) ______ _ ~"-111 ~ g 'Ro~ Agent or Applicant PRINTED Name Signature **P lease read compliance statement on back of permit** ~~~.~ ,~~ Permit Offinm :amtuf: Signature tt; I Ol.zo/23 Application Fee(s) Check #/Money Order Issuing Date Expiration Date CAMA □ DREDGE & FILL GENERAL PERMIT N9 89772 ® B c o Previous permit ___________ _ Date previous permit issued ______ _ New ~odification D Complete Reissue D Part ial 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 _________________ D Rule s attached . [sJ General Permit Rules availab le at the following lin k: www.deq .nc.~ov/CAMArules Applicant Name ---~------i.-----i~----i.--~--\ _f\_!Yl __ , _1 __ _ Address ----'---°'---'----'----'-----'-..:....:..------------ City y Phone# ( __ "D---'--'--------'--- □Ew □1HA G]PTA Duw Affected D CW AEC(s): □ OEA ORW :yes/n °.J PNA : yes/n 0; Shoreline Length __ 1 __ .--__ _ Access Length ________ _ Pier {dock) length ____ c;.c.._-'---- Fixed Platform(s) _______ _ Floating Platform(s) ______ _ Finger pier(s) _________ _ Total Platform area--'--~~-- Groin length/# ________ _ Bulkhead/ Riprap length _____ _ Avg distance offshore ______ _ Breakwater/Sill ________ _ Max distance/ length ______ _ Basin, channel ________ _ Cubic yards _________ _ Boat ramp _________ _ Boathouse/ Boat!!_ft"_, ____ __;_ __ Beach Bulldozing _______ _ Other ___________ _ SAV observed : Moratorium: n/a Site Photos : Riparian Waiver Attached : yes yes yes yes no no no no J □E s □s PIMA OPTS 0Pws Authorized Agent ______________________ _ Project Location (County): -----'---'-=--..:....:..~=c.c....:'-'-'---------- Street Address/State Road/Lot #(s) ---'-'------'-'---'-----=--'-'---------- / ' A building permit/zoning permit may be required by: -----'--'-..:..:.... __ _;_:..:....:_;___._ ___ ....:....:c...._---=. __ _ □ TAR/PAM/NEUSE/BUFFER (circle one) D See note on back regarding River Basin rules D See additional notes/conditions on back (.; -1.-i 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 Perm it Officer's PRINTED Name Signature **Pleas e read comp liance statement on back of permit** Signature Application Fee(s) Check #/Money Order Issuing Date Expiration Date N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM R ECE IVE CERTIFIED MAIL · RETURN RECEIPT REQUESTED or HAND DELIVERY (Top port ion to be completed by owner or their agent) JUN O 1 2023 "' Name of Property Owner. 5:h "l<V) 1 'Yi. ecr y E-mW\O,.s. B CM-EC Address of Property: 507 \ ;J \ 1/\s t)I..{) ~. \,:ef t--+od . JJ (_ {). 71 ~ J... Mailing Address of Owner: \OY ::CS\~v& QJ. ~ nH1S } JJ e._ 2..79 7b owner's email: $kel\4~ e j ~a ;1 -lorvt owner's Phone#: 7S7-717 -8:f.;2,) Agent's Name: _________ _ Agent Phone#:. ________ _ Agent's Ema il: _________________________ _ 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 forth is permit has described to me , as shown on the attached drawing , the development they are proposing. ~ 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 th is 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 (252) 264-3901. 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 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 Adjacent Riparian Properly Owner -OR- I DO NOT wish to waive the 15' setback requirement (initial the blank) ____ _ Typed/Printed name of ARPO: __ J;;;......;;;;t;_R._;......R_y_,_ __ l:\__,__u_~_5_o_N _____ _ Mailing Address of ARPO: 3 S 13 ?> L.. v ~ M. ~LI ,..J C.. IR . \/ ~ 13>~C. H ARPO's email: Jf/(R Y L I.\ v T 50,J f CM~~P~~hone#: 1S7-t32. --i l 1 (. Date: IO M A..J a oD *waiver is valid for up to one year from ARPO's Signature* Revised August 2022 Sh ~ ': '\'\ EUi'i l: 'M MlOv'\, s So 7 w ~,\~\ow f'l_J . \te{ +f«J , J .C . -----. l o' To : Cynthia Rountree/ CAMA 401 S. Griffin St . Suite 300 Elizabeth City, NC 27909 From : Shean and Kerry Emmons 104 Island Rd South Mills, NC 27976 757 -717-8921 -Cell skemmons@gmail.com Project Address : 507 Winslow Rd. Hertford, NC 27944 Ms Rountree , 5-30-23 please see the attached information for your review and an enclosed check for $200. Shean Emmons REC EIVE[, JUN O 1 2023 DCM -E C N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOR CERTIFIED MAIL · RETURN RECEIPT REQUESTED or HAND DELIVERY ECEIVED (Top portion to be completed by owner or their agent) JUN O 1 2023 ... Address of Property : Name of Property Owner: Sheu".'.) ~ rs ec<'( C'(V"\ YV\ o..rS 507 1.v r"s\041 (Y.. \ief+.forJ }JC~ 27c,C}fM-EC I Mailing Addres s of Owner: )QL) 1?.:5\t.1nJ 9-J. ~Jb M~\\S i V C R,79 7~ Owner's email:S~e'Mr\'1CIA-S e 'jtl\Ci,\. l "00wner's Phone#: 757-7/7-!{12-,) Agent's Name : _________ _ Agent Phone#: ________ _ Agent's Ema il: _________________________ _ 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 forth is permit has described to me , as shown on the attached drawing , the development they are proposi ng .~ descri ti n or drawin with dimensions must be rovided with this letter. --~ I DO NOT have objections to this proposal. __ I DO have objections to th is proposa l. If you have objections to what is being proposed, you must notffy 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 (252) 264-3901 . 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 pie r , dock, mooring pilings , boat ramp , breakwater, boathouse , lift , or gro in must be set back a minimum d istance 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 w ish to waive s ome/all of t he 15 ' setback _________________ _ Signature of Adjacent Riparian Property Owner -OR- I DO NOT wish to wa ive the 15' setback requ irement (initial the blank) ____ _ Signature of Adjacent Riparian Property Owner: -~..._..""""" .......... ....i..u'"'-'"""""...;::c.::::.....:;...~1-- Typed/Printed name of ARPO: =:!) A \2 I ,1 10 :-V o. c/-&( Mailing Address of ARPO: 6 0 3 L~ 1 ,JS \ b l,u :Rd f--k-~ ~ ,-. L ARPO 's email:do.rJ-e"/CPtL,J 01@3t"G.a!RPO's Phone#: (2$'2.2> L/:S:S·G 093 Date : .J / 1 Y / 2.. 3 *waiver is valid for up to one year from ARPO's Signature* Revised August 2022 S'h ~ ': '(\ e{{'i l: 'JV\ NIOV\,:) . So 7 w ~"~\ow flJ. \+e{ +-P-«J , J _C, ,..-> 6, I~ -is ' ~ 1, I '" - 16 ' ...__, a ·~-~ I , ,J'l..:~ ..... ,..---·* i·~ ~\- Perquimans GIS 0 0 1:564 0.01 0.01 mi 6/5/2023 , 10:47:38 AM --Centerlines perquimans_nc_easement Imagery 2020 Green: Band_2 ■ Red: Band 1 ■ Blue: Band_3 S h €c.. n A: K~ s ~~"'~ I J I I I I I I I I I I I _Perquimans_nc_misc perquimans_nc_dims perquimans_nc_lot perquimans_nc_acres l c. <-l 1-s o.: ~. S kr-t--l,\l~ \ ~ ~l'rlC.., 0 0.01 0.01 0.02 km State C1( North Garol lna DOT, state or North Carolina DOT, Esrl, HERE, Garmin, GeoTechnok>gles , tnc., USC3S, EPA Perquimans GIS For tax plM'pOSesooy. No(.:, 1&113ld0ctanent or swvey. f'efqulrnans nor ~teOfNC assume any l~ltyresulllng fl'orn use Of this map. Untitled Map Legend Write a description for your map. 507 Winslow Rd N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER . NOTIFiCATlON/WAIVER FORM CERTIFIED MAIL ; RETURN RECEIPT REQUESTED or HANO OEUVERY (Top portion to be completed by owner or the ir agent) Addre5$ of Property: Nt,\me of Property OWner: Sb e ½1(1 ~ ,, e{ f'( C M{Y\CMS _6 __ n_.__ __ uJ ___ : ....... V).g_v\ __ aw~· '------'-~-· ._ .... _____ \\:_g_):_·tt.Ji ....... ~·. i_Q_· ·· --· _JJ_c_~ _:J.79 , MaillngAddressofOwner: )Qt..\ X.S¼wl ... ~ Sau\-h ~ \1$ N£.c 7)CJ 7b Owner's emanf~(m,v\')~e fjtr'ld ,l . 'th'"" Owner's Phone#:-, 757 ... 7 / 7 ... g-9;z. ( Agent's Name :-~--------Agent Phone#: RECEIVED Agent's Email: ________ ~----------------- ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adiac•nt Property Owner) DCM-EC I hereby certify that! own property adjacent to the above referenced property. The fn dividuat applying for this permit has described to me, as shown on the attached drawing·, the devetopment they are proposing. A ~~scription or drawing, with dimensions. mu.st be provided .with this letter, / I DO NOT have obj ections to this proposal, __ I DO have objections to thfs proposal. U you have objections to what is tx,Jng proposed, you muS"t notify the N.C~ Division of Coastal Management-(DCM} in writing within 10 days of rece'ipt of this notice. Correspondence should be mailed to 401 S. Griffin St., Ste. 300, Elizabeth City; NC, 27999. OCM representatives can also be contacted at (2.52) 264-390-1 . No respon~ is eonsidarad the same as no objection ;r you have been notified by Certified Mail. WA.VER SECTION (Choose only one) l understand lhat any proposed pier, d.ock , mooring pilings, boat ramp . breakwater, boathouse , 11ft, or groin must be set bac a minimum distance of 15' from my area of ripa ri a n access unl ess waived by me ·(this does-not appl\! to bulkheads or ri prap revetments)-(If you Wist, to waiVe the setback, you must s ign the appr opri ate blank below.) l DO wfsh to waive ~0_111el att ()f. tt:,e_j_~ ~~~~=ck'-'--,,.,.--,--------------- $ign$lure of Adjacent Riparian Property Owner -OR- I DO NOT wish to walVe the 15' setback requ irement (ina;,,1 the blank) Q l.,(,J 0 Slgna111!9 of Adjacent Riparian Property owner. ~(~.u;O l,\) ' ~ Typed/f:Jrlnted name of ARPO: 1:,:bv ·,d . LV ~ r I<:;. t . . . Mailing Address of ARPO: SO 3 uJ ,iAS\(.M..) a.J. He1} F&cg . Nl . ~7qc.;~ AAPO'seman:J~v1 ,1&av-~O~~M·J·~~s Phone#: J$?:-t.JSS -~ Date: 8) I /220 ,J ;-•waiver is valid for up to one year from ARPO•s Signature* N~C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFJCATION/WAIVER FORM CERTIFIED MAIL · RETURN RECEIPT REQUESTED or HAND DEUVERY (Top portion to be completed by owner or their agent) ' NameofPropertyOwner: 5:;neao ~ \':\e..t ,~C1VI~ Address of Property: 5 0 1 \.,LJ I V1 S ~OW ~-li::-:J.\:£J.rJ J.) Q71LJ l,j Maflfng Address of Owne r: JO ""'' I:.;$\IAJNl fl.J . 3L>J\½ l\A~\\S 0( 2.1'77 6 Owners email: Ske:m Mo,:6 (J 9ms,\ .ltbM Owner's Phone#:-X2 -7 17 .... ~~EC EI VE D Agent's Name : _________ _ Agent Phona#:. ________ _ Agent's Email : __________ ~ ______________ AUS l 5 2023 ADJACENT RIPARIAN P·ROPERTY OWNER'S CERTlf'ICATION (Bottom portion to be completed, by the Adjaceflt Prop~r::!Y Owner) DCM-EC I hereby certify that I cmn .prope:rty adjacent. to the above refe renGBd property _ The indMdual applyingforthis permit has described to me , as show on the attached drawing, the development they are proposing. 8 descriP!!on or drawing, with dimensions, must be provided with this letter. L I DO NOT have obJacUons to this proposa t ___ 1 DO have objections to thi s proposal. If you have objectioM to what is being proJJO$ed, you must notify the N.C. Division of.Coastal Management (DCM) in writing within 1D days of receipt of th;s notice. Correspondencff s.hould be mailed to 401 s. Grlffln St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at {252) 26+-3901 . No response ts considered tha same as no objection if you have been notified by Certified Mail. WAIVER SECTtON (Choose only one) I understand that any proposed pier. dock., mooring pilings, boat ramp . breakwater. boathouse, lift, o groin must be se t bac , a minimu distance ·ot 15' from my area of tfparian access 1,mless waived by me (thjs d,oes not apply to bulkh_~s or riptap revet ents). (If you wish to waive the setback , y ou must sign the a.pprop · ate blank below.} I DO wish to waive some/all of tha 15' setback ___________ -.,.;-;;;,;;;----- ,s;goarnre of Adj acent Riparran Property owner -OR~ I DO NOT wish to waive the 15' setback requirement (lnllial the b!snk )9 1k _Slgnatute of Adjacent Rrpa.rian Property Owner:-----,..---~----,,,,-+--- Typed/Printed name of AR.PO: •L:i f'4-Hu~ Malllng Address of ARPO: .3~ 1 i: iA ve M Gr Jt V\ 1'er "' ff v+-$c1J'\§ GM~ n. c 4N', AR.PO 's email; ARPO's Phone#: C: r \JA . Bev.ch I v/1~ ~Jl1 ~ 7~7 -Y 3$> -;;l, 7G. Date:. 7-31 ~ J..,..,,,.)"-_~aiver is valid for up to one year from ARPO's Signature,_ Sh c'.~·1 1 : \--z ~•1 e 1Y\ Nlo'{\,s So 7 uJ ~-"~\ow fl&• \tet+f(h ,.-J I u .C ' I ;?,5( ~--~-! __ l_ _____ _ RE CEIVE D JUL 2 4 2023 DCM -EC ' \/ I