92905C - Convoy, Chene

"'`iNCANU% 11 DREDGE I FILL �95 A e 6ID
GENERAL PERMIT o,,,l,
IN previous permit Imo/ —
New i JMoc$ c n D Complete fl Partial Reissue sue
♦,s e.-..Leif by the Sun of North Ca*s.Oaparmae d Ewtrprnad Quality and dw Cad Raretaoa Camera/on in to area of av rennanol aonawn p mart*10
',A NcieC CO 7,14,4503 - 0 A`a„nkod. I4 Garad PamtR UM aiila Ado k llseAme rdt InThabaumelrarAtleadio
Mpkan[Noma 6 h in Coe,he y ]� Andortte+l Agent re.a/1- lee f F/H
Ads_ _�_L�tlE270 I A wi Y rjV' Prefect I°tenon(Co.nry)• [r�yin
av_Aft-__1 -7 _ sees NC a gg5L? sawn Adbwnnrae RoadlEin•Ml ay SI G tial n hf 1 4.4 O.-be
Pt.•MY) 17-E- OL2P_-
Emil c h 1 f-1 y 7 7 69 k ta.,:l. U,1 sr..darn — -
•
at, iY6 1�t0., a ,10-SIP
Aflacaad Dew VA FINIA DES Drrs Adl.Wa.Body To✓at p/ A.rh f+J Dare/(r ,k)
AEC(s) DOER ❑per FFF❑uw . IlSPIMA D Pm amok Pig.WtrBody T'fr - A/✓e•-
opw vese PPM.eSr0 p
Type of Project//Activity
, P•'a al J H/i+.41 k 4 S/st o* 8 'x.R 9 A �{
Shoreline Length /17,• 7 Y/ / • :r- - - - --- --- , - ..--- -- a�• /7
Pier(dock)length (- « - --
,' t ---- -(- ' ..�L. _. ..}_-...
1--
Filed rhatfamds) -- t --,' - _ - I- -J- --_-- �' n--_ '•-,...1
�I- '-� --1-"�y 1`
t.
Floatsng Plativm(s) . -r' - IRE 11-�',-�u rl -f'- -_...1.-;_..-.. 1 r -i---- ,..: 'may--f__�_1..�.-�
f vrtger peals) �' ` ;� _ , j ► s' ! '
local Platlortn area -` — I-
L..�- . .j - -' .-.-..-� t 1------^'-�-. .1.• ,
Grow length/a _,-I_ -,r__.�- _ __!._ _ Ih _rr�_. -�- .�__ �grlr Zi.��
Avg&stance offshore �- • a- 1J ---" --"4- "- _ -- --
aa {� --, r
Max distance/IeVA -'- -�-7 1--/-21;; y 'T....-'---! - \, - -T-+� �, f L1
Raisin,channel I'XII' - -�- -`'_ - { - .i - ) .. ,
!--'- - /
Cubic yards_ -1T r �- ,t s '- -
Boat ramp _..._� _ _.._�' _.-, _"
BoatttousrJBaatltlt - - -1 �-
Beach Bulldozing --- ~��~tee- --. .•� 1 _ ^' '.• _._ _ �f��•--
SAV observed* yes _ �- ~-' r -�� (C'' -\� . -r---'-•----
Z----- '� r 4s....,-
Moratorium: n/a yes _ •"•�_ . 1 ,
Site Photos: yes v7 --- jt" a--_- — -.:04 11,4n♦�� jl�lMl'� Md /(.4 ilk ,.
-
Ripartan Waiver Attached: a no
_jam---..y �. pp Z_ -_r L _ -_
A building permit/zoning pliant may be required by: TIMr el DI �er 8.n S
ag M TAEPAHV a sE UEfE (dirks ono)Perrin Cordtson i)Qae._ a !—L ales w ar al�n �taa rwwa? I' fSti
._4_,P1Lajill [XravA - 1( 141 f14IJ' /14gAIw I�►411 �See nyrunba/,rgrttrgiiwn aln rules
ILJQ' AAA' ere I. Wi 1Js 3)IJdI J i* ki li I 2 V'X2Oa
6✓/ D Sea additional natty/conditions on back
I AM AWARE Of STATUTES,CRC EWES AND COMMONS THAT AMY TO THIS PRONECT AND REVIEWED CCMPUANCE STATEMENT. (Please initial)_T10
TV,- Pas Pelf- R.'v&4 fd 1Li l,.d h�
Agent co Applicant PRINTED Name Permitis PRATE me
Signatur •Please read ccanpllance uatement on back of permit" Signature
ar0
Application Fee(s) Check a/Morey Order issuing ate Espuelan Date
1 .e...a.11011•11•..AIIIPmIlIM.. >•..

I
DREDGE & FILL No '92905 A B D
= GENERAL PERMIT Previous permit
Date previous permit issued
E 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 5A NCAC 0 7 4, I500 [1 Rules attached. rgGeneral Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name CPI en q CO VI va tj Authorized Agent Ty e iv 4- /VD s C 0 Y-T
Address 20 / C/nq n R h e/ is n D✓'i've / Project Location(County): C vor wen
City /Ve.' 68-.1 State A/C ZIP 28Sb? Street Address/State Road/Lot#(s) 20 9 G SSA n k,e( IQ cm 0r/id
Phone#('/17) 175- O4"g9
Email C h I 4-'1, 7 7 @ w.t�H r/I . CO rn Subdivision —'
/ City A/C',- 6 e'-'i ZIP a 8S62
Affected CW EW PTA ES I I PTS Adj.Wtr.Body TO'`h U` A 'fre.-- be.,i 64.41 (nat unk)
AEC(s): 7OEA IHA IIIUW I I SPIMA n PWS Closest Maj.Wtr.Body 1 'L- X./ rC r
ORW:yes/0 PNA:yes/0
Type of Project/Activity Prapo 5e.) .i D 1-,,d k S/h t'a g /X`2 et
// / (Scale:if/TS )
Shoreline Length /47p• y /
Access Length —
Pier(dock)length -
��`
Fixed Platform(s) QLi,
Floating Platform(s) 1
^— ext'S � 4
rp4
1
AvaX t fV.Fingerpier(s) -- �o„i-1f
Total Platform area ,1n
Groin length/# - - /'`k'"Z
Bulkhead/Riprap length — 6,,,/act)
Avg distance offshore — -- —
--__ r
Breakwater/Sill
Max distance/length P L "f / \ _
�' _ P`�
Basin,channel g'XAy' Gk
Cubic yards / \ . r
Boat ramp / \
-- .
Boathouse/Boatlift p
Beach Bulldozing / 4 Pv+v��c5eJ
. -� / 1.
Other T e>` rr,lhQ°d \ • ,XR Y�bgslh
SAV observed: yes \ ,,Moratorium: n/a yes N LOn✓on
Site Photos: yes �p�' Town all rye— 06,4 PLa
Riparian Waiver Attached: O. no /n Ch hwCl�
A building permit/zoning permit may be required by: TOW II0 f k/r v C'" Be n d
Permit Conditions I) 04%0;,), ex,Ale.41- 1 r.o <e1,,,,6•.f can rrrno44 1iii-G 4A,
IX TAR/PAM/QV:UFFER(circle one)
/' rof al I
C e/hq l a) A-il eXc01v44-6 1 r 44-e-/4/ 3 b y/� 6g /14 ,n o,w 7,4- 4 d n See note on back regarding River Basin rules
)ielv,,,. A/L.4- wC7 n15 3) SHJk4&«.1- bkLk4'J/ ,/ .-a 9'XR0'
j'�I red n See additional notes/conditions on back
� on a
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 me
Signature**Please read compliance statement on back of permit** Signature
11 4-00 I a C 6 8/3% ') 12/-/a 3
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

��F`°"�rk CAMA DREDGE & FILL No 92905 A B `s D
a� Previous permit
4 GENERAL PERMIT __
Date previous permit issued
I New Modification Complete Reissue n 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 D 7 f-t , 15(/V ❑Rules attached. N General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name (6 £ ', (r I- , 4-''' 7 Authorized Agent - i . i , .'/-T/
Address -,0 t/ (tic,k?I i L / I A k) 0✓,'V( ✓,/n Project Location(County): /�
City ,�, 10, 'n State 4/C. ZIP 1.' Sb,-, Street Address/State Road/Lot#(s) ✓ �/ ( k,C ( Il h /✓,'1.-1
Phone#(/I9) 975 ` Oti o:(9
bicf,-..ti,/ . C - 1
Email C �'1 i i- it 7 7 � Subdivision
City . . - ., ZIP a b 56
Affected n CW rxiEW :s/' PTA n ES n PTS Adj.Wtr.Body 6e I ''+a/ (nat nary unk)
AEC(s): n OEA n IHA n UW SPIMA I I PWS Closest Maj.Wtr.Body "`- /\ ✓c'''
ORW:yes, gi J PNA:yes/no
Type of Project/Activity P,-1Qc 5e.
I/ /
A L/ (scale:,(/TT )
Shoreline Length Ai, , 7 / .
Access Length — l
'!� iPier(dock)length
Fixed Platform(s) rt.
Floating Platform(s) _. , r ,.,
41,
Finger pier(s) } i I ,.
Total Platform area
i , t
Groin length/# --- 1
Bulkhead/Riprap length I (.,
„,1 1
Avg distance offshore i
Breakwater/Sill ��- 4..Max distance/length - f� .� �—�- � 1
Basin,channel / • t ,'' . !�
Cubic yards �� \ tr. l
Boat ramp . ( . ��ma
Boathouse/Boatlift i , ,4 ! '
Beach Bulldozing ( / j
Other —.
SAV observed: yes 6nq /
Moratorium: n/a yes nee' i r ,
Site Photos: yes a , 1 w n}, r -✓i.'--- M-
Riparian Waiver Attached: no i ( H'v;" 1 ,
A building permit/zoning permit may be required by: i\, . ` Li -)J
V n TAR/PAM/WEUSE/BUFFER(circle one)
Permit Conditions , ), . .-i , , ��,,.- (f l
,.r F f,
E,I ) A i l 1 , / .,, . 4., . .. / •) ,/'' o, / /ti C el r-/h ,,.--e f '. " p See note on back regarding River Basin rules
),, iUw A/L. L . �.i '1/'a<.,hchS a) P..//ti, J-,F l , /,i/. 11 <7-1 `2 y Xrla
ElSeeadditional notes/conditions on back
„ ±1,,.-, zed
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
k _ hG, il
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
I6b
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

111"4'4/ CAMA DREDGE & FILL No 92905 ABCD
GENERALPERMIT Previous permit - ___.Date previous permit issued
n New n Modification Complete Reissue n 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:
ISA NCAC n Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name y ff Authorized Agent •
Address / f, .,.r l:' Project Location(County):
City State N' ZIP Street Address/State Road/Lot#(s)
Phone#( ) T — at G
Email - 7 7 - ,/ , j Subdivision
City - , ZIP •
Affected CW pi EW I I PTA ❑ES ❑PTs Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA ❑IHA UW ❑SPIMA n PWS Closest Maj.Wtr.Body
ORW:yest19, PNA:yes/no
Type of Project/Activity ' 7 o t
(Scale://Ti )
Shoreline Length
_ w
Access Length 1111 ®. �II■ �.���..■ ■'
Pier(dock)length ; q .. rani
'
Fixed Platform(s) MI iFloating Platform(s) IIMIMINMIIMIIill ■ ...
Finger pier(s) 4 L
Total Platform area - I ( 1 111 al
Groin length/# i ,
Bulkhead/Riprap length ........_ F t vI__ .
Avg distance offshore i
j
Breakwater/SillIMIIIIP . .
Max distance/length
irll•�EN
Basin,channel 1 , MINN j I
Cubic yards
Boat ramp
■■ AEI ■�
II
Boathouse/Boatlift ■ II■ NI11f1
Beach Bulldozing I / ......1gill
MI
flfl
..
Other REMA f
SAV observed: yes rp' 1I
Moratorium: n/a yes
Site Photos: 1.yes no 111=11111111=1111112/
— IMIMIIIIIIII
e no - • ' -
Riparian Waiver Attached:
A buildingj
permit/zoning permit may be required by: � t.. '' I
Permit Conditions NI TAR/PAM/NEUSE/BUFFER(circle one)
i ❑ See note on back regarding River Basin rules
.1/Lf,1- ❑ See additional notes/conditions on back
zeJ
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

12' (144")
4
EXISTING BULKHEAD ti" ,
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EXISTING ALKWAY =p�D
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ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue,Governor James H.Gregson, Director Dee Freeman,Secretary
1 I ql .13
Date 3
0.eperty Owner Apply' for Permit:
Mailin Add
114fl Or
anne
J'JC1,4 ) loc. ac &, 1
I certify that I have authorized a ent ie S�d� 'to act on
( g ) my
behalf,for the purpose of applying for and obtaining all C• MA Permits nece :ary to
install or construct(activity) I G Q lk I lw•1 e_
at(my property located at)t t C On r ' fl Pr ,
NiztA) �G
This certification is valid thru (date) i 42 '31 - a .
0{11)/V14 edeMAAAsi 3
Property Owner Signature Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone]\FAX: [phone]\Internet: www.nccoastalmanagement.net
An Equal Opportunity\Affirmative Action Employer—50%Recycled\10%Post Consumer Paper

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: CHENA CONROY
204 CHANNEL RUN DR NEW BERN NC
Address of Property:
Mailing Address of Owner:
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: TRENT PRESCOTT 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 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252)808-2808.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 jp4,14,
Signature of Adjacent Ripari n Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner: t4Jr4,I*..
0,c44-rm.
Typed/Printed name of ARPO: DELANE JACKSON
Mailing Address of ARPO: 45 SHORELINE DR RIVER BEND NC 28562
nC stir
ARPO's email: manger@riverbenchapr Phone#: [phone]
Date: D ? I .; 3 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion
�1s,1i Rt
to bee completed by owner or their agent)
Name of Property Owner. ail � ietn e a)011
Address of Property: r? O [� _ 1"1
lc bC- li,t ei <l ("" (98 s IP`�
Mailing Address�of--Owner-r-9 yO�Y)Wk 4Y'1 Or *LA) r� (N c- a�a
Owner's email: `` t4 I77 DJ 'f11• UM s Phones,: ii ( 4 9 7 S (APO,i'
Agent's Name:�CCt141�'VIest-D , Agent Phoned: a' S?c r;7.?g
Agent's Email:
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 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252)808-2808.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.) //�7C/elI DO wish to waive some/all of the 1 ��
- of Adjacent Riparian ply
I do not with to waive the 15'setback requirement(initial the blank)
4 Signature of Adjacent Riparian Property Owner -' .7,
A
`Typed/Printed name of ARPO: -- �i ,,� a/,/t j /� /'� ! /�f
Matti of ARPO: Ce u /1//✓ `s Ai 1 t r/ 4,1 `�Z✓/NDA//" ���/'
ARPO's ig S76te i)'/•/1�C G d i 1P0's`Ptroriar Jai/' 7/4171
Date: o 0/2 `waiver Is valid for up to one year from ARPO's Signature*
Revised July 2021
Scanned by TapScanner

TOWN OF RIVER BEND
CHENA
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Craven County GIS chena Conroy
1 inch = 13 feet
Craven County does NOT warrant the information shown on this map and should be used ONLY fortax assessment purposes. Printed on May 14,2023 al :53.53 PM A'

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Craven County GIS 1 inch =79feet
Craven County does NOT warrant the tnfotmatian shown on this map and should be used ONLY fortes assessment purposes. Printed on Febntary W2,2023 et 12:35;56 PM 1

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: (/r'�4- r�,� r'2'\/ t Vid (61/11 C Ghi/"i;
Address of Property: 6)1"/ C h c/✓l c/ Dr 44' /3 n
Mailing Address of Owner:
Owner's email: ,h/PI/ 77L livt0,4;1•r"11 Owner's Phone#: L//L/-a75 GAG 2
Agent's Name: 1 Y '?r f�i (di-7,- Agent Phone#: z51- 2L/6
Agent's Email: Mt.tope /;,')'I/,k.✓n
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 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252) 808-2808. 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 Adjacent Riparian Property 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:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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: hel 7(k. 600 rO J
Address of Property: Z°`l ChatMOI Rwil Dr eel ;71 71/G
Mailing Address of Owner:
Owner's email: Owner's Phone#: L!/Ll - 7 S CGZK
Agent's Name: Chj T��/7,t'�h(]�Yka%�. ca)41 Agent Phone#: Z�? 2 -
Agent's Email: igeOpfiRj5FR t5pYkA-t'hG Goy)shyG1/4n 9Yfl1..( Gar"I
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 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252) 808-2808. 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 Adjacent Riparian Property 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:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date: `waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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Craven County GIS 1 inch =42feet
Craven County does NOT warrant the information shown on this map and should be used ONLY fortax assessment purposes. Printed on August24,2023 at 8.25:22 AM w'

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