91374C - Hill, Scott

0""481McAMA ❑ DREDGE & FILL N4 91374 A B © D
3 GENERAL PERMIT Previous permit
Date previous permit issued —
K New [Modification ❑Complete Reissue U 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 07 ff. A 3 00 ❑Rules attached. ® General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name S!_O/j- }Pi it -1 Authorized Agent B Yg J Ca►l h i w.f-4 /fole•' 'i Eivh+hq
Address 3 5 4S' EA ER I S/ - Project Location(County): CAY4-#•14 Ll Co"fiiIt �
City I�i M Opel cAli�++ State /V G ZIP 2 712 7 Street Address/State Road/Lot#(s) A d foie-Atli- b,i 19 -i-o
Phone#(3 ) 6 50-077 7 293 .(ti / e'si*
Email 57S A B c I C,+^H Ad. Covy Subdivision
✓ City A/tilco- ZIP 0�9570
Affected ❑CM/ NEW E 4 PTA ❑ES ❑PTS Adj.Wtr.Body/ ( O'C (..r{/`k (�a man/unk)
AEC(s): ❑OEA ❑IHA ❑UW " C SPIMA ❑PWS Closest Maj.Wtr.Body Ce -c (week
ORW:yes/�'o PNA:yes '
Type of Project/Activity P"79o5� bricyl Y ►'t t'Kf 4/11!GG ,
/ / (Scale:,TS )
Shoreline Length -- __r_ _ - --�" j i
Access Length — "{�IF _ I ll/ i if _ '- .-. l . -
F1 I
i T_HAli_
Pier(dock)length -- i -I z �_f.__ _fa -- -._ _�_ i- . -- ,
K
Fixed Platform(s) i_'1_.'i-i-1 I --- 0 r l _ ` `__ s.�l t�1 PH► -
J twe)
Floating Platform(s) - -w` I--r ----t + f -- -
cm 1, k1'C 6�
Finger pier(s) --� .lit L _ - ( �itLL j — _
r_ .__-£--�_._._ � ._1i1ca1 i.- - s..1- ----_— -- _
Groin length/# �- I I I I.. '_ -~
Bulkhead/Riprap length --� r `-E. ;PL(r-t! I i__ flit, _) _ -•__-•---__-__-__..--- __--_ ----•
Avg distance offshore -� . t ! j ; -1 ._ F._..
`F
Breakwater/Sill I - I l'� - 7- --; I- --,____-.- --.
Max distance/length i - - `� jl l' i--44 Y - - i Ai—Mr.-4
chan F la-_.# - $r = ', T .r.2 El MO L& ' _�
1U
Boat ramp - IIIY1 , - , 4'
Boathouse/eoatiift "` - - _ j -t
I r_t I I 1
P ---- - r f _
_ - "—
Beach Bulldozing ' _ _ (_ __ _ _ 1 )- *A --
Other Ref lea 20'X 65 d r
odf ,c ov y I -o -,brid L
5AV observed: yes ® - --- Y�` .-�,_ ___ _ I I _ 1 +
Moratorium: n/a yes 6y? - r_, •-� --- - - - (
Site Photos: ,�yes - - - - --i-- ----§- - _- L - - - ' _•; _ - ��
Riparian Waiver Attached: V no I _.._1._._- _-_J._-__ __4._ _,_.J__-______. _ _..__.__.. . .• I
A building permit/zoning permit may be required by: CA✓f&'7 ‘011,edy
Permit Conditions I) Et(iSf''' t/e'f*(M d( clasp- 4ecJ a- �1 g1- 4/*1, a✓1d nTAR/PAM/NEUSE/BUFFER(circkone)
A kuu-e 1.m J Gl 6 a''h h u 0it 20 ' y had/ be Yh.A/k 1 1/hiJ ❑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)
Brad Connell A,'11.4 r- Am Lai e�
ge t o�pplicant PRIyJED Name`L - Permit r - Name
tad
Signature**Pleases re`eaddcompliance statement on back of permit** Signature
.19'a'- - a a 9.2 t/5/2 3 1/5/19
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

,o,,oF`°"�r",,9cixCAMA I 1 DREDGE & FILL No 91374 A B & D
GENERAL PERMIT Previous permit
Date previous permit issued —
X New Modification 7 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 07#. A 3 00 Rules attached. ® General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
` I
Applicant Name SC p� N�- -/ !i Authorized Agent B veld 6.9)11111 fr-i l'i) Ar4+Cti6 iv E ivi. ►",e'bh91
C suit.„
Address '3 $ 6 S E6 ER T S 7- Project Location(County): Cam,✓4-e'f'-
City fe4 i' 1 Opel SCI1 efn State A/C ZIP 2 712 7 Street Address/State Road/Lot#(s) of d Giavlk bil
•- . 8 fo
Phone#(336) 650-0777 Ot7 t�3 Gttarc1 6��Z lirvll
Email 573" a e c 0,n,ai/, Ga' Subdivision
✓ City fr&.gc ZIP 2 9570
Affected 0 CW ..k EW X PTA 7 ES ❑PTS Adj.Wtr.Body CO"l C"O k/ ( man/unk)
AEC(s): ❑OEA IHA 7 UW n SPIMA PWS Closest Maj.Wtr.Body £ D C ve d k
ORW:yes/s PNA:yes '
Type of Project/Activity P✓79o5eJ bri�y1 ve/I&C e-r' eni
/ (Scale:/✓TS )
Shoreline Length —
Access Length ( NG W 4r ll � '
�i�
Pier(dock)length — !J/ rot oor tv xi/ o A U An
Fixed Platform(s) — tN (4, t�/ 4/
•
Floating Platform(s) W tli W s /I
//U , Cvicek
Finger pier(s) —� IV �/ eer i `reek
, E,ei ftiy krdie
Total Platform area to be ketilAva
Groin length/# --
r
Bulkhead/Riprap length P�.�, ;Nµ i✓
Avg distance offshore -- I WW
Breakwater/Sill —
/
Max distance/length 'y,� W lid, W V( :cAA n,ln 2/ 61 zAvii na pi Nµ1/'
Basin,channel — w 117� U.'. ..) el' 4 _,,.. orr4�_I V'1 ‘/ ."i J+' k.---
Cubic
yards — T'v /'�'1
Boat ramp — NtiIIps 1i1 h01✓/�J41`�n
Boathouse/Boatlift — ✓
Beach Bulldozing
Other Ref lyce 20/X 65 a 'ovii fry ivasy 5t4;01 11L, L
- 1 af•v
beidlyL Ly y
SAV observed: yes
® ,0: S.
Moratorium: n/a yes 61
Site Photos: ,y�es ®' / ,
Riparian Waiver Attached: C::J no / 6S
A building permit/zoning permit may be required by: C,.a✓hi'�r CO K H fy
Permit Conditions I) EXCS •'ny ve,q-'ul' Gl a�i�a1 y c�, r7-g ///ol f ^/H-t✓ h qJ n TAR/PAM/NEUSE/BUFFER(circle one)
w h0"i vh I Cil C,, h h 4e ey- 20 ' 5 k A ll he n..n/h 4-1/',led n See note on back regarding River Basin rules
nSee 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)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
1 f1Ci°12a— s 9-2 ,/s/ 3 1/5/A l
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

���`°m'"i CAMA DREDGE & FILL No 91374 ABCD
GENERAL PERMIT Previous permit ��'
Date previous permit issued ---_
New Modification n 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 3 a
GU f n Rules attached. n General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name c 4-� i /I Authorized Agent
Address it l:- r 7 S T -7 Project Location(County):
City 1:''f State /F✓C ZIP a / I2 7 Street Address/State Road/Lot#(s)
Phone#c31O 7 7
Email el" I y Subdivision
City ZIP 1.3 5-76'
Affected n CW n EW n PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA n IHA n UW SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity p,'Ur ': 1 b, •I„,
(Scale:,/✓i )
Shoreline Length
Access Length j-- ' --- -- r_L ' _.. »� , it t{ i'lV41' -..._ 1-. ...
UN
Pier(dock)length 1r ' �RIMINIIIIII • /, P
1111111
Fixed Platform(s) /�'
11111111111
brisedimmis
Floating Platform(s) '�
1 j i iv 1 ',, • 1 ,,, 4 : —AI MEI
Finger pier(s) \ ,�- a __I ill
pp
Total Platform area
II
2 IMNMIMIMIIIMMMEMIMM'Groin length/# IIEIIMM 4
- INIIPPVAIMIIIIMIIIIINMIIIIMMMIIMMIMIIllinra
Bulkhead/Riprap length l-
�
Avg distance offshore f
Breakwater/Sill i
Max distance/length I a.
Basin,channel •'
Cubic yards t ,` , �_L+✓�1.104_..-- vi / ...
Boat ramp --t.} ...{' ' '.Y
Boathouse/Boatlift 171110111INIMINIIIIIIIMPANIIII Mil , j
Beach Bulldozing , ' f ' ylJbi 1 '
Other � �11 1 'rill - I -
� 1 1 ; Nall 111 I
SAV observed: yes 6p
,
Moratorium: n/a yes
Site Photos: yes no Ammo
- --
Riparian Waiver Attached: yes noaimimmumminammami i
A building permit/zoning permit may be required by: i- 1 CO/4 bit tJ
Permit Conditions 'f, •'II i" 1 4,, . a- R/ ::I T i(/ t, ," "• n TAWPAM/NEUSE/BUFFER(circle one)
n
i.,,c> ®1 ,���(�' -, 1, jI 1 c on.,,,, ti--1, enc.d n See note on back regarding River Basin rules
nSee 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)
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

I°F`° CAMA I I DREDGE & FILL No 91374 ABCD
GENERAL PERMIT Previous permit
Date previous permit issued --
n 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:
I 5A NCAC n Rules attached. I',I General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address 7 Project Location(County):
City State /1/ = ZIP 2 / /,i( 2 Street Address/State Road/Lot#(s)
Phone#( ) .7 1
Email Subdivision
City - ZIP
Affected n CW n EW ❑PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA ❑IHA ❑UW ❑SPIMA Ti PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity -
(Scale:ft/T S )
Shoreline Length
Access Length . . �;�_ + _ _........�l
Pier(dock)length 1 v il /, i t l4 I
Fixed Platform(s) NHL
, .■�allap11, 11111111111111
irmi
Floating Platform(s) i i
11,71
Finger pier(s) �� i II
I Hal E 1.
i .�
iiiiiii
Total Platform area
an
Groin length/#
Bulkhead/Riprap length IuiIiuii!iii
Avg distance offshore ill ELI
Breakwater/Sill
Max distance/length - iiiibiiiiiPijiilllilli
II
N
Basin,channel
, _ _ _
Cubic yards
Boat ramp
i.„,
Boathouse/Boatlift 1
Beach Bulldozing Other P!fhhlhlhil tI. ice.
! liii
i -
SAV observed: yes tyD
Moratorium: n/a yes no j i
Site Photos: yes no I i
Riparian Waiver Attached: yes no 6 f
A building permit/zoning permit may be required by: _ / Gf P i i'y
Permit Conditions - j�i f n TAR/PAM/NEUSE/BUFFER(circle one)
'i<' i J ❑ See note on back regarding River Basin rules
nSee 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)
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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Mr. Scott Hill
Mailing Address: 3565 EBERT ST, WINSTON SALEM NC
Phone Number: 336-650-0777
Email Address: 575aec [e-mail]
I certify that I have authorized Brad Connell, dba American Environmental Consulting
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: existing bridge replacement
at my property located at adjacent to 243 Church Gate Lane, Beaufort Newport
in Carteret County.
I furthermore certify that I 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
‘- , i/
Print or Type Name
ci,�.-tom
Title
I IaU3-�
Date
This certification is valid through 08 I01 I2024

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION &WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return
receipts (showing delivery of notice)are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to)the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15'setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the street/road could be impacted by the proposed development. This
might include street-ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals(or families),send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.qov/search/index/corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand-deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed &returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
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: Scott Hill, et al
Address of Property: 243 Churchgate Lane, Newport, NC 28570
Mailing Address of Owner: 237 Churchgate Lane, Newport, NC 28570
Owner's email: Owner's Phone#:
Agent's Name: Brad Connell 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.
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: NCDOT
Mailing Address of ARPO: 1501 Mail Service Center, Raleigh, NC 27699-1501
ARPO's email: ARPO's Phone#: [phone]
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION &WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return
receipts (showing delivery of notice)are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to)the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15'setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the street/road could be impacted by the proposed development. This
might include street-ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals(or families),send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.gov/search/index/corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation,for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand-deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed &returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised July 2021

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION &WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return
receipts (showing delivery of notice)are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to)the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15'setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the street/road could be impacted by the proposed development. This
might include street-ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals(or families),send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.gov/search/index/corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand-deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised July 2021

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION &WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return
receipts(showing delivery of notice)are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to)the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15'setback area
along the riparian access area of the adjacent property,as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent?(Note: DCM reads this broadly to ensure comment bYpotentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development;AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation. even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the street/road could be impacted by the proposed development.This
might include street-ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals(or families),send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: httos ,Iwww.sosnc.govlsearch/index/corp. For Condominiums or
neighborhoods with an owners'association (HOA/POA),send notice to the association (which is usually a
corporation,for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand-deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed &returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised July 2021

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Mr. Scots Hill
Mailing Address: 3565 CBERT ST, WINSTON SALEM NC
Phone Number: 336-650-0777
Email Address: [e-mail]
I certify that I have authorized Brad Connell, dba American Environmental Consulting
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: existing bridge replacement
RECEIVED
at my property located at adjacent to 243 Church Gate Lane, Beaufort Newport AUG 21 2023
in Carteret County.
''ACM-MHD CITY
I furthermore certify that I 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
GSif i/
Print or Type Name
Title
/ .g c2)- 3
Date
This certification is valid through 08 /01 /2024

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: Scott Hill, et al
Address of Property: 243 Churchgate Lane, Newport, NC 28570
Mailing Address of Owner: 237 Churchgate Lane, Newport, NC 28570
Owner's email: Owner's Phone#:
Agent's Name: Brad Connell 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.
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: Brad Sanford
Mailing Address of ARPO: 291 Hardesty Loop Road, Newport, NC 28570
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: Scott Hill, et al
Address of Property: 243 Churchgate Lane, Newport, NC 28570
Mailing Address of Owner: 237 Churchgate Lane, Newport, NC 28570
Owner's email: Owner's Phone#:
Agent's Name: Brad Connell 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.
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: Mr. Larry Clifton
Mailing Address of ARPO: 229 Churchgate Lane, Newport, NC 28570
ARPO's email: ARPO's Phone#: [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: Scott Hill, et al
Address of Property: 243 Churchgate Lane, Newport, NC 28570
Mailing Address of Owner: 237 Churchgate Lane, Newport, NC 28570
Owner's email: Owner's Phone#:
Agent's Name: Brad Connell 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
Signature of Adjacent Riparian Property Owner
-O R-
DS
I do not wish to waive the 15'setback requirement(initial the blank) rLT
(—DocuSfpned by:
2Ott L. 1.../1Or
Signature of Adjacent Riparian Property Owner� gEE, ED479F467 .
Typed/Printed name of ARPO:
NCDOT District Engineer Robby L. Taylor
209 south Glenburnie Road New Bern, NC 28560
Mailing Address of ARPO:x150x1x lc ea kexG ircAaleiglkxBdex'247 x1c t&31
ARPO's email: [e-mail] ARPO's Phone#: i3 316 1 x 252-649-6500
Date: 08/17/2023 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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