92407C - Candlewood Investments LLC

0c„`°"r',N.
ICAMA DREDGE & FILL No 92407 ABC D
I 1 GENERAL PERMIT Previous permit
iivei I^'f;IZ3 Date previous permit issued
NewModificatlon 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 t OO ❑Rules attached. n General Permit Rules available at the following link:www.dea.nc.gov/CAMArules
Applicant Name I*,'t..--,' `-l� Authorized Agent )� .,ik P1C,r iYso. ( vtC+ (ALA
Address Project Location(County): ,.j-enu -
City ;\A ca ..-)- State /N '. ZIP '2 _7 `)( 4- Street Address/State Road/Lot#(s) I' `'GY•j, 5:4-reQ 1-
Phone#(_) iI'' 1 - (1
Email 9J - ;-.1 (,-,, \ Subdivision ----
City \)Cr, .A o( ').- ZIP ?i c f(c
Affected n CW JJEW ErPTA n ES n PTS Adj.Wtr.Body --I CA 1 v1 of `. iC (nat/man/unk)
AEC(s): n OEA MA UW n SPIMA 0 PWS Closest Maj.Wtr.Body AJ.e(,,i o!'l e,v-tr`
ORW:yes/no PNA:yes/e)Type of Project/Activity -rk,(} P 1 r),,, l: . ,\t ,9-c( ) a/S (7 i
�`
(Scalei ii
Shoreline Length .J(413 P
Access Length Ig X 6 L lt, T - , i- t _..... Ailir..- _/
Pier(dock)length I'> 5r)
Fixed Platform(s) c'Y L ��%�����j\ �■ ,!IMMINMIIIIIIMMIIIMMINIII — I/j�,
likil
Floating Platform(s)3Z X` 1 C27c3 "" l:r -9 -Imo , , Him:
Finger pier(s) 1 ..� V :� _ "-1iiA3riP1l1l
�� 1
1
i (_._
Total Platform area 34`14 N - -., .1 Ii.iI5PIi!NIj9
rh/# ��%" )
Avg distance offshore 1 LIl L, �4% ` 1�! i-. 111111/1''''.; v�, . ..__.._._
Breakwater/Sill C ` _.._
•
Max distance/length _ .__. I _ 3T` c{v A, it1(
, I"
Basin,channel 1 �
•
Cubic yards �. I: )i C) �'1a) 1
Boat ramp J j ?b _._-t...__ ')3'fI1 1 ,
Boathouse/Boatlift t 3 Y 73 (7,c) / )kBeach Bulldozing �' �,ri ' 11116
��� 1 67/s�
Other ? 1 ' ' 4 .� — .! 1 4. s -. ..4' j_..........__.._
, • . _
Itzl \
SAV observed: yes no ` i, Caw ' j , t 1 ' �' /
Moratorium: n/a yes no I L (- I �"�� '"� 1
Site Photos: yes no % Ij� <, - . I
Riparian Waiver Attached: yes no , *, i ( 1 1 f
A building permit/zoning permit may be required by: <4 'f-
Permit Conditions ,,of 4 .,,,�, �^ n TAR/PAM/NEUSE/BUFFER(circle one)
rite r7 i
389 100 ,r{ ( n See note on back regarding River Basin rules
%.04V1 ) 141Z3) n 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)__ _
)(A k.'1 r'
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

•
Ai°rots wn( L ra &*1-k7 Pr e)19°
\ 5 r °Alt St 2 _ 3 Z x 6, -(1 oc�, ��.
5(..:_a+d-- iv, 6,i
docks 3git sr -i
/
2 - 61 x5- de s
b rim 1 eAi 0 r;(/'%4/el
2 - 3 ' >( 20 Alv'v '
__ � .� �a� kJ-Kt-1 s
1 _ 3 ` i � ' 50ci BETS
Z —
r
�- to ........ 6 —
,, , N CD '
, ,e
75 J
4 ,_E. • I P T
y ,� i �
2 �,\
, I Ili El '' ''(
• 1J—I---- ..4_
1l "
i cpci„... .„-c).Of, 12.,,O''OQ 0 .ify:li§ 1 .a.,-,;g6:3,c5.5,75.-!* c'.:63:58)0Tna
�?..)1k)Vv O Q , 1 ==' �r 0 -) rOr,,I� ! 0. Oa". `.�1.•
l( ovS ffar L.100s tC ,IN

oa2'`0"''41x 1 ICAMA I I DREDGE & FILL N9 92407 A B 0 D
3
GENERAL PERMIT
l Previous permit _
Date previous permit issued
nNew El Modification I J 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 2-00 Rules attached. n General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name ,' 14,.,,i LC-,. Authorized Agent
Address - G Project Location(County): •--j<'"-t
City )[ i , u.n4- State '- ZIP 2 4V Street Address/State Road/Lot#(s) 1 I C•-•
Phone#( , '.2) L.) l - Li 33 y
Email •
) l,.J P .."); x (Gd()'^a,n . C r M Subdivision -
-City 1.ti^Yo/ '- ZIP 2 S I(L'
Affected rim n EW n PTA n ES ❑PTS Adj.Wtr.Body ',)I Of S 'CR* (nat/man/unk)
AEC(s): n IDEA ❑IHA I7 UW ❑SPIMA ❑pws Closest Maj.Wtr.Body k,,-(l,✓>j�o 4- , -
ORW:yes/no PNA:yes/no
Type of Project/Activity , i1 - -, Plc, ,. *) c( )1,(11 S (7 e)
(Scale i1 1.2,C)
Shoreline Length
Access Length )t0 f alM — .__. �.._...... I. .....
de* 4
Pier(dock)length T) ' I
Fixed Platforms) ..ar _ �Y
Floating Platform(s) '�""" �, ij, .• —P 11 ( a
Finger pier(s) 'V $) ram.It it f I
7-71► s OA'
Total Platform area } W ,f4 f/i 4
Groin length/# /� 511
1 ocr�r� a * Zj9L L�CBulkhead/Riprap length �� �-f��__ _ 3 , 5 ij
Avg distance offshore ` . ri% - 1---- --._.-..-_.--
,t
Breakwater/Sill / I ,; R°f' X`Z, \
Max distance/length %� 1 A; `llt N
Basin,channel /�! .Ore I�I¢.>;np�Qlydf�nN
7"
Cubic yards /�' M� ti, -;r�....� �.._'.. �J"
Boat ramp __ r __ _
Boathouse/Boatlift, /3 Y/7 (7w) i. i -' 1 I i (G;
Beach Bulldozing .— -- __� r 8 rs�
Other 2 ,�S ! __..._..._ ..._.. i ._..-.._.,,g5,,:r__ '_�._... "�}
wesr� 1i.
SAV observed: yes no // .-�,/'� 3 i V ? `
Moratorium: n/a yes no `j`��� '44 ti i 1Site Photos: yes no - , - � " J.
Riparian Waiver Attached: yes no /// 3 -
A building permit/zoning permit may be required by: �)eCAA v(4-
vU � �` /r n TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions ' v. , , • , d nl tet t.road i.�i, 4/26iL-tk ( ,4r.,,cr(
r�[. ',g00c1.nrt • ?(/If i,,,-,tv, ,a, ve 4 400 rt--fh,,?rd. 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 STATEMENTTj�. �(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

�o�''''" '" I ICAMA ❑ DREDGE & FILL No 92407 ABCD
0 1 GENERAL PERMIT Previous permit
Date previous permit issued Ir
n 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 • C L___I Rules attached. n General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name L'�. Authorized Agent
Address Project Location(County):
City - State \.I ( ZIP ) `60'1 Street Address/State Road/Lot#(s)
Phone#( )
Email 1 ( "\ Subdivision "''-
City t ' ZIP ..
Affected n cw n EW PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW SPIMA n PWS Closest Maj.Wtr.Body r
ORW:yes/no PNA:yes/no
Type of Project/Activity 4i'-_•i ( ; 'Fr)
r
(Scale{li-.2,C
Shoreline Length
Access Length ._ _ _.
AI,en w
Pier(dock)length ,
x
Fixed Platform(s) 1 l arlIGFAIRODILCOMPII ,
MiliiiMl
Floating Platform(s) , 'r�«.""""'i""�"""""""'�'"...
tt
Finger pier(s) 11111115141 MI rfirg sj, niumulauma INN
Total Platform area (I `1
Groin length/#
Bulkhead/Riprap length IMIIIIIMI l ; a.. .
ltiMIRITISIMIIIIM11111111111111111111111111111111 ig osimiassirs
Avg distance offshore iiii
--oliammoilii
Breakwater/Sill
Max distance/length —•
Basin,channel :. I
Cubic yards �� -
Boat ramp lissimotrif
Boathouse/Boatlift )ammimilmonaispouranalicza
Beach Bulldozing 111111111111M,11111g �m
Other
Emig
, male wilini I I
Pir
•'
SAV observed: yes no `
Moratorium: n/a yes no
Site Photos: yes no
1�t I�ryj ug
Riparian Waiver Attached: yes no 11111111111111111111111111111.� 1 1 '� 11I�
A buildin g permit/zoning permit may be required by:
Permit Conditions 'j 4 Rk f
ElTAR/PAM/NEUSE/BUFFER(circle one)
,,, r ,2U -; 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) Y U
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
i
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

Carteret County , N . C .
It, ' , i ..._ ..,„
• -, 113 .•F}" flilt: t. ,41: 1 l F•
j4,I'` , h. t, P'
\ ♦ -_ * ,my - e. -A t �-, 'i
:/ 1 l /`�. I i
�'11111111k4r /.ill r ' f • �,
4 w 199 � / ,, , to . . :.„
' Imo+ "; / rti
• r ----,. / .:, ,-..._ - -. i 1 Illfi ' --- "4: ' .. - ') , /'. • .•-
c , i 131E3 286.5 —"-; JP # 4.74.,--7,,, 7,72.4,..
. .•
. ..... O^r
/ •,
tea? ` , 1;S I l 2: f r/ `rl�
. .. -• . ,_,-. ..far .. • 41. s ‘0, / ,‘" ..
1111-, „, ,„,t,... .... i
..........,„,
. . ,..., .
. .. , sis ....
,....... ........ e f e` 4' 4-
_ , _,.Ito `,:� .."
._, .. ..
, _ . ___
,...
e ? ` 'r2687 r 'i
hh ......„.
. ,.
...,. .,,
J`
t�
. ,..-, A ........,
` _ a j 363•
' � // ,'
r 14A A-1 �
F
N. .- t
•
» �11 #
r ( , 1
, s
• + 1:600 .0
.July 28,2023
The',formation displayed by this webste is prepared for the inventory of real property found within this jurisdiction and is compiled from recorded deeds,plats,and other public records and data.Users of the nformation are hereby notified that the aforementioned pudic primary
',formation sources should be consulted for verification of the',formation contained on this site. Carteret County assumes no legal responsiblity for the information contained on this site. Carteret County does not guarantee that the data and map services wit be available to users without
nterruption or error.Furthermore,Carteret County may modify or remove map services and access methods atwil.

cf) v--, vociircl' t(-'sr , ,
1 is ry-,4- 4-. . , 2 - zE A co -E)I.oca-er 5
z-
- 6 >( f ' .F.At
.._______‘
3 ci co 5F
.
G0 ._,
L
RECEIVED
r AUG 2 2 2023
DCM-MHD CITY
i
5I M9
.. , ,
it-- 1 ---"
--o
P T-
.........,
______,— 0, r .4. 0,__
v a
, ,,,]
is
u
— W `f- T
•I17., h0,,,,,,...,,, i`J► ... „„e, c0 O 6 wj 4 grit V i C c64.• • w ©c�C� I 1���r
,5V
or 100
/ 1ojs -P

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
( CL Name of Property Owner Requesting Permit: /I I f i / -1;hif)ii/insPidk G
Mailing Address: PC) `- q
moa
f
Phone Number: L J 7 V
Email Address: WeA L Q.A.C f'r7 Orh1 i n - ea 41
I certify that I have authorized Dt 0(0 l)
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 67/)(�y r 7/,xs4.1 dcil-s.
0, - 5x C i i- 1394, 8,F 0, - I-x/3 1(4.S )1
at my property located at //'J /TCJA I -/
in L-c ('i / County.
1 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 Infor ation:
Signature RECEIVED
Pri t or Type Name
�rf AUG 22 2023
OCM-MHD CITY
Title
OcY t oUlo2Cd
Date
This certification is valid through / 2_2

N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTiFICATIONMIAI ER FORM
pERTIFIED MAiL • RETURN RECEIPT REQUESTED or HAND DELNERY
(Top portion to be completed by owner or their agent)
Name of Property Owner.01 r J br 6Sk1 o r 4 -CQ n p1 l{..L4 CO I r V-rA irrlcrvig l_L.C
Address of Property. \5 4-0'0* S1V42.4 " eAtn Co✓4 N c c1 ps)
Mailing Address of Owner. .0. K j 0 044104 > 04 C.—
Owner's small: Owners Phone#:
Agent's Name4Yv1 &r -- MC- Agent Phone# 701N 5-3
Agent's Email: bb IY1 E-1 h 'r-i.i i 4_0 1
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATiON
(Vattern colon to be oomolaiod 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, ae shown on the attached drawing, the development they ere proposing. B
-_ ermiona.must bej rovldedwith this letter.
p1 t 'u . I DO NOT have objections to this proposal. I DO have objections to this proposal.
c. �� If you have objections to whet Is being proposs4 you must notify the N C. Division of Coastal
Management(DCM)in writing within 10 days of receipt of this notice. Corraspondence should be
mailed to 400 Commerce Ave.,Morehead Coy NC 28887.DCIt npreeentrdvea an also bo contacted
at(252)808-2808. No response Is considered the same as no objection if you have been notified by
Certified Mall.
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 riprep revetments).(if you wish to waive the setback;you gualilga
7-e appropriate blank below.)
I DO wish to waive some/all of the 15'setback RECEIVED
IA/
1 -oR- Signetwe 7erty Owner AUG 2 2 2023
do not wish to waive the 15 setback requirement Qnttial the hank) DCM-MHD CITY
Signature of Adjacent Riparian Properly Owner: 41IrA i�� •- �_Typed/Printed name of ARPO: GEoRee F.• L:tKft
w/o- Malting Address of ARPO: t(3 Fit 5'T tr3�v'�✓� Inc 2'05 i(o
ARPO's email;5 e/it dietavocif ARPO's Phone#; C (9 . 59 9. 0 7(
$•2 • Z 3 ems`+ •c
Data: waiver Is valid for up to one year from ARPO's Signature'
O. ♦

N.C.DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOT1FICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
�1 1 1
(Top,portion to be completed by owner or their agent)
Name of Property Owner. r • b r 6SW p r `VA --C q n_` j co pt 1 nki-a,,men 4s1_1.,C
Address of Property: \5 f`Ira rl�" - ,(4- r )ea,n � N C a p51
Mailing Address of Owner: •0. 'j o K O Cam yvt
....,4- (1-4 (—
Owner's email: Owner's Phone#:
Agent's Name: t 14vr:c , g IYl c_ Agent Phone#: (9,5 �`). ,5— 3�-1
Agent's Email: bb L' 1 to hpAyvv
i 1 Q ►1
vingaami
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom ootion to be completed by the Adigcsnt Prggerty Owns()
l hereby certify that I own property adjacentto the above referenced property.The individual applying for this
permit hes described to me, as shown on the attached drawing, the development they are proposing. 8
des 'olio or drewino.with djrnensions.musts t� d_vtd with this letter.
LP-V 1
, - ,,t, 1 LI I DO NOT have objections to this proposal. _ I DO have objections to this proposal.
c Lt if you have objections to whet 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 28567.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, Iift,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 slan
®appDOropriate .
I wish to waive
blank some/allbelow)of the 15'seta
1 �"rl r/ ` 4ts.A. '1'0,9- Ifof Pie `
�l Signe re of Adjacent Riparian Property Owner �"1
-OR-
RECEIVED
RECEIVED
I do not wish to waive the 15'setback requirement(initial the blank)
Signature.of Adjacent Riparian Property Ow/n�er. AUG 2 2 2023
A Typed/Printed name of ARPO: J aSon ri•i, t, I °A Pc 41;r ),w1,.t, P6R0 lociCITY
Mailing Address of ARPO:_31 S'6 R C.ho1,,,ti 2 fatt h jiLlm. i iki L 1TZ IS
P\ ARPO's email:.1 kSoi @ cOplp,,,d-Pa,4 r►cS. tARF'O's Phone#; 31 - 213- 7 D
Date: flt` '1 - 2-) *waiver Is valid for up to one year from ARPO's Signature*
Ar.IJ..+..I M.,�Y Oekili 11,

•
•
•
•
'4 J .i. ^4 i...+1" mot. .�`� , •
f ia5.i.!j , • • / '