The URL can be used to link to this page

Home My WebLink About92415C - Wall, Betty „,ce'ktet,riCAMA I I DREDGE & FILL No 92415 ABC \D 0 = GENERAL PERMIT Previous permit Date previous permit issued j><New n 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: 15A NCAC b4 tl- ( Quo ❑Rules attached. F.General Permit Rules available at the following link:www.deq.nc.gov/CAMArules Applicant Name 13 P�'1 T Wu,I' Authorized Agent C--e tQ r1 (moo, I I Address l L 01 f.l Rowsowitml T-C, S O V1 C l Project Location(County): LGw.k.--u A^ :-. ' City \A.V-C1c,)L State MC- ZIP 2�' ,.A7 Street Address/State Road/Lot#(s) (r I7 /rf. ,,4,L L?PG c Phone#( i)� ) (p)fa - 2t02W ` Email 13 c 4 A-c,I mac.11 137 e. (�M G r I . f t n^ Subdivision U-�^ CJ J City Oct-4-,L //S&G\ cI' / ZIP 2 ? S lZ Affected IIICWM .... PTA ❑ES ElPTS Adj.Wtr.Body”)(vi laan.c uAV C-'ii a/ C f fiat/man/unk) AEC(s): n OEA IHA ❑UW u SPIMA ❑PWS Closest Maj.Wtr.Body fe.>D^vn..t_ &w` ORW:yes/no PNA:yes/no Type of Project/Activity r .,S 4-Jv3 clot L(149 "2c r /ft- f LIO( (Scale:r 71 o') Shoreline Length %/(. Access Length jam ... r...._ III.._._ Pier(dock)length ■ 11111111L, ;rn Fixed Platforms) _MI strimilmin Floating Platform(s) IIIMMILIMBINIIIMINIIMMIMMI Finger pier(s) /_......-- INININIIIIIIIIIIII _MIIIIIMIIIIIIIIIIIIIIMMIN ■ Total Platform area IWIIIIMIIIIIIIIIIIIIIIIIIIIIBENIPINIIMIIEEIITIIIIIIIIIIIIIIIIIIIIII ..- Groin length/# 1111M11 111 1111111111111111111111111ra Bulkhead/Riprap length _MINI I 1111111=111M 111 Avg distance offshore' I...._..._.. ....._. i_....... NM Breakwater/Sill CE�I;. ■� �� ■MIMS Max distance/length "III Basin,channel � f Mil�� MOh1ii i Cubic yards - Boat ramp _----- 1 c t. �I pjlltlaer Boathouse/Boat /3 Y15 (7z) M�a�/� gg��f�1a��a�,ganamt� Beach Bulldozing 11f �� ' �� Other/J iJC S/ A., !1,e1'rZt 111111111 `1rtiffill _ ex,S+ _SAV observed: esnorV KJ ia`maismim"-limmi co — Froltallei Moratorium: n/a yes noIIIMMINNIMMIMMIllkiatell , - Site Pantos: yeses ' ■ I ��U r —. Riparian Waiver Attached: yes1 no p " A building permit/zoning permit may be required by: A r1 fA,'IL i(. 1}YG,(, C, / Permit Conditions /I�i „,1 ,�1,; -e•C.( -,k/-( �tr f ✓(wa,11 /1 F,rcfr ,d 'to ,G,,' nTAR/PAM/NEUSE/BUFFER(circle one) C r/'- lO 6 t pr,LL l V ❑ See note on back regarding River Basin rules 9 ❑ 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) - 'e Agent or Applicant PRINTED Name Permit Officer's PRINTED Name \ • L --e./7(- nce ._/ /( Signature**Please read compl'ience 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: 252-247-3330 252-946-6481 (Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: 252-948-0478 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: 910-395-3964 (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. '""'N( ICAMA DREDGE & FILL No 92415 A B C ,D 1 1 GENERAL PERMIT Previous permit ...---- Date previous permit issued I !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 (�- I i, Rules attached. R General Permit Rules available at the following link:www.deq.nc.gov/CAMArules Applicant Name 1 (1 e' ? y j,. 1\ Authorized Agent . Address f 1 I ' ( i Fri' I'; r. l Project Location(County): City 4 : i`l\ r C(i.I C State /J(_ ZIP ,;•.—q r.`I Street Address/State Road/Lot#(s) Phone#(mot ) ( i t. - 2 l, 2 K Email -: 1 . \ +c It11 ' (7-,, , -, ;` . r L ,,',, Subdivision City ZIP r Affected n cw ❑EW fi PTA n ES ❑PTS Adj.Wtr.Body r (I,-.- 4 Ye;- J is (hat/man/unk) AEC(s): n OEA E!HA n uW n SPIMA n PINS Closest Maj.Wtr.Body ?;-.^ a Y •\ ORW:yes/no PNA:yes/no J Type of Project/Activity 4 , -, (zit( ,l r-Ll ci,(71 (Scale:!"-7 0 ) Shoreline Length Access Length — _a__._.:... .. 1 Pier(dock)length 1 1 Fixed Platform(s) 1 )1 _.4. I: "ti 34Q-,,\4J 53•JOIA niFloating Platform(s) Finger pier(s) Total Platform area ' Groin length/# , f4 ) i Bulkhead/Riprap length i j 1 Avg distance offshore )... Breakwater/Sill i Max distance/length i ! , , _ Basin,channel j is, Cubic yards �.._.,___.... _..._ 11/1._.. Boat ramp r 111 �INN _ _ Boathouse/Boatlift - (t )_ ,.,0.4 4 ,'1 _ I i ar Beach Bulldozing I (5�)' IIIIIrIIIIIIIIII iumw m.Other kfr a/'1 ti ••` III - ri SAV observed: yes no\ , ` Moratorium: n/a yes no '' - g +V Site Photos: yes no. j • �� """`� L; 1r,1 j yvr�ry'R.' Riparian Waiver Attached: yes no I ! _ permit/zoningA ± t I A building4 permit may be required by: c,,. C. f,/, t l Permit Conditions ( r v �. f / n TAR/PAM/NEUSE/BUFFER(circle one) yy ,k„) U ❑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) ( i ii ; i 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:252-247-3330 252-946-6481 (Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:252-948-0478 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:910-395-3964 (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 AGENT AUTHORIZATION FOR OAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Be. 1► L3 P Mailing Address: 14'71 b O I d Faison foad d Kniskidate., NC 275Lt5 Phone Number: G (q ' (o 1(9+ 2 (a2 8 Email Address: Vet lj t W01119 35 @ 9ma11. Corn I certify that I have authorized Si-even A . y a 1 , Agent/Contractor to act on my behalf, for the purpose of applying for and obtaining allll CAMA permits necessary for the following proposed development: bat 1 t 7 T at my property located at 713 Atlantic. QPgch Cousewcy , A6 , NG in Carte ret" County. _J 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: gnatur B e i+ N F RECEIVED P t or Type Name Pro pe rt O vJ n e r SEP 14 2023 T le Aug / 51 l 20 23 DCIh-grip City Date This certification is valid through Feb / 1 / 20 2-4 � 1 1 1 . • } a m w N U t766,Siete ab.if Ql2.36v -pieta L a Cana,! Calm,/ 6Aa,i- Sl i ps 11 z 1 ivtaff iecjig $d2.44 1 /213 4f1 tte. nosfiikr q 4 5 ILrG t'rpr Fifty .p- wed' -Co4)ec- -1 « te,och W.c o . .-I-intre490 ,Adis lti Se G ems- rei, Pr* 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 „ac~64-1" ''1.2 %, a , 1 c m= 4 1 Address of Popery t � ► t I7,-"c c �, .; C Mailing Address of Owner: L 1I ())i k ;,('I. f' . j'Vrt t t ! t \ > r-I a. rrer's email r-:.L a: i ,: ;v. `{ ,A 'rtttI t R Owners On : `> t f. R Agent's Name Agent P'hc te#. 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 roe, as shown ein the attached drawing, the devetoprneht they are proposing A description or drawing, with dimensions,must be provided wilts this letter, I DO NOT have objections to this proposal. I DO have obiectirtrr -i to r 7,,. ,,,,.sai' if you have objections to what is being proposed, you must notify the H.L. i'nyisic'n 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 r'epresentative,s can also be contacted at(252) 515-5400. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that any pressed fir, dock,, moonng pilings, boat rime, breakwater, boathouse,lr,or groin mist be set back a minimum distance of 15'from my area of riparian access unless 4v arved by me (this does riot apply to bulkheads or tromp revetments). {tf you wish'.-Wainie the setba+min„'u moat sign the appropriate blank below i I DO wish to waive some/all of tne 15' setb o ' ' ,,,, ii‘ \ '''" ''' S not, re Artec:o i,E,.� nere rem ()sa. e, -OR- a I rip not wish to wa:tie the t 5'setback(rOgtat'errn:apt tirritlai that blank Signature of Adjacent Ripman Df pert, Owner Typed/Printed name of ARPt39 ® `' '.. H .,� Mailing Address of ARPO. ; ' ‘Arl~ > " r , - - ' -4,0e-k- ARPO's0. email: ARP "s Ph14°44ranelir .,16.-'I'- Date. r - j;_ � `waiver Is valid for up to one year from AR'O's Signature* j; i e g � � 0fdj ` off , , Z '' '• y, n 4a,6 e,-,hya�l , i.a 7 ' ILD.DIIIUIIOF OUST ALMANAGEMENT AD1i i IT 1' IIAM PROPIIRTY OMER t$OINCAMIONlWAIVEaI FORM CERTIFIED ha llnlip1 RECEPT REQUESTEgz WIC ._. Lt ER'r Crap portion to be abevieted by owner 0,tNiar agent; Sae e as ar:-ps ,•Qwner (t� e�PC -,4 I F� A:Wass cx Praper!y: 111.E A 4+c. #-N s:t. 48• w 'C' Mixing Address o.`Ow-ter 41 at Cnd Fates, R_, t'`ruls hco l-_, + C. Q/cs t C Noises smut 5r1113 r c_,}Or4-0 3mn 0 qwners Phetneit• ' I4-Z,laQ-04$a AIMIs lilrrry _ Nowt Phone*. Apses EnaE: AD.tACENT RIPARieit PROPERTY OWICER11 CER'TIF CATI[1N 'BotWtn colon)9 be c trtbleisd trt the Atjimegt,Ptobirrtv 00191i1 t hotly care)" gat t sea:prow?r*arvrc z tha ax*re nteeforsoic 0 wipe y Me+', „eue,topytn tor this me her coNatCeG tome Ns snow an j`e a '+ec Orevevic. no 0erreboo-4n; they Ire @ • fAIWilbca serrRa tItt 'tr^otwte<mir be Ala'Ne twat ' /i,+L 4 DC 1407 Nis^oeCecne to tees o^' ' .t Wyss have ilOnetio s to Ube itt bike proposed. you must nth the M.C. tort at commit hence wrW DGM)it away milt*ft elsys tot receipt of this motive Corresponefeoce shoved be mailed to 4470 Cateneet la Asa.*..A.ef City,NC 2tt4f7.DGM ntwene nsM+e+coin else be coratrca.d a ,za2)atS441:1O.No response is conol owed me seine es ra obj.cyon tr yeal ram+been notbled by Cartlff.d Wolf fame S#CT1ot. I^+d.ttW,t1 MI tutor pro pier,dos. mooring pings,o'arms » caoeemx.se,IR €r groin mist be tlet beck s eeittien..nt disirn;A of t 5'!ter.Try sees to r ear 6ccess unions wIterec1 tr.me dm net en*le njbthinette or+Vase ntMe te:, t 14 y«.wrist X.vra.vo tie spheh.v3J Tioel tkar to spproortese Nark.be!trrr i DO+vish+c wt1:s9 sorNnial Of the 15 9ef'f3 J. e ,./7e=/' ,./., ..k.t...._ .OR- ;cie nal w n to ow.* 15 woad.rocoetenat Wed tfNbielli f / Sr- re 1 t�e,ao.nt Property O.rfrtr_ iaia0C1�f./h/ 4 J Typ.NPrrrtso mem*of A Os _` led i f./- t sus Asses of Ate: S Sty A4 hug./ '! i i so: ,,�Ai( 3�c s: 'd.� yu/i..it rFalbev n.f: p.S.' T.'4 1 '$ aR tr,��+r dov;effcs,z,/,-...it?'�,'' Dears: '; :-J twi la-z *wirer is seal for up to one reef n MVOs sieetrstsre' f RFCE1G Awed May 2021 { 2023 RECEIVED DC--_ .., ,earl EP 2 6 2023 _�___ DC4+- `10 \.ITY____ __ r 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:3c44y J'a11PCnr``-) `' t ) ,, rr Address of Property: Ut /NIT Ian+►C 1" ccck C 1.c 1 AB Nl C. Mailing Address of Owner: -41 I1.I (' FO-150 n Rd . Kri t kb.(c It.0 . .75 5- Owner's email: Srt . 1rS4oC P9r TUl. Owner's Phone#: 919-31-Q9 -o(4 g Corn Agent's Name: Agent Phone#: 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) 515-5400. 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' setb c 30 Signet r of Adjace 1 rian Prope Owner -O R- 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 ivet2e21 ED SEP 14 2023 DCM-raw) CITY 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) y Name of Property Owner: t:f+'n P etr' V/.(a [I r1 , r Address of Property: k(3 I"14Iar L1 C cF, ` Su)* l�n tB Mailing Address of Owner: L}1 I lrz O Po-1501-1 Rd . Kr t311 fit, .C..• a-7C1 1 C7 Owner's email: `—mow r"es- o(L gnat Owner's Phone#: \l9-3te.y -O4%-ca Agent's Name: _ Agent Phone#: 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)515-5400. 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 May 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) y Name of Property Owner: �.t4' P'+Cx r '( Wa.t I ff Address of Property: 1a13 A-�tan4- c Ch �SW k AB ,, C Mailing Address of Owner: 147 lie O ICI tsar R • Kr119 h c*.k . 'C' a 1(,1 O Owner's email: o u eS1-oce_ q/rta►i Owner's Phone#: 9(q-3L29-0 4% Agent's Name: Agent Phone#: 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. ` 7 1 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)515-5400. 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 riprap revetments). (If you wish to waive the setback,you must sign the appropriate blank below.) �f I DO wish to waive some/all of the 15' setback Signatu - • Adj a:!nt 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 :mail: ARPO's Phone#: Date: *waiver is valid for up to one year from ARPO's Signature* RECEIVED Revised May 2021 • SEP 14 202 DCiMM-:ok°io CITY