93067C - Connor, Ted

".0wu144 igCAMA ❑ DREDGE & FILL No 93067 A B () D
GENERAL PERMIT Date Previous permit
a Date previous permit issued .----*
NINew ['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 'H t I►OC) ❑Rules attached. kt General Permit Rules available at
the following Ihrk:www.deq.nc.gov/CAMArules
Applicant Name 'Teel Connor Authorized Agent Hi /ek-MAY t h{e_ L()AS 11.4 C4 tsr',
Address ► O ?`lie,c,�seAry - kit*,CA. Project Location(County):t it ir'1'Llr '-
City bik YAVI�i1aWt State 1\l C, ZIP 2 3c.9.1€411 Street Address/State Road/Lot#(s)_s�It�L
Phone#(Zf 2-) Mil'VW5 ��TT11�r �"LL..
Email* eO Y C P`il I e Yh[At1• coon Subdivision /
City C71/41/4'�'�iii(c•Yr,krti ZIP Z il S9'
Affected um ❑EW ❑PTA 'ES Ill pis Ad).Wtr.Body r i itii 0 - 0 n/unk)
,,ww
AEC(s): ❑OEA ❑IHA Ell \UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body W 4 e�t , Yi Kx j
ORW:yes no PNA:yelp
Type of Project/Activity Vvo OSf_a 101AW-A(1Qni CX . '
r�iIop (Scale:NI Tel
Length 78�
i
Access Length / ! ;• i
Pier(dock)length / + ' ; i z
/ 411
Fixed Platform(s) ! i i
Floating Platform(s) /' i j (JCA Y
; ri 01'e sue!
Finger piers) ...,"*. i t I •
Total Platform area I 1 t
Groin Length/if / ! - 1 ?
Li ii • !A v
Bulkhe 'Riprap length -1�t J i ) 1 ! .
Avg distance offshore /' , • ' '
Breakwater/Sill �" i i i i . l i •
Ma distance length IP 1 • ^; i
Basin, annel ..-' ' E{ j i • i t ! i
Cubic yards .-r ' i IYO S 1 ti ...__n !
Boat ramp ✓' f i t 1 bill► <-0 i l i
Boathouse/Boatlift f' I I I ! i i i
Beach Bulldozing ---' fI +'
VI r' 11A �N4rtvja► � I
Other 1/4069�"a.t di' *ear a4/l'� asdtiDldal41 vA
�,\' i i j ( i i ! I t t i 3 I 4
SAVobserved: yes ! ivXf%{yVA t 1 I l : f ' i I i t ! ' 11
Moratorium: n/a yes /0 'c_ ! t i I T I' 1 • 1--.! , ._.
Site Photos: Qj J�� f { I i 1 r �\ib Wqy
Riparian Waiver Attached: no liwatY r 1 �/�1 1 covih0 I i ? ' i ^
A building permit/zooniinngpermitmay be required by: /0tl(�PXG'} l.DUY‘ i(
Permit Conditions('f f 1 /1� 11 rj�At.1 no+ exccec L='•"�"Y'Otr� ❑TAR/PAM/NEUSE/BUFFER(circle one)
�X.iSti )(AR y`�Ar 1 by C.oIiA(i 0Y c� xt kb at-d ❑See note on back regarding River Basin rules
S 25 s J I A T�ant O� Kt AA.,)
k9 t l c r`aco ,nt. 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) r
ib
a ate k l A-► trci eiurrt•hri`.e
Agent or Applicant PRINTED Name Perm Officer's PRJyTED Na
lrt sa 1-c. Y ei. e • ; a�J
S4900
ature"Please read compliance statement on back of permit" Signature
_ 55 1011(Pltb 0211(41A
Application Fee(s) Money Order Issuing Date Expiration Date

4o °"�''1 CAMA DREDGE & FILL
' No 93067 A B D
0
= GENERAL PERMIT Previous permit l _
Date previous permit issued
JNew 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 SA NCAC O34.1+1 I CO)C) Rules attached. R General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
PP D Agent (I"t 1 o r,
Applicant Name Ted C ern r Authorized M(/1Y►�t � inS�W L l)
Address 190 ?('&ASAP* k'10*, CA . Project Location(County): W'TLftr
City Y1 cO(a State t4C J ZIP 21735E314 Street Address/State Road/Lot#(s) M('
Phone#( Jrl14'f3355 1•-
Email+Y.COhY ii l ® rA11• C©VV) Subdivision
y,. '
\Y/City ►YIIN' OL')Vd ZIP 7 a s- q
Affected ❑CW EW I IPTA TES I IPTS Adj.Wtr.Body W1' 1k'e, Ock It Ner 4110 an/unk)
AEC(s): OEA 7!HA I I UW ❑SPIMA n PWS Closest Maj.Wtr.Body W\nl%, Qoi c.-C v ed's('
ORW:yes no PNA:yes no Type of Project/Activity V o')o5 bv+Ikcf1 d
1 Op (Scale:NI TS)
Shoreline Length 4D 1
Access Length / I
Pier(dock)length
Fixed Platform(s) .-
Floating Platform(s) - o(4-
Finger pier(s)
Total Platform area
Groin length/# /
/�
OM Riprap length LAS► ti�
Avg distance offshore /'
Breakwater/Sill
Ma distance length 10 / r\-/
Basin, annel -----
Cubic yards l vWO ` set 1
Boat ramp - ► C bv1101
Boathouse/Boatlift
Beach Bulldozing
Other N`1 rPibWi0lli`ii►Iur�rib-ilr•I'rr:irr OP it
e '
SAV observed: yes 04 ►V
o
Moratorium: n/a yes to soy j Convlov
Site Photos: 0
Riparian Waiver Attached: 010 no LVj& i-'ea> CC7VWi0" fA f4.5 wak0
A building permit/zoning permit may be required by: 0I(4'PXt,* l .M/11l
Q p M sl^ • P - n TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions � U1 N/'�I'� y 1G1�1 hd� ex ere� 2- •T r l�Y"'�
e,xls-h(U r 1 P v-eme.L J o V- co�1(1d UY ��1 vi-itiio 6-zed n See note on back regarding River Basin rules
1 S 25' I a'i.d w`G'r� Own \Z•-�. so(l I►'„ _ '` le I aa X1-• 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)
(!,anal C'lvtth '
Agent or Applicant PRINTED Name Perm' Officer's PRR TED Na e
Si nature**Please read compliance statement on back of permit**
4 Signature
yob � loiltPILb tD2Illo12y
Application Fee(s) a Money Order Issuing Date Expiration ate

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

e.“°"' I ICAMA I I DREDGE & FILL No 93067 A B C D
1 z Previous permit GENERAL PERMIT l"
Date previous permit issued /
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:
15A NCAC_O}-h i I 1 00 ❑Rules attached. [3 General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Ted C Ohnor Authorized Agent ey MGY%VW' C orrS-1-1,-0(-i-1 4.),1
Address li-i&' f 1eol yvt- 1\10 (4c1 _ Project Location(County): ;/Oir-kir-ri"
City y1S fO State G ZIP 2e54344 Street Address/State Road/Lot#(s) 5 ME
Phone#l�J Sill-8 C5 1�1L
EmaiOrrC liI @CYVVA.t`. C(Vv) Subdivision
J City -iAYay-tc ZIP 2 S&`I
Affected I ]cW n EW n PTA [?Es PT5 Adj.Wtr.Body 11 i r 1\c e Oak�.V-1 i elm (nat/man/unk)
AEC(s): n OEA LiIHA UW ❑SPIMA n PWS Closest Maj.Wtr.Body U' w1{9 l�nIC.1� t\,)E(
ORW:yes/no; PNA:yes/fio
Type of Project/Activity . �)n'-e(\ boikherl
(Scale:N T3)
Shoreline Length L.18
Access Length -- -- - '_
Pier(dock)length / - - i 1 - � € i
Fixed Platform(s)
1 3 3 3 I
Floating Platform(s) / i l �/
Finger pier(s) - t 1 ; _ '
` f t 4
r
-1-1 ' ' NIL , i
Total Platform area i I
Groin length/ft _.- ; 1- _--- - - ;- --- E -a
II all
Bulkhead/Riprap length ._._ E L_
I
Avg distance offshore —--
-" - � rmil 4- i
Breakwater/Sill
Max distance/length
Basin,channel �.� I
' 11111
Cubic yards �.► _ 11/0
-
1
Boat ramp __,....--
Boathouse/Boatlift
,
Beach Bulldozing / l mi giA
47
Other : 1`r1, �ammai�M A� rP�, d��� �'��'�► l�' .!�„, li
1
_ _ ��
II
SAV observed: yes �1 � '[
111
. : ' ..ra ..Moratorium: n/a yes Gaim — MINI 1.111111111M1
Site Photos: yes ��( -( " .
Riparian Waiver Attached: e3 g
“.(vslcti gie4 aka ULLIL.III1ii c JS
A building permit/zoning permit may be required by: AvA-erc-E C.nUY1 I n TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions C) I?jU'�Ii ttc S\ICA 1 V\(l+ -e XC're C` 2 • fv-Qw,
e) icki AI l't` vety.C) �\ C)V - C o V'v ct ov r l.\ 0 V r-�'CC.,1 n See note on back regarding River Basin rules
Cx LS I A Vk, i,J(v-(1 EO✓V" 1'ZA ._ ‘IJVI IV in o n e1 le I(1CC l"'\-P vcf•-. 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)
_prit eh/HIM(i t
Agent or Applicant PRINTED Name Permit Officer's PRINTED Na e
Signature'**Please read compliance statement on back of permit** Signature
400 c5 lOiltoi2b 02 lit 0124
A plication Fee(s) t heck ./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

3ie'liNMCAMA I DREDGE & FILL No 93067 A B i(- ' D
Previous permit �-►''
1 GENERAL PERMIT Date previous permit issued .
❑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-i-H 1 I 1 o( ❑Rules attached. 2 General Permit Rules available
'att the following link:www.deq.nc.gov/CAMArules
Applicant Name Te(t 1 n.C i 15.)0 r Authorized Agent iiet(�,:t'Y t�ILt( i\C L Li,\y i eLi( ti V✓\
Address \t CC1S111\'t- Kii-)0ir- erl - Project Location(County): t\,„,'ir i c}
City t tr 1S t)i i 1 State 144C, ZIP 2 44 Street Address/State Road/Lot#(s) r.- NiG
Phone#(41:22,) h l y-9 ,.:
Email "';'C.l"Irli Y'Y i II 0 C' i 1 C Subdivision _/
-I City .i.-0 1\ 1r2_,A,Y-`i , ZIP 2 59'4
Affected ❑CW ❑EW ❑PTA TIES ❑PIS Adj.Wtr.Body ',.1',' 1-'%,re (fit .. V-y V(:►/' elnan/unk)
AEC(s): ❑DEA ❑IHA I I UW ❑SPIMA u PWS Closest Maj.Wtr.Body PI('k(; C CI y,... 4,Q CV
ORW:yes/no PNA:yes/tio 11
Type of Project/Activity (--A h1,i,V...Y1c
(Scale:Ni TO)
Shoreline Length
Access Length {
Pier(dock)length /J7L
Fixed Platform(s) 1 _ I
-{
Floating Platform(s) t(kto.-
i ‘e.. V
Finger �'" 1...... .... .......... I_........_ ....._..
Total Platform area ----'
Groin length/# i 1 a
Bulkhead/Riprap length :i— '......... . ..._.._..{ ^� .r_....._._...... . ...}.. . .
Avg distance offshore { I ( i
Breakwater/Sill -- I
Max distance/length le _ ' ': Pr\..-/ E '
Basin,channel ._---
Cubic yards ,— v C `��Je fir-
Boat ramp - `, \11'.�1tt�t)1
Boathouse/Boatlift ��;
Beach Bulldozing -- I - h b "f" -^.s....^...• _
-�K"- v__—_ \
Other /' • �frifl/!row' '+y.�
��Mil`l+drar�Po.Nr wrr.V or -Al
SAV observed: yes no — - `J
Moratorium: n/a yes no -
Site Photos: yes no Y../-..� _._�_._ L_.�__. ....---,..-_.__..-- ____--_ —___—.�._. ...__............. �2Ancy:_
Riparian Waiver Attached: yes no (UIJC-i�, r �- C C*YV4'1 Y 3 j _A, ' (WO b ri .�1
A building permit/zoning permit may be required by: Alf 4'C v c- C( 01`1 '
Permit Conditions l..- t,t i 1 k 1 I F i (I , ,r i i i V1'+ �'Y.Cr P(k L"'r f y r(` , n TAR/PAM/NEUSE/BUFFER(circle one)
k ) i i\ 'y , Q k ey.( -j ,' ) ( v (C V: ,("t CV ri 1 ‘i L ii- '.7r,( n See note on back regarding River Basin rules
+ f
1 r. L% i I n i vi L.'l)(,-t V C/l l, (C •\ 1 'N .C., ` \`)0 f'( ( C, (( V 1 TI((1'\L( i At. 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)
Krilin ( /114 -)I(I f
Agent or Applicant PRINTED Name Permit Officer's PRINTED Naa et
Signature**Please read compliance statement on back of permit** Signature
j,�«:= Ii (/ ' , r2I►(cl24
Application Fee(s) theck'b/Money Order Issuing Date Expiration ate

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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Ted Connor
Mailing Address: 140 Pleasant Nook Road
Swansboro NC 28584
Phone Number: 252-514-8355
Email Address: [e-mail]
I certify that I have authorized Harber Marine Construction
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Install a vinyl seawall
at my property located at 140 Pleasant Nook Road
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: ##
Slgtf ,tt =
Teo, C a' n A0
Print or Type Name
3 y e,c
Title
bate
RECEIVED
This certification is valid through I , Jam_ OC.' 0 5
2023
DCM-MHD CITY

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OCT 0 5 2023
)CM-MHD Cr

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAII PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • F ETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portio i to be completed by owner or their agent)
Name of Property Owner: Ted Connor
Address of Property: 140 PIE asant Nook Road
Mailing Address of Owner:
Owner's email: [e-mail] Owners Phone#: [phone]
Agent's Name: Harber Marine INC Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT R PARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that I own property djacent to the above referenced property. The individual applying for this
permit has described to me, as st own on the attached drawing, the development they are proposing. A
description or drawing,with dimen:'ions, must be provided with this letter.
I DO NOT have objectic is 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 w'thin 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave.,M urehead City,NC 28657.DCM representatives can also be contacted
at(252)808-2808. No response l.: 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 ray area of riparian access unless waived by me
(this does not apply to bulkheads cr 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 0111
(Z
Signature ofAalaaentRlpsdsnProperty Owner
-OR-
I do not wish to waive the 15'setb ick requirement(initial the blank)
Signature of Adjacent Riparian Pre]erty Owner: 1-4Q\, _`1 \ •
Typed/Printed name of ARPO: • •
Mailing Address of ARPO: , I • maycy, D��
3:c ARPO's email: iA N i _ti1 rice ARPO's Phone#: o1.5a.-act ct -zs‘kp
*woe; n .LOrr`
Date: •A S •ab kips veils valid for up to one year from ARR6+s lgn elised
1�Cv�lReevised July 2021
,. 5 2023
DCM-MHD 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)
Name of Property Owner: Ted Connor
Address of Property: 140 Pleasant Nook Road
Mailing Address of Owner:
Owner's email: [e-mail] Owner's Phone#: [phone]
I i
Agent's Name: Harber Marine INC 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,
�/2 I O 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 Mall.
WAIVER SECTION
I understar d at any proposed pier,dock, mooring pilings, boat ramp, breakwater,boathoo se,lift, or
groin must be seltne minimum distance of 15'from my area of riper! aee uess Tess waived by me
(this does not apply to bulkhea r-rtprap revetments). I u-VO o waive the setback,you must sign
the appropriate blank below.)
I DO wish to waive some/all of e-1 'setback
Signature of Adjacent Riparian Prop wner
-OR-
i do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:7
Typed/Printed name of ARPO: f1 ct f, i C r1n a ar'
Mailing Address of ARPO: �,}C.' P I (�Ul�jO(il f kko k 10I,
A
� = RPO's�e)malt: ARPO's Phone#: j
Date; 7 f�� *waiver is valid for up to one year from ARPO's Signature*
R EC glifErrY 2021
1 1 0 5 2023
DCM-MI-ID CITY