92932C - Price, Eric

o�0`°""41NPCAMA P DREDGE & FILL No 92932 A BCD
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:
15A NCAC Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP 5 ( Street Address/State Road/Lot#(s)
Phone#(_)
Email i !? t - i✓.5 Subdivision
City ZIP S 70
Affected n cw n EW ❑PTA n ES PTs Adj.Wtr.Body na man/unk)
AEC(s): OEA IHA UW n SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: ,)
Shoreline Length
Access Length
Pier(dock)length
Fixed Platform(s)
.
Floating Platform(s)
Finger pier(s)
Total Platform area •
Groin length/#
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill •
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
.
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
t? n See note on back regarding River Basin rules
5/ 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)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement'6n 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

16"74'NECAMA, 7 DREDGE & FILL No 92932 ABCD
Previous permitGENERAL PERMIT __Date previous permit issued
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:
15A NCAC n Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#(_)
Email f r Subdivision
City ZIP
Affected n CW EW I I PTA n ES n PTS Adj.Wtr.Body (natlman/unk)
AEC(s): n OEA n IHA f 7 UW SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity ""`' +r
(Scale:/ ,)
Shoreline Length
Access Length ""� ( - — I i �i
i
Pier(dock)length
Fixed Platform(s) Y? 41! - i _
I 1
Floating Platform(s) ? , CI
i i j r �I 1 i
M - E k I I
Finger pier(s) 1 j I
Total Platform area ""'w4 } `�
{ i •� ' I 4,
Groin length/# tl,y 1 .`' '
Bulkhead!Riprap length _ _.:.. f_ .___}, _, 4 _._._I _.. i__...._ __ 1
Avg distance offshore i'.: /
e or
Breakwater/Sill ,.
Max distance/length
i s
Basin,channel i 4- 4 F
Cubic yards
Boat ramp 7���
Boathouse/BoatliftI. i 1
Beach Bulldozing I - , ri a I ''c t.
Other
K I f/
i t
I
SAV observed: yes no _ ` _—,
Moratorium: n/a yes no
Site Photos: yes no -€ i--.___....1. i_:_._.-.__ ..-.;
Riparian Waiver Attached: yes no
•
A building permit/zoning permit may be required by:
Permit Conditions n TAR/PAM/NEUSE/BUFFER(circle one)
nSee 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)
1
Agent or Applicant PRINTED Name ,--ram' ` Permit Officer's PRINTED Name
Signature**Please read compliance statemewt bn 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

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: C IZ i L 7 j LA
Address of Property: l?pi (2 i ?i( E )PI Gt PP`t-1 f �C. 0-S 3 O
Mailing Address of Owner:_1 T W22.. 1/7I IL& 12-O JAI N 6tAy©v_-TT
Owner's email: : rLi(:.g0i-FSOCEGDi1 14 ©vner's Phone#: ;�5&-Y FJ!lac).
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.
c5 . LDO NOT have ?objections to this proposal. I DOS have objections to this proposal.
\Ls bu.1- 3- �'� r L ve 5 -Rua' we_ LA) 1( ✓G CLv�L iv LA --
if you have objections to what is being proposlitrroli 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: -25�JL-
Typed/Printed name of ARPO: Vrt. - & �h h5e'1 "de-
I
Mailing Address of ARPO: ;VI 0Sjkv�,}-vy p� ,e40...-11-11\--I N e- lSo
ARPO's email: '('1.115t.hjvhttee U • I. CAMARPO's Phone#: aZS2' 1- - z3cy
Date: q *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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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)
=R.I(: �2..i C
Name of Property Owner:_ +
Address of Property: �-e-1n1 TUi' 1 KE RI;kD Nt;vilJam -;k)C J3 9-0
p rty: .� . .
Mailing Address of Owner:_1 S c1 11AQI.J 2/ a izome) ►v i✓A-1Pbi?T;tv1 C- fig, -7-0
Owner's email: E-'CC')of cW6. )ufi.+3 ctillAPa'2;£sr Owner's Phone#: afsD- LI ' 51 I.o(9.
l c U,, —
Agent's Name: Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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.
.5-- 1 DO NOT have objections to this proposal. I DO have objections to this proposal.
---
si�y j
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 Riparian Property Ow er.`-— "--G�
9 AdjacentP P Y 2.__
Typed/Printed name of ARPO: S Cn g' (I
Mailing Address of ARPO: :>5.7 6.4., , 4_1 at/e
ARPO's email:LS1( (i Co 44.A ' ok., ARPO's Phone#: . St-`6 U ?7 7'-7
Date: /0 - C " d 3 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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December 12,2022
The reformation displayed by this webste is prepared for the inventory of reel property found within this jurisaction and is compiled from recorded deeds,plats,and other public records and data Users of this information are hereby notified that the aforementioned public pdmay
Information sources should be consulted for verification of the n m
formatbn contained on this site.Carteret County assumes no legal responslblity for the Information contained on this site. Carteret County does not guarantee that the data and rrepservi es wll be availedelo users without
nterruption or error.Furthermore,Carteret County may modify or remove map services and access methods at wil.
I

209 Old Stanton Rd.
Beaufort, NC 28516
March 13, 2023
Heather Styron, District Manager
NC Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
Dear Manager Styron,
I spoke with Eric Price today of 189 Turnpike Rd, Newport. We are the ARPO. He told me that
he drew the enclosed map from memory, but his plans are to put the pier/dock in the same
place. We previously objected to that location because of possible navigation problems with
the dock being in the bend of the creek. Those objections still stand. The new drawings are
somewhat ambiguous. We object once more to the project as proposed.
Thank you,
Debra Stinson
Prentice Stinson
RECEIVED
MAR 13 VI
Dcm_MHC 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: G�'`t
r,
(ee- evict
Address of Property: `p ( - f 1:„,,l(C ` ei 4c.Jfie),---/ 17c e .5-7.0
Mailing Address of Owner: SK+r+e 4 460✓e
//� ii Cl�etr1'eri . ca." 7 r ' ' a a- s G Z
c[t
Owner's email: er-. OrigitenCt4 MEV Owner's Phone#:
Agent's Name: 19//'� Agent Phone#: .4
Agent's Email: ✓ X
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. X 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 RECEIVED
-OR-
I do not wish to waive the 15' setback requirement(initial the blank) MAR 1 3 202,E
DCM-"HD
Signature of Adjacent Riparian Property Owner CITY
Typed/Printed name of ARPO: fe-vvii_e. f...5A4v+SvIn
Mailing Address of ARPO: ,Zoe OOA 561,61,t Tv) , P I�v4--r ►'C� zys,',
ARPO's email: S}ivfaoh,1. (k C�r�a.I.rim ARPO's Phone#: _ W.'12 2_ o11-
Date: Si 13I20l *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

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Carteret County Parcel '.7 t
2023 Tax Parcels Contains 2022 changes ` - { z• r
OWNER: RILEX3 LLC ` �� °� °
Addresses: 189 TURNPIKE ROAD
639901166857000 •
PIN: (https://arcgisweb.carteretcountync.gov/PropertyRecor '„ <"* ,,I.-.'. a� , .' .ifpin=639901166857000) ,, sit 4•" :g , ?r y,, , t
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Deed Ref: 1780-008 9/19/2022(assets/carteret/deedhandler.ash> A,,r:,. r.r.r,. a
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Plat Ref: 34-161 (assets/carteret/deedhandler.ashx2book=348*p ,,,.�+" ,,....w..--•.% ?.a�*t
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Total Acres: 16.67 :G. "'''r� t J :�r.,
Sale Price: $0 *-. CI ,,•' z
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Land Value: $125,025 1 fit'
Structure -` 3 �{r ;
Value: $0 . e •, :�
,,, .', 4` '10.01A
Other Value: $0 i
Condo: 0
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Township: 1277 HARLOWE ,r`2 ) 1 '
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City: _ .40,.... '.� . k
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120001 HARLOWE Codes „ ? �
Neighborhood: {
(https://arcgisweb.carteretcountync.gov/PropertyRecor �' .x i
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Fire District: HARLOWE FIRE - v �� � " ••3 "'
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MILL CREEK RESCUE
District: �,
Legal Desc: TRACT 7-LOGANS LANDING HARLOWE s Y- t t 9 ' '
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,� ; ',. l
ROY COOPER - -- ( �
Governor �;�� / _I '�
ELIZABETH S.BISER " ; — -"
Secretary #�` s
BRAXTON DAVIS NORTH`CAROLINA 6111/L
Director Environmental Quality
October 31, 2023
Debra Stinson
209 Old Stanton Road
Beaufort, NC 28516
Dear Mrs. Stinson:
This letter is in response to your objections dated received by DCM on 3/13/2023 regarding your
concerns about the proposal by Eric Price to install a pier and platforms within a tributary that
connects to Core Creek at 189 Turnpike Road in Beaufort, Carteret County. The proposed
project has been determined to comply with the Rules of the Coastal Resources Commission
(7H. .1200), and as such, a permit has been issued to authorize the development. I have enclosed
a copy of the permit, the relevant statutes and third-party hearing forms.
If you wish to contest our decision to issue this permit,you may file a request for a Third-
Party Hearing.The request for a hearing will be considered by the Chairman of the Coastal
Resources Commission. The hearing request must be filed with the Director, Division of
Coastal Management, in writing and must be received within twenty (20) days after the
disputed permit decision is made. I have enclosed the applicable forms and instructions
that must be filed prior to that deadline. Please contact me at [phone], if you have
any questions, or if I can provide any additional information.
Sincerely,
a&c �uJltt:P M. rIttjAhm
Heather Styron
District Manager
CC: Richard Mahoney, Field Representative, DCM
Jonathan Howell, Regulatory Section Chief, DCM
DNorth Carolina Department of Environmental Quality I Division of Coastal Management
EQ) Morehead City Office 1400 Commerce Avenue I Morehead City,North Carolina 28557
NOR H CAROLINA
0epibnw"°'E,*onnMnd10ua� /‘° 252.515.5400

iii"4ctilir CANA,, ' 92932 A a i ) D
ii
C3.DREDGE & FILL.
4 GENERAL
PERMIT Previous permit ry ,
Date previous permit issued
N New OModification 0 Complete Reissue C Partial Reissue
As authorized by the State of North Carolina.Department of Environmental Quality and the Coastal Resources Commission in'an area of environmental concern pursuant to:
ISA NCAC 0 7/f , :, .* [Rules attached. 3 General Permit Rules available at the following link:vwvw.deq.nc,Eov/CAMArules
APpli alt Name ,�; . £`,`, ',.- Authorized Agent , N..`«,
Address € Project Location(County): ,r'
City ,a, State 2 ZIP Street Address/State Road/Lot#(s) _ r° ,,.
Phone#( : ;.) s -' - . . - -
Email_; : f;,,,' i„.,. -,. t = :-.: , ; &: ,_ :.`' Subdivision -
City ,',1/ . zip
Affected [1 CW [.EW r PTA f ES, L^�PTs Ad).Wtr.Body . , ,r'satlniaNO un
AEC(s): L OEA r IHA ____UM/ \ SPIMA I, I PWS Closest Maj.Wtr.Body
ORW:yes/no` PNA:yes/no
Type of Project/Activity _
(Scale: )
Shoreline Length - w
Access Length �'.�" , i _,i
Pier(dock)length _r i. 3-_
_ t
Fixed Platform(s) � F ; :-' : r ' r
Floating Platform(s)
f )
31 z l - f 1 t
' rt'F r'-t---r
Finger piers) ,
Total Platform area— ___� s, r ;,,.�. - .,
f
Groin len h# --- v g _ .e. t. _ . .
Bulkhead/Riprap length '
Avg distance offshore , a
Breakwater/Sill ; `
Max distance/length
i
Basin,channel v.. 1 a ! .. . ,
Cubic yards ` i._
� rLLr
r- �-—- __ T i ----1 1.---- _ .. i ; 17Beach Bulldozing _ g r r r j ; r 1 , ) I '� t r) i
Other i t:il 8 l )- v �t "T"a ��
i
SAV observed yes a � - - { -+-== I -L _ _1,.�,,, _ .__l. �;
t.
Moratorium: n/a yes na ;t `�_ }+ { _
Site Photos: yes rid d. ! +' , _ i I- . :. ( , , f , E # fL- - s .. ..S :i.
-. t
Riparian Waiver Attached: ;yes/` no ' 1 ,,. .. I a r r < _ t
A building permit/zoning permit may be required by: : -
sTMr__,- TAR{PAM/NFUSEI6UFFER(circle one)
Permit Conditions
ef; _ , <s - -. See onRiver rules
n note back regarding Basin
,.- See additional notes/conditions on back,-----
,
I AM AWARE OF STATUTES,., C
RULES
GR AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name " " . _� F Permit Officer's PRINTED Name r
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Signature**Please read compliance statement.n back of permit** '' Signature
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Application Feels) Check#/Money Order Issuing Date Expiration Date

CAMA THIRD PARTY DCM FORM 5
HEARING REQUEST FORM DCM FILE No:
PETITIONER'S NAME
COUNTY WHERE THE DEVELOPMENT IS PROPOSED
PLEASE TAKE NOTE that the undersigned, a person affected by the decision of(check one):
a Local Permit Officer acting on a CAMA Minor Development Permit application; or
the Division of Coastal Management acting on a CAMA Permit application
hereby requests permission from the Coastal Resources Commission(CRC) to file an appeal pursuant
to N.C.G.S. § 113A-121.1(b) and 15A N.C.A.C. 07J.0301. (Please attach a copy of the permit. If you
cannot obtain a copy of the permit,please provide the name of the permittee, the project location, and
the permit number.) Requests are reviewed and determined by the chairman of the CRC to determine
whether a hearing should be granted. 15A N.C.A.C. 07J .0301(b). Approval of a Third Party Hearing
Request allows a petitioner to file a contested case petition with the Office of Administrative Hearings
within twenty(20) days of receipt of the CRC's Order. N.C.G.S. § 113A-121.1(b). Denial of a Third
Party Hearing Request is a final agency decision which may be appealed to Superior Court under
N.C.G.S. § 113A-121.1(b) and Chapter 150B, Article 4.
For this application to be complete, the Petitioner must address each of the three factors listed below.
The CRC's chairman's decision to grant a hearing will be based on whether the Petitioner:
(1) Has alleged that the decision is contrary to a statute or rule [N.C.G.S. § 113A-121.1(b)(1)];
(Please cite the statute or regulation allegedly violated by the permit decision.)
(2) Is directly affected by the decision [N.C.G.S. § 1 13A-121.1(b)(2)]; and
(Please describe how you are directly affected by the permit decision. Persons directly
affected by a decision often include, but are not limited to, owners of real property in the
vicinity of the proposed development who can show that it is likely to have a significant
adverse effect on the value and enjoyment of their property, or persons who can
demonstrate a history of substantial use of public resources in the area directly affected
by the development.)
(3) Has alleged facts or made legal arguments that demonstrate that the request for the
hearing is not frivolous [N.C.G.S. § 113A-121.1(b)(3)]. (Summarize the evidence and
arguments you would present at a hearing in support of your appeal explaining why the permit
was improperly issued.)
Please answer these questions on a separate piece of paper and attach it to this form.

The Commission notes that there are some opinions of the State Bar which indicate that non-attorneys may not
represent others at quasi-judicial proceedings such as this Third Party Hearing Request before the Commission.
These opinions note that the practice of non-lawyer professionals, such as engineers, surveyors or contractors,
representing others in quasi-judicial proceedings through written argument may be considered the practice of
law. Before you proceed with this hearing request, you may wish to seek the advice of counsel before having a
non-lawyer represent your interests through preparation of this Petition.
DELIVERY OF THIS HEARING REQUEST
This request must be received by the Division of Coastal Management(DCM)within twenty(20) days
of the date of the disputed permit decision. N.C.G.S. § 113A-121.1(b). Failure to do so constitutes
waiver of the right to request a hearing. A copy of this request must also be sent to the Attorney
General's Office, Environmental Division. 15A N.C.A.C. 07J .0301(b).
Contact Information for DCM: Contact Information for Attorney General's Office:
By mail,express mail or hand delivery: By U.S. mail:
Director Environmental Division
Division of Coastal Management 9001 Mail Service Center
400 Commerce Avenue Raleigh,NC 27699-9001
Morehead City,NC 28557
By express mail:
By Fax: Environmental Division
[phone] 114 W. Edenton Street
Raleigh,NC 27603
By Email:
Check DCM website for the email By Fax:
address of the current DCM Director [phone]
www.nccoastalmanagement.net
Based on the attached responses to the above factors,the undersigned hereby requests a third party
hearing.
Signature of Petitioner or Attorney Date
Printed Name of Petitioner or Attorney Email address of Petitioner or Attorney
( )
Mailing Address Telephone number of Petitioner or Attorney
( )
City State Zip Fax number of Petitioner or Attorney
Updated: February 2011