89962A - Country Club Drive Boat Basin Association

o��`°"`� CAMA k DREDGE & FILL NU 89962 CAB C D
-'� c Previous permit
G E N E RAL 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:
q
I SA NCAC 1 W t 11 0G ❑ Rules attached. [.�Z' General Permit Rules available at the following link: wwsvdeq.nc.gwiCAMArules
Applicant Name (,M&IN Nn--�N1 QYkye � &' 15� i�itthorized Agent 1�
Address T).6\. 3i:4x a 3 Project Location (County): Cho
o uu6
City EJ`P-Yh n State NC ZIP 279 3 Z Street Address/Sate Road/Lot #(s) : +S 28 y , if, z"l
Phone #ai52) 3`i0``---SIS5, aij a /�Stti�T Yti Cew%+.,t ck,,A i�i
Email 1 a W W Q19-7-S 4.l 1 if e , Co TYI Subdivision L(CtLt6 Qrr^
city eA zip X7532-
Affected CW NEW ® PTA ® ES M PTS Ad], Wtr. Body t3ctS f % jj S�^ (nat/man nk
� AEC(s): OEA n IHA 0 UW OSPIMA � ppA , hPWS Closest Mal. War. Body YJ t ety-'P C1tw
ORW: yes/,V PNA: yes
. 1 �I�RI.M1CA px��� I L
Type of Project/Activity t00r oF-n Kjen L-.l':.Isaced ad reRnl a aJr nec-'15o1',
Floating Platform(s)
Finger pier(s)
Total Platform area
^
Groin length/#
°!
Ikhea Riprap length lc:,Or
Avg distance offshore
Breakwater/Sill
Max distance/ length
2 r
Basin, channel
Cubic yards
^
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
44
N i
(. �_ -
SAV observed: Yes r � �
Moratorium: m yes no i '--r--� - - s --- '
Site Photos: no
Riparian Waiver Attached: yes ®�_.._•..., ,,,� �_+'t� '._i_ ._. _. .___._.._�._.
A building permit/zoning permit may be required by: l.i1lOWP,u1 Cotnn, .
�— Permit Conditions ❑ TAR/PAM/NEUSEIBUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) P- W
KcrA W A.Teyus - CotAATTLy C Ate bu.13.Rom. JYs
Agent or Applicant PRINTED Name \
Signature **Please read compliance statement on back of permit**
$�(Cb. I act3`1
Application Feels) Check R/Money Order
Permit Offi er's PRINTED Name
Signature Y ' J
Issuing Date Expiration Date
i

L�CAMA ® DREDGE & FILL N° 89962 ® B C D
Previous permit
GENERAL PERMIT
Date previous permit issued
®New ❑Modification El Complete Reissue ❑Partial Reissue
As authorized by the SSt7ate of Nort�hsCarolina, Department of Environmental Qualityand the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 1 f� � 1 1yG ❑ Rules attached. �d General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
City Fc 4rAorn State NC ZIP 2-11.5Z
Phone # ('jS2) 170 3lS1
Email IL9WWq:k,tT@—H1Ve , (Orh
it*+ thorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
City F-deA+cy\ 7 ' zip 2.l Z q 3
Affected ❑ CW EW © PTA ❑)( ES © PTS Adj. Wtr. Body SCLS / N(nat/ma nk
AEC(s): ,,r�❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body _ 9 �bo—IIN , 1,P SC (e w d
ORW: yes/0 PNA: yes
` Kt��l�- (1 I��fu. P.
Type of((��G 0P Project/ Activity 1"rtJ1' �00� (,P Nffl1pty ���cztA n ck vj renal- A asr SeC ybVI
cs' III N 41 ry' MV'2r %;Ae of 11,V^0 (Scale:i""- o')
Shoreline Length it — -T
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/p
`—
Ikhea Ripraplength
la0r
Avg distance offshore
Z r
Breakwater/Sill
-�
Max distance/ length
z r
Basin, channel
Cubic yards
Boat ramp
^
Boathouse/ Boatlift
'—
Beach Bulldozing
d
Other
SAv observed: yes e
Moratorium: /a �ye�s no
Site Photos: < :i no
Riparian Waiver Attached: yes ® II
A building permit/zoning permit may be required by: CKotayP , CoL,14i
Permit Conditions
OF
Agent or Applicant PRINTED Name
\2u
Permit OffKer's PRINTED Name
eo
` kv A Lk
y
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature ••Please read compliance statement on back of permit'' Signature Y
$�rm,� 1aR31 6//i IZz I,
Application Fee(s) Check ft/Money Order Issuing Date Expiration Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
Cckkv�T" (,LkA), > 1 � toe'
I hereby certify that I own property adjacent to 1P-6o>~T -ASiwl 4,1Sna _ 's
(Name of Property Owner) ,
property located at
Z I 'z
j Pr ct Site: Address, Lot, Bloc , Road, etc.)
on �\C Wpm t-CAl , in CIALO I-b, N.C.
(Waterbody)
Agent's Name #:
Agents phone #:
(City/Town and/or County)
MailingAddress'�b Pp1G J-2a'�)
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or, attach a site rdrawing)
RECEIVED
N t A06 1 4 2023
DCM-EC
If you have objections to what is being proposed, you mustnottryme uivtston or c:oastat Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Gruen St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252)
2643901. No response is considered the same as no objection if you have been notified by Certified
(Property Owner Information)
Signature
or Type Name
Mailing Address
City/State2ip
Telephone Number/Email Address
D kTE
U
City/State ip J
lephone Number/E it A dress
N
Ate_

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
ll(4,4()
Date
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
on my property at
in
County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property Owner's Name Telephone Number
Address
V
City
State
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
—�
/2-3
Adjacent Riparian Signature
ti ' is Oro-1 k �
Print or Type Nam
Address
City
Date
C2�3a--50(0 -fd�
Telephone Number
State
Zip
Zip
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
To Whom It May Concern:
This correspondence is to.notify you as a riparian property owner that I am applying for a CAMA Minor permit to
Oil my property at
in County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property Owner's Name
Address
City
Telephone Number
State
i� I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
7jb/ZoZ3
A jac n Riparian Signature Date
Yyak) � • C061c-
ri At or Type Name
Address
City
n4-M-)135
Telephone Number
State
Zip
Zip
Revised July 2021

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

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