87053A - Hehl, Christopher

#F]New
❑CAMA ElDREDGE & FILL N9 87053 A B C DGENERAL PERMIT Previous permit
Date previous permit issued
[]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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent . r\ . _ 1 ' 1-<'.i , i
Address Project Location (County): I'
City State ZIP Street Address/State Road/Lot #(s)
Phone # O
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no., PNA: yes/no ,
Type of Project/ Activity
(Scale: ' )
cu.. He Ie., k `I - L., Ci
Access Length
Pier (dock) length
Fixed Platform(s)
::■
�:
..
EEEEEE�EEI
FA
SEE
■IE�EEMEFloating
�E0�EE�EE�
EE�E■�E:EE'
Platform(s)
EE��EEN
SESSIESE
IN
.
�.....EE....Groin
Total Platform area
SEENEEEEso
MISSION
SEEN
length/#
SE
0
Bulkhead/ Riprap lengthAvg distance offshore_
Other
a
so
E■®■�■■■:■®■■E
HEE:EEEEEEMONSOON
E0E=1
■■■■■■■■■■■■�■■■
■■■®■■;■�;■■■
IN
ME;p:
EE
EE
IImm.EE
■
�
■.�
"
■■E
ON
NONE
■�■NINE
■■MUMENMEN
■
N■
E�
Iy�
�
®
K
E�
��■■■■
EEEEE■E
SAV observed: yes no!-.
Site r Riparian Waiver Attached; yes no. 1
■■N■■■ti■■■aMoratori
■■■■
S
■■■®■■■■�1■■■■H■■■■■■■■N■■■■■■■��i■■■
�
��Ei�IN��E��E■��■■■I�■■■■■■■■■■■�
A building permit/zoning permit maybe required by:
❑ TAWPAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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) k ' I ('
Agent or Applicant PRINTED Name
Signature ""Please read compliance statement on back of permit""
Permit Officer's PRINTED Name
Signature
/
Issuing Date Expiration Date
Application Feels) Check q/Money Order

RECEIVE®
AGENT AUTHORIZATION FORK! FOR PERMIT APPLICATIONS NOV 13 2023
Name of Property Owner Applying for Permit: C.t RAS VAEHL IJCM-EC
Mailing address: t ©l Q UJrJEi!:,k&�D -r>LZ
EDEns't-oti1 N ic- z�932
Telephone Number: -15-7 2-54 SL-to4
I certify that I have authorized -ePtpu NS <,.A+ul> '0Q(ELJ2Ptr-G� (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all LAMA permits
necessary for the proposed development of Z5 ' '4 6Tri w ,
atmy property located at if)t VJWU8PA4.6n-ML- E>>- p' oQ ter✓ - lc'i 3Z
This certification is valid through 12- (date).
(Property Owner Information)
— - L-- , 4
Sign tune
anc,
Print or Type Name
DVJAJQX
Title, co. owner or trustee for property
tl-�- 2.3
Date
25 L� 8q-(A
l Telephone Number
N d . e ov
Email Address

RECEIVE®
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
NOV 1 3 2023
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent) DCM—EC
Name of Property Owner: `A/4--V-i3"T C 0'9 I S )" 1- N (_
Address of Property:
Mailing Address of
Owner's email:
i ns U'Vid bev-eh
Agent's Name:
a.
T-.
_[> Owner's Phone#
C-. V/1hJ106. Agent Phone#: Z.S?.,-306..600I
1011V9 Irtadaft ooj,
� zklZLe-Le
k�/iSYL� �r
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.
f`I DO NOT have objechons to this proposal. _______ I DO have objections to this proposal.
H 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 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909, DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only one
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, sift, 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 riorap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
100 NOT wish to waive the 15' setback requirement (initial the blank) 4PV
Signature of Adjacent Riparian Property Owner: V,
TypedlPrinted name of ARPO: 1 �tA NCn- W r n.. 0 pW
Mailing Address of ARPO: i (3 /T+/ nc✓ f �( iV 5L4t-" 1a6
ARPO's email:
ARPO's Phone#:
Date: 1 I --?— Z% *waiver is valid for up to one year from ARPO's Signature`
Revised August 2022

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
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.
The purpose of this notice is to make 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 an opportunity to consider these comments/objections before a permit decision is made.
'Permission' of adjacent property owners is not necessarily reouired for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments it they fall within a 15' setback area
along the riparian access area of the adjacent property, as determined solely by DCM. 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 permit 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 franchises.
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 -
especialiy 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: httpa,/Mrww.sosnc covlsParrhiinrex'coro. 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
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (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
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
tol wjNNEBa�o ��
E►`�)Et,rvcw NG 2n C132
i S 1 25 4 (,�5/-{-604
RECEIVED
NOV 13 2023
DCM-EC
Revised August 2022

N.C. DIVISION OF COASTAL MANAGEMENT RECEIVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY NOV 13 2023
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
2
Mailing Address of Owner: /g6a
Owner's email: 'fs� 4.wVwner's Phone#:
DCM—EC
L
tic �7`3jZ
Agent's Name:�f U 13 La t,+ "beV 0P01!)Agent Phoned�SZi
Agent's Email: c7f 1d-J • (J
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
I DO NOT have objections to this proposal. i DO have objections to this proposal.
u 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
mailcd to 401 S. Griffin St., Ste, 300, Elizabeth City, NC, 27909. DCM representatives can afso be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only one
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 norao 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
-OR-
Signature of Adjacent Riparian Property Owner
I DO NOT wish to waive the 15' setback requirement (initial the blank)d
Signature of Adjacent Riparian Property Owner: _' /
Typed/Printed name of ARPO:---
Mailing Address of ARPO: 4 ( lt%i ✓i+�� Ta— (� x-c 27g3 Z
ARPO's email: rjQ,✓i b'P kU46� ARPO's Phone#; 75767G Lf 8D Z
Date: f /Z%Q7& _'waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

�
�
_ _..,__
F
..? . i

J
tA
M
�
a
2
f
V
3
s
Una
v
1w