87202A - Kline, Martin

0comrw&[ICAMA ❑ DREDGE & FILL No 87202 _'A B C D
Previous permit
3 GENERAL PERMIT Date previous permit issued
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❑v New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Co tal Resources Commission in an area of environmental concern pursuant to:
2
I SA NCAC 0-7 14 • I { 0 D t Ui A 1 .0 0 1-1ttache Rules ad. General Permit Rules available at the following link: www.deq.nc.Roy/CAMAruIa;
Applicant Name I' l Q. t t 1 V! V_t t o P,
Address 14 5 t'1 I-A,I r ('yT.4 Lnka Lct x\ e
City %r3iP<\ A I� 1'1 state \// _ZIP
Phone # n `) '11 C, 1> •- I 1 Gi (J
Email 0) A C, I1\ r-' � �n1 r hV1c lt-�
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Affected ❑CW dEW `dPTA M' ES dPTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
ORW: ye9t! i PNA(yeiJno
Type of Project/ Activity
Authorized Agent T) Y, '!?t k za. A
Project Location (County): I re —
Street Address/State Road/Lot #(s) 10 9 e-'� I ) r� t t ) C>n cT
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Subdivision `ri V 1 c: 41 1 I Gt - 1 1 `( 1 L G.. 1 Z."i 206 - Z OZ
city -.(_rv, c,aVAo<e-.'", ZIP 219A-'_Q
Adj. Wtr. Body
Closest Maj. Wtr. Body
(Scale:) = 4U )
Access Length
Pier (dock) length
Fixed Platform(s) Y-
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Floating Platform(s)
Finger pier(s)
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Total Platform area 74,E4
Groin length/#
Avg distance offshore
Max distance/,length
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Permit Conditions
Agent or Applicant PRINTED Name
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❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AND REVIEWED COMPLIANCE STATEMENT. (Please Initial(
Permit Officer's PRINTED Name
Signature "•Please read compliance statement on
Application Feels)
of permit" Signature
Check #/Money Order Issuing Date Expiration Date

Do ftn Enwbpe lD'7761345F-AF6848OC-A62M5764B4123B1
Name of Property owner Reques" Permit: Mara-, n M +(fie
Mailing Address: %A51'i �l+cKolu LAkec� \ e se 170
Phwe Number: i �103 Gr.a.vl4st n j -b wur-4kj,
a_ddk'es5,
Email Address:
l c srnty tfW i have authorized �liulK�t12ad5
AgsMICOnVRCW
to act on my bqW, fw the purpose of ap*ft for and obtaining all CAMA perms its
necessary for the Mlowing Proposed deveioprwt: New gN11�tnRao� i
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Proparty Owner Nlfarmidow
oecr. W—' +�
�M Aa RAI 1 UVLI.
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Martin Kline
Print or Tyw Mww
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1/1 /2024 1
This oertlHcatl is vaBd through

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. t "uc '} Iyn � i .n e,
erty: � �nn`t J Address of PropbU ,JW o0rJ _Vy(xt
2
Malting Address of Owner:
Owner's email:MC M\%4NC yCtiq CCU •L&y"bwnefs Phone* 8 C S6 ' 11
Agent's Name.l \r CWdDA MiiCh L i Agent Phone*: a54 a rJi �
Agent's Email: ��lV QS Y <�1c� 7qs q ( { 1 CO"-)
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 tot this
permit has described to me, as shown on the attached drawing, the development they are proposing. Q
100 NOT have objections to this proposal. 1 DO have objections to this proposal.
tf you have objections to what is being proposed, you must now the mu. umsron or &-uffoual
Management (DCM) In writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. QrWn St., Ste. 300, Elizabeth Chy, NC, 27909. t)CM represantatives can also be
contacted at [phone]. No response is considered the same as no objection Ifyou have been
notified by CErtiffed Mail.
WAIVER SECTION (Choose only an
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, litt, or
groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
{this does not app v to bulkheads or rlaraoXevetments). (it you wish to waive the setback you St n
the appropriate blank below.)
100 wish t0 waive somelall of the 15' setback Signature of Adjacent Mpadan Property Owner
-OR-
DO NOT wish to waive the 15' setback requirement (Initial the blank) R . G C ck � ( IaI,AA' e-, l
signature of Adjacent Riparian Property Owner.
TypedlPrinted name of ARPO:
&&.Fling Address of ARPO:
N.
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ARPOs email: ALL, oh %JNq ARPO's Phonall!
®ete: eC . a a9 waiver Is valid for up to one year ttnrn ARPO's Signature" Y
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