87248A - Blair, Weeden

3&otcourac QCAMA ❑ DREDGE & FILL Nu 87248 A B
Previous permit
GENERAL PERMIT
Date previous permit issued
Fvl'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 0 ' 1 tl, - 1 2 .J ❑ Rules attached. Ef General Permit Rules available at the followinglinkwww.d : eq nc gov/CAMArules
Applicant Name (/+.) fe e^ A Ryi Qua I fat Y'
Address 17> 1 r In C. c-_*
City it t'.i er3. C: L Statey A ZIP 'Z
Phone #(VS ) 2:3'l 1ij21.
/; ,
Email wk�>in �r�-4-t Idca Malxi C.,-, VA
Authorized Agent ,: wity .) s c^' J). .-(,
,
Project Location (County): /„ t i C f' l k- ; x
Street Address/State Road/Lot #(s) t l j, i 4
Subdivsion
City l'. Gt^¢c'>r"__ ZIP ./-.y°,i ;
Affected ❑CW HEW H`PTA ❑ES ❑PTS Adj. Wtr. Body C u.r f t A u, c E''' >t>.a ln-i I�(nat/rJp�n/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body C llrt i 14 LL c:•t.n.l
ORW: yes/fio � PNA: yesO :)
Type of Protect/ Activity t ` : < <:;A ( ,.tcA, 4 ' Y 24,cal k' 1 ((') ' s[ t t. � � t x , c� '4� i r -)' �- f x t✓1 � cZ st J
4 � � 1 nttl rcr t--� rack (5cale:l��= •��` )
Shoreline Length ., I
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 I
Moratorium: n/a
yes no
Site Photos:
yes no
Riparian Waiver Attached:
yes no
A building permit/zoning permit may be required by: I. ( T1 A It r C r9 to vx —I1
Permit Conditions r
❑ TAP/PAM/NEUSE/BUFFER (circle one)
❑ 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)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit**
Signature
Application Feels)
Check tf/Money Order Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Waterlily Sunset LLC
Mailing Address: 5124 Providence Rd
Virginia Beach, VA 23464
Phone Number: 757-237-4522
Email Address: [e-mail]
I certify that I have authorized Emanuelson and Dad
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
4' wide wrap around lower platfonn
at my property located at 1127 Waterlily Rd, Coinjock
in Currituck
County,
4' wide x 40' long pier with 10'x10' platform and
1 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:
Signature
Print or Type Name
/V'4r,ni ef/
Title
li 111 I )UJ
Date
This certification is valid through

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner Waterbly Sunset LLC
Address of Property 1127 Waterlily Rd, Coinjock NC 27923
Mailing Address of Owner 5124 Providence Rd, Virginia Beach VA 23464
Owner's email
Agent's Name. Emanuelson and Dad
Owner's Phone# [phone]
Agent's Email [e-mail]
Agent Phonell 252,261.2212
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 let er.
-r lk I DO NOT have objections to this proposal. I DO have objections to this proposal
rr you nave ooiecttons to wnat is being proposed, you must notify the N.D. Division or Coastat
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
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.) J
I DO wish to waive sometall of the 15' setback i-2,/
`•' '" °'`` "` - Signature of AdAcent Riparian q openly Owner
I do not wish to waive the 15' setback requirement (initial the blank)
qe�
Signature of Adjacent Riparian Property Owner. ,,,1A ���r1 , 11
V
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
Phone#(,?sz-aL! - -h
Date: ?I/ r%T� 'waiver is valid for up to one year from ARPO's Signature'
3
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Revised July 2021

`n''Smauelson a Dad
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Certified Mall — Return F
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1125124
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Victoria Hall
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1125 Wateraly Rd
Coinjock NC 27923
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Dear Victoria,
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We have been contracted by Waterllly Sunset LLC to do the following work at 1127 Waterlily Rd,
Comiock
1 Construct new 4' wide x 40' long pier, with 10'x10' platform on end, and 4' wide wrap around
platform
As the adjacent riparian property owner, I am required to notify you of the project in order to give you the
opportunity to comment Please review the attached sketch for additional information.
We ask that you sign the attached Waiver Form and return it to us as soon as you can. You may scan
and email, fax or simply mail If you have any questions, please do not hesitate to contact us. Should you
have any objections to the proposed work, you may contact a NC Division of Coastal Management
representative at 252-264-3901, or in writing to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909
We thank you for your co
■ Complete items 1, 2, and 3.
A. ftwtore
■ Print your name and address on the reverse
so that
X ( �11 C f ❑ Agent
�'
we can return the card to you,
Sincerely,
l --<_-- 0Addcn1.ia
■ Attach this card to the back of tho mailpiece,
or on the front if space
B. Received by lP rite Name) c. O.er m l.en C:I•
L1-� ^
permits.
(�'
1. Mrolo ACtl;ccsetl to:
0. Is tlarivery addwss d.ffvont hom i-. m l7 ❑ 11 � -
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II YES, enter deliveryaddreas below: ❑rye
yl(1L1 ICl I���II
Lorelei Barrett
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Emanuelson 3 Dad 2T„ l,�'�{�{;y b1 ICI h!-J.
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1127 Waterlily Rd, Coinjock
February 6, 2024 1.402
Addresses Parcels Waterlll Sunset LLC 0 000325 0.0065 0.013 mi
11274 Waterlily Rd i��'—"T�
--- County Boundary 1
Coin'ock, NC 27923 0 0005 001 0.02 km
Streets PIN 008000000290000

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