HomeMy WebLinkAbout87212A - (MOD)- Pierce, Justin and Anne#E]
JCAMA XDREDGE & FILL 1AP B C D
Previous permit
GENERAL PERMIT Date previous permit issued
1+/19jaD�N New Modificatio ❑ 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:
I SA NCAC �R R • f %0 0� 11} 1,100 ❑ Rules attached. 1XI General Permit Rules available at the following link: w w+.deq nc gov/CAMArules
Applicant Name 'I'll r f1n rt,L y LA —
Address Io11 P�n.t (Ilw� J
City 4CIJ23r-. stateyh zip Z;k In
Phone #(S 0 )—+1 J-- 54 )?
Email It-J2 trtx Z11,k 12 vn Sn v (' .n
Authorized Agent
Project Location (County): ler%rga. nir, r.
Street Address/State Road/Lot #(s) 113 Pe I t cr n n,, ^ l t 12 A c.l
Subdivision
city 1--1
Affected ❑ CW ❑ EW MilPTA ❑ ES PTS Adj. Wtr. Body Cc ,r�c� I (natunk)
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ��` S vIL f2
ORW: yes{t♦"., PNA: yese
Type of Project/ Activity WhA.. ' DX kt
6 t nt,1✓b- 0.0 Y,4\ Y/tt 1� w Zc- 51 p 1../4 'TK n,1C� Cf✓mac h, ti 1-1�, 147,10 ottj frn Iox)c os.2l (Scale 1o'r. s 1
Shoreline Length ±91
('InF\'Orm nn2 10`Xys
aucSS Qlc.l-je,lm
Access Length
20 XH'
'�V'
..-.
Ier ock) length
ixed Platfor ) 14 A10''}10Ali
I\�
�.,�tt1
✓\
n y1
rk SQ Vr,6AV_ /<`t�/'kt
_ f•
1-6 . r Plo tA.', ' 10 ' X 4' rt ucsi
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r-----Y
Finger pier(s)
ly���Idt
r'1JYltur fZ'2 14"ifr.t c\
1411,
-rf Total Platform area Ll 10 4"r}
cn
fi
�
Groin length/q
ulkhe / Riprap length � 1
��
1
�
u-
1`.7T'•'l ��`
Avg distance offshore d'
1�uycj'1..r.2 A1`c►t^^""'1
3'
0. � �0
\\
Breakwater/Sill
Max distance/length
Basin, channel
lilt)
/ I t t l
Cubic yards
It
r�
Boat ramp
L7. [ra )�w.
ESu:rP mw�rl Nwt-
Boathouse/ Boatlift
J �L
'
Beach Bulldozing
r+ te�cc
SAV observed: yes no p
Moratorium: ( yes no p[
Site Photos: es �no �
Riparian Waiver Attached: yes C.
A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
pl�c,,rKz\ isS..c� PrrM,�
Signature "Please rea compliance statement on back of permit**
4V)0 *Moab
Application Feels) Check H/Money Order
2/0/ aoa4 �%' dD� 4
Issuing Date Expiration Date
#nNew
❑CAMA ❑ DREDGE & FILL N9.87300'1 ," � �rA B C D
GENERAL 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. ❑t,' General Permit Rules available at the following link: www.deo.nc aov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State ZIP -vl
Authorized Agent
Project Location (County): {;•• n ,•, I , t
Street Address/State Road/Lot #(s) 1 'v 2 Y i r.
Subdivision I Y , Ft_
City I. 1 i-. 4 1-. 0. 14 zip v
Affected ❑ CW ❑ EW M PTA ❑ ES Q PTS Adj. Wtr. Body ��. c I (nat/mzn%unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA:yes/no
Type of Project/ Activity i,.
,'k
(Scale:& � i )
.„.,..... ....
Access Length
Pier(dock)length
Fixed Platform(s)
-
j
,.
Floating Platform(s)
Finger pier(s)
F-
._—
%i.
j -
v
J
ti..
li
t-
_
..l
a_
G
,
Total Platform area a 1 U
Groin length/#
Bulkhead/ Riprap length `"A !
Avg distance offshore •+
Breakwater/Sill
Max distance/ length a ,
Basin, channel
Cubic yards
Boat ramp_
Boathouse/ Boatlift
Beach Bulldozing
Other
i
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—
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1
-
�
-o
-v
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--
yr
—
'nz
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SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
j t
-
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—i—
j
I-----
I.
A building permit/zoning permit may be required by: I I v 2 <. ) ;.. (- l e ? •/
Permit Conditions
❑ TAR/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
41 I:
Application Feels) Check#/Money Order IssuingDi
Expiration Date
r
Y
lip 0
jo to
° Suo / �19
N.G. 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. Justin Pierce & Agne Pierce
Address of Property: 123 Pelican Pointe Elizabeth City NC 27909
Mailing Address of Owner: 191 Pine Chapel Rd Hampton VA 23666
Owner's email: Jcpierce21Qmsn.com Owner's Phone#: 530-712-5466
Agent's Name: N/A Agent Phone#: N/A
Agent's Email: N/A
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certifythat I own property adjacent to the above referenced property. The individual applying forthis
permit has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawingwith dimensions must be provided with this letter.
I DO NOT have objections to this proposal. 1 DO have objections to this proposal.
if you have objections to what is being proposed, you must ovary me N.�. urvrnrvrr ,.1....4.1a1
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 (252) 264.390f. 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
Typed/Printed name of ARPO: l D " , U'f�
Mailing Address of ARPO: 52°j r:71 !� ran. t n ch es4Adke V14 233Z 3
ARPO'semail: kaleo. o e e'pma,/�v,,,ARPO'sPhone#: 75-7— y01, 2yz�`f
Date: 13 412 202 y "waiver is valid for up to one year from ARPO's Signature
Revised July 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: Justin Pierce & Agne Pierce
Address of Property: 123 Pelican Pointe Elizabeth City, NC 27909
Mailing Address of Owner: 191 Pine Chapel Rd Hampton VA 23666
Owners email: Jcpierce2l @msn.com Owner's Phone#: 530-712-5486
Agent's Name:
N/A
Agent's Email: N/A
Agent Phone#: N/A
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 far 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. 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at (252) 2"3901. 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
M
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: "
Typed/Printed name of ARPO: Ryan nianna
Mailing Address of ARPO: 2329 Alone Dr Naples Fl 34112 united states
ARPO's email: rahnca mailrnm ARPO's Phone#: (4n4) mu-6sim
Date: 4117t24 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
J� ,C, A I c C f Ien—\
(P NeclS Ai1.poS
Renaldi, Ronald
From: Renaldi, Ronald
Sent: Friday, April 12, 2024 8:27 AM
To: Justin Pierce
Subject: RE: [External] 123 Pelican Pointe Elizabeth City, NC Bulkhead/Dock Permit
Attachments: 2022 Adjacent Riparian Owner Notice -Waiver Form with Tips -Elizabeth City_August
2022.pdf
Good morning Justin,
I can modify the permit, but you wi[In eed to renotify the adjacent riparian property owners
with the updated proposal. Once I have the new notifications, I can modify the permit. I'm
attaching the ARPO form in case you do not have one.
Ron Renaldi
District Manager, Northeastern District
North Carolina Division of Coastal Management
North Carolina Department of Environmental Quality
401 S. Griffin St., Ste 300
Elizabeth City, NC 27909
Office: (252) 621-6452
Please note that my email address is now Ronald. Renaldi'n deq.nc.gov.
Click HERE to Find the DCM Field Rep in your CAMA region.
4� - DW
6c{t.niment of EoHrottmerztai quality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Justin Pierce <jcpierce2l@msn.com>
Sent: Thursday, April 11, 2024 6:32 PM
To: Renaldi, Ronald <ronald.renaldi@deq.nc.gov>
Subject: Re: [External] 123 Pelican Pointe Elizabeth City, NC Bulkhead/Dock Permit
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Good evening, sir. We made a modification to the dock design for 123 Pelican. It is still under 400sgft and
I have attached the drawing for reference. Will we need to modify our permit for this or can we still
proceed? Thank you
From: Renaldi, Ronald <ronald.renaldi@dea.nc.¢ov>
Sent: Thursday, March 14, 202411:03:09 AM
To: Justin Pierce <icpierce2l@msn.com>
Subject: RE: [External] 123 Pelican Pointe Elizabeth City, NC Bulkhead/Dock Permit
Thank you Justin,
Your next step would be to provide the CAMA permit to your contractor building the
bulkhead so a building permit from Elizabeth City can be acquired (if required).
Ron Renaldi
District Manager, Northeastern District
North Carolina Division of Coastal Management
North Carolina Department of Environmental Quality
401 S. Griffin St., Ste 300
Elizabeth City, NC 27909
Office: (252) 621-6452
Please note that my email address is now Ronald.Renaldi(a�deg.nc. gov.
Click HEREto Find the DCM Field Rep in your CAMA region.
�--M
;
IR,XINA
Oepartm¢ni of Envlmnm¢nkdl WBiiry
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Justin Pierce <icpierce2l@msn.com>
Sent: Thursday, March 14, 202410:53 AM
To: Renaldi, Ronald <ronald.renaldl @deo.nc.eov>; Agnieszka P. <agnep2003@hotmail.com>
Subject: Re: [External] 123 Pelican Pointe Elizabeth City, NC Bulkhead/Dock Permit
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
,.�t !CAMA X DREDGE & FILL N� pi
LA%R c C)Previouspi
GENERALPERMIT MID previous Permit 1%%ued _
I New I, Modification [ (Complete Reissue '_-iPartial Reissue
AS .,ulnol ded ILr Sour al Nultb(anA.l i.I LYri ry nnrul of L nvu.... .l Quvby.v,,fl1,,Coaval Rc,omu.Cuu.urn,wl .gun arev eluvvnnrnn,lal un,cur
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Allrmd CW LW rl'. ((11
AKw CIA .NIA 1 IUW ISPIMA -.JPWS o.'em m,%vI'em, 1'-5I'_
Type of Project/ Activity y_t�r�S��hL.! ciLu.,,'_..nlaa•1.�s,x�—]h+-..-�1,.^—`. �J. +� _!— n 1L L•L r1�, it a: r �
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I AM AWARE Of STnlllT[s.(R(RULE S AND (ONO IONS THAT APPLY TO THIS PROICCT AND REVIEWED COMPLIANCE STATEMENT Irn.xn lnr apX 7
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°tto"r° *CAMA 4 DREDGE & FILL N9 87212 S)B C
ism GENERAL PERMIT Previous 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:
e
15A NCAC 1�' 11 00 �-%+• 1 a,bD ❑ Rules attached. V General Permit Rules available at the following link: www.de .nc. ov CAMArules
Applicant Name '4't V iI F1 erw
Address
City State VA zip �t316,61L.
Phone#(SMO) i1d-54lTb
Email TeherL. a%
Authorized Agent
Project Location (County): 1'a s uo'1r r.
Street Address/State Road/Lot #(s) I �k PC I• c.r. ✓t 1Pe.an Fe iLr:� d
Lf 1L la
Subdivision Pc I • F a � Pe • rs k
city CNy IF 21'3:909
Affected ❑ CW ❑ EW PTA ❑ ES PTS Adj. Wtr. Body Cr- —e- k `` ` (nat(4Vunk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA PWS Closest Maj. Wtr. Body LSY Jrl f�✓c IL YE. Vl ✓
ORW: yes/PNA: yes t�
Type of Project/Activity N8J1tf. cA nl tj^. %,ra..rti A 5js r I n.c A52 L X Ib W Vlc,,r
(Scale: N :T•S )
Shoreline Length # a 1
Access Length
Pier (d ck length
ed Plattor s)
Floating Platform(s)
Finger piers)
Ta 400-Vr
Groin length/#
ulkhea Riprap lengthy W )
Avg ate bore ar
Breakwater/Sill
Max distance/ length 5 °
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatllft
Beach Bulldozing
Other
/Jw'Y1. c , z c Arlr hu.2
Q1•r7nMMI• i.___—�
_1-- _ A
Cl
.ti
Aj`Y(1 r,hd
SAV observed: yes cs�
Moratorium: 4f7-:) yes no
Site Photos: eg> no
Riparian Waiver Attached: yes 0)
A building permit/zoning permit may be required by: I• Z-c.1].el'h C.i-Y
Permit Conditions
APPLY TO THIS PROJECT AND
Agent or Applicant PRINTED Name
Signature "*Please read compliance statement on back of permit"
Permit
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please
1111 aoay-/aI)ody
Issuing Date I Expiration Date
Application Feels)
41- 10 ,alb
rh, e, ,k q/Money Order
DREDGE & FILL No 87212 A B C D
Previous permit
GENERAL 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:
I SA NCAC i ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City State
Phone # ( )
Authorized Agent
Project Location (County): 1 �r
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (naNman/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW:yes/no PNA: yes/no
Type of Project/ Activity
(Scale: r.) i.. )
Access Length
Pier (dock) length
Fixed Plattorm(s)
II
!
—
Lo
I
Floating Platform(s) J
T
Finger pier(s)
14-1
Total Platform area
Groin length/q
Bulkhead/. Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
--
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SAV observed: yes no
Moratorium: .n/a yes no
Site Photos: no es
Y
Riparian Waiver Attached: yes no
t
,/.
7I
-I—
,
A building permit/zoning permit may be required
Permit Conditions
❑ TAR/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* *
Application Fee(s) Check #/Money Order
Signature
Issuing Date Expiration Date
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
E
(Top portion to be completed by owner or their agent) RCEIVED
Name of Property Owner: Justin Pierce t£ Agne Pierce MAR 0 0 2024
Address of Property: 123 Pelican Pointe Elizabeth City, NC 27909
Mailing Address of Owner: 191 Pine Chapel Rd Hampton VA 23666 M- E C
Owner's email: Jcpierce21(U)msn.com Owner's Phone#: 530-712-5486
Agent's Name:
Agent's Email:
NIA
NIA
Agent Phone#: N/A
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.
VI DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. utwston 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 (252) 264-3901. 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 nprap 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) 1-6-1
Signature of Adjacent Riparian Property Owner: /`-Li+tifpp�
Typed/Printed name of ARPO: K1tt'�i7Crjy �. I�otS�P.✓rorrO
Mailing Address of ARPO: N-1 6i A PL4 Ln C S :riL ✓A 23323
ARPO's email: V 9'u Ce, (ARPO's Phone#: C757) '105-Z,1gq
Date: 19 re ti 20 93 'waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT IACONER AIAEVFOR
ERTIFED MAILLRETURN EEIPTQUESTEDorHHADDEERYM RECEIVE).
(Top portion to be completed by owner or their agent) MAR 0 8 2024
Name of Property Owner: Justin Pierce & Agne Pierce
Address of Property: 123 Pelican Pointe Elizabeth City NC 27909 D �� �` "
Mailing Address of Owner: 191 Pine Chapel Rd Hampton VA 23666
Owners email: Jcpierce2l @msn.com Owner's Phone#: 530-712-W6
Agent's Name: N/A
Agent's Email: NIA
Agent Phone#: NIA
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.
2CI DO NOT have objections to this proposal. 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at (252) 264-3901. 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 15from 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 somelall of the 15' setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank) 'UL-
Signature of Adjacent Riparian Property Owner:
TypedlPrinted name of ARPO:
Mailing Address ofAddRPO: Z "1 A�,
ARPO's email: �6��t r �'Pa,,al hvl...v ARPO's Phone#:
Date: Z -2 2 -ZL�, *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
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