87265A - Goodling, James and Susan

dte"re CAMA Q�DREDGE & FILL W 87265 0 a C o
Previous permit
'I GENERAL PERMIT Date previous permit issued
t1Qew ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coals sources Commission In an area of environmental concern pursuant to:
I SA NCAC _.._� �• a �`/Z'�' ❑Rulesattached. ffrGenaral Pemtn Roes available at the following link: w ..dea.nc.eov/CN+Uyules
Applicant Name
% ¢/k Y' SKIS �/v i o.s ] Authorized Agent r,0.t
Address �Ltin e '`A'10 Project Location (County): _
city L) t'Cr e-n State � 3 ZIP _ b 7 � 5 9 _ Street Addresustate RotdJl.a
Phone N('7-0Y)243 -(0330 o
Email 1 i A,A OL ryltif'to 2(''�5 dr Subdivision i
�y�y"_"- City fCi Cc.o
Affected ❑CIV OO"A S� PIPTS Adj. Wtr. Body Cc.& o. (nor( ar Ne)
AEC(s): ❑OEA ❑INA ❑UW ❑SPIMA [IPWS Closest Mal. Wit. Body / AIts AC -a
ORW: yeti � PNA: yes% o
�.� J /
Type of Project/ Activity I ( t7o ce e., ' n A tki .''�"��
g.vsn 0 ll `1- /—/i' ¢� rn ! .II! r,ASLCv6 /2`1(JJ 1—_J;07 _1J` (Scale:.l.�l
Shoreline Length `� J 1) / ` t CM-5
Access Length
Pier (clock) length
Fixed Plalform(s)
Floating Pladorm(s)
Finger pier(s)
Total Platform area
GrWn lh/p
(Bulkhead prop length
Avg distance offshoreL `
Breakwaler/Sill
Max distance lenglh
Basin, channel _
Cubicyards —
Boat ramp
Boathouse/Boatlih
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a \ ` yes
Site Photos: yes no
Riparian Waiver Attached: yes (ta
�A-N k s_-
At'
C
A µ"-i A
P/wt�r s
It irel
A building permit/zoning permit may be required by:�Y
Permit Conditions
tCAnp I
Ixs^�i�>rt zeal I d
[Y'Sed•,n.
Px-
❑ TAR/PAMINEUSEIBUFFER (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 lnitialR�—.L-P
r _ _� �I
Agent or A/1yp Rant PRINT Name Permit
Officer's PRINTED Name
V'__ �/b!i"t/ � Alt • ...� C.ac...-c•....__
Signature*'Please ad compliance star menl on back of permit" Sig ure
Application Feels) Check R/Money Order Issuing Date Expiration Date

0ta"r"'CAMA C)KDREDGE & FILL N° 87265 ( B C D
Previous permit
GENERAL PERMIT Date previous permit issued
t4ew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal sources Commission in an area of environmental concern pursuant to:
15A NCAC � ,0, / / - b -t- / Z-W � ❑ Rules attached. Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name J .-y ry" SAS a-/v (�;.—<1 ) Authorized Agent Q � -
Address I M uo `' L oe� ,�t Project Location (County): az /
City G t.C(�Q-/c State zip g a59 Street Address/State Road/Lot#(s)
Phone # (-) 9 (0 3" �n.� 3 a )) D o ��11 1
Email 1 nit, D ,n�-rw ('a d. sx,ir Subdivision /, rT m dS 4i G.!I
City r-risca U zip <0
Affected ❑CW N6EW �m OB �P75 Adj. Wtr. Body. CGn O_ (nat/ an nk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body e 0-M /f C.e+ S u A tli
ORW: yee6o­PNA: yes/4!�5
Type of Project/ Activity L
�r
Shoreline Length 7
Access Length —'
Pier (dock) length
Fixed Platform(s) gg�/ 2-
/ o vS¢� G oG• ro?r• X 1,3 '
Floating Platform(s)
Finger pier(s)
Total Platform area
reins h/q
Bulkhead prap length 1 3 '
Avg distance offshore Z.r
Breakwater/Sill
Max distance length r�
Basin, channel _
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Ii /Or Kam.�0 CR MCnT V7Aft A&L /XAt AtI to, I'� ���J
' e. win dI
G�n�z7 (fyoaf r
SAV observed: yes no
Moratorium: n/a yes �
Site Photos: yes In PL
Riparian Waiver Attached: yes /-�
A building permit/zoning permit may be required by:
Permit Conditions
THAT APPLY
Agent or Applicant PRINTED Name
Signature -*Please read compliance statement on back of permit"
Kb o 7 o `(5
Application Feels) Check H/Money Order
V__ I s r (scale: N,S )
Awy"pleri is
cl�s� bo
rw, LjM�
OJ CK
Beni
t�4-ti�rsud I
L
❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please
Permit Officer's PRINTED Name
t/
Sig l ell 2 / Y
Z !? 2
Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Manaeement Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bartle, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pander Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

❑CAMA ❑ DREDGE & FILL Nn 87265 A B C D
a� 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 ❑ Rules attached. -General Permit Rules available at the following link: www.deq.nc goy/CAMArules
Applicant Name _
Address
City
Phone # I—)
ZIP
Authorized Agent I-
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
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: /� )
Access Length
Pier (dock) length—
Fixed Platforms)
_
I
L
(
f
—}
Floating Platforms)
-
--L
_
)._¢
_
�
Finger pler(s)
r
Total Platform area
� -
"�
-
-
�L.
�.�
�
---
--•�
!
C
Groin length/q
I
�
---
Bulkhead/ Riprap length
—
i
—
—
-
t-
�--
,
:
-�--
--
-
t—
--
Avg distanceoffshore
�
rt
�
i
�
�,
t
�
i-�.
�
i
F�
?-
�
` .,
��
Breakwater/Sill
j
`
�
112-
j-
—I—
,�
}�
Maxdistance/length
i
_
Basin, channel
Cubic yards—
✓
f
Boat ramp
v:.�.
Boathouse/ BoatliR
Bulldozing_
Beach Bulldozing
other
X"�>+
1
-
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no-
RinarianWaiverAttached: ves no
A building permit/zoning permit may be required by: _t,-''•! ':v.n `I-- "�
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AN D REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature **Please read compliant
Application Fee(s)
Permit Officer's PRINTED Name
statement on back of permit** Signature
Check it/Money Order Issuing Date
Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bartle, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

CANAL
PROPOSED 16' X 12, DOCK
WITH 2.6T LOWER PLATFORM
PROPOSED
BULKHEAD r 21
TY WIZ CAP
EXt GBULKHE40 AVIEMBNWRANI
XLLS
Al BE REMOVED n
R'
I pNpZ / OF-'
EXISTING RESIDENCE
10104 KINGS PGINT DR.
APO APO:
CARTWRIGHT
CONLEY
KINGS POINT DRIVE
CAMA PLAN FOR
JAMES P. GOODLING
50Jst�KINGS POINT DR., FRISCO, NC, 27936
50 c DATE: 02/22/2024
30 15 0 30 60 90 120

I
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t

AGENT AUTHORIZATION FORM FOR CAMA PERMIT APPLICATION
Name of Property Owner Applying for Permit:
James P. Goodling
Mailing Address:
f 11 Mt. Horeb Rd.
Warren, NJ, 07059
Telephone Number:
certify that I have authorized Gary Price agent to act on my behalf,
for the purpose of applying and obtaining a CAMA Permit necessary for
construction a new bulkhead and dock with step-down platform.
My property is located at, 50104 Kings Point Dr, Frisco, NC, 27936
I further certify that I am authorized to grant permission to the Division of Coastal
Management staff, the Local Permit Officer anf their agents to enter upon the
aforementioned lands in connection with evaluating information related to this
permit application.
This certification is valid through 06/30/24
(Property Owner Information)
Print or Type Name
,;7fa�a-
Dat
/' .S- &e
Telephone Number
� A1n,4k en eR. eq �v�Ts_ GSM

UNITEDSTATES
POSTAL SERVICE
March 25, 2024
Dear Gary Price:
The following is in response to your request for proof of delivery on your item with the tracking number:
9589 0710 5270 1173 3300 52,
Item Details
Status:
Delivered, Individual Picked Up at Post Office
Status Date / Time:
March 14, 2024, 3:52 pm
Location:
FRISCO, NC 27936
Postal Product:
First -Class Mail
Extra Services:
Certified MailT^"
Return Receipt Electronic
Shipment Details
Weight:
=A
Signature of Recipient:
PO BOX 579
Address of Recipient: •___.-__ ••-
Note: Scanned image may reflect a different destination address due to Intended Recipient's delivery instructions on file.
Thank you for selecting the United States Postal Service' for your mailing needs. If you require additional
assistance, please contact your local Post Office TM or a Postal representative at 1-800-222-1811.
Sincerely,
United States Postal Service'
475 L'Enfant Plaza SW
Washington, D.C. 20260-0004
J

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uxeTEOSTATEs_..._____._.._
P�OSTlSL SERVKE
March 25, 2024
Dear Gary Price:
The following is in response to your request for proof of delivery on your item with the tracking number:
9589 0710 5270 1173 3300 76.
Item Details
Status:
Status Date / Time:
Location:
Postal Product:
Extra Services:
Shipment Details
Weight:
Recipient Signature
Delivered, Left with Individual
March 21, 2024, 12:58 pm
LEXINGTON, NC 27292
First -Class Mail`
Certified MailT11
Return Receipt Electronic
1.0oz
U1 Ci
Signature of Recipient: %-1
177113�WATERFORD POINTEI
RD, LEXINGTON, N027292
Address of Recipient:
Note: Scanned image may reflect a different destination address due to Intended Recipient's delivery instructions on file.
Thank you for selecting the United States Postal Service"' for your mailing needs. If you require additional
assistance, please contact your local Post OfficeTM or a Postal representative at 1-800-222-1811.
Sincerely,
United States Postal Service
475 L'Enfant Plaza SW
Washington, D.C. 20260-0004

.. . .. I' -t . I Z'i
Aq�
Xd-.-

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: TO 11---s F' 6crrdjr`ta
Address of Property: 5-01YO kwLf�S 1^'t si Dr1, rmrrsev T27g34
Mailing Address of Owner: 111 A4 00: C 6 PA V-lt,(-revtl- 14D 7!eV
Owner's email:
Owner's Phone#:
Agent's Name: 6;gA h Price- Agent Phone#: 2$2. 305, &319
Agent'sEmail: CoM
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Pfoperty Owner)
I here certify that I own property adjacent to the above referenced properly. The individual a ying for this
permit he escribed to me, as shown on the attached drawing, the development the a proposing. A
I DO NO�ave objections to this proposal. I DO have obIOons to this proposal.
If you have ob/actions what is being proposed, you must n the N.u. urwsron or cwasrar
Management (DCM) it wri,. within 10 days of receipt of must
otice. Correspondence should be
mailed to 401 S. Griffin St..'A 300, Elizabeth City, NC, 2 9. DCM representatives can also be
contacted at [phone]. No re onse Is considers a same as no objection If you have been
notified by Certified Mail.
WArWR SECTION
I understand that any proposed pier, dock, ring ' inga' boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum dista of 15' from area of riparian access unless waived by me
(this does not apply to bulkheads or ' ap revetments). (I u wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somelatf of the 15' setback
Signature of Adjacent Riparian
rem
I do nosh to waive the 15' setback requirement (initial the blank)
nature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
"'f Mailing Address of ARPO:
—'1 ARPO's email:
-� Date:
ARPO's Phone#:
`waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

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Carver, Yvonne
From:
Carver, Yvonne
Sent:
Thursday, April 18, 2024 12:34 PM
To:
Gary Price
Cc:
[e-mail]; [e-mail]
Subject:
GP87265, Receipt, Conley letter
Attachments:
GOODLING GP87265-04172024090451.pdf; GOODLING RECEIPT.pdf, CONLEY
RESPONSE LTR, REF GOODLING GP87265.pdf
Good afternoon Gary,
A copy of general permit (GP) number 87265 authorizing the Goodling's development
project at 50104 Kings Point Dr., Frisco, is attached for your review. The pdf attachment
also contains a copy of Goodling's receipt for the permit fees. I have also included a copy
of the letter responding to Mr. Conley's objections to the proposed bulkhead for each of
you to have.
To validate this permit, please address the following:
1. print and sign the permit on the bottom left-hand corner below your printed name,
2. initial where indicated on the bottom right of the permit, and
3. scan and send a signed copy of the GP back to me.
I have also included Dave Swanner on this email to let him know the permit has been
issued so that he can add this to his schedule.
If you have any questions regarding this correspondence, please don't hesitate to contact
me.
Thankyou.
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-621-6453
401 S. Griffin St., Suite 300
Elizabeth City, NC 27909
1

ROY COOPER
Governor
ELIZABETH S. BISER
Secretory
TANCRED MILLER
Director
NORTH CAROLINA
Environmental Quality
April 17, 2024
Mr. David T. Conley
P.O. Box 1204
Buxton, NC 27920
Also sent via email: drd@[e-mail]
Re: Objection to the Issuance of CAMA General Permit No. 87265A for a Development
Project at 50104 Kings Point Dr., Frisco, Dare County
Dear Mr. Conley:
This letter is in response to your objection as an adjacent riparian property owner to a
permit request from James and Susan Goodling for the bulkhead project proposed at
50104 Kings Point Drive in Frisco, Dare County, Yvonne Carver, Field Representative
the Division of Coastal Management (DCM) staff, was recently on site to evaluate the
permit applicant's request.
The permit applicants have requested a permit to install a replacement vinyl bulkhead
two feet waterward of the f29-year-old wooden bulkhead in the adjacent canal, as well
as a dock with lower platform. Under the Coastal Area Management Act (CAMA), the
Coastal Resources Commission (CRC) has established Rules for General Permits for this
type of development that are found in 15A NCAC 07H.1100 and 07H.1200 (copy
attached).
You have notified the Division of Coastal Management of your objections to this
proposed development by written correspondence related to the adjacent riparian
property owner notification form. This also confirms a phone conversation with Mrs.
Carver on April 12, 2024, regarding the replacement bulkhead and your preference to
the owners' new bulkhead remaining in the current alignment. The Division has
reviewed your objections, along with all aspects of this development proposal for
consistency with the aforementioned Rules, which describe the CRC's standards and
guidelines for this type of development. Our review of the proposed development has
found it to be consistent with these Rules.
North Carolina Department of Environmental Quafty I Division of Coastal Management
Elizabeth City Office 1 401 South Griffin Street. Suite 300 1 Elizabeth City, North Carolina 27909
252264.3901

Mr. David T. Conley
April 17, 2024
Page 2
After having given careful consideration to your objections to this proposed
development, we have determined that it is consistent with the Rules of the CRC and
the State's Coastal Management Program, and that all pre -requisites have been
satisfied. Therefore, the Division of Coastal Management issued General Permit No.
87265A (copy attached) for the proposed development.
If you wish to appeal this permit decision, you must file a Third Party Hearing Request
Form with the Director of the Division of Coastal Management within 20 days of the
permit issuance date. If you choose to pursue an appeal, please contact this office so
that we can provide you with the appropriate forms and addresses. However, these
forms can also be found at the following website:
https://www.deq.nc,g v/about/divisions/coasta I-management/coastai-ma nagement-
permits/variances-a ppea lsls
If you have any further questions regarding this matter, please do not hesitate to contact
Mrs. Carver or me at our Elizabeth City office.
Sincere
Ron Renaldi
District Manager, Northeastern District
Division of Coastal Management
RR/yc
Enclosures
cc: Yvonne B. Carver, Environmental Specialist II; yvonne.carver0deq.nc.gov
Gary Price, Consultant; hatterassuif(@vahoo.com
Jim Goodling, Applicant; jimCc�amarcoproducts.com

N.C. DIVISION OF COASTAL MANAGEMENT g
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FQEC E d y, f E D
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent) APR - 1 2024
Name of Property Owner:
t'
r"ek"di"D
---DCM-
EC
Address of Property:
5G/10 Kw±5S
7>eA-r Di'.
1'y-!St"' f0c, 27 j 3f•
Mailing Address of Owner: HI 041. 14OCe h IP--L ✓`1� Srehi zQ Z 02eS7
Owner's email:
Owner's Phone#:
Agent's Name: Ce rrh P ii-rZ- Agent Phone#:
Agent's Email: h4Cc w55:c= F�Yi•kci> Go.M19
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner) X,
I here certify that I own property adjacent to the above referenced properly. The individual applying for this
permit ha described to me, as shown on the attached drawing, the development they , -
I
If you have objections what is being proposed, you' must n y the N.C. Division of Coastal
Management (DCM) in wrib within 10 days of receipt of th' otice. Correspondence should be
mailed to 401 S. Griffin St., S 300, Elizabeth City, NC, 2 9. DCM representatives can also be
contacted at [phone]. No re Ronse is considere a same as no objection if you have been
notified by Certified Mail.
WATVRA SECTION
I understand that any proposed pier, dock, m ring ' ings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distan of 15' from area of riparian access unless waived by me
(this does not apply to bulkheads or rap revetments). (I u wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somejaft of the 15' setback
Signature of Adjacent Riparian Prop Owner
-OR-
I do no ish to waive the 15' setback requirement (initial the blank)
ignature of Adjacent Riparian Property Owner: L /
-f G
�j Typed/Printed name of ARPO: P' i I V l
Mailing Address of ARPO: I /-7 I F c) t rJTC 2/ D
-9 ARPO's email: (Jr,-f0_vP�_?y,WO's Phone#:
- v Date: Z� _*waiver is valid for up to one year from ARPO's Signature*
Revised Many 2-021

RECEIVED
APR - 1 2024
ern A _Gr,

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to
2,.
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50140 KINGS POINT DR., FRISCO, NC, 27936
DATE: 02/22/2024
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