87248A - Weeden Blair Mgr (MOD #2)

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dA,"`°°t" ❑CAMA ❑ DREDGE & FILL 472.4° A B C D
Previous permit
GENERAL PERMIT Date previous permit issued
❑New ©Modification ❑ Complete Reissue ❑ Partial Reissue ModlRedO511712O24 W31154reAmV
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:w ,ceo.nceov/CAMArules
Applicant Name t'
Address
City State r ZIP
Phone#(i_)_
Email
Authorized Agent '
Project Location (County): _
Street Address/Sum Road/Lot
Suhdiv skm
City 1ZIP
Affected ❑CW a!W ❑ PTA ❑ ES ❑ Pis Adj. Wtc Body I I I (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PINS Closest Mal. War. Body
ORW: yes/no PNA:yes/no
Type of Proje0l' Activity
(Scale: l)
cFn.nli no 1 noon. 1
Access length
Pier (dock) length
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Fixed Platform(s)
Floating Platform(s)�
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PROP.
A
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-
-
Finger pier(s)
In
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Total Platform area 180 }
Groin length/g
i
f.
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'
--
—
Bulkhead/ RipraP length
-.
2 ((„
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Avg distance offshore
Breakwater/Sill
r
S?
Max distance/ length T—
t
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(_
Basin, channel 1
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-
Cubic Yards '
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L...
_
-
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_
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Boat ramp
ow
Boathouse/BoatliR�
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LP
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Beach Bulldozing
T-
Other /
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f
,
SAV observed: yes no
Moratorium: n/a Yes no
Site Photos: yes no
—
-
Rinanan Waiver Attached: yes no
A building permithoning permit maybe required by: 0 1 r r ) I ( s A
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note an back regarding River Basin rules
❑ See additional notes/conditions on back
AM AWARE OF STATUTES, CRC RULES AND CONDITIONSTHAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please lnitiall
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit••
Signature
Application Feels)
Check If/Money Order
Issuing Dale Expiration Date
Modified 0511712024 lI.4ftrrc/rslC

EfCAMA ❑ DREDGE & FILL NQ 87248 ��— n a J
All
GENERAL Previous permit RA
ERAL PERMIT
3 Date previous permit issued
❑F'New [+Modification []Complete Reissue ❑Partial Reissue Mlcd��� S�yI z-4
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
Applicant Name
Address
City State
Phone #
Email t/J
❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArulec
Authorized Agent I
Project Location (County): , +-
Street Address/State Road/Lot #(s)
Subdivision
City, (.', nil. Ir... ZIP
Affected ❑ CW ❑ EW DATA ❑ ES ❑ PTS Adj. Wtr. Body (' r: (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORIN: yes/rio,.'- PNA: yes/no
Type of Project/ Activity f-
Fnlnc;('t rJ rJ"c I2` X�t' cP.(CA)6&f-1. (Scale: j
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Access Len h ... -..,
e ,
1
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1I 4 U
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i—
it
i
Fixed Plakorm(s) 1
Fined Platform s) Il:/X. 1 UCD
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4 V 2 0
_
_
f
Floating Platform(s)
(
—_
Finger pier(s)
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_
_ i ;_.
_
d
r'
-..
_.
...
i
Total Platform area rrS D
Groin length/p !
r
—
Bulkhead/ Riprap length
7_-
Avg distance offshore
--
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-
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- -
!
-
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--
-
f
IL
_-
Breakwater/Silly-
Maxdistance/length
Li.
Basin, channel
1
...y
Cubic yards
t
44
—
Boat ramp
Boathouse/ Boatlik�_
r
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i2 r�
_
5
J
Beach Bulldozing
_
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l
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Other El. tt/ + l
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7—__
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SAV observed:
t
i
Moratorium: n/a yes no
i'r
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t
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_
I
J
Site Photos: yes no
Rioarian Waiver Attached: yes no
A building permit/zoning permit may be required by: C. yC Z td �
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
Signature "Please read compliance statement on back of permit's
Application Feels) Check #/Money Order
Permit Officer's PRINTED Name
Signature
Issuing Date Expiration Date
4A&44tch g1912-4'w4oelf-

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 I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 4• widex 40' long pierw4h to'xta platform and
4' wide wrap around lower platform
at my property located at 1127 Waterlily Rd, Coinjock ,
in Currituck County,
I furthermore certify that 1 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:
14-jyti„ &'�
Signature
Weediell �CarT
Print or Type Name
I't IauJ3
Date
This certification is valid through

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 Waterhly Sunset LLC
Address of Property 1127 Waterl)iy Rd, Coinjock NC 27923
Mailing Address of Owner 5124 Providence Rd, Virginia Beach VA 23464
Owner's email "1` imugv li` Owner's Phone# [phone]
Agent's Name. Emenuelson and Dad Agent Phone# 252,261.2212
Agents Email [e-mail]
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.
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, it 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.)
I DO wish to waive somelall of the 15' setback
'- •"`"' Signature of /cent Riparian ropertyOwner (�
-OR- CalO
I do not wish to waive the 15' setback requirement (initial the blank) •�Q� V' \J
1e
Signature of Adjacent Riparian Property Owner:
i
Typed/Printed name of ARPO: ,
Mailing Address of ARPO: it / 3. _(�,t"1�,m �!( d,!lk ! r/C
a\-�1 �ry�Cgay%,��Z3
ARPO's email: J r��/Jp%rr RPO's P4honeH(
Date: r? 'waiver is valid for up to one year from ARPO's Signature'
Revised July 2021
V

' Emanuelson a Dad
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Certified Mall — Return F
0
1/25/24
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Victoria Hall -00
1125 Waterllly Rd
Coinjock NC 27923
a
ry
Dear Victoria,
njo;v, NC
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at rl;...S4.40_ _ ns`,Y
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$0.68
p7MOrae.. j (12/06/2024
PJ .
We have been contracted by Waterllly Sunset LLC to do the following work at 1127 Waterill_yr 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 cc
IN Complete Items 1, 2, and 3.
■ Print your name and address on the reverse
Sincerely, so that we can return the card to you.
■ Attach this card to the back of tha mailpiece,
A sig9ture
R r' �. ❑ Agent
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or on the front if space permits.
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D. Is C.':r,. ryaddress dalorant form item f 7 ❑ 1ks
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If YES, entu delivery address bolow: El NJ
Lorelei Barrett f�
Emanuelson 3 Dad �� t_, 1'U✓t,�E:Y L1 �� pet .
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PS Form 3811. July 2020 pStJ 7s9oD;FWogOS!-"
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uomeslb Return Roc. ipt
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1127 Waterlily Rd, Coinjock
February 6, 2024 1:402
Addresses ❑ Parcels Waterlily Sunset LLC o 000325 0.0065 oola mi
11274 Watedily Rd o 0005 o01 0,02 km
••••• County Boundary Coinjock, INC 27923
Streets PIN 008000000290000

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