89042A - Croley, Charles and Kathleen

1*o(CM"r ❑CAMA ❑ DREDGE & FILL No 89042 A B C D
GENERAL PERMIT Previous permit J.
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:
1 SA NCAC n ) I-). ❑ Rules attached. ❑' General Permit Rules available at the following link: www.deq.nc.goy/CAMArules
Applicant Name
Address
City
Phone # ( )
Affected ❑CW
AEC(s): ❑ OEA
ORW: yes/no
State
❑EW ❑PTA
❑IHA ❑UW
PNA:yes/no
Type of Project/ Activity
Shoreline Length t C,<� ,
Authorized Agent
Project Location (County):
ZIP Street Address/State Road/Lot #(s)
Subdivision
City
❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
(Scale:
Access Length t Q
Pier (dock) length
Fixed Platform(s)
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Floating Platform(s)
Finger pier(s)
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Total Platform area 6L, JL
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Groinlength/ff vt
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Bulkhead/ Riprap length
Avg distance offshore
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Breakwater/Sill
Max distance/
Basin,channel
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Cubic yards
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Boat ramp
Boathous�8'oetff �» V 12_
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Beach Bulldozing
Other
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SAV observed: yes no
Moratorium: n/a yes no
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Site Photos: yes no
Riparian Waiver Attached: ; yes no
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A building permit/zoning permit may be required
Permit Conditions
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Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature**Please read compliance statement on back of permit** Signature
Application Feels) Check p/Money Order Issuing Date r Expiration Date

Name of Property Owner Requesting Permit: Charles and Kathleen Croley,
Entail Address:
143 Poteskeet
Southern Shores, NC 27949
Daniel_markes@hotmail.00m
I certify that I have authorized Affordable BiIPsAAliAiam Eger
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: Install boat lift and 414 walkway
along bulkhead,
at my property located at 143 Poteskeet Loop, Southern Shores
in Dare 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:'

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION)WAIVER FORM
QER11FtED MAIL RETURN RECEIPT REQUESTED or WgND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner; Charles and Kathleen Croley
Address of Property: 143 Poteskeet Loop, Southern Shores
Mailing Address of Owner:
Owner's email: [e-mail] Owner's Phone#:
Agent's Name: Affordable Bill'siWilliam Eger Agent Phone#: [phone]
Agent's Email: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom oortton to be completed by the Adjacent Property Owner?
I hereby certify that 1 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 nwith dimensions: must be provided with this letter
,. 0 NOT have objections to this proposal. I DO have objections to this proposal.
If you haveobjections 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
nailed 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 N you have been
noOtJed 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 iiprap revetments). (if you wish to waive the setback, you must stain
the appropriate blank below.}
I DO wish to waive somelall of the 15'setback
Signature otAd c n iparian rope Owner
1. '. .ORa
i
I do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian Property
Typed(Printed name of ARPO: Steph,
Mailing Address of ARPO. 145 Poles
A i t+
ARPO's Phone#.. W!a- ElV
'walver Is valid for up to one year from ARPO's Signature°
Revised May 2021
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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: Charles and Kathleen
Address of Property:
143 Poteskeet Loop, Southern Shores
Mailing Address of Owner:
Owner's email: Daniel—[e-mail]
Owner's Phone#:
Agent's Name: Affordable Bili'sMlilliam Eger Agent Phone#: [phone]
Agent's 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 letter.
xI DO NOT have objections to this proposal. 100 have objections to this proposal.
If you have objections to what is being proposed, you must notrry the mu. vivrsron or coasrar
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 sion
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback a ? , 4 '�
Sign tt eua rSign of Adjacent Iriparian 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: Anthony or Linda Lombardi ✓
Mailing Address of ARPO: 141 Poteskeet Loop, Southern Shores 27949
ARPO's email: G/i 1 0 r r 'p ARPO's Phone#:= ti22
1.
Date: -*waiver Is valid for up to one year from ARPO's Signature*
Revised May 2021

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