89059A - Collins, Michael

s °LOUT,'kNk. ❑CAMA ElDREDGE & FILL N9 89059 A s C D
Previous permit
121 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:
15A NCAC ❑ Rules attached. j •.General Permit Rules available at the following link: wwwcIeq.nc.gov/CAMArules
Applicant Name _
Address
City State ZIP
Phone#(-)
Email
Authorized Agent r•,e.;'
Project Location (County):
Street Address/State Road/Lot #(s)sA+%-
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ p-rS Adj. Wtr. Body 'I (nat man/unkl
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes(fio , PNA: yes/no
Type of Project/ Activity
Shoreline Length.
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
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: )
❑ 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
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of
Application Feels)
tit** Signature
Check #/Money Order Issuing Date Expiration Date

LEGEND
kALSEMARLE
BAY N
EX. 1° PINCH PIPE 1. THIS SURVEY IS SUBJECT D ANY FACTS THAT MAY BE
- DISCLOSED BY A FULL AND ACCURATE TITLE SEARCH
- EX. 5/8' REBAR AND EASEMENTS & RESTRICTIONS OF RECORD.
O - 1/2- REBAR SET 2. AREA BY COORDINATE COMPUTATION = 8,325 S.F.
E - SET HUB & TACK 3. F.LR.M. ZONE: AS SHOWN
O - CALCULATED POINT 4. PIN NO.: 987305 07 2759
- EX. MAG NAIL 5. RECORDED REFERENCE: M.B. 6, SL. 23; D.B. 2692, PG. 510
- MAD NAIL SET 6. MINIMUM BUILDING LINES (MBL), IF SHOWN HEREON, ARE PER THE
CURRENT LOCAL ZONING REGULATIONS. OTHER SETBACKS
- EX. DRILL HOLE AND/OR RESTRICTIONS MAY APPLY AND MUST BE VERIFIED
- EX. 1-1/2" OPEN PIPE PRIOR TO CONSTRUCTION- WATER METER 7. ELEVATIONS (NAVD 1988):
PHONE PEDESTAL LOW GROUND OBUILDING = 6.0'
C.A.T.V. HIGH GROUND O BUILDING = 7.0'
-UTILITY POLE FIRST FLOOR = 16.66'
GUY PARE UTILITY/STORAGE ROOM - 7.49'
_ FIRE HYDRANT K. B.
LOT COVERAGE N CAXISTING LOT .MM.A?A.E.C1433 S.F
F786 S?F./4,183 S.F. (1&8%)
®- ELECT. TRANS. m 10. DARE COUNTY ZONING: 'R-4'
AG - ABOVE GRADE �' I, JOHN R. WAYNE, CERTIFY THAT THIS PLAT WAS DRAWN UNDER
BUIIAAO BAY BG - BELOW GRADE (B 7 '� HY SUPERMSION FROM AN ACTUAL SURVEY MADE UNDER MY SUPERVISION
VICINITY MAP TUTS PL -PROPERTY LINE (OEEO DESCRIPTION RECORDED IN BOOK _2692- PAGE 510
THAT THE BOUNDARIES NOT SURVEYED ARE NDICAn AS DRAWN FROM
pG -WATER VALVE F,'i (DEED DESCRIPTION RECORDED IN BOOK PAGE );
LIOUIO PROPANE TANK S THAT THE RATIO OF PRECISION AS CALCULATED IS 1/10,000t; THAT PIS
p PLAT MEETS THE REOUIREMENIS OF THE STANDARDS OF PRACTICE FOR
•••p•"""'r 4r,�, jg FORECASTLE INLET i.AND $URYE11Nc IN NORTH CAP(uNA (21 NCAC `i.1600).
nvS__I I IN ._DAY C<.. JANUARY... �024..
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HARBOUR VIEW DR.

MICHAEL & JUNLI COLLINS
510 HARBOUR VIEW DRIVE
KILL DEVIL HILLS, NC 27948
`ZA
4' 10"
6'

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Michael T. Collins
2411 Rippling Brook Rd
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Frederick, MD 21701
301-788-2923
[e-mail]
Climax Construction - Lawrence Benner
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Dock that parallels bulkhead
as described by Survey Plan Document by Seaboard Surveying & Planning
510 Harbour View Dr, Kill Devil Hills, NC 27948 (Lot 75)
at my property located at
DARE
in
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:
MICHAEL COLLINS Datea202 0505 4:215:211CHAEL -0 OOLLINS
Signature
Michael Collins
Print or Type Name
Owner
Title
05 1 06 1 2024
Date
This certification is valid through
Revised Mar. 2016

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 or Property Owner. Michael Collins/Owner
Address of Property: 510 Harbour View Or, Kill Devil Hillis, NC 2794e
Meiling Address of Owner. 2411 Rippling Brook Rd, Frederick, MD 21701
Owner's email: colllnsm65Qgmeil.com Owners Phone#: [phone]
Agent's Name: _ Lawrence Benner/Climax Construction Agent Phone#'. 252-216-6005
Climax ConsbuctionllcQgmail.com
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom nortlon to be completed by the Adjacent Property Owner)
I hereby certify that 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. 6
description or drawing, with dimensions must be provided with this letter. -
_-x, I DO NOT have objections to this proposal.- 100 have objections to this proposal.
ff you have objections to what is being proposed, you must noflfy the N.C. Division Of Coastal
Management (OGM) In writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Grim St., Ste. 300, Elizabeth City, NG, 27909, DCM representatives can Also be
contacted of [phone]. No response is considered the same as no objection 11 you have been
notified by Certified Mail.
WAIVER SECTION (Choose only oriel 4
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or l
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 riorap gy%tments). (If you wish to waive the se back, you must sign
the appropriate blank below.) l7rj�t3� 1.
1 DO wish to waive somefall of the 15' setback t
ign t re djacenl Ripariad.Property Owner
-OR-
1 00 NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Jeff Walker
Mailing Address of ARPO: 508 Harbour View Dr, KIII Devil Hills, NC 27948
[e-mail] 252-489-1311
ARPO's email: _. ___ ARPO's Phone#: __
Date: _ {%S I13 e d t *waiver is valid for up to one year from ARPO's Signature*

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
I.15jvl( e, A-�K Wj,Ick ohfFIt -tII it, OSAAV_ eaJ p
on my property at `0 0rnJ7 rWj �i eW Or. x, ��!/2at�rll;,nl L Z7�tlO
in P AixCounty, which is adjacent to your property. A copy of the application and project
drawing Is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my uddress/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property Own a Telephone Number
Address City State Zip
x I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
dja en[ Ri •rian ignature
'�' I !�el-
Print or Type Name
�•�b �L�
Date
asa,Ll,29- �3 �I
Telephone Number
Address City State Zip
Revised July 2021
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
r—(74er �
City, State Zip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that 1 am applying for a CAMA Minor permit to
iASVaII A JdcK Ukit I, Olt rtIIeIs`tin,bwIVVWCc
on my property at
in 1> Pv PE County, which is adjacent to your property. A copy of the application and project
drawing Is attachedlenclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
3z--
Property 0 atne Telephone Number
Address City State Zip
have no objection to the project described in this correspondence. r-2s ptA .VV'1 ED ,� f c4-p I
--I have objection(s) to the project described in this correspondence. 04,e ,? pAT:•9 fr 7/tN n'=-*,
Adjacent Riparian Signature Date
S%�. ArilCld�n1 A �?S.7 1G� 3�3 7
Print or Type Name Telephone Number
SO NAe6au2 rjt-T�i yc grce oy(c A)mL5 ,vc 7y(ek
Address City State Zip
Revised July 2021

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