89067A - Allen, Otto and Karen

❑CAMA ❑ DREDGE & FILL Na 89067 +AB C D
It Previous permit
GENERAL PERMIT s 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. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _ Authorized Aoent
Address
City
Phone
Email
State ZIP
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑ OEA ❑ IHA ❑ UW
ORW: yes/no, PNA: yes/ho
Type of Project/ Activity
Project Location (County): I
Street Address/State Road/Lot #(s)
City ZIP
❑ ES ❑ PTS Adj. Wtr. Body (pat/
❑SPIMA ❑PWS Closest Mal. Wtr. Body
I
i
Access Length
i
i
r
Pier dock length
Fixed Platform(s)�
I
=-
-
'
Sri♦
I
I
I
i
-
--
j
L
�-
Floating Platform(s)
Finger pier(s)
Total Platform area
L
'
-i
�
i
f
Groin length/t!
�
-1
—
Bulkhead/ Riprap length
-
Avg distance offshore-
Breakwater/Sill
---
-
{:
I
Max distance/ length
�
Basin, channel
T
_
_
J�
Cubic yards
Boat ramp
Boathouse/Boatlik
Beach Bulldozing
71
Other
�L
tl
SAV observed: yes no
'
s j�
1
Moratorium: n/a J yes no
Site Photos: .yes no
-
'
r^
t'
J
Riparian Waiver Attached: ves no
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
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
Application Fee(s) Check q/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT IBM 14 U4
ADJACENT RIPARIAN PROPERTY OWNER NOTIf ICA1I0NtWAiVFR FORM
CHRTIFJ,�( MAIL.. RF,,TURN RF.4Etf'i.. .0 .11.4 5i (,D w I!AND DIE 1 1v�:.I{'! /''`+
(Tap pt1 ittn to be completed by owner ortheir �<jrni} DC
Addfe€s at Peiipeity }h i 1" �(y"vkfG A
tiahog Addles ei Oivco� _j'+ Pi l't•ty' Way C:pV rf t�eiy,f�a Z'tg3°}
15"i ?Yi n3#
Ut-xst v red _. Qwnor g Phape7r
12,9
Adantc
i 1�'t' ii«t 4 1i1s,ijtvt.+i I r nlVt
A.°k:iiit
AWAOENT RIPARIAN PROPERTY tOWAN�ERn npRr TIFICAT0014 :.
g l rki } lee.e
nsra
p ,on has do IhMcon l ouv property adjacent b the above raferenced properly. Tho r" 111 uat a b n " q
gernNl has deacrttwo m me, as shown an the atiactiad drawing, the dnvelopmert tncy are p.aygs,=v,1 $
_m-
ust ba rovided with yris ettor. -
d 5C ` Onn of d ew�wi1h dhienslons
100 NOT have objections to this proposal. I DO have objections to this proposal,
tf. you have ob/ecttons to what !s being proposed, -you must nofri tho N.C. Devls10 of Coastal
ence should be
Management (DCM) in writing within 10 days of receipt o� 809.this IoDCM representatives calf also 15e
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC,
contacted at (252) 2644901. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
t 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 s en
phis does not apply to bulkheads or ripap revetments). (if You wish to waive the setback,y � !9...
the appropriate blank below.)
Yb0 wish to waive somelall of the 15' setback
Signatum of Ad%agent Riparian property
.OR_
I do not wish to waive the 15` setback requirement (initial the blank) t o . ---
Signature of Adjacent Riparian Property owner:
TypedlPrinted name of ARPO: L.L` C. I
Mailing Address of ARPO _ 1 " /S' L-�)NCn 7'?
ARPO's emal1: ref k n rat rF1�y'C itz± CcssARPO's Phone is -2._J,�... 3
To( t04,18'a
ARPO's Signature"
Date[ �jZ' _ _ t,_`waiver is valid for up to One year from .,., s

RECEIVED
JON 0 62024
N.C. DIVISION OF COASTAL MANAGEMENT [)CM—Ec
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM ��,,// 11 vV ,•
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: O'rin ci (ire,' A- IC
Address of Property: 15P. -, ReCALCA HL
Mailing Address of Owner: R9 ( -rkAS Cfe a,k P-d HO UOCI QL
Owner'semail: Ksa lie. kt(4uahco,e ern Owners Phone#: '4S'a-6d0`rk-11•-i
Agent's Name: Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed by the Adiacent Property Owner)
I hereby certify that I own property adjacentto 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 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 representativescan 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 somelall 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 Signature of Adjacent Riparian Property Owner; ti1 I C A J
Typed/Printed name of ARPO: �frs✓Jfilrf_. f=� °r'_ _
Mailing Address of ARPO: Ai 'fit OC CC VV I& id A A)!
ARPO's email: C2i ARPO's Phone#:.,} r5 r _ `l `. IS
Date: " {' *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

RECEIVED
■ complete items 1, 2, and 3.
❑ A■
Print your name and address on the reverse
so that we can return the card to you.
d Name)Dteof■
Attach this card to the back of the mailpiece,or
on the front if space permits.ry
Itew.em 17
addressItem
if ❑ No
ChC1ri�s tZogt"�
nlive
L 0n9bL00eh b F
1 S 5;
`� 4
3. Service Type
gPrI itYMeil sail
�I�'IfIII I�IIIIIIIIINI�IIIIIIIIII I�I�I IIII111
❑Adult signature
❑Atlutt Signature Restdctetl gallery
❑ Registered Meii
ofteegglstared Mail
9590 9402 8743 3310 0875 65
Cl Derailed Mellor
❑ Certified Mat Restdated Delivery
Da1Nery
q Signature Coat
❑ Collect on Delivery
❑ Collect on Delivery Resttleted Delivery
q Signature Con
Restricted Del
nr„mtwr R?a/ISfEI /tom SeNlce label
4 ?
n Insured Mail
' -`= - 1 11 3}1Qk�&W 9789
6562 Rdctetl Delivery

RECEIVE
lUN 0 6 2M4
CM -EC
JNFI
ffx
1 l vlkh�Q� 00
' d �
X s
i "
Y

I o e t
aNII.
x Mom, '�'tx ` a • ' � .�4
i �s �' 49 J.F' r �i JuiA Y � \`� rLi�'� J • 9
C
er 22
d t ��'� k "�'"�. • i tr J
'w`'¢.. _ ",,r •.rf ... cam': # As. I ,;°?Y
'Fr
tt �f
a