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Home My WebLink About92599C - King �4CAIOOIA DREDGE & Fli_L I NU 92599 _.__A_B 'tio Previous permit GENE L PERMIT Date previous permit issued New []Modification ❑Complete Reissue ❑ art' 1 Reissue J ` oas Resources Commission In an area of environmental concern pursuant to: As authorized S to61%rth Carding,Department of Environmental Quality and t R � my 1(�AMAn iwc II 1 l ral Permlt'Rules available at the followtrg I;rk: 5A NCAC 4 s s ;es attached. Apolkant Name Authorized Agent Address i Project Locat!on(County): C'y State ZIP St-!et AddreV tat Lot� ) I Phone#t ) _y cmali Subdivl city _ IP Ar ec;ed CW EW PTA ❑PTS Adj.Wtr.Body (nat/man/urk) AEC(s): ❑OEA ❑IMAO UW KIMAP ❑PiClosest Maj.W:r.Body +�� -- ORW:yes/0 PNA e9i`o 1 Type of Pres)ect/Activity (scale: r Shoreline Length Access Lergth —'� P'c'(dccK) Fixed Pfatfor (s Floating 4l@tf��1 ringerpier(s) ^� Tota!Platfcrm area Bul a R;prap length / Avgd'stanceoffshcre e_� �� .�� fjQ o Breakwater/Sill /►J �� pl Max distance/:ength Oq, Basin,channel Cubic yards `r I Bcat ramp i Boathouse/Boatlift Beac!t Bullcozirtg Othe-l ex SAV observed: yes no Moratorium: i Moratorium: n/a yes no Site Photos: e� no Riparian Waiver Attached:/1 o A builcing permit/zoning permit may be required by: Permit Conditions s TAIVPAI VNEUS BUFFER(circle one) See note on Sack regarding Rlver Basin rules See additional notes/conditions on back I AM AWARE OF$MTUTES,CRC RULES AND CONDITIONS THAT APFLY TO THIS PROJECT AND A91111WED COMP IANC CEMENT. (Please Initial) ItQeet o A nt PRINTEQillperm r PRINTED ame Signature • ase read compliance statement on back of permit•' S!g re �o1+F`OASf4l YCAMA XDREDGE & FILL N9 92599 A BCD GENERAL PERMIT Previous permit i Date previous permit issued XNew ❑Modification ❑Complete Reissue ❑Partial Reissue As authorized th State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to: 15A NCAC ��! 0011144 ❑Rules attached. ❑ General Permit Rules available at the following link:www.deq.nc.fov/CAMArules Applicant Name Authorized Agent Address 1 Project Location(County): City State ZIP Street Address/State oad/Lot# ) Phone# ) Email Subdivi City ZIP Affected ❑CW X W KFTA ES ❑PTS Adj.Wtr.Body (nat/man/unk) / AEC(s): ❑OEA ❑IHA W SPIMA ❑PWS Closest Mal.Wtr.Body ORW:yes/® PNAI( e lino Type of Project/Activity �� 1 (Scale: f Shoreline Length Access Length Pier(dock)length Fixed Plaffor (s J oZ U Floating iPl//attf��o//r��m^(s) Finger pier(s) i Total Platform area h/# r Bul a Riprap length I Avg distance offshore Breakwater/Sill f 487 t1�� rvL"r 1 fJ1�riX $ 11 Max distance/length Basin,channel Cubicyards _._....... -..._._................ -._..__..__..... . Boat ramp Boathouse/Boatlift �- — - Beach Bulldozing Other �� SAV observed: yes no J � Moratorium: n/a yes no �✓r'1uQ�J Site Photos: es no Riparian Waiver Attached: o A building permit/zoning permit maybe required by: ❑ TAR/PAM/NEUSE/BUFFER(circle one) Permit Conditions L ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back i I AM AWARE OF MLTUTE ,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND RE I WED COMPLIANCVA61EMENT. (Please Initial) Agent or App icant PRINTED Name Permi r' PRINTED am` Signature** ase read compliance statement on back of permit** Sig rer� Application Feels) Check#/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: F-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 Washington District 400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889 252-808-2808/1-888-4RCOAST Fax: 252-247-3330 252-946-6481 (Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:252-948-0478 Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Elizabeth City District Wilmington District 401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax:910-395-3964 (Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties) Pasquotank and Perquimans Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 @*FtoASrq',INI ❑CAMA ❑ DREDGE & FILL No 92599 A B C D 0 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: 15A NCAC ❑Rules attached. ❑ General Permit Rules available at the following link:www.dgq.nc.Yov/CAMArules Applicant Name Authorized Agent Address Project Location(County): City State ZIP Street Address/State Road/Lot#(s) Phone#(_) Email Subdivision City ZIP r • Affected ❑CW ZJ EW ❑PTA 2fES ❑PTS Adj.Wtr.Body (nat/man/unk) AEC(s): ❑IDEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body ORW:yes/no PNA:yes/no Type of Project/Activity (Scale:, ) Shoreline Length Access Length Pier(dock)length Fixed Platform(s) } Floating Platform(s) Finger pier(s) I I �... ......... - .... .. .... Total Platform area I Groin length/# Bulkhead/Riprap length - -- - - Avg distance offshore ......... ..... .... '...- - _._. _.._. Breakwater/Sill Max distance/length 1 Basin,channel w Cubicyards _..._. . . -. i .. _....- ....... _ ......--_. __.._... __. __i_--- __.. ... __ ._.__-.- ..._ Boat ramp i Boathouse/Boatlift - Beach Bulldozing k 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: ❑TAR/PAM/NEUSE/BUFFER(circle one) Permit Conditions III L{. ��(C ❑ 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#/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 Washington District 400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889 252-808-2808/1-888-4RCOAST Fax:252-247-3330 252-946-6481 (Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:252-948-0478 Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Elizabeth City District Wilmington District 401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax:910-395-3964 (Serves: Bertie, Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties) Pasquotank and Perquimans Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 (OAS`"� _R CAMA ❑ DREDGE & FILL No 92599 A B c D Previous permit GENERAL PERMIT Date previous permit issued N, FJNevv ❑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.gov/CAMArules Applicant Name Authorized Agent Address Project Location(County): City State ZIP Street Address/State Road/Lot#(s) Phone#(_) Email Subdivision City ZIP ❑PTA ❑PTS Adj.Wtr.Body (nat/man/unk)Affected ❑CW Z EW AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body ORW:yes/no PNA:yes/no Type of Project/Activity (Scale: ) Shoreline Length Access Length . 1_......... E Pier(dock)length Fixed Platform(s) ._�. _....k.._J ....._.__ Floating Platform(s) j Finger pier(s) j I Total Platform area 1 Groin length/## q , Bulkhead/Riprap length — �- - Avg distance offshore - - -- Breakwater/Sill f Max distance/length Basin,channel , Cubic yards Boat ramp Boathouse/Boatlift - - Beach Bulldozing Other �( f.. SAV observed: yes no i Moratorium: n/a yes no Site Photos: yes no i Riparian Waiver Attached: yes no A building permit/zoning permit may be required by: ❑TAR/PAM/NEUSE/BUFFER(circle one) Permit Conditions ❑ 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 p/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 Washington District 400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889 252-808-2808/1-888-4RCOAST Fax:252-247-3330 252-946-6481 (Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: 252-948-0478 Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Elizabeth City District Wilmington District 401 S.Griffin St.Ste.300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax:910-395-3964 (Serves: Bertie,Camden,Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties) Pasquotank and Perquimans Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM ('FRTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: _Deborah King Address of Property: 140 Cando Rd, Sneads Ferry NC 28540 Mailing Address of Owner _550 DJs Lane Jacksonville NC 28540 Owner's email: debbyking69@yahoo.com Owner's Phone#: _910-358-1492 Agent's Name:J�l"� �4CLA4- Agent Phone#: Hgenrs Email: C-O—,-r4, <1D 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. /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 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted at(252) 515-5400. 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 some/all of the 15' setback , L Signature of Adjacent Riparian 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: T �� Mailing Address of ARPO: ARPO's email: L APO's Phone#: ,blah LIZ Date: *waiver is valid for up to one year from ARPO's Signature' RECEIVED Revised Ma v 2021 l U N 2 5 2024 DCM-MHD CITY TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION &WAIVER FORMS CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners(15A NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return receipts(showing delivery of notice)are needed, or any other method which satisfies the Local Permit Officer (LPO)that a good faith effort has been made to provide notice. The purpose of this notice is to make adjacent riparian property owners aware of the proposed development so that they have an opportunity to provide comments(or potentially object to)the proposed development,and to give DCM or the LPO an opportunity to consider these comments/objections before a permit decision is made. "Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however, permission must be obtained for certain types of proposed developments if they fall within a 15' setback area along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's best interest to provide comprehensive and accurate notice so that any concerns or objections can be resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the permit decision, insufficient notice could be a basis for granting such an appeal. Who is an Adjacent Riparian Property Owner? What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors) • A property that shares a boundary line with the site of proposed development; AND • A property that fronts a natural or manmade waterbody that is connected to coastal waters and can support some form of navigation, even a kayak or canoe, including a common canal system or a manmade basin. • Easement holders?Yes, if the easement could be impacted by the proposed development. • Streets/Roads? Only if the street/road could be impacted by the proposed development. This might include street-ends which might be used for parking and beach access. • Holders of recognized submerged lands claims/shellfish franchises. What is Riparian? Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a question about whether an adjacent property is considered "riparian," please reach out to DCM Staff - especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water. Who/What is a Property Owner? For private individuals (or families), send notice to the address listed on the tax card. If the property is owned by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of State's Corporations Look Up site: hitpsa/av* v. nc.aov/search/indericor . For Condominiums or neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a corporation, for which you send notice to its registered agent). What is Notice, and how do 1 ensure it is received? • You can meet with your adjacent property owner, provide a description or drawing of the proposed development, and ask them to sign this form and return it to DCM; OR • You can hand-deliver this form and a description or drawing, and ask your neighbor to return it to DCM (consider providing them with a stamped envelope); OR • You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you choose this option, you must provide either the signed & returned green card OR track the certified mail package number on USPS.GOV's online tracking system, and provide the tracking print-out as proof of delivery to DCM IT you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel and we will work to answer your questions. Revised May 2021 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:_Deborah King Address of Property: 140 Cando Rd. Sneads Ferry NC 28540 Mailing Address of Owner._550 DJs Lane Jacksonville NC 28540 Owner's email:debbyking69@yahoo.com Owner's Phone#:_910-358-1492 Agent's Name: Jan �S Agent Phone#:_1 ) Agent's Email: oz;�+ DJACENT 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. 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 400 Commerce Ave.. Morehead Citv. NC 28557. DCM representatives can also be contacted at (252) 515-5400. 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,DreaKwater,Doatnouse, lift,of 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 setoacK,you muss sirr the appropriate blank below.) I DO wish to waive some/all of the 15'setback Signature of Adjac arian Property uwn�-, -Or RECEIVED I do not wish to waive the 15'setback requirement(initial the blank) J U N 2 5 2024 —.nature of Adjacent Riparian Property Owner: sY DCM-MHD CITY Typed/Printed name of ARPO; � V �" ` l�_� Mailing Address of ARPU: Cz t� 32PO's email: ARPO's Phone#: Data: ' "waiver is valid for uo to one year from ARPO's Signature" TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION&WAIVER FORMS CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A NCAC 7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mail return receipts (showing delivery of notice) are needed, or any other method which satisfies the Local Permit Officer(LPO)that a good faith effort has been made to provide notice. The purpose of this notice is to make adjacent riparian property owners aware of the proposed development so that they have an opportunity to provide comments(or potentially object to)the proposed development, and to give DCM or the LPO an opportunity to consider these comments/objections before a permit decision is made. "Permission"of adjacent p o erty owners is not necessarily required for DCM to issue a permit; however, permission must be obtained for certain types of proposed developments if they fall within a 15'setback area along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's best interest to provide comprehensive and accurate notice so that any concerns or objections can be resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the permit decision, insufficient notice could be a basis for granting such an appeal. Who is an Adjacent Riparian Property Owner? What is Adjacent?(Note: DCM reads this broadly to ensure comment by_potentially impacted neighbors) •A property that shares a boundary line with the site of proposed development;AND •A property that fronts a natural or manmade waterbody that is connected to coastal waters and can support some form of navigation,even a kayak or canoe, including a common canal system or a manmade basin. • Easement holders?Yes, if the easement could be impacted by the proposed development. • Streets/Roads?Only if the street/road could be impacted by the proposed development.This might include street-ends which might be used for parking and beach access. • Holders of recognized submerged lands claims/shellfish franchises. What is Riparian? Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a question about whether an adjacent property is considered "riparian," please reach out to DCM Staff- especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water Who/What is a Property Owner? For private individuals (or families), send notice to the address listed on the tax card. If the property is owned by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of State's Corporations Look Up site: https//www.sosnc.gov/search/index/corp. For Condominiums or neighborhoods with an owners'association (HOA/POA), send notice to the association (which is usually a corporation,for which you send notice to its registered agent). What is Notice,and how do I ensure it is received? • You can meet with your adjacent property owner,provide a description or drawing of the proposed development, and ask them to sign this form and return it to DCM;OR • You can hand-deliver this form and a description or drawing,and ask your neighbor to return it to DCM(consider providing them with a stamped envelope),OR • You can mail this form by USPS Certified Mail, return receipt requested(the Green Card). If you choose this option,you must provide either the signed&returned green card OR track the certified mail package number on USPS.GOV's online tracking system, and provide the tracking print-out as proof of delivery to DCM If you have any questions about this process,please reach out to DCM Staff and DCM Legal Counsel and we will work to answer your questions. Revised May 2021 x RECEIVED JUN 2 5 2024 DCM-MHD CITY AGENT AUTHORIZATIIN FOR CAMA RMIT p Name of Property Owner Requesting Permit: _ Mailing Address: _ 1 Phone Number: Email Address: I certify that I have authorized J )'N Agent/Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: SPA Ls.JG at my property located at `t'C' rLc}� `l "��r C)F`f 6�) in �r(OS1C%1l County. 1 furthermore certify that I 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: Gv . I Signature Print or Type Name Title Date This certification is valid through