HomeMy WebLinkAbout100466C - Smith frA`LWNI ><CAMA ❑ DREDGE & FILL 1`� N9 100466 A B Oc D
A GENERAL PERMIT Previous permit
in '
Date previous permit issued
;New []Modification []Complete Reissue [ Pa ial Reissue
As authorized by the State of North Carolina,Department of Environmental Quality and the; oa� I Resources Commission in an area of environmental concern pursuant to:
I SA NCAC V�y. ID ❑Rules attached. General Permit Rules available at the following link:www.deq.ncyov/CAMArules
Applicant Name�t11/�CJI V1 3`,1111a S>W1!11A Authorized Agent Gy(T CjoA M&1 nie
Address—CA4 Hollav►d Mi,,l11l L1� Project Location(County):' Dmiow
City cS&yA A State NC. zip 2858 2 Street Address/State Road/Lot#(s) s A r t E
Phone#(104) 5-4�q g 2
Email h"av,) 2 V VaMoD•cow Subdivision I--' p c
City a 01 ZIP 2F�s8?-
Affected NCW fg EW , PTA ❑ES ❑PTS Adj.Wtr.Body 0N (not/ an/unk)
AEC(s): ❑IDEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body �oaUt 0,�'O "
ORW:ye no PNA ye no
Type of Project/Activity_R Y-090sea a�C�C.tY1U '�TJ►C/1 11 TV
(Scale:N'ro—j
Shoreline Length I() I
Access Length 5� X U!5 I*t
Pier(dock)length
Fixed Platform(s) 13 x)
"'Holland
Floating Platform(s) Cvee
1 � jJ1i 11 Ys'
y wi di-b 10 mo.4
Finger pier(s) -/ ` /—\—J
Total Platform area 7>t
Groin length/#
Bulkhead/Riprap length
Avg distance offshore / �t
Breakwater/Sill eik}tvf w taS�1
Max istanc I t Ov" Cw '`,l
Basin,c annel ✓'— �C\^
Cubic yards i"'
Boat ramp l {YO{DpS
Boathouse/Raatliff_ /" rJr X(iCJ r
Beach Bulldozing icy
Other K\
SAV observed: yes no
Moratorium: n/a yes o �Qnie Q„1,
Site Phntns, rs Q
Riparian Waiver Attached: es no l \J ) o, S1/Y11 , 1 ,1 vL (Walvta�
A building permit/zoning permit maybe required by: // 11 rL• 11 dh5 `O�
Permit ConditionsQrobal _ Lw- G1.�T - U ❑TARIPAMINFUSE/BUFFER(circle one)
�Q ` �d
�I_b_l e _�� �1' � (h{ -ageY CW � l�l ❑ See note on back regarding River Basin rules
�j� w1 ol�ya� l 0C J► - be a Mc011►%u1+,
n ?—)t ^l ,Q GW S v!2s to�-l � ❑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)
Crystal Coast MarineContracting 011� �i
Agent or Ap I nt PRINTED
\.. n/� Permi Officer's PRIN ED Name
v 0
Si 0tur0
e"*Please read compliance statement on back of permit** Signature
T�
108115
Ap lication Feels) Check#/Money Order Issuing Date Expiration bate
,jt°"'', XCAMA ElDREDGE & FILL N9 100466 A B O D
10MALGENERAL PERMIT Previous permit
� Date previous permit issued
NNew ❑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 2o o ❑Rules attached. General Permit Rules available at the following link:www.deg.nc.gov/CAMArules
Applicant Name-TwICilA-la1l 3 7 bnAy S�'W11-1A► Authorized Agent Gni� GDA, M ow( he
Address iS, ty Hollav►d Mitt(1 Un r�D p Project Location(County): O"-0o W ,^
City 5 1'+CA 1 p State Nc ZIP 2C758 Z Street Address/State Road/Lot#(s) S A I�1 E
Phone#(0) 54 0" I C1 6 1
EmailA'Dh�AQ\fsl AR,yAYlw'COM Subdivision I--,' p
City skel\0% ZIP 285 2
Affected NCW k EW X PTA ❑ES ❑PTS Adi.Wtr.Body O 1 c� .Y'^ (nat/ an/unk)
AEC(s): ❑OEA ❑IHA FI UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body �odUe ✓W" �1
ORW:ye no PNA yes no -_11 r
Type of Project/Activity �Y OQOS eCA A C AA YlU -C n Cn \1
(Scale:N'r4�-:)
Shoreline length 1 0 d
� 1
Access Length 6X U 3
Pier(dock)length
Fixed Platform(s) �3•%
^'HoUaind
Floating Platform(s) CveeV'
b
Finger pier(s) -f Q
Total Platform area o- `3� o
Groin length/# l }� n
Bulkhead/Riprap length O Cw
Avg distance offshore
Breakwater/Sill
Max istanc 1 4 '' 0w) Cw wti\lS �
Basin,channel C C vd
Cubic yards
Boat ramp / �ro�osed
Boathouse/Boatlift
Beach Bulldozing,/ icy
Other KkS S
12%A-VI b Y I V/
SAV observed: yes no
Moratorium: n/a yes
Site Photos:,
Riparian WiverAttached: es no
A building permit/zoning permit may be required by: J Y1 OhS I0U3
Permit Conditions 1 vA C.I4 ' ❑ TAR/PAM/NEUSE/BUFFER(circle one)
W'--d• JDOVA�pn 0V kI ❑ See note on back regarding River Basin rules
him h-e wk JZ Y ala'd' m } be a (V ;0111AAA ,
❑ See additional notes/conditions on back
o4 �1, Wmic Gw S . 1 o}j . 12 )
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
A�Irn C-1 yk4Ny
Agent or Applicant PRINTED Name Perm. Officer's PRINTED Name( UL(x
Si ature"Please read compliance statement on back of permit" Signature %-
`t 081 is 12A 1211s IzLf
Ap lication Fee(s) Check#/Money Order Issuing Date Expiration bate
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 F� 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
t°"'4 ❑CAMA ❑ DREDGE & FILL N9100466 A B (C D
s GENERAL PERMIT Previous permit
J Date previous permit issued r /
❑.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 b+-{-• Zo�7 ❑Rules attached. General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Name,1J b lnr✓\T Y1G1►/1 �h�1 V ck L'4'y1'A 16 Authorized Agent rTh C'Q 6 s-f 1'1 C\Y i vie
Address A LA Ho1l(oc1 M I I t Lyi pp Project Location(County): r,ocoo w
City _ e 1`n State �C zip Z&: S 2 Street Address/State Road/Lot#(s) M E
Phone#(_q) �3"An _ 99 6 2-
Email k_4l -A oVK7C'(o yy) Subdivision
city zip
Affected BCW MEW ,MPTA ❑ES ❑PTS Adj.Wtr.Body H C11[\\\ N 1 1 C y P 2 rfna an/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr. 1
Body �O��
ORW:yes/no PNA(ye;/no
Type of Project/Activity YC vCSeC, Cl C C \V)C� -t r\(
(Scale:N"TCJ
Shoreline Length 1
Access Length 7 X(f `y
Pier(dock)length
Fixed Platform(s)
Floating Platform(s) r
^� -- A�Llir".1�FI1= ICtri1C14
e
Finger pier(s)
�(o��
Total Platform area 2`I SLI
Groin length/# I R
Ti
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill / et )�Crf ti I
Max istanc I 4Ae
Basin,channel
Cubic yards
Boat ramp ��G;SPCI
Boathouse/Boatlift
Beach Bulldozing
Other C r
in "t,'.-I,- p Ui
SAV observed: yes no
Moratorium: n/a yes no t
Site Photos: eyes no (\\11 e 1 \ t V{ 1
Riparian Waiver Attached: es no �l� Y11'J�Ct 1 AFL Y �-e(1 t
A building permit/zoning permit may be required by: 1 Y) V\S 1 Old
Permit Conditions \ 'Tofn S M!td
1/ v A cLc4 = l a ❑ TAR/PAM/NEUSE/BUFFER(circle one)
L(l-. C\\1b WC C4 • 'C-4"•(2'co) ' �lI y w Ai c/1 � 'V l� V\Ct kl ❑ See note on back regarding River Basin rules
vl� h e W\ACV �. "� �0' n in d Vvt,,\SA V)P Cl IM;�,11 t�,u w,
❑ See additional notes/conditions on back
nlooVP C W SU1v5 etit Zwx
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
V1'( i+\4 l
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Si nature"Please read compliance statement on back of permit" Signature
� �C) IH'514 DLL3 IS Ztl IZ i51T_4
Ap lication Feels) Check#/Money Order Issuing Date Expiration bate
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 F-1 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
❑CAMA ❑ DREDGE & FILL N° 100466 A B C D
-01
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.gov/CAMArules
Applicant Name [ i y A Vvt i 1 C I t t Authorized Agent
Address A 6, t °(\ I` L1 1 Project Location(County): �
City l,'i State C ZIP �> > Street Address/State Road/Lot#(s) l
Phone# 17 " T i 2-
Email �. T �'S r \�<t`K 1 Subdivision
City t` {\ ZIP
Affected ❑CW ®EW ®PTA ❑ES ❑PTS Adj.Wtr.Body l i i °i (t 1 i N C C (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body I
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:N i< )
Shoreline Length C''
Access Length
a I 1 1 +'
Pier(dock)length
Fixed Platform(s) I X 1 I
t
Floating Platform(s) I
` ~ t
Finger pier(s) .............
Total Platform area 1 S(j ; v
1 I ; !
Groin length/# � __ _ __ �_
Bulkhead/Riprap length / - __. ___ -. .. ... I t
Ile
Avg distance offshore
Breakwater/Sill r
Max distance/17,gth
Basin,channel
Cubic yards -
. €
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
__.. ........-.. .. _..._._ ............. ...i _C.._____- 7-..._._..... t...__...._ .. ._...___...a.._.....
Other f� `
SAV observed: yes no -
i
Moratorium: n/a yes no
Site Photos: yes no 6. L ..`.) }-Riparian Waiver Attached: yes no t
A buildingpermit/zoning zonin y q y p / g permit may be required b : 1 �-[��
Permit Conditions ' I: C l` '� t(1l�f d 1 v.. tJr t C" .? 5ll C'ut- ( T ❑ TAR/PAM/NEUSE/BUFFER(circle one)
i F <� i M•I)_l1A C lRl �l/t t l ❑ See note on back regarding River Basin rules
t (s Ct" C� r,,°�'.4 1.iF' n kti °,�_tt„
❑ 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
Apolication 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:
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
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jonathan & Tonya Smith
Mailing Address: 524 Holland Mill Ln
Stella, NC 28582
Phone Number: J (704) 840-9982 / T (336) 918-5751
Email Address: tonyaw34@yahoo.com
I certify that I have authorized Crystal Coast Marine Contracting
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Construction of a Concrete Dock
at my property located at 524 Holland Mill Ln, Stella
in Onslow 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:
3 4g&4
Tn Smlth lul 14 2m4 15-S)FDT'
Signature
Jonathan & Tonya Smith
Print or Type Name
Owner
Title
19/07/24
Date
This certification is valid through I I RECEIVED
JUL 2 4 2024
DCM-MHD CITY
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: Jonathan & Tonya Smith
Address of Property: 524 Holland Mill Ln, Stella, NC 28582
Mailing Address of Owner: Same
Owner's email: tonyaw34@yahoo.com Owner's Phone#: J (704) 840-9982 /T (336) 918-5751
Agent's Name: Crystal Coast Marine Contracting Agent Phone#:(910)325-8481
Agent's Email: hannah@crystalcoastmarinecontracting.com
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.
TQQ 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) 808-2808. No response is considered the same as no objection if you have been notified by
Certified Mail.
WAIVER SECTION
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
Signature of AdjacentPipaAnan Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property OwnerT� DA&; & D"A.W
Typed/Printed name of ARPO: Timothy & Helen Daniell
Mailing Address of ARPO: 523 Holland Mill Ln, Stella, NC 28582
tdanie1158@comcast.net/helendaniellmpc@gmail.com 770 856-5673
ARPO s email: ARPO s Phone#: H ( )
Date: 7/22/2024 *waiver is valid for up to one year from ARPO's Signature*
ReA �lPJfI E D
JUL 2 4 2024
DCM-MHD CITY
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Jonathan & Tonya Smith
Address of Property: 524 Holland Mill Ln, Stella, NC 28582
Mailing Address of Owner: Same
Owner's email: tonyaw34@yahoo.com Owner's Phone#: J (704) 840-9982/T(336) 918-5751
Agent's Name: Crystal Coast Marine Contracting Agent Phone#: (910)325-8481
Agent's Email: hannah@crystalcoastmarinecontracting.com
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) 808-2808. 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
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: Richard Bell
Mailing Address of ARPO: 122 Little Bay Dr, Swansboro, NC 28584
ARPO's email: ARPO's Phone#:
Date: *waiver is valid for up to one year from ARPO's Signature*
PtW 2021
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JUL 2 4 2024
DCM-MHD CITY
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RECEIVED
JUL 2 4 2024
DCM-MHD CITY
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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: Jonathan & Tonya Smith
Address of Property 524 Holland Mill Ln, Stella NC 28582
Mailing Address of Owner Same
Owner's email tonyaw34@yahoo.com Owner's Phone# J (704)840-9982/T(336) 918-5751
Agent's Name Crystal Coast Marne Contracting Agent Phone# (910)325-8481
Agent's Email hannah@crystalcoastmannecontracting com
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
-9- - 1 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)808-2808.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 J
Signature of Adjacent Ripa—ilan Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:
TypedlPrinted name of ARPO: Richard Bell
Mailing Address of ARPO: 122 Little Bay Dr. Swansboro. NC 28584
ARPO's email: ARPO's Phone#:
Date: "waiver is valid for up to one year from ARPO's Signature'
Revised July 2021
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