100468C - Daniell

1
Utourk KCAMA ❑ DREDGE & FILL N° 100468 A B © D
GENERAL PERMIT Previous permit /
Le
Date previous permit issued
XNew ❑Modification [IComplete R ❑Partial Reissue
As authorized,byz 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 Q1Z OO ❑Rules attached. Ig General Permit Rules available at the following link:www.dgq.nc.Yov/CAMArules
Applicant Name
11TI hn att %16 ; ��n Sain t,61 Authorized Agent `Dasi1w mav 1
Address ';Z `1 Un _ Project Location(County): �m t1b L—N
City 6 State—_�—ZIP 28587 Street Address/State Road/Lot#(s) S AM 9
Phone#(� _B5U-U-4 J
Email yile.l`58@ rbMCQ -e�: Subdivision /
City�& -,,\A A ZIP
Affected X CW IKEW >�PTA ❑ES ❑PTS Adj.Wtr.Body 1 na an/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal.Wtr.Body B UR SOL "
ORW:yes no PNA:Ono 11
Type of Project/Activity ?Y0 b OS'ed do G 6 ykn CA LTV
1 f
(Scale:N��
Shoreline Length 2 1 h
Access Length C5,K g 11
Pier(dock)length lw—
Fixed Platform(s) h
3, n��i l� o,•l I c�.{�o���
Floating Platform(s) l S� i
Finger pler(s)
Total Platform area 5q;-1 �I 3►S�c♦( `�1 y
Groin length/p
Bulkhead/Riprap length
1v St, aac�F�
Avg distance offshore vj Pro aged I
r
Breakwater/Sill
MaxQnn
e length �� p i1 ,l
Basiel A IOr (�("W"
Cubic yards .�
Boat ramp
Boathouse/Boatlift---
Beach Bulldozing
Other j ►Y ` W
Y
SAV observed: yes o 'p v�Co ir Y(ok
Moratorium: n/a yes
Site Photos: yes CN O \NQ\y �^h1 t s7�/1�}1 1 ►'I
Riparian Waiver Attached: yes n /W Da e 0 L ( No �i 4ev)l
A building permit/zoning permit may be required by: o ow Coles
Peerr�mit�Conditionso g�Qld eA rl ❑TAR/PAM/NEUSE/BUFFER(circle one)
S/�S W►f►t �0 See note on back regarding River Basin rules
► See additional notes/conditions on back
w►. %ti u a+e,.la
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Crystal Coast Marine Contracting (A -)'hYit
Agent or App is nt PRINTED Warne Perm, Officer's P I TED Name
S, nature"Please read compliance statement on back of permit" Signature
400 Iy5►3 oslisl2�l ►z(�sl2y
A plication Feels) Check N/Money Order Issuing Date Expira on Date

`OAU4,+NKCAMA ❑ DREDGE & FILL N9 100468 A B © D
GENERAL PERMIT Previous permit
Date previous permit issued /
0KNew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized bbyy�+-1
the
,State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC 0 ,11 00 ❑Rules attached. X General Permit Rules available at the following link:www.deq.nc.Yov/CAMArules
Applicant Name TIVYI }A-elan Doll.Vlt�" Authorized Agent S1�(VS-kD►� l octsi ,May 1 n-C
Address 5213 i10\\aY►d M S O
; \I Un Project Location(County): I
City! Q 1\A a State zip Street Address/State Road/Lot#(s) _ S A H 6
Phone#(��j asu-15U-4,5 1"
Email +� V1 f,1 S C7 @j C hm cL% . n-e�7 Subdivision �/ p
City zip
Affected XCW XEW �PTA ❑ES ❑PTS Adj.Wtr.Body \ \ 1c ^ e� na an/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body �[�ytp sow
ORW:yes no PNA:Ono ,llJJ1l
�� `A Type of Project/Activity ?If O 10 OS�d (A0 G Y YVA U ` l�
(Scale:079
Shoreline Length 2 1 d
NAccess length r'J x
Pier(dock)length
Fixed Platforms) J-)
3' xl1' I �..Ho�lavld
Floating Platform(s) l f
O I
W�
Finger pier(s) I Y IILA\o �+"' e2LI r
�7. p� , ?w'Qxl� 10--
GroinC�Total Platform area 2T2 sq-f l � ic I�1 length/# / I
1v St�aac�
Bulkhead/Riprap length
Avg distance offshore / Qb�� C,A
Breakwater/Sill �/ �J�"1�rM
1
Max istance length W'�bV-% -2AC
o i �✓ (p' ��Qi
Basin, nnel
Cubic yards
Boat ramp
t
Boathouse/Boatlift/
Beach Bu Idozing
Other b
Y
SAV observed: yes
Moratorium: n/a yes
Site Photos: Yes (1�0 \N6\uW, rn Dn ' 11 , �• ��\
Riparian Waiver Attached: es no YV 1 rj L l lv0 Lt, ^ J\
A building permit/zoning permit may be required by: 0 O W Cow f
r1 VYl _ TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions � 1syacli-eA
S O 1� 7 0 See note on back regarding River Basin rules
O`n CNCX Cw �mkl 6'e. VYO A't"cuA
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)
rA '1 bV-'\t
Agent or Applicant PRINTED Name Perm, Officer's PRI TED Name
Signature"Please read compliance statement on back of permit" Signature
11140D Ig513 MI 1512L1 l211517-4
AlYplication 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: [phone] 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
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:[phone]
(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: Timothy & HelenG;, i
Mailing Address: 523 Holland Mill Ln
Stella, NC 28582
Phone Number: H [phone]
Email Address: [e-mail]/[e-mail]
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 523 Holland Mill Ln, Stella
in County.
I 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:
Signature
Timothy & Helen Daniell RECEIVED
Print or Type!Name
Owner Title JUL 2 4 2024
o 29 DCM-MHD CITY
Date
This certification is valid through

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: Timothy & Helen Daniell
Address of Property. 523 Holland Mill Ln, Stella, NC 28582
Mailing Address of Owner: Same
[e-mail]/[e-mail] H 770
Owner's email: Owner's Phone#: ) 856-5673
Agent's Name: Crystal Coast Marine Contracting 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.
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
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15' setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Darin Peterson/Stephanie or Cynthia Carroll
Mailing Address of ARPO: 405 Whistling Heron Way, Swansboro, NC 28584
ARPO's email: ARPO's Phone#:
Date: *waiver is valid for up to one year from ARPO's Signature*
/
�6f=f V 96
J U L 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: Timothy & Helen Daniell
Address of Property: 523 Holland Mill Ln, Stella, NC 28582
Mailing Address of Owner: Same
[e-mail]/[e-mail] H 770 856-5673
Owner's email: Owner's Phone#: ( )
Agent's Name: Crystal Coast Marine Contracting 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.
11" 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
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)X-1 is
Signature of Adjacent Riparian Property Owner: 74,7 M Smith J.122,202412:41 EDT)
Typed/Printed name of ARPO: Jonathan & Tonya Smith
Mailing Address of ARPO: 524 Holland Mill Ln, Stella, NC 28582
ARPO's email: [e-mail] ARPO's Phone#: J [phone] /T [phone]
Date: 22/07/24 "waiver is valid for up to one year from ARPO's Signature"
21
Y .
JUL 2 4 2024
DCM-MHD CITY

Adjacent Riparian Owner Notice Waiver Form -
Daniell, 523 Holland Mill Ln , Stella
Final Audit Report 2024-07-22
Created: 2024-07-22
By: Justin Cleve [e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAAnS4ZD9Y611FXT4smxTbVegQN_dfoiegu
"Adjacent Riparian Owner Notice Waiver Form - Daniell, 523 Hol
land Mill Ln, Stella" History
Document created by Justin Cleve [e-mail])
2024-07-22-4:07:07 PM GMT-IP address:75.180.234.53
Document emailed to [e-mail] for signature
2024-07-22-4:07:13 PM GMT
Email viewed by [e-mail]
2024-07-22-4:33:14 PM GMT-IP address: 12.74.212.135
AG Signer [e-mail] entered name at signing as Tonya M Smith
2024-07-22-4:41:20 PM GMT-IP address: 12.74.212.135
6© Document e-signed by Tonya M Smith ([e-mail])
Signature Date:2024-07-22-4:41:22 PM GMT-Time Source:server-IP address: 12.74.212.135
Agreement completed.
2024-07-22-4:41:22 PM GMT
RECEIVED
JUL 2 4 2024
Q Adobe Acrobat Sign DCM-MHD CITY

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RECEIVED
JUL 2 4 2024
DCM-MHD CITY

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RECEIVED
JUL 2 4 2024
DCM-MHD CITY

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