91239C - Cape Island HOA

��`°"'"� �9CAMA ❑ DREDGE & FILL N9 91239 A B CO D
GENERAL PERMIT Previous 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 ._._� 20 Qd Rules attached. General Permit Rules available at the following link:www.dea.nc.gov/CAMArules
Applicant Name KI .bQIALF Qf CAPE ISLAND INJR Authorized Agent--fJ+_j-_ j [9UC- tt71f
_.._.--
Address __SA iLV!cw bru V6 Project Location(County): ONSj QW
City NcfijJ1-MPSAv_ 3EAC11 State NC zip �tgy(00,_ Street Address/State Road/Lot#(s) CAPE ISLAND AM MARINA
Phone#
Email MN►JERS1_a@_&rA► L.GoM Subdivision CAQE L$L-AND
City hlogn1 -rb(nAIL Sc6cA zip .1Vop
Ad' Wtr.Body /� ^___,_,,,,___„ na ian/unk)
Affected �CW ®EW �PTA �ES �PTS i� Y—>t..E 1 GpA�f�x-, �.-�..-
AEC(s): ❑OEA IHA ❑UW SPIMA 0 PWS Closest Maj.Wtr.Body Cry VV
ORWeno PNA Bno
Type of Project/Activity 13'xl3' w wacp &A-r a Fr
(Scale: 1;�0 1
Shoreline Length.... ---�`
Access Length Au l b4r&& bA i
Pier(dock)length
Fixed Platform(s)
Floating Platform(s) — ""
Finger pier(s)
Total Platform area
Groin length/q
Bulkhead/Riprap length_ "___-w
Avg distance offshore - '"' Cp sn N U D OCK i NG FAe..1 L I T"y
Breakwater/Sill
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse oatlift l3X 13'
Beach Bulldozing ---o "•
Other PIZWnsFA i3R13 -> 9
SAV observed: yes rio WATER WTI,, y'
Moratorium: n/a yes hT J,,w TOE
Site Photos: yes
Riparian Waiver Attached: (0 0
A building permit/zoning permit may be required by:____0NS- Qn.4_CAiL,�J t.)t. 'j,..tzW14. pF bL7-9
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions� �1,�__4vQd�NA4�.gF_,C1AIN. _1N TNf E)f,(STING.._._$LIP__.
_Fo Q7 PK)Nt (b44100 _...��,__.._N�_ IPICRLA 1N -DT14 L (1�IM�I3E C See note on back regarding River Basin rules
(0.714 ,�tr00 _ - 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)
UL Comflif u4o_n 3wA-rnP-P Lugs
Agent or Applicant P N Permit Office' PRINTED
Name
Signature Plea
se read compliance statement on back of permiN• 5ignat7
't'V 00.0c) 3657 J5120.�Y
Application Feels) Check tt/Money Order Issuing Dat6 ExpiratioA Date

WAS 7.1, "CAMA ❑ DREDGE & FILL N9 91239 A B Q D
�= GENERAL PERMIT Previous 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 01 N . ;t0 00 ❑Rules attached.11 ❑ General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name RICK Alfttg ml oN J�EKALF of GAPE 6LAN115)IQA Authorized Agent PFL CZNSTA(AC_T10d
Address 46 SA I LV 1&W bKI VC Project Location(County): ONSLnW 1111
City I,d(TM mesemL 5EAcA State NC zip ( 8ZLW Street Address/State Road/Lot#(s) CAPE ISLnNb +10A MAR1I4A
Phone#( ) 771 -S401 SAILVIbW DR)VE
Email RANDEKsI.1@ 6mh%L.GoM Subdivision GAPE ISLAND
City NoR-r14 MCIAIL $E45.8 zip a2$440
Affected ❑CW NEW PTA ES ❑PTS Adj.Wtr.Body AU-1 GA?D'C 6Ay na an/unk)
AEC(s): ❑0EA ❑IHA ❑UW ❑SPIMA ❑PINS Closest Maj.Wtr.Body ATWW
ORW• es no PNA ye no
Type of Project/Activity 3'X)3' LANCOVER ED &AT LI FT
(Scale:
Shoreline Length
Access Length Au 16ToR 8AY
Pier(dock)length �—
Fixed Platform(s) ----
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/Riprap length
Avg distance offshore 67)(I ST)N GI D Qc)c I N& FAC(L I T y
Breakwater/Sill
Max distance/length
Basin,channel o
Cubic yards
Boat ramp �
Boathouse, oatlift 13X 13
Beach Bulldozing
Other PR.OtoSEA 13K)I' b 9 ,
O-OAT LIFT /v
SAV observed: yes 0.0
WER De►TH y'
Moratorium: n/a yes AT L-vJ T1bC
Site Photos: yes
Riparian Waiver Attached: <
A building permit/zoning permit may be required by: ONS L()W Of W-T-s
Permit Conditions )) ALL VyDRK SNA(.L R EMAI/1I IN THE EYiSTiAl6 SLIP ❑TAR/PAM/NEUSE/BUFFER(circle one)
_Fo on PRI NT (12714.1AW010) 21 ND INC%LAISF- 11V TZ TA%L NW"t OE4 ❑ See note on back regarding River Basin rules
6F ESL/PS (07 N .';L '0
% ❑ 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)
.)wA-row LucAs
Agent or Applicant PRINTED Name Permit Office ' PRINTED Name
Signature"Please read compliance statement on back of permit" Signa-tYK
't'loo.(ia 3105 7 8/15/.2 y I a i3 ,2024
Application Fee(s) Check#/Money Order Issuing Dat Expiratio 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� 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: [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

oX%0(OAS
tV Z, CAMA ❑ DREDGE & FILL NI? 91239 A B c D
3
GENERAL PERMIT Previous 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 2 Rules attached. General Permit Rules available at the following link:www.dgq.nc.Yov/CAMArules
Applicant Name 1 1-t. •� !_i ; r \, Authorized Agent
Address `I#9 Project Location(County): J
City 0+ ' c• 1 State C. ZIP L4 Street Address/State Road/Lot#(s) t + \ +N A
Phone#(_) -771 401 ^,i14' %-,Z
Email Subdivision
City N"';,T+1 \i1- t.tllc.H ZIP �4•�a/J
Affected ❑CW El EW ❑PTA ❑ES ❑PTS Adj.Wtr.Body -^J_1 i_ter\Tu ti 1- 11Y na man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body T w VV
ORW:yes/no PNA:yes/no
Type of Project/Activity x 17, LW(WLgi D NT L,+ i
(Scale:
Shoreline Length -�
Access Length - I 7 _-. ._..._...__... _.._._ _.. ..... I ............. _ s
Pier(dock)length
Fixed Platform(s)
i I
Floating Platform(s)
Finger pier(s)
I
Total Platform area
i
Groin length/#
Bulkhead/Riprap length I
Avg distance offshore _._. 1.............._7 t VA
Breakwater/Sill
N OF
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse oatlift �X�7�
Beach Bulldozing
Other r JP 't i �l 9
ur t"t►
SAV observed: yes no'
Moratorium: n/a yes no
Site Photos: yes noJ.
Riparian Waiver Attached: no I
A building permit/zoning permit may be required by: 'i�w-1iv or N r(3
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions i r`L w.,nif -�f�1`�L i•t'11ArN 1N T1iE ,L1i>
NJ T ,7!I ,�� ) 1 hl J IN( E AV 1N i 2 T A L NL,�t4llL k �See note on back regarding River Basin rules
➢L1I'S r'o7 I1 .:��.�
❑ 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)
J�,/vA'►ri,�rJ Li,
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature"Please read compliance statement on back of permit" Signature
7 1- -
Application Fee(s) Check#/Money Order Issuing Dat6 Expiratio 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 F1 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:
4L
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, K 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

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Rick Anderson
Mailing Address:_46 Sailview Lane, North Topsail Beach, NC 28460
Phone Number: 512-771-3401 Email
Address: [e-mail] I n
certify that I have authorized t' rL ,
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I n ri 61, bm H i
at my property located at
czn e,
.) rnw
in0 County.
i furthermore certify that / 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
Rick Anderson
Print or Type Name
HOA President
Title
09 /06 /2023
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: Cape Island HOA Address of Property: Xil 111Q �l Db y� t/�CI W l S�a rrt 1 tDA
Mailing Address of Owner: /h aj
Owner's email: Owner's Phone#:
Agent's Name: Josh Barber/PFL Construction 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
descri tion or drawing, with dimensions must be provided with this letter.
X I DO NOT have objections to this proposal. I DO have objections to this proposal.
ff 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 reve ents). (If you wish to waive the setback, you must sign
;he appropriate blank below.)
I DO wish to waive some/all of the 15'setback
X
SignatdLe.,A#Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:X
TypedlPrinted name of ARPO: I�
Mailing Address of ARPO: !�& Z�V
ARPO's email: bcdoIC_Pxc, ,Cam ARPO's Phone#:
Date: us�9-4 -waiver is valid for up to one year from ARPO's Signature'
Revised May 2021

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: Cape Island HOA Dock
Address of Property:
Mailing Address of Owner: 4JSailview Lane, North Topsail Beach, NC 28460
Owner's email: Owner's Phone#: [phone]
Agent's Name: Josh Barber/PFL Construction 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.ACM 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 X �-
zr
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 Ownex ex ,,..."_
Typed/Printed name of ARPO: Charles Mantooth
Mailing Address of ARPO: 201 Salisbury Circle, Danville, VA 24541
ARPO's email: ARPO's Phone#:
Date: _._.._._ *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021