89235A - Moore Street Properties, LLC

❑LAMA ❑ DREDGE & FILL N9 89235 A B C 3�
GENERAL PERMIT Date pre io sPreviouslpermitissued /
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:
I SA NCAC Q 7 H 1 Ii r` ( ❑ Rules attached. FJ' General Permit Rules available at the following link: w ..deq.nc.gov/CAMArules
Applicant Name KQt1 CC^ `�A r,
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Address �, t, S 22 IN e- `-I� r r�l tsl r•
City state \I A ZIP 7_ % S•
Phone #( OL) qno
Email 6 1 ( rt L( i C C
Authorized Agent (' Ivan v, . I e ( S n i, rii DG A
Project Location (County): -C a . y t t 1) %_
Street Address/State Road/Lot #(s) /'!, � r. a T c.:-
Subdivision
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Affected ❑CW ❑EW DP7A ❑ES ❑Pf5 Adj. Wtr. Body Clxr lI��r
AEC(s): ❑OEA ❑IRA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body iyYt'E fir.' ,:1 r�
ORW: yes/no 1 RNA: yek/no_)
Type of Project/ Activity
(Scale:t'� 30)
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Access Length
Pier (dock) length
Fixed Platform(s)
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length
Cubic yards
ramp
Boathouse/ Boatlift
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Moratorium: n/a yes no
Site Photos: yes,: no
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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)
1
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Feels) Check N/Money Order
Signature
Issuing Date Expiration Date

Docusign Envelope ID: 95277F3F-13FF46D6-A6F4-CF4389BF6922
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Moore Street Properties LLC
Name of Property Owner Requesting Permit: c/o David Chandler
Mailing Address: 8535 Riverside Dr
Richmond, VA 23235
Phone Number: 804-400-9709
Email Address: [e-mail]
I certify that I have authorized Emanuelson and Dad
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: new 5' tali x 116' long vinyl bulkhead
at my property located at 978 Ocean Forest Ct, Coroll
in Currituck 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:
e«�er
Signature
David Chandler
Print or Type Name
David chandler
Title
7/29/20�4 /
Date
This certification is valid through I I

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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: Moore Street Properties LLC c/o David Chandler
Address of Property: 978 Ocean Forest Ct, Corolla NC 27927
Mailing Address of Owner: 8535 Riverside Dr, Richmond VA 23235
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Emanuelson and Dad
Agent's Email: [e-mail]
Agent Phone#: [phone]
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
Initial appropriate blank I DO NOT have objections to this proposal. I DO have objections to this proposal.
it you nave oolecuons to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writin99999 w/thln 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Fte. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. o 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 tamp, 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
Inlaal/sign appropriate blank Signature of Adjacent Riparian Property Owner
-0 R-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: Sandra Bonnet
Mailing Address of ARPO: 1r1A7 Surrey wnnric nr'.a Cannughonrip PA 1 F'g17
ARPO's email: Bnnnnict rawnr Inn nat ARPO's Phone#: 419.R77_Ra42
Date: _nstnst2roe "waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
Fill out and sign bottom portion

Parcel ID Number. 115C00001840000 Map Date: August 5, 2024
Property Address: 978 OCEAN FOREST
COROLLA
27927
Property Owner. MOORE STREET PROPERTIES LLC
This map should be used for general reference purposes only. Curmuck County assumes no legal liability
for the information shown on this map. This map is not a survey.
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N
A
1:448
0 0,00375 0.0075 0.015 mi
0 0.005 n01 002 km

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