101358C - Kennedy

3o��C0"'k ❑CAMA ❑ DREDGE & FILL N9101358 A B icy D
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. 0 General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name ' S J c:> Authorized Agent c J s .:✓ ✓1 f
Address Project Location(County): �N✓. C✓C�'
City 14 01' State /r ZIP 2 BSL Street Address/State Road/Lot#(s) BD 1 D 11 S IA-i iu» n o A
Phone#( )
Email ? Subdivision pp
City ZIP 8 S
Affected ❑CW ©EW ❑PTA ❑ES ❑PTS Adj.Wtr.Body ✓C� (d/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body C ✓L�
ORW:yes/no PNA:yes/1 `
Type of Project/Activity Cod.
(Scale:/t/—T5)
Shoreline Length
Access Length _a I
Pier(dock)length r` /Y ✓,y ( ✓ /v
Fixed Platform(s) �` U
I
Floating Platform(s)
Finger pier(s)
a. L
Total Platform area L •I i
Groin length/# `- G I
Bulkhead/Riprap:length
Avg distance offshore t/
Breakwater/Sill
Max distance/length i /✓/(tom✓t
Basin,channel
Cubic yards
Boat ramp Al t4
Boathouse/Boatlift
Beach Bulldozing
Other
SAV observed: yes i
Moratorium: n/a yes y) �C! ,
�'
Site Photos: yes
fi j al
Riparian Waiver Attached: es no 44)
A building permit/zoning permit may be required by: r L 4`
1 / "v " , " h�/r ❑TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions
N be ro/•�� 4 ❑ See note on back regarding River Basin rules
4 �rlt f l
❑ See additional n tes/conditions on back J
1 AM AWARRE,OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Ap i ant am Permit Officer's PRINTED Name
i atur ase pl nce tement on back of permit" Signature
Application Fee(s) Check#/Money Order Issu— ir�' 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 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

`°AS'41 ❑CAMA ❑ DREDGE & FILL N9 101 3") 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 ❑Rules attached. ❑ General Permit Rules available at the following link:www.dgg.nc.gov/CAMArules
Applicant Name .J Authorized Agent
Address Project Location(County):
City ! f State ZIP Street Address/State Road/Lot#(s) l 1 e s 7
Phone#(_)
Email Subdivision
City i ZIP
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS Adj.Wtr.Body (nat/man/unk)
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
Pier(dock)length
Fixed Platform(s)
Floating Platform(s) }};
I,
Finger pier(s) — +(
I
Total Platform area
Groin length/#
Bulkhead/Riprap length 7
Avg distance offshore
Breakwater/Sill
Max distance/length
i
Basin,channel
Cubic yards '
Boat ramp
Boathouse/Boatlift
,
Beach Bulldozing )
Other
}
SAV observed: yes no
Moratorium: n/a yes no ; r
Site Photos: yes no
Riparian Waiver Attached: yes, no j
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 Feels) Check#/Money Order Issuing 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: Cyw�t5
Mailing Address: g Og- "E3-iMfw1 C L&yj<._
IIIC )E51&
Phone Number: �3(P - 9-t f�-a-73Lf
Email Address: i4,wn ecL4 @ Me . c_ptyL
I certify that I have authorized DENNIS&SONS MARINE CONSTRUCTION, LLC
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: (�. g
at my property located at /JC qoqsfo
in CARTERET County.
1 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:
Signature
Print or Type Na a RECEIVED
HOMEOWNER OCT 2 8 2024
Title
10 / / DCM-MHD CITY
Date
This certification is valid through 12 131 I 2024

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;;HN14VIO

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. ('.har 14'S k)_W(),ed14
Address of Property: 9)01 '5614u Bo_"M A C
Mailing Address of Owner: q 0A EAS-MENS c_-9BF 4 'BEVVH Fo?-7-,Nc 6?d'51(o
Owner's email: Chuck, �c n n ed V @ Owner's Phona &- ;1 I, - 7 3
m4-.c urh
Agent's Name: DEmmis & SONS tmgmmE cawT.LLc Agent Phone#:2s2-241-6962
Agents Email: D4McL Ls(dwiL.cOM
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be completed W 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
descrigtioll or drawing,with dimensions, must be provided with is letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
N you have objwdons to what Is being proposed, you must notify the N.C. DlWsion 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/s considered the same as no ob fection/f you have been notified by
CertMed Mall.
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 nprap revetments). (If you wish to waive the setback, you must#Ian
the appropriate blank below.)
I DO wish to waive sometall 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: L—
Mailing Address of ARPO:�z� ,�, 1-712 - �/gf,LeL ��^.r� Ike-
ARPO's email:b4y 1_Dxz116_1 ARPv's Phomft ?117 -
Date: � Q �*wah►er is valid for-qr NIL_ � �ARPO's Signature*
O C T 2 8 2024 Revised July 2021
DCM-MHD CITY

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: C r1A r k s I�t n n Sj±4
Address of Property: 2201 CUP
$TAnrraiu '?D• �� . NC51l�
Mailing Address of Owner/ r1 Da EflS-WC-NS g✓�/L - NC 36'51 ro
Owner's email: l.h u.Ct�- K e f o eAVL Owner's Phone#: 3 3(o-oZ 15 a-1�,4
W .corv\
Agent's Name: mwm & SONS MARINE rmsT.LLr Agent Phone#:2s2-241-6962
Agent's Email: psmc LrawiL.com
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent ProR2rtv 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.
IDO NOT have objections to this proposal. 1 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 Commence Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252)808-2808. No response/s considered the same as no objection K you have been notified by
CertiRed 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 gwst sin
the appropriate blank below.)
I DO wish to waive some/all of the 15'setback _
Signature of Adjacent~Riparian Owner
-0R-
I do not wish to waive the 15' setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner.L
Typed/Printed name of ARPO:
Mailing Address of ARPO: 3 5r� 2+� •u�rav 5��� UC- 7
ram, / �
ARPO's email:7i n if �AWft Phonst. 3� /1,�r�` --/p �7(}
Date: ! ����/ 'waiver is valid for iRLb f rVE
hen ARPO's Signature'
Revised July 2021
O C T 2 8 2024
DCM-MHD CITY

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