10154C - Indian Beach Fishing Pier Inc.

`°"'k ❑CAMA ❑ DREDGE & FILL N9101354 A B OD
�3 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 II �1� GrJC! ❑Rules attached. General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Name „d "Co✓1 BCC+ Authorized Agent E'7 c F"'; r
Address (1I &A 9 S �9 � Project Location(County): e"c //--
City I^,n, (� Z S I C'State G zip Street Address/State Road/Lot#(s) y fl✓
Phone#(_) Uwe- J
Email 6, c'VAI Subdivision
City 4,4 n zip i Sl
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS Adj.Wtr.Body 17671«4 ! Ga f(gWman/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body �5✓s9 ��=� /0"'r
CIRW:yeg/no PNA:yes/;fiy'
Type of Project/Activity C 'y o c.r1 ✓ �, c' •",:"�� 7L
(Scale: t )
Shoreline Lengthi016
Access Length I "•/- �;y'�
Pier(dock)length
Fixed Platform(s) i X ✓ 1
Floating Platform(s) r [
i
Finger pier(s) A
�„ � t• ;r�l�d
Total Platform area
Groin length/#
Bulkhead/Riprap length
Avg distance offshore t 3r r,
Breakwater/Sill rh`r'yj t'
Max distance/length
Basin,channel 9
Cubic yards
Boat ramp �c
Boathousenoatlift i X
Beach Bulldozing
n
Other
SAV observed: yes no ` c
Moratorium: n/a yes 664 ,, i „�,c.•� l,;,:., i ! ` ,-•J f. c : N C n c.
Site Photos: y,�es �fia
Riparian Waiver Attached: ✓ no
A building permit/zoning permit may be required by:
��� r� h� T/�R/PAM/NEUSE/BUFFER(circle one)
Permit Conditions w�✓'( 1 c ✓[ 'tiril�' r n C�•� �rnC 4 �� k, p•
❑ 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/COMPLI1ANCE STATEMENT. (Please Initial)
Il-c �1[,�G �q chLy
Agent r ,Iicant PRINTED N me Permit Officer's PRINTED Name v V
r a ^
c /1
Sig atur ** JAe r d compliance statement on back of permit' Signature
s' you G
Application 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 Manasement 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

00"'V ❑CAMA ❑ DREDGE & FILL 1�1354 A B C D
Previous permit
t 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.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State G ZIP Street Address/State Road/Lot#(s)
Phone#
Email / v/Y1 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/6V
Type of Project/Activity
(Scale: )
Shoreline Length
Access Length
Pier(dock)length "
Fixed Platform(s)
Floating Platform(s) ##
t`
}
Finger pier(s)
Total Platform area - J
e
Groin length/#
; ► r ,
Bulkhead/Riprap length
Avg distance offshore j
Breakwater/Sill
Max distance/length i �_ t
Basin,channel
111 �. a W._._I
Cubic yards
Boat ramp
Boathouse/Boatli�t - �1
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
i
Site Photos: yes no
Riparian Waiver Attached: yes no i
A building permit/zoning permit may be required by:
Permit Conditions ❑ TAR/PAM/NEUSE/BUFFER(circle one)
r ��7
❑ See note on back regarding River Basin rules
r
❑ 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) t '
4 ,
Agent pr Applicant PRINTED N me Permit Officer's PRINTED Name
Signatur.-* PI ase read compliance statement on back of permit" Signatures _
Application 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 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Indian Beach Fishing Pier Inc
Mailing Address: PO Box 4549 Emerald Isle NC 28594
Phone Number:
Email Address: [e-mail]
I certify that I have authorized Stephen Perry/Dynamic East Construction
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
remove the existing wood dock and rebuild with hog slat
at my property located at 1940 Salter Path Rd - Unit 3
in Carteret County.
1 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.
Prope Owner Information:
SignatQrej
Georgia L. Ricks
Print or Type Name
lilt
itle
_Z.p ZLf
Date
This certification is valid through / /

Docusign Envelope ID:D22BE189-570C-468C-B01A-1EDF1BC919E9
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jeff ward
Mailing Address: 4166 North Browntown Rd Battleboro NC 27809
Phone Number: 252-904-9042
Email Address: jeffwardll26@gmail .com
certify that I have authorized Stephen Perry/ Dynamic East Construction
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
remove the existing wood dock and build a new hog slat dock.
at my property located at Lot #3 wam Squam Ln Atl antic Beach NC 28512
,
in Carteret County.
1 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:
F D-
�7 -
Signs ure
Jeff ward
Print or Type Name
Owner
Title
10/30/2024
Date
This certification is valid through / /

I I
� d
A.
+ REVISIONS
w
MM/DD/YY REMARKS �
i O
DOCK CONCEPT •••••••�•• --/--/--
3 --/--/-- ...
JEFF WARD-3 WAMSQUAM LN.AB 4

INDIAN SUMMER MOBILE HOME PARK
POST OFFICE BOX 4549
EMERALD ISLE, NORTH CAROLINA 28594
[phone]
August 27, 2024
Mr.and Mrs.Jeff Ward
4166 North Browntown Road
Battleboro, North Carolina 27809
RE: Lot#3 - Dock Replacement/Boat Lift
Dear Mr.and Mrs.Ward,
After reviewing the description and Concept photo for the dock replacement and lift,
it is approved by Ms. Ricks, per your submitted request on August 25, 2024.
We require that all permits and final inspections be sent to the office for our files.
Also,since it is a small Park, please have the Contractor be courteous of the
neighbor's property and parking.
Thank you,
1 .Ak*,V-
BethAnn Newton
Indian Summer Mobile Home Park

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: Indian Beach Fishing Pier Inc
Address of Property: 1940 Salter Path Rd
Mailing Address of Owner: PO Box 4549 Emerald Isle NC 28594
Owner's email: [e-mail] Owner's Phone#:
Agent's Name: Stephen Perry Agent Phone#: [phone]
Agent's Email: [e-mail]
1 .
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.
2 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
SigrIature of Adjacen iparla Property Owner
-O R-
I do not wish to waive the 15' setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner: lik
Typed/Printed name of ARPO: Baptist Children's Home of NC Inc
Mailing Address of ARPO: PO Box 338 Thomasville NC 27361
ARPO's email:i //� RPO's Phone#: _�/l.' G"" 2A
Date: *waiver is valid for up to one year from ARPO's Signature"
Revised July 2021

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: Indian Beach Fishing Pier Inc
Address of Property: 1940 Salter Path Rd
Mailing Address of Owner: PO Box 4549 Emerald Isle NC 28594
Owner's email: [e-mail] Owner's Phone#:
Agent's Name: Stephen Perry Agent Phone#: [phone]
Agent's Email: [e-mail]
1 .
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.
—t BO NOT have objections to this proposal. I DO have objections to this proposal.
2• K you have objections to what is beingpropose
P A , 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 noted 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
1 do not wish to waive the 15' setback requirement(initial the blank)
3.
Signature of Adjacent Riparian Property Owner: �— r
Typed/Printed name of ARPO: AIM Investment Properties LLC
Mailing Address of ARPO: 7015 Emerald Isle NC 28594
ARPO's email: [e-mail] ARPO's Phone#:
Date: 10/30/2024 *waiver is valid for up to one year from ARPO's Signature'
Revised July 2021
r

MVR-191 (Rev.06n022)
CERTIFICATE OF TITLE
p►
VEHICLE IDEN'TIF[CATION NUMBER YEAR MODEL MAKE BODY STYLE
HONC27014FK2227393 1993 FREE MH I
TM,F. NUMBER TITLE ISSUE DATE PREVIOUS TITLE NUMBER
773457241846089 07/10/2024 771121230559089
ODOMETER READING
JEFFREY SHANE WARD JTWROS
0 4166 N BROWNTOWN RD
.t BATTLEBORO NC 27809-9278 ODOMETER STATUS
TITLE BRANDS
E
i
ONNNrR(S)NAME AND ADDRESS
JEFFREY SHANE WARD JTWROS
ROBIN OVERBY WARD JTWROS
4166 N BROWNTOWN RD
BATTLEBORO NC 27809-9278
IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
The Commissioner of Motor Vehicles of the State of North Carolina hereby certifies that an application for a certificate of title for the herein described vehicle
has been filed pursuant to the General Statutes of North Carolina and based on that application.the Division of Motor Vehicles is satisfied that the applicant
is the lawful owner.Official records of the Division of Motor Vehicles reflect vehicle is subject to the liens.if any,herein enumerated at the date of issuance
of this certificate.
As WITNESS,his hand and seal of this Division of the day and year appearing in this certificate as the title issue date.
W� �►R7b(/�lf�ti
COMNIIISIONER OF MOTOR VEHICLES
FIRST LIENHOLDER: DATE OF LIEN
LIEN RELEASED BY:
SIGNATURE.
TITLE— DATE_—
SECOND LIENHOLDER: DATE OF LIEN
LIEN RELEASED BY:
ll SIGNATURE
TITLE_ _DATE
i
THIRD LIENHOLDER: DATE OF LIEN
LIEN RELEASED BY:
SIGNATURE
TITLE-------___ DATE-
FOURTH LIENHOLDER: DATE OF LIEN
LIEN RELEASED BY:
SIGNATURE
TITLE--- --DATE--- - -
i
i
ADDITIONAL LIENS: 089 T 1 C04136490
O 8413 6 4 9 0
i91
1-4-MY i�

i
STATE OF NORTH CAIZOLINA
COUNTY OIL NORTH CAROLINA
Louse Aereemcnt
THIS LEASE AGREEMENT,dated for purposes of reference only this 91h day of July 20?d by and
between Spell-Howe Properti (hereinafter"Landlord")and Jeff and Robin Ward , (hereinafter"Tenant").
WHEREAS, Landlord is the owner of an interest in the INDIAN SUMMER MOBILE HOME PARK, and
has procured all necessary governmental approvals for such mobile home park(hereinafter the Park ); a d
WHEREAS, Tenant desires to lease from Landlord a lot within the Park for purposes of installation thereon o
a mobile home to be utilized for residential purposes, and Landlord has agreed to lease a lot within the Park to Tenant t
such purposes, subject to the terms and conditions contained herein:
THEREFORE, the parties hereto agree as follows:
1. LOT. Landlord hereby leases to Tenant, and Tenant accepts the demise thereof, of Lot No. 03 , Indian
Summer Mobile Home Park.
2. TERM. The Lease shall commence as of the 9`h day of July 2024 and shall extend for a term of hvc
12 months,ending at 1 1:59 p.m. on the 315`day of December 2024.
ow 3. RENEWAL. Subject to the specific provisions of this paragraph,Tenant shall be entitled to one succes:
one-year renewal terms. Tenant may exercise each renewal term by giving written notice to Landlord at least sixty (
but no more than one hundred twenty(120)days prior to the end of the then current lease or renewal term. The rene
shall only be effective if the following conditions have been met.
a. Every rental payment has been made in a timely fashion in accordance with his Lease;
b. Tenant has received from Landlord during the current term of the Lease no notice of violation of
provision of this Lease, or any rule or regulation relating to the Park.
C. The lot has been maintained in a good and sightly condition at all times;
d. All utility and other payments required to be made by Tenant have been timely made; and
e. Tenant is in compliance with all municipal ordinances relating to the lot and the mobile horne e
thereon.
4. RENTAL. Rental may be paid either annually, monthly quarterly,or semi-annually. The total rental
paid during the term of this Lease will increase with the frequency of payment as reflected in the following sehed
Annually $8,390.00 Paid 12/12/2023 by Sirickland's
Semi-Annually $9,900.20 (2 payments of$4,950.10)
Quarterly $10,151.90(4 paymenh of$2,537.98)
The payment plan selected by the Tenant is Annual_
lithe Tenant elects to pay annually, the total rental a ' Seml-Annual , Quarterly
trade, the initial rental payment is due: upon the execution ofent ts due upon this Lease. Theution of'this Lease, if any other ►c
Vl1A(tT°ER(,Y, the first day Of January, April, Jul "Cllfiet, rental payments shall lac tit
y and October, or SEMI-ANNUALLY, the first day J+uILIAly 4