89313A - Amick, Ralph and Martha

"°" , AMA ElDREDGE & FILL N9 89313 UA B C D
47 G NERAL PERMIT Previous permit
Date previous permit issued
EviNew [-]Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the §tateof North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC �Ilt ' 1ga �' ❑ Rules attached. ❑ General Permit Rules available at the following link www_dea nc cov/CA_ MFyuIes
Applicant
Address
A
City f AttaT_ State /J ZIP
Phone ty 9 g �
Email 01 z'K M 1'� ct.Csty a ti la ^5 r. G oil+
Affected ❑CW �W 29PTA ❑ES ❑PIS
AEC(s): ❑OEA ❑INA ❑UW ❑SPIMA ❑PWS
ORW: yes, r�a PNA: yes/0
Type of Protect/
Shoreline Length / a7
Access Length
Pier (dock) length ^
Fixed Platform(s)
Floating
Finger plerls)
Total Platform area
Groin length/g
Bulkhead/ Rlprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Authorized Agent 1 /ytQ}-j K� Ca//S+Ti cZ`44Ix
Project Location (County): `li aC'SZ_ Street Address/State Road/Lot#(a) 5-7 9 ✓{'1 V Auz.S1.. rir_i.a—
Subdivision S ,e. S Ra.+r act \ C ai
City _{�'� (� 5 �/ ZIP
Adj. Wtr. Body C'm- ^�1 �(O[iSJ �.(tiZa. i/C� k)
Closest Mal. Win Body PO. m,'CC Sa wl4
rcam�ist--s (Scale:tpT�5 )
6'�4 If S /A1`6 E•o cl�r nf�g �j¢�1 C YiY �a
• � • A�.t� tad.
• N iwrcr Ft—
Boat ramp ��� ��yf l
Boathou / Boatlift 11`� , uS(„
Beach Bull ng — W
Other.
A EJC I S Y-iN c o�
SAV
ors
observed: yes
Moratorium: n/a yes I
Site Photos: a no !y
Riparian Waiver Attached: /pepyc no
A building permit/zoning peter-mR�in3)y be required by:c}-
Permit Conditions
i � •i S
� C
3
�µI L
U
❑ 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 THATAPPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT (Please Initial( •fyl. -m
Monica L. M. Small V..
Agent or Applicant PRINTED N
7��r� :rW • �aua
57ure••Please read co pi nce st emeont on back of permit••
C--rt=> 3 3��
Application Feels) Check H/Money order
Permit Officer's PRINTED Name
Si re
�Z' /zs/zy J�25�zY
Issuing Da e[ Expiration Date

❑DREDGE & FILL N9 89313 B C D
G NERAL PERMIT Previous permit
Date previous permit issued
w ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized b`y.J,th/e rate of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC (f° �� ❑ Rules attached. General Permit Rules available at the following link: www.de .nc. ov CAMArules
Applicant Name {t X
Address 10, 2%
City o�S Bracezip
Phone#(�) 989—syrldy (
Email C1I M 0c¢ .Gs�nN s�AtSA•cavl
U
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s) 5721f77 y1i V
/25,7 LoF
Subdivision Can c( spa
City /t��"`—e('as ZIP `, '79 13
Affected ❑ CW 1�ifW R�P?A ❑ ES ❑ PTS Adj. Wtr. Body CQ. n\,o--` / c--. ;c
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body Pa- m' a Co Sa Kn 6,
ORW: yes4o PNA: yes/. Type of Project/ Activity n s �c..� / /�g t.._l ,fJ i , : na i it 5 /' P /Ja Cst 47.
(Scale: t.(`%!>
Shoreline Length / as
Access length
Pier (dock) length ^ �Y j S/N(S
Fixed Platform(s) � / • � • Ae..�,nf a 2ecL
Floating Platform(s)
Fingerpier(s) • C�K/SFr
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore t
Breakwater/Sill'-
Maxdistance/length C_ • �q
Basin, channel 1�
Cubic yards
Boat ramp
Boathou a/Boatlift / r "At S(
Beach Bull ozmg — r
Other E/CISr/N6 T�
o �Z DO G K
SAVobserved: yes
Moratorium:
)
Moratorium: n/a yes
Site Photos: es no
Riparian Waiver Attached: /q€�yc no _
A building permit/zoning perm, y be required by: Cac....
❑
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
Agent or Applicant PRINTED Name
Sign ure "Please read compliance statement on back of permit"
Application Feels) Check #/Money Order
(Please Initial)
Permit Officer's PRINTED Name
Si re
�Z5 125A`, A
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 1-1 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:
xr
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]
(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
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Berne, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender 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: RALPH O. AMICK & MARTHA J. AMICK
Mailing Address: PO BOX 182
HATTERAS, NC 27943
Phone Number: 910-987-5488
Email Address: [e-mail]
I certify that I have authorized SCOTT C SMALL / LSI 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: INSTALL 2 NEW PILES IN
EXISTING SLIP FOR NEW 6 PILE BOAT LIFT (14' X 16')
at my property located at 57179 M V AUSTRALIA LANE, HATTERAS, NC
in DARE 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:
Title
l Date
This certification is valid through

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09 3m 2s 25 e2 6996

Docusign Envelope ID: 3AD472CE-E6EA-4BFB-BD9A-34C3FAD55481
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:
Address of Property:
RALPH O. AMICK & MARTHA J. AMICK
57179 M V AUSTRALIA LANE, HATTERAS, NC 27943
Mailing Address of Owner: PO BOX 182, HATTERAS, NC 27943
Owner's email: [e-mail]
Owner's Phone#: [phone]
Agent's Name: SCOTT C. SMALL/LSI MARINE Agent Phone#: [phone] ofc / 252-473-7695 cell
Agent's Email: MONICA@LSIMARINE / [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 forthis
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.
iI 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. 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
No
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: 11Z Iu e,414
Typed/Printed name of ARPO:
Mailing Address of ARPO:
TIMOTHY W. MIDGETT
PO BOX 250, HATTERAS, NC 27943
ARPO's email: [e-mail]'s Phone#: [phone]
Date: 9/26/2024
'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 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:
RALPH 0. AMICK & MARTHA J. AMICK
Address of Property: 57179 M V AUSTRALIA LANE, HATTERAS, NC 27943
Mailing Address of Owner: PO BOX 182, HATTERAS, NC 27943
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: SCOTT C. SMALULSI MARINE Agent Phone#: [phone] ofc / 252-473-7695 cell
Agent's Email: MONICA@LSIMARINE / SCOTT@LSI MARI NE.COM
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 forthis
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.
It 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. 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 15from 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
S;gnetur oM6jace t P.ip i n Property Ownor
OR_ L - 3�5- 2
���� yy :Qll
T- 3 -3zvz
I do not wish to waive the 15' setback requirement (initial the blaw
Signature of Adjacent Riparian Property Owner:
Typed/Printed name ofARPO: DAVID HEETER & PEGGY HEETER
Mailing Address of ARPO: 513 CHARLESTON ROAD, SPENCER, WV 25276
ARPO's email:
Date:
ARPO's Phone#:
*waiver is valid for up to one year from ARPO's Signature`
Revised July 2021

LTa ial i u
Land rr•;nsfer S 2500.00
Excise Ta:,: $ _ 5M•e0
830
mill4
1
Idlli�tiM l'4dlh6GlGt hi41Y+,1iD41N a 1I III
B: 1830 P: 477 Doc Id: 6274462
04/23/2010 03,39 M aeeelct 4 10-4381, 10-4402
mn2C�'ae nDEED NCE,n: P.,,.t.r or oe:ai'CDa . " oNc 5500 ao
This instrument should be mailed to the preparer:
Dixon & Dixon Law Offices, PLLC; P.O. Box 750, Avon, NC 27915
Brief Index Description: Unit 202, Hatteras Retreat Condos
Parcel Identifier Namber. 015422202 File Number: Ahi!P.HO01-410
NORTH CAROLINA GENERAL WARRANTY DEEP
THIS WARRANTY DEED u wade this 22° day of April, 2010 by and between:
GEORGIA G. RHODES
and Husband, JOSEPH W. RHODES
3920 Savannah Drive
Chesapeake, VA 23322
(hereinafter referred to in the neuter singular as' Ike Grantor") and
RALPH O. AMICK
and Wife, MARTHAJ, AMICK
2071 Tailwi:t+s Court
Eastover, NC L8312
(hereinafter referred to in the neuter singular as "the Grantee"):
WITNESSETH, that the Grantor, for a valuable consideration paid by the; rmmce, the receipt of which is hereby acknowledged, has
and by these presents does hereby give, grant, bargain, sell and convey u„to the Grantee, its heirs, successors, administrators and
assigns, all of that certain lot or parcel of land situated in the Village of Hattc,as, Hatteras Township of said Dare County, North
Carolina, and more particularly described as follows:
Attached hereto and incorporated herein by reference as Exhibit A.
The property herein described was acquired by the Grantor by deed recorded in Book 842 at Page 113. in the Public Registry of Dare
County.
A map showing the above described property is recorded in Unit Ownership Book 4, Page 269-273. incic^.isve, in the Public Registry
or P.,re County.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belorging to the Grantee in
fee simple.

The Grantor covenants with the Grantee that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the
lawful claims of all persons whomsoever except for the following exceptions:
Ad Valorem taxes for 2010 and all subsequent years.
2. Subject to any easements and restrictive covenants as may appear of record in the Pehlic Registry of Dare County.
GR,tNTOR MUST INITIAL ONE OF THE FOLLOWING:
This properly includes the primary residence of at least one of the Grantors, (per NC GS § 105-317.2)
7 hi: properly does not include the primary residence of at least one of the Grantors. (per NC GE § 105-317.2)
IN WITNESS W1L:REOF. the Grantor has hereunto set his hand and seal.
GEORGIA CrWODES
�' (SEAL)
JOSE H W. RHODES
STATE OF N orFe. Car""' Do. rc- COUNTY
1, a Notary Public of the County and State afores, is, certify that GEORGIA G. RHODES, Grantor personally appeared be a this
day and acknowledged the execution of the foregoing instrument. Witness my hand and official stamp of seal, this ay of
April, 2010.
My Commission Expires:
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STATE OF V \ (q "n t Gam- Civ-PS L'-�'QO-I�f C�U:dT
h a Notary Public of the County and State aforesaid, certify that JOSEPH W. RHODES, Grantor personally appeared before me this
day and acknowledged the execution of the foregoing instrument. Witness my hand any official stamp or seal, this � aay of
April. 2010.
My Commission Expires:
III hri'+Y�l9+W�dI�G�bi�Rlfi+Pfr� Gy4t dH41Y�1 If�tIN�J �I III

Exhibit A
All that certain condominium unit and its appurtenances located and being in the Village
of Hatteras, Hatteras Township, Dare County, North Carolina, and known as, designated
and being Condominium Unit No. 202 of the Hatteras Retreat Condominium as shown on
the plans entitled, 'Plat of Hatteras Retreat Condominium," recorded in Unit Ownership
Book 4, Pages 269-273, inclusive, in the Office of the Register of D^%s of Dare County,
North Carolina, together with a 1/6" undivided interest in the common elements as
declared in the Declaration of Unit Ownership to be appurtenant to said Condominium
Unit and, in addition thereto, as limited common elements pursuant to Annie 3 of the
said Condominium Declaration, of a boat dock and slip designated as Boa! Slip No. 6,
further identified as the Sixth Boat Slip of six (6) slips as numbered sequemiatly from
west to east with the westernmost boat slip being numbered 1, and a parking garage
ondemeath the condominium building identified as the Southeast Garage, together with
an additional parking space located immediately adjacent to and southward of the boat
dorl, and slip herein conveyed, and together with any furniture, fixtures and persons(
property which may be located within said Condominium Unit. All of the aforesaid
common rlements and limited common elements as declared in the Declaration of Unit
Ownership are appurtenant to said Condominium Unit, which said Declaration was
recorded iq the Office of the Register of Deeds of Dare County, North Carolina, on
January 12, 1990, and recorded in Book 661, Page 670, said Declaration of Unit
Ownership, Bylaws and plat having been declared and re -adopted by Resolution Trust
Corporation, and its Trustee, The Fidelity Company, by that certain instrument dated the
30" day of July,1991, and recorded in Book 814, Page 637, Dare County Registry.
But the foregoing conveyance is made subject to those certain restrictions, conditions,
obligations and assessments as contained in that certain Declaration of Unit Ownership
filed on January 12, 1990, it the Office of the Register of Deeds of Dare County, North
Carolina, in Book 661, Page 670, including also those Bylaws and rules, regulations and
restrictions adopted pursuant to the authorizations contained therein, and adopted
pursuant thereto by the Hatteras Retreat Condominium Unit Owners Association, Inc., a
North Carolina nonprofit property owners association.
6274462 8: 1830 P: 477 Pa+p 3 of 3 4/23/10 3:39 PM
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