100324C- Osprey HOA

AMA [] DREDGE & FILL I P 100324 A B
Previous permit
ENERAL PERMIT ---
Date previous permit issued
ew ❑Modification r J Complete Reissue ❑Partial Reissue
As authorized by the S to f r�thh Caroli , epartment of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 5 '.._V Rules attached. General Permit Rules available at the following link:www.deq_nc,ggy[CAMArules
ApplicanVNa '/ ' Authorized Agent _Address jj��oProject Location(County):City Stat ZIP Str t dress/State Loc#(s)Phone#Email Subdivisio s
City.._ _ ZIP
Affected CW EW PTA u ES ❑PTS Adj.Wtc Body _. . . _(natlman/unk)
AEC(s): PN OEA M IHA UW SPIMA PWS Closest Maj.Wtr.Body _
ORW. s/ es/ o
Type of Project/Activity Ar
_....._._.........._ (Sca)e: U. )
Shoreline Length—
Access length
Pier(dock)length
Fixed Platform(s) % ----
Floating latform(c)
Finger pier(s)—`—"'
Total Platform ar63'
Groin length/#
Bulkhead/Riprap length_ l•
t Avg distance offshore
Breakwater/Sill
Max distance/length — 1j
Basin,channel
Cubic yards
Boat ramp
Boathouse at
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: no '
Riparian Waiver Attached: es -
A building permit/Z VP(rmW, Mee
by Permit Co o ' TAR/PAM/NEUSE/BUFFER(circle one)
- � Cau X
See note on back regarding River Basin rules
- See additional notes/conditions on back
I AM ARE OF STATUTES,
CRC RUM AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWE OMPLIA TATE f>iT. . ( lease Initial)
A t or Ap cant P t'N , Permit r' P ame
Si atu Please r om liance statement on back of it.' Tsin
' t e } y
A plica n ee(s) C ck#/Money Order atel Expiration Date

3oe°`C0AS'4, CAMA ❑ DREDGE & FILL N9 100324 A B
Previous permit
E N E RAL PERMIT
y � Date previous permit issued
ew ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by th e ff rthC roll epartment of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC Tf/—�� ❑Rules attached. ❑ General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Narpc Authorized Agent
Address Project Location(County):
City Stat Aff ZIP S=tdress/State o /Lot#(s)Phone# t
Email Subdivisio k
City ZIP
Affected ❑CW EW PTA ❑ES ❑PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): ❑OEA THA UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body
ORW: es/ o PN es/ o
Type of Project/Activity
(Scale:� )
Shoreline Length `'��
Access Length
Pier(dock)length
Fixed Platform(s)
Floating I tform(c)
Finger pier(sT_______'
Total Platform area ,�(�//�
Groin length/#
Bulkhead/Riprap length`
Avg distance offshore If��
Breakwater Sill /
Max distance/length _
Basin,channel —� , J
Cubic yards
Boat ramp
Boathouse oat ft
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: no '
Riparian Waiver Attached: eS
A building permit/z g perm i y b re "e by:
Permit Co ' "o ❑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 RU AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWE OMPLIA TATE T. . ( lease Initial)
.•
Age7 t or Ap cant PR—IN TE 5 Name Permit MP_ a�,e
Si atur Please r om liance statement on back of it* S" at e 150b
7l
A plica&n ee(s) ck#/Money Order Iss in ate 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

❑LAMA ❑ DREDGE & FILL N9100324 A B 'c 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��r'// (l Cam-' L—�� ❑Rules attached. ❑ General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City '� Stat/ ZIP% Street Address/State oa /Lot#(s)
c
Phone#
Tu
Email Subdivisioq
City / �' ZIP
Affected ❑CW EW PTA ❑ES ❑PTS Ad!.Wtr.Body (nat/man/unk)
AEC(s): ❑OEA �IHA UW ❑SPIMA ❑PWS Closest Ma.Wtr.Borl
I Y
ORWges/no PN es/ o —
Type of Project/Activity r
--/ (Scale: -,VC )
Shoreline Length` �� /7'1 > Ct / ""
Access Length
Pier(dock)length /
Fixed Platform(s) -
Floating Flatf rrrt(c}—
Finger pier(s)
Total Platform area`
Groin length/# I ) /
Bulkhead/Riprap length l L
Avg distance offshore ,
Breakwater/Sill
Max distance/length
Basin,channel
Cubic yards
Boat ramp i
Boathouse/Boatift
Beach Bulldozing
Other
n
SAV observed: yes no
Moratorium: n/a yes no j
Site Photos: Y961 no
Riparian Waiver Attached: es
A building permit/z g permi y b req a by:
Permit Conditiops
❑TAR/PAM/NEUSE/BUFFER(circle one)
k . ❑ 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. ( lease Initial)
Agent or Applcant PRINTED Name Permit Officer' 01 ame `
Si nature**Please red compliance statement on back ofOrmit" Si at e
Application Feels) ck#/Money Order Issbij 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:
F1Tar- 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 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

o1*0(WrAe FICAMA ❑ DREDGE & FILL V 100_1'24 A B C D
-0Previous permit
R GENERAL PERMIT
z 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.dgq.nc.gov/CAMArules
Applicant Name Ly Authorized Agent ti
Address 11i Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#( ) . ,_ , i J :�1f ; /
Email Subdivision
City ZIP
Affected ❑cW ❑EW PTA ❑ES ❑PTS Adj.Wtr.Body j (nat/man/unk)
AEC(s): ❑IDEA ❑IHA UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale• _—,;) )
Shoreline Length
7771 Access Length
Pier(dock)length � 3
Fixed Platform(s) AV—
` r
Floating Platform(s)...
Finger pier(s) {
Total Platform area -
Groin length/# iiL
OF
Bulkhead/Riprap length
t --
Avg distance offshore
Breakwater Sill -
" i
Max distance/length -
Basin,channel
4
Cubic yards
Boat rampIN I
r
Boathouse/Boatlift
Beach Bulldozing
_...___...__. .....1.._.._..--- __.. _
Other
I � r
SAV observed: yes no
Moratorium: n/a yes no t
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by: ! - 1-
Permit Conditions (- ❑ TAR/PAM/NEUSE/BUFFER(circle one)
r�Y i �,. ❑ 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 App icant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
1/
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:
F-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

i t
Styron, Heather M.
Frorn: Joshua Barber <[e-mail]>
Sent: Friday, November 1, 2024 10:08 AM
To: Styron, Heather M.; Mahoney, Richard
Subject: [External] Lift permit Osprey HOA
CAUTION: External email.Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Good morning,
I wasn't sure who to send it to, so I attached you both. We need a permit, hopefully an easy one for you.
It's for a lift in an existing slip at the Osprey HOA dock on North Topsail. I have an agent authorization
from both the HOA president and the owner of the slip. If you are in town, I would love to meet you out
there to hand the check to you and grab the permit.
Thankyou,
Ryley
910-330-0703
i

AGENT AUTHORIZATION F OR LAMA PERMIT A.PPUCATION
Name of Property Owner Requesting Permit. Osprey HOA- David Dalsimer
Mailing Address: 28 Osprey Driv,e,
North Toosail Beach, NC 28460
Phone Number: 910-674-5028
Email Address: 222dals2gmail.00m
...............................
i certify that I have authorized Josh Barber"PFL Construction
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Boat Lift in Existing Slip#8_
at my property located at Osprey HOA Community Dock
in On Iow 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:
Signature
David Dalsaimer David Dalsimer
Print or Type, Name
HOA r nit
Title
_U_l L12 12021
Date
This certification is valid through-1-/-

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: ��
V �nSa f�CQC�
Phone Number:
Email Address: ( I'r a ow
I certify that I have authorized
Agent!Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development.
t 1
at my property located at nsnao ui)i oat
r
in ,n� County.
1 furtherrwre certify that l 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 Info 'on:
Signature
f
PhhKor Type Name
Title
f
Date
This certification is valid through / I

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: AA�1( af S — `h
Address of Property; t
Mailing Address of Owner. 1
Owner's email: 3bapp er's Phone#: -I
. Josh Barber/PFL Construction .91D-33U-5569
Agent's Name. Agent 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 de sc"bed to me, as shown on the attached drawing,the development they are proposing.A
descn on,,6i 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(OCIW)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 respo6 ens conslderei the some as no objection it you have been notified by
Certified Mad.,""
ail..
WAIVER SECTION
I understand that any proposed pier,stock, 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.)
100 wish to waive sometall of the 15'setback O hl
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 7 ,.
Typed/Printed name of ARPO:
rt
Mailing Address of ARPO: /
r
ARPO's email: ARPO's Phone#: L
Date: IZ9 /f/�� -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 NOTIFICATIONfWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property owner Shane BaFtus
Address Of Property Community dock, Slip 8 (Easement between 15 & 17 Osprey D I r, NT61,11 NC 28460)
kJailing Address of Owner 13 Osprey Dr, Nr Topsail Beach, NC 28460
Owner's email shane,[e-mail] —Owner's Phone# [phone]
Josh Barber/PFL Construction , 910.330-5569
Agent-s Naff*,. AgentPhone,
Agent's Email pfimanne@gmail com
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property—Owner)
I hereby certi�,,that I own prop"adjacent to the above referenced property The individual applying for this
pe,mit has described to me, as shown on the attached drawing, the development they are proposing A
scrii6lo,i or drawinq 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 26557.DCM representatives can also be contacted
at f252)805.2805,N6 t#Vonse is considered 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 r-nust tie set back a minimum distance Of 15'from my area of riparian access unless waived by me
(this does not apply to bulkheads or inprap revetments) (If you wish to waive the setback, you must sign
the appropriate blank below)
100 wish to waive somelall of the ',5'setback
Signature of Adjacen An�an Property Owner
-OR.
I do not wish to waive the 15'setback requirement(initial the blank)
7 1
Signature of Adjacent Riparian Property Owner'vire n a Vicki Finger
Typed/Printed name of ARPO: Kevin & Vicki
Mailing Address of ARPO: 17 Osprey Dr, NTB, NC 8460
ARPO's email; [e-mail] ARPO's PhoneM 707-688-1213
Date: waiver Is valid for up to one year from ARPO's Signature*
Revised May 2021

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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: (}(
Address of Property:
Mailing Address of Owner: osnr �t `���L^ ���
Owner's email:i� YIP Y fi�{C t �Nn� er°s Phone#: 2b&- Li 9-2---Ub q
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 de gibed to me, as shown on the attached drawing, the development they are proposing_ A
descri do r drawinq. with dimensions must be provided with this letter.
_I DO 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 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.)
1 DO wish to waive some/all of the 15'setback
-OR-
Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15'setback requirement(initial the blank
Signature of Adjacent Riparian Property Owner
Typed/printed name of ARPO: __nn �•
Mailing Address of ARPO: i�d (� (TO-U,
----
ARPO's email: ARPO s Phone*:
Date: 10 `fZ `waiver is valid for up to one year from ARPO's Signature"
Revised May 2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Osprey HOA- David Dalsimer
Mailing Address: 28 Osprey Drive
North Topsail Beach, NC 28460
Phone Number: 910-674-5028
Email Address: [e-mail]
certify that I have authorized Josh Barber/PFL 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: Boat Lift in Existing Slip#8
at my property located at Osprey HOA Community Dock
in Onslow County.
I furthermore certify that J 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
David Dalsaimer David Dalsimer
Print or Type Name
HOA President
Title
11 J 02 / 2024
Date
This certification is valid through I /

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: LtA -"'O'e-diau
Mailing Address: 13 OS=
N. -MpEOU
Phone Number: a0kS -- Llcl a—"7:�(�i-1
Email Address: ,.
I certify that I have authorized L
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 ah T"A
WdWE htjW&4 I �IIA V-.)
at my property located at�1 J I(� L�)
in. DOSAJ 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 i on:
ignatune
PrinYor Type Name
Title
Date
This certification is valid through l I

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: Shane Bartus
Address of Property: Community dock, Slip 8(Easement between 15& 17 Osprey Dr, NTB, NC 28460)
Mailing Address of Owner 13 Osprey Dr, N. Topsail Beach, NC 28460
owner's email: [e-mail] 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
descriolion 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.
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
mailer!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,)
'U I DO wish to waive some/all of the 15'setback
-OR-
Signature afAdjacen .prign.Properfy Owner
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO: Kevin 8 Vicki Finger
Mailing Address of ARPO: 17 Osprey Dr, NTB, NC 18460
ARPO's email: [e-mail] ARPO's Phone#: [phone]
Date: 0712912024 'waiver is valid for up to one year from ARPO's Signature'
Revised May 2021