HomeMy WebLinkAbout101521C - Cochran *o(oksr"' c�CAMA ❑ DREDGE & FILL N9 10 1521 A B 0 D
Iffi l GENERAL PERMIT Previous permit
� Date previous permit issued
k 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-01 H-17-00 ❑Rules attached. A General Permit Rules available at the following link:www.dgq.nc.Fov/CAMArules
Applicant Name StAlLaYMPE C��(
l� Coowl Authorized Agent 0-yir.+eL+^Cons+ Mar; V -e
COVt� N0.t�7Yq
Address 1 �b,,oV11Y1 bast C Project Location(County): l��i11r��(��• \1
City State t*,1 G zip 2-8584 Street Address/StateRoad/Lot
Phone#(Z_Z)'U-✓P �.3D5
Email %?Cb611Y01Y1 °' GG•YY•Lbt✓) Subdivision
city citaay po1Y1+ ZIP
Affected XCW JKEW PTA ❑ES ❑PTS Adj.Wtr.Body_UJMtA-e Da�— ( (` man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body Book(^e �Ot�✓<G1
ORW:yes, io PNA:yes 'L J
Type of Project/Activity ?Y•ern ty"C ! ak'y OIYVA 010C[Drm
p (Scale:
Shoreline Length (O t
Access Length /
Pier(dock)length X 3
J PYc'
Fixed Platform(s) �r-A V: v n
Floating Platform(s) /11
�
Finger pier(s) pJ. Qro?M-r-611
UL
V'CW
Total Platform area J/r r�{�✓5-q0_— u/ > tv t% cca` al
Groin length/# ./
Bulkhead/Riprap length / Y�
Avg distance offshore
Breakwater/Sill l
Max distance/length
Basin,channel
Cubic yards I�
Boat ramp
Boathouse/Boatlift
Beach B�u/ll�dozing
Other of 2 lom+
SAV observed: I„� 'yes no (w(A%verA> _
Moratorium: n/a yes no (�
Site Photos: yes no v oc)nsor rAvl\
Riparian Waiver Attached: yes
A building 'PL PL
permit/zoning permit may be required by: A � QY' P ',O 1 rcft
Permit Conditions r ti b V)a11 ❑TAR/PAM/NEUSE/BUFFER(circle one)
fj� eX oc u�, �� ,�1,�
V1/t1V1sW1�.lYy) O£�J' above C00.S' 1�_I/Je.TY.`nca 5+A1ob �e' ❑ See note on back regarding River Basin rules
l0�-1�•l2 �'o{a1 vnadec9 '�_w„p c _.�__�°13_s_01h o� of
��--- �See additional notes/conditions on back
43_ CQQ__Q c a l l o c�4-d W%-m Y►yo ,',jnq ye C ovnpgyu 4 4�9 O-?'tf 1 vJ
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Z4.-I
Hannah Cochran Yaroli ;
Agent r Applicant PRI ED Narne Permit Officer's PRI TED Name
Si nature**Please read compliance statement on back of permit— Signature
0A Lk bso tT 2L4 o31z�1?_
Application Feels) Check# oney Order Issuing Date Expi lion bate
;�000W412N �C]CAMA ❑ DREDGE & FILL -NY 10152 l A B � D
0
GENERAL PERMIT Previous permit
i 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 O H-IZCD ❑Rules attached. ,� General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Name pt*cr I SIA10nrnIe- CoCkSY010 Authorized Agent Ciru+al Coo1S+ �`1a►ri Ylt Co►'r�-� of vq
Address
U� 0 C s 0�IoVi%Y1 aM Y01'{'l tS Project Location(County): G '
\JJ a rtey-e
City f/&6kO\Y Qdl� State 1A G zip zacs$4 Street Address/State Road/Lot#(s)
Phone# --T23- 13 OS
Email Subdivision �p 0\pWk h y
City Ceday Po\Y* zip 2$E 84A
Affected XCW ><EW PTA ❑ES ❑PTS Adj.Wtr.Body W\(\kA-e Do1k (na man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body 904AI,At SOc�
ORW:yes eo PNA:yes/6 'L
Type of Project/Activity. Sjje� '�A y l a [pYm
(Scale:NT S )
pr
Shoreline Length 2 O
Access Length
Pier(dock)length
Fixed Platforms) Xl Q vyo NwN;
Floating Platform(s) /00o' 0 A-
Fingerpier(s) pJ
Total Platform area 05 5& 'C v/ ui CO,-A4"u�"1�q
Groin length/# / /_ U>tl�rwYaw
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill— l
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing
Other Moot 0f 2 low
%N S exi sit ng
SAv observed: yes no 1' i S
Moratorium: n/a yes no (wa��c��
Site Photos: yes no �� v
Riparian Waiver Attached: yes no
A building permit/zoning/permit may be required by: A r PO 1
Permit Conditions 0 o eX oA �A t1 ❑TAR/PAM/NEUSE/BUFFER(circle one)
bC Ql VWIY1\VYNS-A 1 O:F 3' abo.,e C.O0LSJZ?N( ►JZe_J`0. 5 LAlobtYVIV4e' ❑ See note on back regarding River Basin rules
to c Toi-mI sVICLdej \nyaso, ° 0LA- o
o sG-F�4 al l owe d w�-W1 �►� ��1-e C ovr�n�nc.cF7 y See additional notes/conditions on back
S1 �9
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
Si nature"Please read compliance statement on back of permit" Signature_�
0A y b3o 011Z 29 Cal Z
Application Fee(s) Check# oney Order Issuing Date Expi lion 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] 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: 252-247-3330 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: 252-948-0478
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:910-395-3964
(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
3oX%aC AR4, E]CAMA ❑ DREDGE & FILL N° 101521 A B C' D
Previous permit
GENERAL PERMIT Date previous permit issued
❑New ❑Modification ❑Complete Reissue [_1 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 O l N• i -c7 ❑Rules attached. E] General Permit Rules available at the following link:www.dgq.nc.gov/CAMArules
Applicant Name pt C1�' 3 `_L\tiC++�"c C + r6i Ct�'C�'>� M6Y b1-C C,;�-I}-V"" .- i��
C�i�ti`C 1� ) Authorized Agent �
Address , ` �C 1 1�\\,0 Y�0\' Project Location(County): C_GI
City State f A zip = y Street Address/State Road/Lot#(s) 7�)` I
Phone#(_)
Email Subdivision
City ZIP
Affected ❑CW ❑E W ❑PTA ❑ES ❑PTS Adj.Wtr.Body C,��k ((na�t man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body c'c � \-e ':�,C C r\C-I
ORW:yes/no PNA:yes/no
Type of Project/Activity C\Tl C +
(Scale:N-T S )
Shoreline Length
Access Length
Pier(dock)length J X I
Fixed Platform(s)
Floating Platform(s) �__•- u (A ,,e
Finger pier(s)
Total Platform areai
t� i
Groin length/# ! V �l' tL •r '{:
Bulkhead/Riprap length
Avg distance offshore V,
Breakwater/Sill l
Max distance/length
Basin,channel i
Cubic yards
Boat ramp
Boathouse/Boatlift ! r`
Beach Bulldozing
Other PSG\x 0 �v nr
SAV observed: yes ' no
Moratorium: n/a yes no ` .
Site Photos: yes no
Riparian Waiver Attached: yes no;
X
A building permit/zoning
permit may be required by: '�l(-fr v ��I 't i r Vc,
Permit Conditions
7 try U� 1�1C� 1 u\`je Y Cc stc�l 1N Ct �r , `�1,� L\\1 ❑TAR/PAM/NEUSE/BUFFER(circle one)
r
2p, cooc-,Jt C CC',Sin( �e k\//rtC� \�CiS�YCI ❑ See note on back regarding River Basin rules
)C<< = �� � S['�,7"� C � Gf
�\( Y❑ 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)
�_n�-C\Lk,Tthv E
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
CCar l
Signature"Please read compliance statement on back of permit" Signature
Z.
Application Fee(s) Check#/Money Order Issuing Date 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:
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:252-247-3330 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:252-948-0478
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:910-395-3964
(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
3o� COAST4, DCAMA ❑ DREDGE & FILL N9101521 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:
I SA 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 ZIP Street Address/State Road/Lot#(s)
Phone#(_)
Email Subdivision
City 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 i +
Fixed Platform(s)
rr
FloatingPlatform(s)
Y-
i
Finger pier(s) -t -- - _r ell I
- - - -IL--
,F
Total Platform area z
Groin length/#
Bulkhead/Riprap length -
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing ! ; ; i
Other
`..,tv
I _ �.. . I -
SAV observed: yes no
Moratorium: n/a yes no
I
Site Photos: yes no - --
Riparian Waiver Attached: yes no1 {
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)
I
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature"Please read compliance statement on back of permit"* Signature
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: 252-247-3330 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax: 252-948-0478
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:910-395-3964
(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: Peter& Suzanne Cochran
Mailing Address: 129 Dolphin Bay Estate
Cedar Point, NC 28584
Phone Number: (252) 723-1305
Email Address: pcochran@ec.rr.com
I certify that I have authorized Crystal Coast Marine Contracting
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Demolition of Current Wooden Dock/
Construction of n Concrete Dock
at my property located at 129 Dolphin Bay Estate, Cedar Point
in Carteret County.
l 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.
Property Owner Information:
Signature
Peter Cochran
Print or Type Name
Owner
Title
Date
This certification is valid through ! /
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: Peter & Suzanne Cochran
Address of Property: 129 Dolphin Bay Estate, Cedar Point
Mailing Address of Owner: 129 Dolphin Bay Estate, Cedar Point
Owner's email: pcochran@ec.rr.com Owner's Phone#: (252) 723-1305
Agent's Name: Crystal Coast Marine Contracting Agent Phone#: (910)325-8481
Agent's Email: liannah@crystalcoastmarinecontracting.corn.
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
+1--l'y—Gry tl—r I—"F:—Pa.ty adJE.cc of f+ the 6nvc roferenced 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.
8r kM 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 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
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank) RN 87"
bm Ma6ow gar6ar�rayCof
Signature of Adjacent Riparian Property Owner: RoSe�,ai,ow nove,2uz<,_
Typed/Printed name of ARPO: Doris Shaw
Mailing Address of ARPO: 7520 Lead Mine Road #306, Raleigh, NC 27615
ARPO's email: Nrsmarlow@gmail.com ARPO's Phone#: 919-221-3376
Date: 11/06/24 *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: Peter& Suzanne Cochran
Address of Property: 129 Dolphin Bay Estate, Cedar Point
Mailing Address of owner: 129 Dolphin Bay Estate, Cedar Point
Owner's email: pcochran@ec.rr.com Owner's Phone#: (252) 723-1305
Agent's Name: Crystal Coast Marine Contracting Agent Phone#: (910)325-8481
Agent's Email: `iannah@crystalcoastmarinecontracting.com
ADJAGLNT RIPARIAN PROPERTY OWNER'S GERTIFIGATION
(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 descrihed 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.
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) 608-2808. 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.)
t
I DO wish to waive some/all of the 15' setbackLz�cl �
Signature of Adjacent Riphrian Pro y wner
-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: Carl & Michelle Lewis
Mailing Address of ARPO: P.O. Box 3182. Eureka, NC 27830
ARPO's email: ARPO's Phone#:
Date: `waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
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