20190058 Ver 1_CAMA Application_20190112

NORTH CAROLINA
Environmental Quali*
January 11, 2019
MEMORANDUM:
FROM: Gregg Bodnar, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Ave., Morehead City, NC 28557
Fax: [phone] (Courier 04-16-33)
gregq.bodnara_ncdenr.gov
SUBJECT: CAMA /Dredge & Fill Application Review
Applicant: Billy Tyson Sr.
Project Location: SR 1115 at 120 Dickinson Road Chocowinity NC 27817
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
BRAXTON DAVIS
Director, Division ofCoastal
Management
Proposed Project: Propose to cover existing uncovered boatlift with 14' wide x 30' long roof and
expand existing platform additional 104 ft2 also replace 389 liner feet of
bulkhead 2' waterward of existing bulkhead.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Gregg Bodnar at the address above by February 1 2019. If you have any questions
regarding the proposed project, contact Kelly Spivey [phone] when appropriate, in-depth comments
with supporting data is requested.
REPLY: This agency has no objection to the project as proposed.
"Additional comments may be attached"
This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
PRINT NAME _
AGENCY
SIGNATURE
DATE
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext., Wilmington, NC 28405 919 796 7215

DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Billy R. Tyson, Sr.
2. LOCATION OF PROJECT SITE: located off SR 1115 at 120 Dickinson Road, in Long Point Landing
Subdivision, near the Town of Aurora in Beaufort County, North Carolina
Photo Index —2000; 97-1116, F6 2006; 97-8182, T18, U18
Location - 35° 25' 42" N 760 58' 18" W
3. INVESTIGATION TYPE: CAMA & Dredge and Fill
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit — 24 October 2018
Was Applicant Present — yes
5. PROCESSING PROCEDURE: Application Received — 21 December 2018
Office — Washington
6. SITE DESCRIPTION:
(A) Local Land Use Plan -1997 Beaufort County Land Use Plan
Land Classification from LUP - Conservation (water), Rural (land)
(B) AEC(s) Involved: Coastal Shoreline, Public Trust
(C) Water Dependent: Yes
(D) Intended Use: private
(E) Wastewater Treatment: Existing — septic tank
Planned - none
(F) Type of Structures: Existing — bulkhead, pier, boathouse, single-family dwelling
Planned — boathouse, bulkhead, platform
(G) Estimated Annual Rate of Erosion: N/A
(H) Source — applicant
7. HABITAT DESCRIPTION: [AREA]
PR FTI(:FTI Fir 7 Fn ��rrrnn
(A) Vegetated Wetlands
(404)
(B) Non -Vegetated Wetlands
±778 ft2
±780 ft' (shaded)
Creek Bottom
(bulkhead)
(C) Other (Uplands)
disturbed
±7,800 ftz
(bulkhead
(D) Total Area Disturbed: ±9,358 ft' (0.21 acres)
(E) Primary Nursery Area: no
(F) Water Classification: SB NSW Open: No
8. PROJECT SUMMARY: The applicant proposes to cover an existing uncovered boatlift with a 14' x 30'

roof and expand an existing platform to 20' x 18'. Additionally, the applicant proposes to replace 389 linear
feet of bulkhead.

Billy R. Tyson, Sr.
120 Dickinson Road.
Beaufort County
Proiect settine
The project site is located off SR 1115 in the Long Point Landing Subdivision at 120 Dickinson Rd.
near the community of Blounts Creek in Beaufort County, North Carolina. The lot is approximately 0.8
acres (34,900 ft) in size and has 389 linear feet of shoreline on Blounts Creek. Man-made features on the
lot include a single family residence, outbuildings, bulkhead, pier, platform, and uncovered boatlift. The lot
is approximately 6.0' in elevation above the Normal Water Level. The lot is mostly vegetated with lawn
grasses, pines and various hardwood trees.
Both the downstream and upstream properties are developed with single family dwellings with piers
and bulkheads. Blounts Creek Creek is classified as SB NSW by the Environmental Management
Commission at the project location. No SAV was observed in the area. Blounts Creek is classified as inland
fishing waters at the project location. The property is subject the Tar -Pamlico Riparian Buffer rules enforced
by the N.C. Division of Water Resources.
Project description
The applicant proposes to cover the existing uncovered boatlift with a 14' wide x 30' long roof and
expand the existing 224 ft' platform an additional 104 ft2 by adding a 12' x 4' and 14' x 4' section on the
right side of the platform. The new boathouse will be located no further waterward than the existing pier.
Additionally, the applicant proposes to replace 389 linear feet of bulkhead 2' waterward of the existing
bulkhead.
Anticipated impacts
The construction of the replacement bulkhead will result in the filling ±778 ft'of Creek bottom. The
installation of the dead -men and tie back system will result in the high ground disturbance of±7,800 W. The
construction of the 14'x30' roof will result in ±420 ft2 boathouse coverage. The total platform square footage
of the pier, platform and boathouse will be 984 ft'. The maximum allowed square footage for this property is
2,000 W.
Kelly Spivey — 28 December 2018

December S, 2019
Mr,. Spivq
Nc orcoumi. manapmant
943,
s6 AV Sq.11e11
RR: Bnikhealrepl4MmmL Boat LOT Roof and Piet addlfion at 120 Dickinson Rd Choeowinity
Dear *. Npivey
I O& submitting myrapplIcathm package tee sd ' a x-at?fia my* WOO&baaf HA add 48 sq� it to m ezistingpiar and
to xepls4re tuyegl dlotatltig.Wostd"bulk:Uead with anew vinyl balkbesifi (apprmeitly 3&0'
I:havainahtded'the �`�dna�net?ta;
� Annliaatiar`fnrMA(usr'ilvalr..x.tan*Dm..,.7r-
• Bxaavmion: and'i li apptigatton
e Stimtures appi#cation
• Plotplan ofthe lot
• Dmdofmcordfor tkl)ro"°
• Cortified shack In the amount of$4WOQ
• Drawkg shawiugapmposedplan view anttnlovatlm Otte $oat lift -"of
• Drawing showing the proposed Pier Addition
• Limited drawing offfinexhing and proposed site plan
Thank youfar all your help praparing fhis infoxmatianF:Please let.rae imaw ifyou need anythittg else.
Respectfullysubftdt d
Billy Tyson St; CH
President
• ,J
DEC 0 3 2018
vtieats�rstc .t rk+
Ptaat9 25xa7§&tM FaXZ62784et NWOIjp�jg n6a kl�+'M`{.A4�t$25

pen Mr -1
APPLICATION for
Mayor Development Permit
(last revised 12127108).
North Carolina DIVISION OF COASTAL MANAGEMENT
tip
!Y li; Sac4"f 3 1"l. 4
Business Name
Project Name (d applicable)
Applicant 1: First Name
MI
Last Name
'
'R.
(�^
�-so✓t
Applicant2: First ame
MI
Last Name
ff additional applicants, please attach an additional page(s) with names listed.
Mailing Address
PO Box
City
State
�e� T>l wSei—
Af? N
N
ZIP
Country
; ft
Phone No.
FAX No.
ASt,- �)/q -133 b ext.
Street Address (if different from above)
City
State
ZIP
Email
NO /O
Business Name
� f
� V
Agent/ Contractor 1: First Nam
MI
Last Name
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
Phone No. 2
- - ext.
- - ext.
FAX No.
Contractor #
Street Address (if different from above)
City
State I
Email
UtlM-YVHRO
<Form continues on back>
252-808-2888 :e 1-888.411COAST :: www.nccoastaimanagament.net

Form DCM MP -1 (Page 2 of 4)
APPLICATION for
Major Development Permit
RM
0
County (can be mul8ple) Street Address State Rd. #
1���t�`�prT 1'�O l7;GKP.�Sor �d• 5;P, I0►5
Slubdivision Name A
hon I pinrt i•�..•�c�t`.t
C/i
(...�jo4e W iN7'
Stea�t/e /
� µ Y
Zip
� }�! '�
Phone No.
Lot No.(s) (d many, attach additional page with list)
ext.
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
�7ew_ - 7 L, c- o
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major waterbody to the proposed project site.
atural ❑Manmade []Unknown
h. How does local government zonethetract?
i. Is the proposed project consistent with the applicable zoning?
Ck wl I ot C \` 1 U 't v
e. Is proposed work within city limits or planning jurisdiction?
I. If applicable, list the planning jurisdiction or city limit the proposed
❑Yes JAo
work falls within .In,
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes Ke No ❑NA
/r
i4
,
a. Total length of shoreline on the tract (ft.) b. Size of entire tract (sq.ft.)
38'9 , d . Y A(oil- s
c. Size of individual lot(s)n
d. Approximate elevation of tract above NHW (normal high water) or
NT:r
(If many lot sizes, please attach additional page with a list)
NWWL (normal water level)
6 ,d ❑NHW or)1WL
e. Vegetation on tract
wH1^�ss,�;���-,�teS) shrubs
f. Man-made features and uses now ontract
1 / 75[ ,c 1
S..,S lTa •c_. �kN+� l v ti L • L r"or h� �Cd Dr4 f 1 f 41
be E, a S 1%G
C. r `�Q� l �� 4
l , q _F
/�iK
g. Identify and describe the existing land uses adlacent to the proposed project site.
i3o�-►, 4.d1�-eic•�,.�T p�.o�.�..�t�f f�rr R�;�1 �-rtil u�.�-1.
e K
�a. j C i7 e CQ J
h. How does local government zonethetract?
i. Is the proposed project consistent with the applicable zoning?
r n /
(Attach zoning compliance certificate, if applicable)
�(/
❑Yes ❑No ERNA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes Wo
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes Ke No ❑NA
If yes, by whom?
I. Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes ANo ❑NA
National Register listed or eligible property?
<Form continues on next page> DECEIVED
DEC 0 3 2018
252-808-2808 .. 1-888-4RCOAST .. www.nccoastalmanagemen®

Form DCM MP -1 (Page 3 of 4)
m. (i) Are there wetlands on the site?
(ii) Are there coastal wetlands on the site?
(iii) If yes to either (i) or (ii) above, has a delineation been conducted?
(Attach documentation, i/availabie)
IF. Descdbeexisting wastewater treatment facilities.
C4N Sj t- C S'& P' -P C
o. Describe existing
P . Describe existing storm water managemor treatment
a. Will the project be for commercial, public,
v
APPLICATION for
Major Development Permit
❑Yes
❑Yes {hyo
❑Yes /❑No
b. Give a brief description of purpose, use, and daily operations of the project when complete. �ivate/Community
Q r.°Pvg•Tu �ove.r 00,7' L.i'F y' °thcA
eX�� In 7
ep Lc�c e cam( �� V_ '& if
C. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
1� n.v r 14f rv,, .10T tb t tl
/15�rug] i
d. List all development activities you propose. ^ r
ah✓J C K 1 7'i LSmc..� �i-� W t 1 k
eKF
d Plage gee(aC V-- iCK.i`i n( Q�.1 tC�p 41L
e. Are the proposed activities maintenance of an existing Project, new work, or both?
N!U/
f. What is the�Yapproximate total disturbed land area resulting from the proposd project?'
�7p 'i8gYt or❑Acres
g. Will the proposed p oject encroach on any public easement, public accessway or other area
that the public has established use of? ❑Yes o ❑NA
h. Describe location andel type of existing a proposed discharges to waters of the state.
LO T -T-
i. Will wastewater orstormwater be discharged into a
If yes, will this discharged water be of the same salinity as the receiving water?t
j. Is there any mitigation proposed? ❑Yes []No ❑NA
If yes, attach a mitigation proposal. ❑Yes o ❑NA
<Form continues on back>
DEC 0 3 2018
252-888-2808 :: 1.888-4RCOAST :: w ww.ncicoaskalmanagement.net

Form DOM MP -1 (Page 4 of 4)
APPLICATION for
Major Development Permit
S. AddiflOnal/n aimafidn # r a nip p y hw- g a
In addition to this completed application form, (MP 1) the following items below, if applicable, must be submitted In order for the'applioatidn
packagelto,bo complete Items (a) (I) are always applicable to any major development application Please consult the application
7 sttucf. b b bowt0y rop prepare fib 1f Jt `tis below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly Indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that Is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with stale application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DE DO O O
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name a h o I&A e S --s- Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable. rV
A-
i. Wetland delineation, if necessary. n 11))4-
1. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N. C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
lfunds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
I understand trial any permit Issueo In response to this application will allow only to
The project will be subject to the conditions and restrictions contained in the permit.
in the application.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned landsin connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best qfxny knowledge.
Date `PZ0 — % K Print Name
Signature
Please indicate application attachments pertaining to your proposed project. RECEIVED
❑DOM MP -2 Excavation and Fill Information ❑DOM MP -5 Bridges and Culverts
❑DOM MP -3 Upland Development
❑DOM MP -4 Structures Information DEC 0 3 2018
OCM-WARD
252.808.2808 ..
i-88B.4RCOAST ..
www.necoastalmanagement.net

(Form DCM MP -2.
IQ
EXCAVATION and FILL
(Except far bridges and culverts-)­­
asp-�� y- (3 3v
I 1
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please Include all supplemental Information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given In feet.
Access
Channel
Other
(NLW or
Canal
Boat Basin
Boat Ramp
Rock Grolh
Rock
(excluding
Breakwater
er
shoreline
Length
stabilization
Width
Avg, Existing
Depth
NA
NA
Final Protect
Depth
NA
NA
I. EXCAVATION
a. Amount of material to be excavated from below NHW or NWL In
cubic yards.
-. (1) Does the area to be excavated include coastal wetlands/marsh
(CW), submerged -aquatic vegetation (.SAV), shell bottom (SB),
or other wetlands (W L)7 If any boxes are checked, provide the
number of square feet affected.
OCW OSAV QSB
OWL _ ONone
(ii) Describe the purpose of the excavation in these. areas:
2. DISPOSAL OF EXCAVATED MATERIAL
i. Location of disposal area.
(1) Do you claim title to disposal area?
OYes ❑No [INA
(ii) If no, attach a letter granting permission from the owner.
(1) Does the disposal area include any -coastal wetlands/marsh
(CW). submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL .— ❑Npne
(ii) Describe the purpose of disposal in these areas:
`This section not applicable
b. Type of material to be excavated.
d. High -ground excavation in cubic yards.
IEC
DEC
y 0e n3, /20118AR8
DCM-WD
This section not applicable
b. Dimensions of disposal area.
d. (1) Will a disposal area be available for future maintenance?
❑Yes ONO 'ONA _
(ii) If yes, where?
L (1) Ooes the disposal include any area in the water?
OYes ❑No ❑NA
(it) It yes, how much water area is affected?

(Car
Form DCM MP -4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
a. (i) Is the docking facility/marina:
❑Commercial ❑Public/Government rivate/Community
c. (i) Dock(s) and/or piers) ^//0
(ii) Number
(iii)Length
(iv) Width
(v) Floating ❑Yes []No
e. (i) Are Platforms included? lf<s ❑No
If yes:
(ii) Number
(iii) Length
(iv) Width
(v) Floating ❑Yes $No
Note: Roofed areas are calculated from dripline dimensions.
g. (i) Number of slips proposed
(ii) Number of slips existing
If
1. Check the proposed type of siting:
❑ Land cut and access channel
[]Open water; dredging for basin and/or channel
J$bpen water; no dredging required
❑Other; please describe:
fi �
k. Typical boat length:
m. (i) Will the facility have tie pilings?
❑Yes XNo
(ii) If yes number of tie pilings?
b. (i) Will the facility be open to the general public?
❑Yes,19No
d. (i) Are Finger Piers included? ❑Yes PO
If yes:
(ii) Number
(iii) Length _
(iv) Width _
(v) Floating ❑Yes []No
f. (1) Are Boatlifts included? []Yes [ANo
If yes:
(ii) Number _
(iii) Length _
IN) Width _
In. Check all the types of services to be provided.
❑ Full service, including travel lift and/or rail, repair or
maintenance service
❑ Dockage, fuel, and marine supplies
Dockage ("wet slips") only, number of slips: 21
❑ Dry storage; number of boats: _
❑ Boat ramp(s); number of boat ramps: _
Other, please describe:
?"r.tV T. C,00aV ex.fr �y
Ocea is - r .Asch Ra '
j. Describe the typical boats to be served (e.g., open runabout,
charter boats, sail boats, mixed types).
Rmu.,J ab c,"T/GC -Zi -V.- `ZJK-4 d/Y
1. (i) Will the facility be open to fpq page{toubllw?- D
❑Yes Q�No �'{ i!✓ C I V � SJ
DEC 0 3 2018
CCM -WARD
252.808-2808 :: 11-888.4RCOAST :-. www ncconstalmanagement.net revised: 12/27/06

Form DCM NIP -4 (structures, wage 2 of 4)
a.
Check each of the following sanitary facilities that will be included in the proposed project.
❑ Office Toilets
❑ Toilets for patrons; Number: _; Location:
❑ Showers
❑ Boatholding tank pumpout; Give type and location:
b. Describe treatment type and disposal location for all sanitary wastewater.
a Describe the disposal of solid waste, fish offal and trash.
d. How will overboard discharge of sewage from boats be controlled?
e. (i) Give the location and number of "No Sewage Discharge" signs proposed.
(ii) Give the location and number of "Pumpout Available" signs proposed.
f. Describe the special design, if applicable, for containing industrial type pollutants, such as paint, sandblasting waste and petroleum products.
g. Where will residue from vessel maintenance be disposed of?
h. Give the number of channel markers and "No Wake" signs proposed. _
I. Give the location of fuel -handling facilities, and describe the safety measures planned to protect area water quality.
j. What will be the marina policy on overnight and live -aboard dockage?
k. Describe design measures that promote boat basin flushing?
I. If this project Is an expansion of an existing marina, what types of services are currently provided?
M. Is the marina/docking facility proposed within a primary or secondary nursery area?
[]Yes []No
___ _ _ —_9 __ _ _ _ _ revised: 12/27(00
252.80$-2808 :: 1-888-4RCOA84 :: vsvyrl.nccoas4�imana ement.pet

Form DCM MP -4 {Structures, Page 3 of 4)
n. Is the marina/docking facility proposed within or adjacent to any shellfish harvesting area?
[]Yes XNo - t
o. Is the marina/docking facility proposed within or adjacent to coastal wetlands/marsh (CW), submerged aquatic vegetation
(SB), or other wetlands (WL)? If any boxes are checked,provide the number of square feet affected.
❑CW _ ❑SAV ❑SB
❑WL _ eipone
p. Is the proposed marina/docking facility located within orwithin close proximity to any shellfish leases? ❑Yes'❑DJ0
If yes, give the name and address of the leaseholder(s), and give the proximity to the lease. �7+�
shell bottom
BOATHOUSE (including' covered lifts) ❑This section not applicable:
a. (1) Is the boathouse structure(s):
❑Commercial ❑Public/Government ❑Private/Community
(ii) Number 1_
(iii) Length 1�
(iv) Widths r
Note: Roofed areas are calculated from ddpline dimensions.
�4. GROIN (e.g., wood, sheetpde, etc, If a: rock groin;: use MP -2, :Excavation and Fill,) MThis section not applicable
a. (i) Number
(ii) Length
(iii) Width
5. BREAKWATER (e.g., wood, sheetpile, etc)This section not applicable
a. Length b. Average distance from NHW, NWL, or wetlands
c. Maximum distance beyond NHW, NWL or wetlands
6. MOORING PILINGS and BUOYSThissedtlon noPappliaable
a. Is the structure(s):
❑Commercial ❑PubliGGovernment ❑Private/Community
C. Distance to be placed beyond shoreline _
Note: This should be measured from marsh edge, if present.
e. Arc of the swing
b. Number
d. Description of buoy (color, inscription', size, anchor, etc.)
RECEIVED
7. GENERAL I DEC 0 3 2013
DCM-WARD
252.608-2806:: 1-886-4RCOAST : wuv_gv,,preca &falsnanagsment.ne# revised: 92/27/06

Form DCM MP -4 (Structures, Page 4 of 4)
a. Proximity of structure(s) to adjacent riparian property lines
��r WI�SI - t_rts 1 r
Note; For buoy or mooring piing, use arc of swing including length
of vessel.
c. Width of water body
+ lsnv'
e. (i) Will navigational aids be required as a result of the project?
E]Yes RFNo [INA
(ii) If yes, explain what type and how they will be implemented.
a. Give complete description:
b. Proximity of structure(s) to adjacent docking facilities.
^ f r G
tIS-0—wsl -i3o-" w sl
d. Water depth at waterward end of structure at NLW or NWL
252-888-2808 :: I.888-4RCOAST :: www. nccoas4alma nagement_net revised: 1227:us

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DATE: NOMAM 246 1981 SML- r - 40'
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WOODLIEF 3 ASSOCIATES, P. A.
'
``
1228 REWM STREET . C E, I y E
WABNNBTON, RC 28191 8T"TS1
22za DEC 03 2018
®C M -WARD

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to >6?k'Ql of c 's
(Name of Property Owner)
property located at 112 k7 r K� S a� 9C -,
(Address, Lot I ck, Road, etc.)
on _�/ecr7? �,n �fl in jrrr Lown N.C.
(Waterbody) (City/Tan /or County)
The' i'cant has described to me, as shown below, the development propose t
I c on:
I have no objection to this proposal.
U OEC 0 3 2018
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPM O
(Individual proposing development must fill in description below or attach a site drawing)
0 (
I
�—
r� s
7LI—py CC��
J�Ory
1I4
WAIVER SECTION
I understand that a 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'.
. (If ou wish to waive the setback, you must initial the appropriate blank below.)
LkI do wish to waive the 15' setback requirement.
JI do not wish to waive the 15' setback reauiriment
MAiing Flddress
Ng %1/
City/State/Zip
*C(
Telephone Number/email address
9�r__- 7/ Y - /3 .� o
Date
r Information)
;14/_
Print or Type Na/�\]e
//,7 l;�/L/•✓'dn/�/
Marling Addi
/ 7
city/stat
Telephone Number/emaiiaddress
�a-i9�2u�P
(Revised Aug. 2014)
"Valid for one calendar year after signature'

I hereby certify that I own property adjacent to l' �/) C'� 4yjI A 's
property located at
on
Property Owner)
The applicant has described to me, as shown below, the development proposed at the above
loc 'on.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
hu ­/
WAIVER SECTION
/---1 3'
I understand that a 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. (If rt�wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
C Aor n wf--tI /
City/State/Zip A ' ��
Telephone Number/ email address
a'n -i/ v - /.? _� a
Date
9-e�8-jam
"Valid for one calendar year after signature*
Property Owner Information)
Print or>T 0 Name
Mailirspddress T /l �>V'
LL��
City/State/Zio
Telephone)vum,ber/email address
/0/ //D/ _F
Date*
(Revised Aug. 2014)

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DCM.'VVARO L',1CM-WARC,
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5' DEEP
WATER
M
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e vs 1 o
oa. 1i Cover
and
Pier Addition
SITE,
American Builders, Inc.
Silly Tyson, Sr.
phone: [phone],996
THESE PLANS HAVE BEEN PREPARED TO
COMPLY WITH THE CLIENTS SPECIFICATIONS
AND ANY LOCAL BUILDING CODES IN EFFECT
AT THE TIME OF ISSUE. THE CONTRACTOR
SHALL VERIFY AND BE RESPONSIBLE FOR
ALL DIMENSIONS, DETAILS, AND
SPECIFICATIONS Al THE JOB SITE PRIOR
TO CONSTRUCTION, THE DESIGNER WILL
NOT BE RESPONSIBLE FOR ANY ERRORS
AFTER CONSTRUCTION BEGINS,
DRAWN BY:
N Cense Jones
phone: [phone]
11/`25/' `i 8 A2
date Sheet
Pro e'—c 7
River 2 of 2