Thomas Flood 71784D

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LAMA / DREDGE & Fl L No
�. � 1784 A B C
ENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
• As authorized by the State of North Carolina,Department of Environmental Quality G �� 1
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 0�H• 1 t 00 G t+I 0 .
T r ❑Rules attached.
Applicant Name 1140144,X S -� {�4 Project Location: County 014 St V'v/
Address 1-i Z- k v-e 1,+) f-)u i vt Street Address/State Road/Lot#(s) 512. R)V.Y+j
City A v-( a d S ke N r t,1 / State kit, ZIP 2('Jl-I(.jC PO ‘V1A n
Phone#(1t0) E-Mail Subdivision )QV '� I i 1A-4—
Authorized Agent PGl V,(f gc C1'\ City Fula Rd s 4--e Y r LI- ZIP 2 yL(0 '/
Affected ❑Cw 'NEW )(PTA ES PTS Phone# ( ) River Basin In I.1 (l( Oa- f1
AEC s : E OEA ❑HHF ❑IH UBA N/A Adj.Wtr. Body �Q-IA, 2 V'c {, s/man /unkn)
O ❑ PWS: /)
ORW: yes / PNA yes / no Closest Maj.Wtr. Body 4t I w w
i
Type of Project/Activity ()I a(� d (j( - 1' V k - t(f t R�10(C (� ( 4(U I') j i iGMk i ( ( t`i (it- (.- i (A /l ( I\ K 11� V I Y �l .I hi C. d (Scale: III"; U
Pier(dock)length�0'X 9'
Fixed Platform(s) 5 X Z N
Floating Platform(s) i _ I'l t,Yi v t
Finger pier(s) I 1
Groin length �"1,S(
r
number ``•' `Z
i
ul head/ iprap length �_ L 1
-- ' avg distance offshore 0 Z\ I
max distance offshore I o 4
Basin,channel q -1-- - I_ —
.) � I" 'U
cubic yards '� ( - I \-. `�� Lit \" �4\
a ,� (a
Boat ramp �V ' . v A vV'l- \ , \iv'
Boathouse atli ILj'y7 9 ' ^ ' \4 I I `� ; / �� (�� )�
MI k
Beach Bulldozing - - o+ N11
�� � C' 'E
Other I — t`-,�,N- v x.' iA NO I \\\1 \1\V'`
.t.
Shoreline Length-�I V �r��,...._„_ ....../ 7//y
,. j\ 11 tSC ' I I e t
SAV: not sure yes f
Moratorium: n/a yes no J
Photos: no fAki
Waiver Attached: yes no �v f((Od
,kiA building permit may be required by: a1A,SI()1,U la . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)77
Notes/Special Conditions (-) --H . t 9)0/ (-)q-H • Iwo woo a tt L2 out( ( oca.(, s f f, f A/5 f
--2 z t L(Gu -I c-vt S 64?pll.
1,3A k:-/0 p-rsc t Co u r to A . S a I c
Agent or Applicant Printe Oplame PermitOffic 's rinted e
1' )C"I/e) fiA6k^ —ei
Signature Please read compliance statement on back of permit** Signat re
'l-IUi (.I►Ou) waaVed (.2c0) �d t�3 (o/Zy/it; ,
ClIS
Application Fee(s) Check# Issuing Date Ol- Expiration ate

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 1 k
`�
Mailing Address: 2-23 7 ►'15 ck 'oc v-
�� L 2 15o
Phone Number: (96 t B - $L
Email Address: 4\94IYI*,J-C`ri 06d., LY-tho ' Co m
(� Z
1 certify that I have authorized�clJk �, @ ���,cs►� 6 (in C01146:66
Agent/Contractor
to act on my behalf,'for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: V1_LA_) S€A _ busk'
C,C-i ✓t r J
at my property located at S- Z edv fv* (d i 5 1
in OnS1 County.
I 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:
Signature
1ccreickS . -�--(,cC
^� Print or Type Name
l lit.) V\Q.Al
Title
IDi / 201B
Date
This certification is valid through / /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to E14,.G(,c T w 04 's
©�/� (Name of Property wner)
property located at V U Vrt
(Address Lot, lock, Road,etc.)
r
on IUt 17/LVti , in N-aa,c , N.C.
(Waterbody) (City/Town and/no�ounty)
The applicant has described to me, as shown below, the development proposed at the above location.
q?, -
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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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 you 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.
(P erty Own ation) (Adjacent Property Owner Information)
Si ature r- Signature
0 c 5y.) 1-1/t 0ImAaA RODC4
Print or Ty pee Print or Type Name P1
M ". g Address C ailing Ad ess
City/State/Zip p ( O Ir City/State/Zip
Telephone Number ;` Telephone Number
tO _ ' Lein/
Date Date
(Revised 6/18/2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to \ yx r(Y c1.5 ') ‘kClOc _ 's
(Name of Prope Owner)
property located at S `�Z P Je- Po -i - osc `7I�g 1 y' 1L 2-S4& )
* ` (Address, Lot, Block, Road, etc.)
on 1V C�v) 1 4e( , in -Yleald Y''i , N.C.
(Waterbody) (City/Town and/or'County)
The applicant has described to me, as shown below, the development proposed at the above
location,,
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)
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 you 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.
(Property Owner Informatio (Adjacen Property Owner Information)
s _itCi,ti K 0.gt tO0 t 1••
Signature Signat
Print or Type Name Print or ype Name
2,631 Lon ctsAn . 13 i C ry G
Mailing AddrePail.c\k el ss V 21.S.S atl► � ss
City/St'ath/Zi City/State/Zip�
r� E,P)4sLs bY>1 i `J Q hl4o 65
Telep one.Number/email address Telephone Number/email address
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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Date
Date Received Deposited Check From(Name) Name of Permit Holder _ Vendor Check Number Check amount Permit Number/Comments Receipt or Refund/Reallocated
Cokmutl Cokmn2 Column) Column4 Cohmn6 ColumnQ Cokam7 Column8
Column.
10/292018 Permit Pals Steven McManimen LCresCom Bank 2137 $ 400.00 GP#70598D TP rct.6989
10/29/2018 Orlando and Deborah G Powell _Thomas Flood Wells Fargo 843 $ 400.00 GP#71784D JD rct 6748
10/29/2018 _Willie Clarence Richardson/Richardson Construction Eddie Pennell BB&T 7149 $ 600.00 GP#71755D BS rct.6925
_10292018 __ Orlando and Deborah G Powell Orlando Powell Wells Fargo 842 $ 400.00 GP#71785D JD rct 6747
10/29/2018 McGill Associates(1 of 2) _ ATMC/Scott Dutton First Citizens Bank _ 42101 $ 200.00 GP#717361) TMc rct.7020
10/292018 McGill Associates(2 of 2) ATMC/Scott Dutton First Citizens Bank 42368 $ 200.00 GP#71736D Tmc rct.7022
10/29/2018 William C and Paula B King William King Jr. Wells Fargo 4788 $ 200.00 GP#71096D TMc rct.6835
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