Charles Maxwell Davis 72833D

C(jwi+s 3K!121 —
iCAMA / DREDGE & FILL0
t No. 72833
GENERAL PERMIT QT?Ei''�cE Previous permit# A B C
)G Jew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality h �s DQ /����Oa
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC j (� •
j�
❑Rules attach
In
Applicant Name (,,ka e/S /'7BX w e1 t D62d/S Project Location: County /YE d✓ �f9r✓0-U ca
Address ,2/.2 / 11�i d /-e Seeleid 4 OOD Rd, Street Address/State Road/Lot#(s)
I City ! itm1/pTG,cl State 4( ZIP 28y// 5 firi C
Phone# (9/n)S20.2fJJ E-Mail Subdivision
Authorized Agent /9 d olir, RA,/C R//1 City ZIP //
[ Affected ❑CW IW L TA ❑ES ❑PTS Phone# ( ) River Basin WA,ie 6/C64
AEC(s): ❑oEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body"9N thBoix C/2,44L (nat tiirly unkn)
❑ PWS:
i moo' PNA yes /� Closest Maj.Wtr. Body A/w AI
ORW: yes /
0
1 ll /
Type of Project/Activity K6/t7O(/e 12,20x, 92 5 cy 0-C '7 9)t' /a1 I_A1S vi,SAroi! /N 1 d
B/9S/, G�Ae Ai A r zi)ON p r /ni o�ite .SOUN4 lay Rd W!/S/JeC+ old (Scale: N7-5 )
Pier(dock)length 1111111111=111.111111111111M1111111111111111111•11111111111=11111111111111111111M1111
Fixed Platform(s) I♦IIIIIEIIIIIIMMIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIMIHIIIII♦IMIIIII
Floating Platform(s) / '
Finger pier(s) S •
Groin length +�
RITE CH
l'o Imo, Uf 1,d++li n I'm lh, Il ++r I nurnnm
number f pit��'�f`` S,a` „",
Bulkhead/Riprap length _ r `
avg distance offshore , \ \,
l / ,�,�r 'i 4.vi, :alb T I NA
OPmax distance offshore / ;
hannel d�RpR °� i`rjr i i _
cubic yards 72c PROPOSED AREA F /\. .+
Boat ramp MAINTENANCE DR ING ;. ' _ t f
10,000,gtt x S-0'MLW( I�
" ! • * -
Boathouse/Boatlift -. - {; 1" ,; tt
Beach Bulldozing //
Other + ' J " , Tempera t ckpilrng a for
Land Excava3l-
Shoreline Length 31(p s _ `,.. ' A
SAV: not sure yes fio'tnogle E:ertf, At
Moratorium: n/a yes tii" EM
iI N- '
Photos: yes • INII i 1111111
" j
MIL
Waiver Attached: yes o
}
A building permit may be required by: NPAi 149N0V t A Cow.v)`U i See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)Notes/Special Conditions E y r ig vA )l o./ , tp1 i !Vot r t,,c Eecb ,1 0ey.
/4--4
/1 (7 -- 4,4 2) 14// s�
Agent or Apyjieant Printed Name Permit Officer's Printed Name
i
�.- - 19,..f ✓ lT.._..---
-Signature *Please read compliance statement on back of permit** Signature
✓Ai ,/t= /V 61 �26�/y �/ao /Y
Application Fees eck# IssuSng Date Expi tion Date
()�

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: CL&AA-e s Re•.4 4cLyeA`
Mailing Address: date Sa�,�a(.p�p
7 /V. C, 28V//
Phone Number: 9/o- Szo-2.31
Email Address: Scwsidtcpa A.-K3 bo c/ Iciiipo,Cow-...I certify that I have authorized Gd0. �
v . 1�v
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: .D �3Z
at my property located at 212% htit a.,At e Sew-a �o� ��.. W a, AI4, 2W 1/ ,
in Are / 1iZranr County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management stag 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
Print or Type Name
Owner
Title
Z 125 1 /9
Date
This certification is valid through

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Charles Max Davis 'a
property located at 2121 Middle Sound Loop Road of Property )
(Address,Lot,Block,Road,etc.)
on MiririlA Rnund ,in Wilmington ,
(Watery) (Citylovm andlor County) N.C.
The applicant has described to me, as shown below, the development proposed at the above
kmcatjon.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lnnBvldual p�ngposIng development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pings, 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 -- not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
sign
p
� r(�S �� Die �� ��
11L114
C ry
Print or Type Name Print or Type N / /
zi Z 1 ►H.ddl< Si, loop l�/, /"4 /7�
J Maili
td,(ng/adrliess�.(/G, ,zc 1r// ..,� �y�rn 4/[— �QSf//
City city/Stan.
9/v•szo q�d /7-
Telephone Number/email address Telephone Nwnt er/ i address
S2aSIde �+1i oe.. hOv,Cow /
Date 2-2 r-l 9 i Uata+
(Revised Aug.2014)
`Valid for one calendar year after signature* /tA
VP

ADJACENT_RIIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Charles Max Davis
(Name of Property Owner) s
property located at 212'f Middle SOund_LQOD Road
Middl pLnd_ (Address,�'Block,Road,etc..)
on in Wilmington , N.C.
( dy) (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 Information) (Ad acent Property Owner information)
Sign ere Si ature*
an
Print or Type Name Pn�ype Name
Mailing Addre 2(/-212101,
Mailing Address
II%%tar 1 City/State/Zip
9/0 � S�-y_ 2S3S, Glo te�4-�6t2
Telephone Number/email address
Telephone Number/email address
Sea I 60
Date
(Revised Aug. 2014)
'Valid for one calendar year after signature*

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CONTACT US I iV
Home Property Records t*C Tax Horne Register of Deeds
Profile PARID:R04500-006-006-000
DAVIS CHARLES MAXWELL JENNIFER
Sales
Residential -enter a parcel Id-
Commercial R04400-004'175-000
Misc.Improvements
+ R04500-006-011-000
f s,
Permits — � 4t- `.p
R0 v0-004-004-000 -, m �698
Land , R04500.00 w6 I 0•
Values C ,or " �.-1
Agricultural `/ '� �-
Sketch .,+'
Full Legal
Exemptions !'J161%
ea
Sub-parcel(s)Info
Original Parcel Info 8.4,
_.:a ,�
o c V+/, 72 �1•♦f
J
�Al1 a 1�— 94,97 R04517-003-007-000 c'-tµ ow
e3
' Corn A �'`))
A�i S
R04500-006-006-000 •61
s��
B R04517-0
�� ' R04500-006-003-002 ro'� �o�
9Y `ae9.)(' 0 a,
R04500-006-00, 0 ,T'
R04517-003-010-000
c - R04500-006-005-000
04yt 30 bon �1� 7,2,l
a