74515D_Scanlon_Lupo

StCAMA / ❑DREDGE & FILL No. 74515 A B C (DD
ENERAL PERMIT Previous permit#
I )� w Ne ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued I
` 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 0 . (1..0 •
❑Rules attached.
Applicant Name C*45 jaU/k/l $ John 1-11/%0 Project Location: County ki tt...J Rc..••ayv+-✓
Addrresss6504-j- O$ D -rrG.i I Street Address/State Road/Lot#(s) (05011 * tsc$
City ltimtt, }on State JJL ZIP oav I1 I �"4 'fir a,c 1
.Phone# (�-11U) (o' L ��(a2C1 E-Mail L.190 33-1 tO y vu.,k. .". Subdivision
Authorized Agent 1S6vittoko S CI+1/4g1\ov City W c c,. .- ZIP Li2 t Yk91 I
Affected ❑CW AEW Al PTA ❑ES ❑PTS Phone# (110)J`S:1O 5301 River Basin kc Ve 0 _
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body t4Ot„1 i CV g\c... tel.man /unkn)
❑ PWS:
Closest Maj.Wtr. Body AI
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ORW: �/ no PNA �e / no lr-�w
` Type of Project/Activity gopz.cL... P,(\ CC ck,EXA cA3 ,tb
(Scale: I It=2_0' )
Pier(dock)length(01 K- ),jS
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Fixed Platform(s)COuLdEtt III,Yir1 ■■■ v■■IS1111■I1■ ( ■rappiatirim ��r■■■■I
Floating Platform(s) P■It#.�■■■■■■ U mmei■■(C■■� �■iI■■■■■■■■
Finger pier(s) I1IIIIiiØI1III1
I Groin length
number
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Bukhead/Riprap length fFrA
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max distance offshore ``..
Basin,channel g111112_
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BBoat ramp oathouse/Boatlift iilliK1111111111P1121111.111111.11e.111111M
i 11■■VirlillEMIIIIIIIIISIIIPEIRIMIIIIMMIIIIIII
®/,......__dill ■�■■�■►1■ ■■■■■10
i Beach Bulldozing I�� : ■OtherdW• a�� y FA62-impialmilipamisima �■■■■■■■■■mm�
a■■■■■ � ■■ ,■■■ o
iasummuciimmirgicrltrupopErzirta
Shoreline Length 3N (oMh�,tid pm iEiropmlilltiodL.,Fireril �, ✓J,- 1 Fj
SAV: not sure yes ® /� �.
Moratorium: n/ yes no j^,!�riri_ r!_7,3��1C1�■���. �
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Photos: yes �o ■ .T imiiii: ■■�■■■ ■ ■ ■■�,■�■
Waiver Attached: yes ■
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A building permit may be required by: e p L L/i(......-h,. /ik...1 (14.v,,.i Co . I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) (
Notes/Special Conditions OIL (0„c,,, o,. Q. ((0114.124C)/(tic 4 4S4-k•k, ,.A C a�lo
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Agen • � ri ' Na�e� �i Permit er' Print N ;feu(
Signature **Please read cOiiipliance statement on back of Rermit** ignature
Application Feels Check# Issuing Date Expiration Date

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AGENT AUTHORIZATSON FOR CAMA PERMIT AppLICATION
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Name of Property Owner Requesting Permit: :1t, 1, fri I Lye.
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Mailing Address: 1 . -p.........L...__4,__s...a44LLL::Lk_,** ;t____
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Phone Number: 0/ '. „. . .
Email Address: TI / (j...' ,- i •
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I certify that I have authorized ' '1 il a r .,_ 1
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Agent/Contractor
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to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
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necessary
for the following proposed development: i'),4.,4 /.,, , I di *:-.1
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at my propeity located at 4Sa ? C.-A k-.--7..- I 1 r-e, , 11), 1-4.)
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f flitthemwre certify that I am authorized to giant, and do in fact grant permission tO:L.:Vvision of Coastal Management staff, the Local Permit Officer and their agents to en . la
)n the aforementioned lands in connection with evaluating information related to th.::i::' Cg ermit application.
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https://mail.google.com/mail/u/Ontinbi 1/1

ADJACENT RIPARJ h PROPERTY ONMER STATEMENT
I hereby certify that I own property adjacent to Tok•. I. b /C.1ti4 . s 5c a,,, 10-'
property located at I Pro s
perty Owner)
on_ sw,� � k- (' ddress, Lot, k, Road, .)
(Waterbody) in "" (C ar�d/orr a u ty) N.C.
�
The applicant has described to me, as shown below, the development proposed at the above location.
I___T____/._
I have no objection Ejection to this proposal.
I have objections to this proposal.
DESCRIPT►ON AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in
descr4otion below or attach a site afrawin9)
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id d o 4k I f I d-�-s 4- to J 7 4
fI °-'''`�• c—e- 'I i 4 ►''') I '-/ c e— _i.ct„,y..�,S .
I understand that a WAIVER SECTION
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.
(Prope 04=41,
(Adjacent operty Owner Information)
4 ww„,...
Si e Si
Print or Type Name Print or T Name ��
`s ec / /12 CD#. t l
Mail_ing ress. �✓/�f
L Mall Add
CitylStatetOp �� ik78l/ 2g ��
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Telephone
Telep/hho�ne Nu/ ember s
Date //�4 L l /
Date
(Revised s/182012) j
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to JOIN - L b /c-ku.,i
propert"yff located at ( ame of Property Owner)
on �-tm ��„ � (Address, Lot, Block, Road, etc.)
(Waterbdy) , in "• '"• 4-,! N.C.
(CJ y n and/or County)
The
,,ap/plicant 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)
g_v__L lA i le/ D I/ l -e-. i .- ce€S - .e Q •i 7
fl v Yam- i A, h C�{, .�s .
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.
(Pro er 1 f
�, fi' (Adj ent Property er Information)
Signe Signature
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Print o.Type Name /i �L"t� i12 �l►� 1 /2 I
// �'J Print or Type Name
(iT (� i ►''ice -.e I -/ Ka , ) S'c C_.-
Mailing Address .
//� Mailing Address
C.ti /? vet e iV C_Z�'`7 W i Cyr17 x -Z; Z City/State/Zip� / City/State/Zip // i
Telephone N mb toZ? `7! /3/ /
7I �� Te%�o e'Nu ber
Date 4 Zc:/ ci
Date
(Revised 6/18/2012)
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httpsJ/mail.google.com/mail/u/OJ#inbox/FMfcgxwChJmKNBCtVjIMWbvDDtJtSSWL?projector=1&messagePartld=0.1 1l1

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comments Receipt or Refund/Reallocated
Columnf Column2 Column3 Column{ Columns Column6 Column? Column9 Column9
7/17/2019 Charles F Scanlon Charles Scanlon and John Lup South State Bank 1696. $ 200.00 GP#74515D PA rct.9155
7/17/2019 Emmett M.Sniff Henry Batton III TD Bank 5624 $ 400.00 GP#74518D CS rct.7935
7/17/2019 Signature Building Solutions,LLC Randy Beardsworth First Citizens Bank 1118 $ 200.00 GP#74516D PA rct 9156 ,
7/17/2019 Andrew A Callihan Andrew Callihan First Citizens Bank 1041 $ 200.00 GP#71800D TMc rct.8774
7/17/2019 AMW Docks&Marine Const./Rick*Rodney Norton Sr. BB&T 5533 $ 200.00 GP#74239D TMc rct 8775
7/17/2019 Brian Jay Cox Brian Cox PNCBank 980 $ 200.00 GP#74300D CS rct.7933