74712D - Cain

- CAMA / ❑ DREDGE & FILL NO. 74712 A B c
GENERAL PERMIT Previous permit #
)New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality '' 11
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Q q-
'(� ❑ Rules attached.
Applicant Name �, Jn.-� �.. / Project Location: County 1 J ✓-/- S ,, . C �-
Address p I (o a� S w Street Address/ State Road/ Lot #(s)
City S J A s c G e. (n State 7lp
Phone # (S�) H 53S-�_Mail '�""�' Subdivision n v
Authorized Agent City �Zl A C e IJ -e zip a la p
Affected ❑CW CEW PTA ES ❑PTS % "� Phone # ( °ticy) y-(3 y8 R�r River Basin
AEC(s): El �� El HHF El IH ❑ USA El N/A Adj. Wtr. Body `Gty6 S 1 ` i ±001an /unkn)
❑ PWS: �j (�
<'Inccct Mai Wtr Rnriv ` ~'U �G S h '� ✓t ✓
ILA' -rr —i(01S
Agent or Applicant Printed Name
Si Or Please read compliance statement on back of permit
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Applicati Fee(s) Check #
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Perm' er s Printed Name
Signature
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Issuing Dat Ex irati n Date

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWA1VER FORM
Name of Property Owner.C d1► IU
Address of Property. " 4 W hire d 5
I �elpis
{Lot or Street#, Street or Road, C", gCounty)
Agent'sName#:TN Mailing.ckldr-Bw. _1 R07 k I ✓&j
Agents phone #:
I hereby certify that I own property adjacent to the above referenced 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.
IVUt ►� ve no objections to this proposal. I have objections to this proposal.
�7
lo'uhave objections to what is being proposed, you must notify the Division of Coastal Management(DCM) in
writing within 10 days of receipt of this notice. Correspondence should be ma6ed to 127 Cardinal Drive Ext.,
fflimington, NC, 28405-3W. DCM representatives can also be contacted at [phone]. No response is
considered the same as no olyection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin -must be set
hack a minimum distance of 15' from my area of riparian acce s ; unless waived by me. (If you
wish to waive the setback, you must initial the appropriate bl. ' below.)
I4;k( I doback requiremen' .
not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
Mailing Address '
c�
City/S a e/Z'
Telephone Number
Date
Owner Information)
Print or Type Name
VW &Lbop—eAle—
Mailing Address
City/StatefZio v
Telephor, giber
ate
Revised 6/la/2012

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner. L--vxYk
Address of Property: (l 4 V30C hi nr VJ 5o_
'' II {Lot or Street*, Street or Road, C;" � County)
Agent's Name #: TA NeAm S Mailing .A idr 3w: r qQ7 ki✓bu 0
Agent's phone#: CI��'�y3'��i �jNC oi��(ooZ.
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
j they are proposing. A description or drawing, with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
if you have objections to whatis being proposed, you must nod fy the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mafied to 127 Cardinal Drive Ext.,
Mimington, NC, 28405-3846. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin -must be set
track a minimum distance of 15' from my area of riparian acce .> , unless waived by me. (If you
wish to waive the setback, you must initial the appropriate bk , below.)
In 4—� I do wish to waive the 15' setback requiremen .
_ I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature r c
-� 4Ie- /�S
Print or Type Name
_.1R47 14-,bq "i
Mailing Address
City/S a e/Z'
Telephone Number
Qh2-11
Date
(Adjacentzrwrier Information)
Signature
1 non
Print or Type Nam
Mailing Addme :s
U nS-G�- & ztSLI & S(
City/State/Zin
q10-LiL13- 0<950
Telephor, giber
/� )�b
Date
Revised 61IM012

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Lrh A NUl CAjn
Mailing Address: �S�jq In (xj Dc 6ry K(A S
Phone Number: 17- 203- �j��-%/
Email Address: jhCacnCD 'tClo-.Ld .CAM
I certify that I have authorized I c( �+o MS ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:c.�
at my property located it ,
in �run� County.
l furthermore certify that l 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 et L luating information related to this
permit application.
Property Owner Information:
Qnat
d I` I
Print or Type Name
Title
l O l 2 Z/ Zol
Date
This certification is valid through /

Dafe Received
Date De sited
Check Rom ama
Name of Permit Nokler
Vendor
Check M-6-
chetlrt
amounf
Pe If NumbanCommenfs
Receipt or Refund/Reallocated
Columnt
Column2
Column"
Cofumn4
Col_umn5
Cofumne
Column?
Co1umn8
Co/umn9
11/6/2019
11/7/2019 Overbeck Marine Const./Daniel Shirley
John Anenpnost/Arcadia Properties Suntmst Bank
5253
$ 200.00 GP #74777D
PA rct 8511
11/6/20191
1117/2019,AMW Docks and Marine Construction LLC
Anthony Corvino
BBBT
5678
$ 600.00 GP #74387D
BB rct. 7940
11/6/2019
11/72019 1 Backwater Marine Construction
David Cain
B88T
1344
$ 200.00 GP #74712D
I BB rct. 7939
11/8/2019
11/7/2019 1 Ryan D Cooper
_
Ran Cooper
State Employees Credtt Union
3354
$ 200.00 GP #74388D _
BB rct 7941
11/6/201191
1llfl=19 William L. Owens
William L Owens Jr.
I State Empto ees Credit Union
1335 $ 200.00 GP #74549D
Tmc rct 8298