74564D - Clement

A)CAMA / XDREDGE & FILL I No. 74564 A B C (�
GENERAL PERMIT Previous permit #
?V.ew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality n �
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC U 1 H , (too
I O O
Gam"
5 Q� ❑ R les attached
Applicant Name 1.1Wn � N �
Addres -�J T ���:.� ►� �+� l� "
City Stater ZIP_L
Phone # 'PE -Mail
Authorized Agent
Affected ❑ CW �OEW ETA )ZES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: �/
ORW:! eyes /, no PNA o lV�l
Project Location: County
Street Address/ Sta�Road/ Lot #(s)
k� e� � N •
Subdivisi n
City tlgwp�)(ZIP Z�AAS
Phone # ( River Basin w (.,
Adj. Wtr. Body na an /unkn)
Closest Maj. Wtr. Body )'A--1.DfXm Sn 1,
■ E■E■E■■■■■
■O
NOON
■11111.■N■■�■■■ ■■■■E■NONE
• .— •,®=E■
d r ►f" f ri►>■■■■■■■■NEON
E®EEEN■.I■OOP■■■�1!�!I�:y1!l1�1/EN■■■■■`I!■N■■■■
- -
- -
■■■■■■■�■
�■E■N■�■N■■■■`�■CNN■�■■■■■■■■_�■
�����.-'�:..�u■�■ice■EN�N■■�■E�EENN■■■
�■■EMI■■■■■E■�N■N®E■■■■■■■■N■■■E■
i�iCTi:ic;■
�
7
O■■�
l�Et�E■■■N■■■NEE■E■■ON■E
M.
MMEMEM OE
M. NOUN
ww off■■■■■■■■■m■■■N■�i�7�/��■:��,/�■
■N■■■■■�� NEON ■.■■�■■
MEN
.i.
IMME ■■ ■■■OE■EN1WAM M■■O■N■■E■E
■�iii1'liiiiiiiifl
■�i�ii�■E ■■. �OO� ION■■■EEN■■■■II■IG'\■■
won
''
■■■■ E■EE� MEN EMEN E�■■■■■■■■E
1!!�■
in)
Printed Name
Sign7ure ** Please read compliance statement on back of.6ermit *
�1)0 W UU
App ication Fee(s) U g
Alt —
Officer's Printed Name
Issuing Date
Expiration Date

y
AGENT AUTHOPUATICA MR CA(IdA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Thomas Clement
MaRV Add -
347 Dogwood Ln
Hampstead, NC 28443 ;
Phone Number:
301-748-5910
Email Address:
[e-mail]
I certify that I have authorized
Greg Martin
Agent I Contractor r
to act on my behalf, for the purpose of applying ft and obtaining all LAMA permits
necessary for the following proposed development:
Replace failing sea wall and relocate the dock
at my property located at 347 Dogwood Ln, Hampstead, NC 28443
in fender County.
I furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Olhcer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Thomas Clement
Print or Type Name
rule
8 J 30 12019
Date
This certification fs valid fhrough 12 1 31 12019
f

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to _ /NG�Y1 S CAL LrrYt.�/ s
�7 (Name of Property Owner)
property located at -S y / -Dd G-wGe= 4b /'t) ,
(WaerbodY)
Address, Lot, Block, Road, etc.)
J
in C1021,S �C_Q-C1' N.C.
(Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development he is
proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
FA
Print or Type Name
Telephone Number
De

� �� I Illlil)I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Gm --5 �'ri �� s
(Name of Property Owner)
property located at -3 / / L,42
Address, Lot, Block, Road,
on -� C'- C-J C- J in / eG fX l�Cl N.C.
(Waterbody) (To n and/or County)
He has described to me as shown in the attached application and project drawing(s), the development he is
proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
L,
Signature 1,41
dlle-#954 L. LGIZI�I S
Print or Type Name
'i10 " z7O `1%
Telephone Number ,
Date

Locality Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Name Thomas Clement
Address 347 Dogwood Ln
City Hampstead State NC Zip 28443
Email [e-mail]
AUTHORIZED AGENT
Name 644
Address &', -3 7 C 7-
c
Phone [phone]
ity State AIL Zip ZVfK-? Phone / l J -1-06 Z3 6 %
Email AZY�i' 14% ,7
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
347 Dogwood Ln, Hampstead, NC 28443 Located on canal with access to ICWW
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
Replace existing failing seawall with a vinyl seawall along entire property line (75ft). Relocate floating dock to center
SIZE OF LOT/PARCEL: 14,174 square feet 0.33 acres
PROPOSED USE: Residential ❑x (Single-family ® Multi -family ) Commercial/Industrial Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: 0 square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc, that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO X
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
X an owner or record title, Title is vested in name of Thomas Clement and Lisa Clement
see Deed Book 4664
page2377-2379 in the
Pender
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in
County Registry of Deeds.
County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I fiirthermore certify that the following persons are owners of properties adjoining this property. I affirn that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name)
(1) Conway and Donna Spiers
(Address)
349 Dogwood Ln, Hampstead, NC 28443
(2) Mike and Lola Loizides 345 Dogwood Ln, Hampstead, NC 28443
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I 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.
This the 5th day of August 120 19
Thomas Clement / Gree Martin
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check.for $100.00 made payable to the locality, and
any information as pray be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.

Date Received
Date De osited
Check From (Namej
Name ofPennit Holder
Vendor
Check Numher
Check
amount
Permit Number/Comments
Recei f or Refuml/Reallocatod
CClumnl
Column2
Column3
Column/
Column3
Column6
Column?
Column6
Columns
9/3/2019 9/3/2019
9/3/2019 9/3/2019
9!3/2019 9/3/2019
9/3/2019 9/3/2019
McPherson Marine Services LLC
South Cape Marine LLC
Delta Dock and Boat Lift check 1 of 2
Lorraine Mohler
Dorothy Trapp _
Thomas Clement
First Citizens Bank
Wells Fargo Bank _
First Citizens Bank
First Citizens Bank
2839
$_200.00
GP #74588D _ _
Tmac rct. 9187__
JD rct. 8558
JD rct. 8559
JD rot. 8559
1078
$ 200.00
GP #74598D _
GP #74584D _
GP #74584D
8821
$ 200.00
Delta Dock and Boat Lift check 2 of 2
Thomas Clement
8818
400.00