74608D - Evans

LAMA / DREDGE & FILL NO. 74608
A B C
GENERAL PERMIT Previous permit #
EM
Rew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality -o
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Name 4J S c<. rr / �V a Project Location: County � r\
Address 4 Uo f 0� ✓SV� Cr k Street Address/ State Road/ Lot #(s)
City
State _�{�ZIP 2`16004 ` 051 `�1 *
,�'nNy / 6
Phone # 1�'1 I -,
Subdivision
Authorized Agent OL �'C-
7y K
City "w
ZIP �C1 l L�
El CW )CZ)EW M;rTA ElES U ElPTS
Phone # ("'-'j-'----+
River Basin
Affected
❑ OEA ❑ HHF ❑ IH
AEC(s):
❑ UBA ❑ N/A
S { S✓r
Adj. Wtr. Body ct /` f "1 at unkn
❑ Pws:
ORW: yes ifo PNA yes
/Q
Closest Maj. Wtr. Body
u
Type of Project/ Activity
1`j2'l ut
(A k
►' r
I'
(Scale: )
Pier (dock) length
21 0'
Fixed Platform(s)
,
Floating Platform(s)
t
_
Finger 'er(s)
Ij
Groin enkth
-
Bulkhead/ Ripra length
avg distance Nshc
max distance offN
Basin, channel
cubic yards
Boat ramp T/
Boathous oatli �2 /Kye 1 2
Beach Bulldozin
Other
Shoreline Length t
SAV: not sure yes
Moratorium: n/a yes nd
Photos: yes no
Waiver Attached: es no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
1 ) L�Y'11/ L
Agent or Applicant Printed I'
Signature **,P, llease read compliance sti�t�ment on back of perm' 19
%0 0 `jt
o
Application Fee(s) Check #
See note on back regarding River Basin rules.
f'1�----
P Officer's Printed Name
ig
re 12-
Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLOCATION
[Name of Property Owner Requesting Permit: Morris and Trudy Evans
Mailing Address: 4001 Marsh Creek Road
Raleigh, NC 27604
Phone Number: 919 790-1476 919 780-8167 (Cell)
Email Address: lynntrud@aol . com
certify that I have authorized Lighthouse Marine Construction - Darrell Erny)
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all. CAMA permits
necessary for the following proposed development:. repair/replace dock
at my property located at 4057 4th Street, surf City, NC
in Onslow 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 evaluating information related to this
permit application.
Property Owner information:
Signature
Morris Evans Trudy Evans
. Print or Type Name
Owners
Title
3 / 23 / 2019
Date
This certification is valid through

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Morris and Trudy Evans s
(Name of Property Owner)
property located at 407-5ro�k�(4
(Address, Lot Block, Road, etc.)
on , in ZLtZF <� /Ty . (004L.�"k1 , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Io ati n.
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.)
(V 1� I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
roperlty Owner Infor anon) (Adjacent Property Owner Information)
Signature i n Lure
Morris Evans Trudy Evans �a 0�) p
Print or Type Name Print or T pe Name
4001 Marsh Creek Road t-
Mailing Address Mailing�A,d(ressf
Raleigh, NC 27604 �� -" /Ty
City/State/Zip City State- ip
919 780-8167 [e-mail] --�3 40- -�;,
Telephone Number/email address Te/ep o e m er/email address
3/23/19 -73 0
Date Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Morris and Trudy Evans s
(Name of Property Owner)
property located at 4057 4th Street
(Address, Lot, Block, Road, etc.)
on ,In Surf City Onslow County N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to n.
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
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.
(roper\owner I�forrr}ati�en�
Signature
Morris Evans Trudy Evans
Print or Type Name
4001 Marsh Creek Road
Raleighddrs 27604
City/State/Zip
919 780-8167 [e-mail]
Telephone Number/email address
3/23/19
Date
(Adjacen
Owner Information)
SLJ cl, 4e- Rqy
City/State/Zip
0/4-C90-R/��
Telephone Number/email address
Date
*Valid for one calendar year after signature*
(Revised Aug. 2014)

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1�1
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Dsfe Received
Dery De oelfed Check From Name
Name of Permlf Holder
Vendor
Check Number
Check
amount
Permit Number/Comments
Rood t or Refund/Reallocated
Column!
Co1umn2
Column3
C01-4
Calumny
Columnt
1umn7
column#
Columns-
8/8/2019
Lighthouse Marine Const/Darrell Emy
Will Richardson/Richardson Construction
Will Richardson/Richardson Construction
Moms & Trudy Evans
Morris Purdy _
Jerryfflanks
Coastal Bank & Trust
BB&T
IBB&T
2799
7503
7502
$ 200.00
GP #74608D
GP #74528D
GP #74359D
JD rct. 8530
BB rct. 9138
BB rct. 9137
8/8/2019
$_ 200.00
8/8/2019
200.00