74723D - Filer

>r,XCAMA / --DREDGE & FILL
GENERAL PERMIT
_
XNew Modification ❑Complete Reissue CCPartial Reissue
No. 74723
A B C O
Previous permit #
Date previous permit issued
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 15A NCAC 0 7 H . 1 200
❑ Rules attached.
Applicant Name `1��5 �C_�IAA/E /1-GFt Project Location: County 13GL%Ads w % 44C.
� W Address 17 W. C-AAIAL Avr . Street Address/ State Road/ Lot #(s)
CityZ57��f.Au1 State NC ZIP .Za•Ki Jr W CIr�l A ( l'�
Phone # ( ) 508- Wi E-Mail m1A Subdivision /Ji/A
Authorized Agent Gl&ICC C' NS-rautC--r.oN '(►-JA'JVA:> City_ SWr, Se-c 6e(kckV ZIP ;Zg46
Affected ❑ Cw XEW XFTA ❑ ES ❑ iTS ""'� Phone # River Basin L_" IAS f_ii
[IOEA ❑ HHF ❑ IH ❑ UBA El WA
AEC(s): Adj. Wtr. Body Q I W W (Cn3t1/� man /unkn)
❑ PWS:
ORW: yes / no PNA � no Closest Maj. Wtr. Body (W
Vq
Type of Project/ Activity CONSTRucT Ate- W FLOAnNO 1,4 Af-R ?my . gL
gOATL(F-r To 15!(is— ,AIG S7OC9-1n/G T:�AC.IL►IT'Y (Scale: �� �30�)
Fixed
length
" )e / O 1,
e VE C %RA t.
=U�T4j,prap length
IIIIIINVENOMMONNFA
11.1 "AmommENEN
Basin, channel
cubic yards
ram t -5 x l iI
Boathous oat' 1Vx / 3 "
Other O W 3 31.O -F+
Shoreline Length 1051,
SAV: not sure yes 0
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:-ToVJf4 of .SNNSV_T BtAr-14 ❑ See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/Special Conditions Z5 ;ZOO gc ALL DTN;rR rV_VI='RAL. 5, AAD LOCAL.
)ZE—G lAnow/5 AETLU A544 �i 'kc--r,&RE- +Q EK-:S=IAtf, _DMV-_ F-4C-1I-tZX
j_A- Nd(a L""�" \`S
ent or Applicant Pri e
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Signat re Please read compliance statement on back of permit
- * w-[I —
Applicati ee(s) Check#
�ll.>ER C- C LAIP.E-
PermitOff'icer's Printed N e
1�r_ 6-,;'
Signature
27 20 t 27 a
Issuin Date Expiration ate

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis ,iohn E. Skvarla, III
Govemor Direcbr Secretary
AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FuRm
Date: 3/Z 2ILL
Name of Property Owner Applying for Permit: Na a of Authorized Agent for this project
Owner's Mailing Address: /}
Phone Number qI D) -08 • L Z' i
Agent's Mailing Address:
�cszca SS�e \:�euch l\C
2_1J%9
Phone Number An) 511' R(R5
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
For my property located at 217 w' Cavi,:�� L e I SAkiscL &c(ch /�C 2-
This certification is valid th (date) ; . hC o: n ►O `\
rty Owner Signature
Date
127 C aniinal Driv e Ex t, Wilmington, N C 28405
Phone: 910-796 i215 1 FAX: [phone] InM-ret www. coastalmanagen}�it.re,
An Equal Opptuniry ',Aifmative Action Employer

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: James t" 11� r Q tt -
Address of Property: 217 Ceti rh a. i AV 2 Sun S,Lt Bee CYO= .Q c- $ranisw ick
(Lot or Street #, Street or Road, City 8 County)
Agent's Name #:
Agent's phone #:
Mailing Address:
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 ordrawinq with dimensions must be provided with this letter.
_ I have no objections to this proposal. I have objections to this proposal 7 f © t
_zCC-
If you have 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
mailed to 127 Cardinal Drive Ext, Wilmington, NC, 28405-3845. 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, orgroin must beset 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& I do not wish to waive the 15' setback requirement.
(P erty Owner I rmation)
Si nat re
Ja Inn.e s j�l
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Print or Type Name
Z1 7 W Capt4
( Ave
Mailing Address
(Adjacent Property Own reformation)
Aztl—
Signature
Print or Typq Name
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SuhSGf � aT NC Zgq&ts
cttyistaterztp
Telepho a Number L7
Date
Mailing A
Telephone Number
Date
,
Ur
SC ZqS�
Revised 611812012

■ Complete items 1, 2, and 3. A. S�91
■ Print your name and address on the reverse X/
so that we can return the card to you.
■ Attach this card to the back of the mailpiece, B• ec,cE
or on the front if space permits.
1. Article Addressed to:
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Q"Agent
❑ Addressee
C. Date of Del[Wery
D. Is delivery address/ lifferent from item 1? ❑ Yews
If YES, enter delivery address below: I❑-IQo
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Service Type
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❑ Adult Signature
❑Registered MaiIT'"
9590 9402 2219 6193 1045 61
❑ Adult Signature Restricted Delivery
ItMertified Mail@
❑ Registered Mail Restricted
Delivery
❑ Certified Mail Restricted Delivery
return Receipt for
_
❑ Collect on Delivery
Merchandise
_• cif In n1 imhar /Transfer from servira lahall
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation'r"
7 017 0660 0000 7487
0771 tricted Delivery
❑ Signature Confirmation
Restricted Delivery
V 7530-02-000-9053
Domestic Return Receipt
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■ Complete items Y,2,'id 3. ' A. Signature
■ Print your name and'address on the reverse X ❑ Agent
so that we can return the card, to you. ❑ Addressee
■ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. Date of Delivery
or on the front if space permits.
1. Article Addressed to:
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D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
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3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
El Registered MaiIT'"
9590 9402 2219 6193 1045 54
❑ Adult Signature Restricted Delivery
anertified WHO
❑ Registered Mail Restrict
Delivery
ertified Mail Restricted Delivery
19 eturn Receipt for
❑ Collect on Delivery
rolerchandise
2. Article Number (Transfer from service label)
❑Collect on Delivery Restricted Delivery
Signature Confirmation TM
7 017 0660 0000 7 4 8 7 0764 Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt

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Date Received
Date Deposited
Check From Name
Name of Permit Holder
Vendor
Check Number
Check
amount
Permlt Numb -Comments
Receipt or Ref—&Realbcated
cbk�l
Columnl
Column3
Colu-4
Columns
COIU-6
Column?
Co1umn8
Co1umn9
9/30/2019
Grice Construction
James and Diane Filer
BUT _
12911
$ 200.00
GP #74723D _ _ _
GP #74722D _ _
1 GP #74721 D
BB rct. 8283
BB rct. 8282 _
BB rct. 8281
9/30/2019
Grice Construction
Christopher Brittin
BBBT
13298
$ 400.00
9/30/20191
_ _ _
Grice Construction
IMildred Willoughby
BUT
1 13297
$ 400.00