72303D - Fish

GE & FILL
iFERAL PERMIT
yModification [-]Complete Reissue El Partial Reissue
No 72303 A B C Q
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 00
❑ Rules attached.
Applicant Name D E'MQVLAH F7IS14
Address 1 3 (! SA (,F 1.514 Pp
-
City HOLA fn/ 19CACIA State ZIP 2-Y4-6 7-
Phone # ( ) E-Mail
Authorized Agent 0-0EL, KLASS
Affected IKCW ❑ EW ❑ PTA XEs XPTs
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs:
ORW: yes /� PNA yes /tom✓
Project Location: County 13P %At VL j %C-4'L
Street Address/ State Road/ Lot #(s) 13 4
,5AILFI'SA -I>RIVIE
Subdivision NA
City OOI.DR/►/ 9CAC- A ZIP 2. $ 4G 2
Phone # (9 % o) S40 - 0" DRiver Basin [,tAµ Qy- R
Adj. Wtr. Body CA VAL- (nat m14-� unkn)
Closest Maj. Wtr. Body -A I W W
Type of Project/ Activity R E P i. A C_5 F�-x ► S T w c, 9 Lk I.-1G N KAD I PJ
SAME /Q u C3 s/ M EJJ T (Scale: �� - 20 )
Pier oth
Fixed
Floati
Finge
Groir
ulkF
Basin
Boat
Boatl
Beacl
Othe
Shon
SAV:
Morz
Phot,
Waiv
ng Platform(s)
■■■■■■■■■■■■■■�nwr■■�■■■
■■■■�.__=�■�■
r pier(s)
�■■■■■■■■�■■■�■■
; length
■■■EM■■■■■■1i■:1OPENSnumber
W-.iprap length
avg distance offshore 0
max distance offshore 10
■■■■■■■■■■■■■■►�■■■■■ram■■■
�;Yr■®■■I�l1l■■
JF
cubic yards
ramp
louse/ Boatlift
■■■■■■■■■■
y�i�■�■■■■ice■■■.�,
I �■■■®■■■■■■■
i Bulldozing
00ahall■■■■■notsure
�i
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/■1
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fline Length
■ri«�1M�■i■■
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■■►hir■r■/%■11■1■■■�■■■■■■■
yes
Qp yes no■■■N■■■■■
■■
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_ .:T:,
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A building permit may be required by:
( Note Local Planning Jurisdiction)
001,MAJ 13EAc-A ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions ALL C,-owor I o,^/s OF 07H. 1100 K ALt. o + AEr-
1 ocAL �i STA-TF Bc FF DiETLAI- Rr-4:4uLA-TtooVS APPLY
f J7 Z e / 4- IA-S
%'D- o Appli t Printed Nam
.�,�
Si ture ** Please read compliance statement on back of permit
400 44-- (5 04
Application Fee(s) Check #
M C- Grall-.
Permit Officer's Printed Name ,
Signature
(R�11/19 1O 9/ Iq
Issuing Date Expiration Date

Name of Property owner Requesting permit Deborah K, Fish
Mailing Address: 136 Sailfish Dr.
Holden Beach, NC 28462
Phone Number:
Email Address: e� l��
I oeriify that I have authorized Joel Klass
Agent t ConbI
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following Proposed development: replace hi if Ac
me a,
banal claed � t
m� kit kc� kw �R01zcn A
to x
at my property located at 134 NSailfish Dr.
in Brunswick County
l furifwmore certify that t am authorized to grant, and do in fact grant permission to
Divisr'on of Coastal Management staff, the Local Permit Offrcer and their ager#s to eater
©n the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner 1Morntatim:
odw�.. P
IAJ
Signature
660KA 1 F't stt
Print or Type Name
irtle
OO9
ky
This certification is valid through

'3
3,
AD.IACENT RIPARIAN PROPERTY OWNER STA ENT
d hereby certify that I own property adjacent to _ Deborah K. Eish S
(Name of Property Owner)
property located at___i3A Sailfish ter
(Address, Lot, Block, Road, etc.)
on 12.r1a.; in __--Holden Rgarh N.C.
(WaWrbody) (City/Town andfo r County)
The applicant has described to me, as shown below, the develgmm proposed at the above
location.
l have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
126pa
,,� vs�; 1�1Cc1 c-�.u`��al k► h�u:�C.c�'t� �=laz� �. �.�''
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.)
t do wish to waive the 15' =Uxwk o9quirement.
i do not wish to waive the 15 setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Signature Signature
Deborah K. Fish Utility Resources Inc
Flint or Type Name Print or Type Name
136 5ailfth Dr. 136 S�ifish Dr,
Aft ting Address MaN Addte�s
Holdon Deacb, NQ 28462 Holden Beach NC 28462
� �1.%l�9 alc�vr�•�1� �A.o �L2=�+�:�� ��'��acrc.�s. ��z`
Telephon Numberl e�addAns ; ( Telephone N mbar email Tess
0tL?� o
Date Date*
(Ravised Aug.,
*Valid for one calendar year after signature"

ar r- r t •: I own property atacentto Da.•
rah K Fish Is
t s t _ Owner)
property t ., located .,r ..
aJn
i o!fit �n Beach
(Waterbody)
Town anWorr:
The applicant has descnbed to me, as shCW below, the &wWopment p*"W at the above
!n-no objectsobjecom to t proposal.
a r•�w+Ms � a s a..., ,.
DESCFJFTION ANWOR DRAYVING OF PROPOSED DEVELOPMENT
(IftdvkkW proposing dftekp~ awst fffi in dawn below or arch a ske draw*}
Rtplaee &,�&tcrl d4m VO a)'#L a- n&�)
J)g- M r. aO tt � � algect Gjt
Frog,`✓
YYAIVER SECTION
I understand ttrat a Pier, dodo, M010nng PWng* boat ramp, breakwater, boathouse, tiff, or groin
must be set back a minimum distance of IS fr m my area of riparian mess unless waled by
me. (If you wish to waive the setback, you must initial the appropriate Manic below.)
do wish to waive the IS setback requiren t.
do not wish to waive the 1 5t setback requiremerrt_
(Property Owner information) (Adjacent Property Owner lnfornratfon)
Signatwe
Deborah K. Fish dlasfi Shirley Keith
Print orT Nance ye) yJ� Prim a' T Nartrs
136 Sailfish Car. 3004 5oft Hawk PL
tQ 7ir� Address tNal7 Ada Tess
Holden Beach. NC 28462 _ Ap xF NC 27539-9307
, C&Amwzip
+7
Date
a7/11 �Fjg
Nalid for one calendar year after signature
Teleptime Numb 1 it address
Date* I
(Revised Aug. 2014)

i
I! - �­_ '
Al;;t �_

Deft Rarely d
Data
Check From Name
Name of Permit Nokler
Vendor
Cheep Akmlbw
Chwk
anuuM
Permit NumhenCommente
Receipt or Refund'Reaflocated
columnt
8QW019
6/26/2019
6/26/20191
6/26/2019
6/26/2019
6/26/2019
6262019
6262019
6262019
6262019
C01umn2
colttm"
Wellman's Construction Inc.
Solstice Builders LLC
Charles F. Riggs and Associates Inc.
Circle Q Equity
Circle Q Equity
Heaven Scent M mt Services
Sonja and Brian Nunn
Kenneth McDaniel
Lighthouse Marine Construction Inc.
Jerry Ennett / Ennett Marine Construction
ColumtM
Wellman's Construction Inc.
Martha O'Neill
William O'Grady
Circle Q Equity
Circle Q Equity
Margaret MacKay
Sonia Nunn
Kenneth McDaniel
Mark Calcutt
Haywood Parker
Cakmm6
BB&T
First Citizens Bank
First Bank
Wells Fargo Bank
Coming Federal CU
Coastal Bank and Trust
Coastal Bank and Trust
Cokmw@
18133
15935
16130
25362
25361
7320
7376
1126
2724
2280
Corumn7
$ 100.00
$ 100.00
$ 100.00
$ 100.00
$ 100.00
$ 200.00
$ 200.00
$ 200.00
$ 200.00
$ 200.00
Columns
minor fee 7716 8th Ave Lot B. North Topsail Onto
minor fee 334 Caswell Beach Rd, Caswell Beach BrCo
minor fee 1808 N Shore Dr Surf City, Onco
minor fee 911 Bumble Bee Ln TB PnCo
minor fee 938 Observation Ln TB PnCo
GP #74333D
GP #73548D
GP #74685D
GP #74692D
GP #74610D
Colum i?
Jd rct. 8781
Tmac rcL 8471
JD rct. 8250
JD rcL 8778
JD rcL 8779
TMc rct. 8755
PA rct. 7970
PA rct. 7972
JD rct. 8777
JD rct. 7925
6262019
6262019
AMW Dodos and Marine Construction Inc.
Joel Klass
Tricia Gosnell
Deborah Fish
BB&T
BB&T
5500
604
$ 200.00
$ 400.00
GP #74257D
GP #72303D
Tmc rct. 8489
Tmc rct. 8499
626/2019
_
Joel Klass
Brian and Ragan Daigle
Shelton Chaney
John Moore
Clarence Junior Allen
Adam Lauber _
BB&T
600
$ 200.00
GP #74232D
TMc rct 8500
6262019
Shelton and Jennifer Chaney
Lf hthouse Marine Construction Inc
Clarence J and Kathy Alien
Wells Fargo Bank
309
$ 200.00
GP 073539D
TMc rcL 8751
_
6262019
Coastal Bank and Trust
2713
$ 600.00
GP #74622D
JD rcl. 7923
6/26/2019
United Comm nitv Bank
9545
$ 200.00
GP 1174626D
JD rct. 7920
6/26/2019
Logan Marine LLC
ComingFederal CU
6561
$ 200.00
GP #74304D
8271
rct.6262019
Charles Fox Home, LTD
Debbie Smith
Branch Banking and Trust Company
26562
$ 200.00
GP 072243D
Tmc rct. 8492
6262019
F & S Marine Contractors Inc
David Swain
PNC Bank
7912
$ 200.00
GP #74695D
TP rcL 8737
6/26/20191
F and S Marine Contractors Inc
ISusan Culp PNC Bank
Joel Killion PNC Bank
Jonathan Holland _ _ _ __ Fidelil r�Bank
Emmett Aldredge Branch Banking and Trust Company
Michael Davis BB&T
Murry and Ann Crawford Wells Fargo Bank
7913
$ 200.00
GP #74696D
TP rcL 8736
626/2019
6/26/2019
•6126/19
6/26/2019
6/26/2079
F and S Marine Contractors Inc
7914
$ 200.00
GP #746383D
TP rct 8735
JBH Lawn Care and Landscaping Inc
13792
$ 200.00
GP 074315D
TP rct. 8734
Duncan Marine Contractors Inc.
8278
$ 400.00
GP #746860
TP rct. 8733
Grice_ Construction of Brunswick County I
Brandon Grimes MO
13072
$ 200.00
GP 973534D
Tmc rd. 8493
6.74E+09
400.00
GP #74667D
JD rct. 8782