74576D - Hughes

CAMA / DREDGE & FILL NO. 74576 A C
GENERAL PERMIT Previous permit #
New . ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality d� r Z�C.,
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
f.c�❑Rules attached.
Applicant Name \N p\ tt=112 S Project Location: County FAQ 4 C—P ,.
Address It; 19 c0l*t Ck V �% , Street Address/ State Road/ Lot #(s)
City Y4 V%L M i N)6E ( 0 ►d State i�_ ZIP Z O3 Z� '—� - �lA✓� De—,
Phone # 'Z- E-Mail Subdivision
Authorized Agent N 1 % City7�[�'--F ZIP 2&AA-S—
Affected ❑ CW W EW )C PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /CJ PNA yes /(D
Phone # ( —jr—^ River Basin Vv" jTE Off► K—
Adj. Wtr. Body 'F'A f4 BLS 4UNn VA I;;� (natem'Rilunkn)
Closest Maj. Wtr. Body 70"C'A t (.-- 45(D 0",D
Type of Project/ Activity 1 N r77( ^ 0 - P;;VAT U FT
(Scale: f 1 ?,o ► )
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Groin length
Riprap length
max distance offsl
Basin, channel
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r1 bunamg permit may be reguirea by: /N`y- yXIM>t
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Applicant P inted Name
ignature ** Please read compliance statement on back of permit*
Application Fee(s) Check #
I_I bee note on back regarding Kiver Basin rules.
'Do, t %---
Permit Officer's Printed Name
Silre
Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Req
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in Pe n <1 P i' County.
I furthermore certify that 1 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:
q .
Signatur i
k
(7syJa l kr T. I�u CSJr.
Print or Type Name
Title
Date
This certification is valid through t �� b t
RECEIVED
AUG 0.1 2019
DCM WILMINGTON, NC
AEI q Z_

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 1kLc I-fPr l , H(Aah4� ,s
Address of Property:
Agent's Name #:
Agent's phorre #:
(Lot or Street #, Street of Road, City.,&r
Mailing Address:
�)Sy ci,57
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.
I have no objections to this proposal. I have objections to this proposal.
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, 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.
(Property Owner Information)
(G4-14z)
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Print or Type Name _1
J519 Cuntg cluk
Mailing Address
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Telephone Number
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Date
Agnature- JI—A
Print or Type Name
Z ,
Mai ►ng Address
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City/State2ip d RECEIVED
zsZ- 00 -(a oil 9 AUG 01 Ci9
Telephone Number
l2 2-0[c) DCM WILMINGTON, NC
Date `
Revised 611812012

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rO For delivery information, visit our website at www.usps.com".
WIL I'�r. NNC 2340V
rl Certified Mail Fee
p $3,511 $ 1{4�If
Extra Services & Fees (check box, add tee ppld 'ate)ic
❑ Return Receipt(hardeopy) $ ,00
p ❑ Return Receipt (electronic) $ Postmark
p ❑ Certified Mail Restricted Delivery $ Here
p ❑ Adult Signature Required $ to fie
[]Adult Signature Restricted Delivery $ per • rr=
p Postage
—0 $ $0.5 5
n3 p Total Postage and Fees { �6/� {1 /2� )19
$ $6.85
Er sent To � 1'fru
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Str t and Apt IVo., or ffoz Ff
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----------------AZALEA------
3916 OLEANDER DR
WILMINGTON, NC
28403-6758
3686440406
019 [phone] 10:55 AM
-------------------------------
-------------------------------
c Sale Final
Ption oty Price
Class 1 $0.55
NGTON, NC 28403)
Mh:0 Lb 0.70 Oz)
(Estimated Delivery Date)
(Monday 06/03/2019)
tified 1 $3.50
(NUSPS Certified Mail #)
70190160000110198503)
urn 1 $2.
• ceipt
(NUSPS Return Receipt #)
(9590940248199032599366)
Total
Cash $10.00
Change ($3.15)
Text your tracking number to 28777
(2USPS) to get the latest status.
Standard Message and Data rates may
apply. You may also visit www.usps.com
USPS Tracking or call 1-800-222-1811.
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(RECEIVED
AUG 0.1 7019
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Jean -B -
I'hereby certify that I own property adjacent to r 's
(Name of OPitti O er)
property located at
(Address, Lot, Block, Road, etc.)
on , in S u v-4� C i, J v , N.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
(Property Owner Information)
ature v 1 W r I-
5 Qh 5 t�v'
Print or Tye Name F `J
q�
Mailing Address
C' /StateTZip
a- 1_ o IC710-
Telephone Number
Ma a )5( 9-
Date
Information)
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AFA
Print or Type Npme
2717Y5 S ShL-,v� Y) P—
rlrng Address
City/State2ip
I/O 0/ RECEIVED
Telepho n Number
i it 01 2019
Date n
(RoftOWUMWON, NC

F''P r+
T/2FUEn�
(RECEIVED
AUG 01 2019
DCM WILMINGTON, NC

Date Rece/ved
Date Deposited
Check from Name
Name o{Permlt Holder
Vendor
Chock Number
Chock
amount
Permit Number/Comments
Recei t or Relund/Realbcafed
Column?
Co/umn2
Column?
Column/
C0/umn5 _
Column.
Column?
Column8
COIu.
817/2019'
Water T Hu hes Jr
i Walter and Jean Hughes Wells Faro Bank
--
200 00
GP #74576D
JD rct. 8794