74711D - Jones

CAMA / DREDGE & FILL
4G>X'(1N
ENERAL PERMIT
ew ❑''Modification ❑Complete Reissue El Partial Reissue
No. 74711
A B C
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 I SA NCAC 07 N i i L V o
❑ Rules attached.
Applicant Name QNAW KODV Z-Owmr-s
Address A3- D ,+ A%xro Al FLo
City �RCE�✓�R o StateAJC ZIP7-1140V
Phone # (334 271 - 0577E-Mail J1A
Authorized Agent (a1tr-C 00%o DEAL
Project Location: County 5¢ %&AJIS 4J 1C- K
Street Address/ State Road/ Lot #(s) / i.Z
Al2F'i)I Die .
Subdivision _ /V/A
city N'3En c h zip 2 t `! VZ
❑ CW XEW (XPTA ❑ ES ❑ PTS A C1eWTPhone # (110) 640 - 6 5 it O River Basin I-UKFC f.
Affected OEA HHF ❑ lH ❑ URA El N/A AEC(s): ElElAdj. Wtr. Body CJ4NIltr (na m_ a�)
ElPWS:
ORW: yes / PNA yes /© Closest Maj. Wtr. Body A W w
Type of Project/ Activity 'R C PL A CC- O C Y- 1 /J Ci A C- t L 1 T/ 1 At
C >[ IS :Z1 A/G Vg> P R. 1 All (Scale: O 1) s
doc length 4 ' X 4"
pofw Platform(J)��� X
ing latfor (s) g � X i ii�
Bulkhead/ F
avg di!
max d
Basin, Simon,
cubic yards
Shoreline Length 500,
SAV: not sure yes
Moratorium: n/a yes
Photos: yes o _
Waiver Attached: no ro!-
0%1N
A building permit may be required by: �� jLr/ bl� NI L-2 E/V 1EA cH ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions B( A L - OT14VE i "F Ar-D V-(X A L.
SSTr' LO CAL, RE Lut,A--na V_,5 APPLY
Agent or
Signature base read compliance statemen`f tin back f permit —
Application
Check #
Permit Officer's Printed Nam
Signature
o { 020
Issuing Date Expiration ate

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to V-AdV IQyt,25 is
� of Property Owner)
property located at �.�c�..Zi�� s t� � C,y,
(Address, L•oh lock, oad, tc.)
on , in -tt4 ifP.V� ' eacUL N.C.
4ater'bift (Clty/Town and/or County)
The appl' nt has described to me, as shown below, the development proposed at the above
ksca
1 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)
ftW DoLL --�b b"p— ?'Ct -e - ; h �"- SCk M �
p6z e— C� S '* e— E)c ,, S4', V-A
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C-6�,a y
�� e 5-�;ov� sea s� ea1 l nie n 4 g E b s yD-6,5-/ o
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.)
�. I do wish to waive the 15' setback requirement.
I do not wish to waive the 16 setback requirement.
Owner information) (Ad cent Property Own Information)
. ypa Name / Prmt or Type am,,
`L /ly
ig A �s $tyn9 Address
049staldop Cily/s(a 311 —12 10
Telephone Number/email address Telephone Number/email address
loci ^ 19L
Date Date*
T (Revised Aug. 2014)
'Valid for one calendar year after signature'

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Date Received
Date Deposited
Ch.* Fiom LN&VO
Name of Permit Holder
Vendor
Check Number
Check
I
P—if NumberComments
Racal t or Refund/Reallocated
Columnl
Col-2
Cofu-3
Com-4
Co1umn5
COA-16
Column]
Colu-8
C.0-9
10/30/2019
Holden Dodos and Bulkheads
Ryan Kody Jones
Town of Sunset Beach
CresCom Bank
First Citizens Bank
3728
$ 200.00
GP #74711 D
GP #74545D
Tmc rct. 8288
10/30/2019
Town of Sunset Beach
19479
$ 200.00
Tmc rct. 8293