74807D - Mona

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AMA / DREDGE A FILL No. 74807 A B C
ENERAL PERMIT Previous pet #
-'Modification !:'Complete _ Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality /
and the Coastal Resources Commission in fan/ area of environmental concern pursuant to I SA NCAC
(L I Y!� �i� _L / 01 Rubs amKhed.
Applicant Name_�Qf%�i ICI-'_-. __-� ""`=-_------- Project Location: County Gy�c�
Add�� ��/'t AGE_D V-8 Street Address/ State Road/ Lot #(s)in
�J% —
Crt}'W cc State ZtP�
Phone # (1rf�_ / i) — Subdivision ff _
Authorized Agent�a Ghnvt _._ ----- _. _-- city d�1�%E l� _ Z(P r � /�ril_iS j
CW S'EW - t?TA ❑ES PTS # (7%11) 4oy River Basin+` k OAL
Affected y OHW *1 -3 UM -J WA aA
EA ❑
AEC(s): , Adj. Mr. Bmlit "- � / _ ankr'j
PWS:
ORW: yes rig PHA yes / Gosest Mal. Wtr. Body _------------.._--
Type of
S
(Scale:
Fixed Pfatfcxm(s)
Floating
X 16 13
Finger pier(s)—�' E �—
Groin length _--
- —
number -
Bulkhead/ Riprap length_------i
avg distance oihhore
— t
max distance offshore
Basin, charnel
tabu yards
Boat ramp--- - _. —i-
Boathouse/Boatlitt_.""--____--'�
Beach Bulkkuing _- --
Other.QW
3 . �F., _
-- — j U . 7o
Shoreline length_
SAV: riot sure yes n� i
Moratorium: n/a yesi =r
Photos: yes
Waiver Attached: yes .------ ----- --- ------ _._—_- _
A building permit maybe required by: �/G 1�%/J�/i c�'�� '� _ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) J L
Not Special Conditions I S b its !(1t C ��� /<
r�
l a i n -{v✓�'l�
f/
t or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit is Printed N
t
Signature 4/5 /,Zo`
Issuing Date - -- Expiration Date

CAMA / DREDGE & FILL No. 74807 A B C 0
GENERAL PERMIT Previous permit#
.*N'ew Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ,j(f,
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC D7/�i'.2-
�ID�/Gl �la�l� Marh� LAG ,,�� Rules attached.
ApplicantName Project Location: CountyJlrt'ssw *
Addres ✓ r1'eA#1 bl('Ve Street Address/ State Road/ Lot #(s) S/, p hb
City State ZIP P40 2 /re30 St � 19
Phone # (11o) 5-76) 5a4 ail Subdivision --
Authorized Agent Viva toc ha v, Ce, CityL a � ,kx et%r4-- /V C zip iK�i ri ,4,4'S4'-*-
❑ CW SEW A"A ❑ ES El "S # (`l I o) Oy River Basin'+►/'. 1L ��C�G/
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A n �� �C� y -A �
AEC(s): ❑ PWS: Adj. Wtr. Body / jL i�LI 5g Sl;ii 113fm unkn)
ORW: yes /� PNA yes / ij� Closest Maj. Wtr. Body
Type of Projgct/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platforno ¢ IV E;)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel —
cubic yards
Boat ramp --
Boathouse/ Boatlift —"
Beach Bulldozing ---
Other3S4 SF in OkA)
Shoreline Length �S
SAV: not sure yes
� I
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes V
A building permit may be required by:
( Note Local Planning jurisdiction) n I /
Notes/ Special Conditions (P y yi [al% Z -7H 2 00%i .
V
4or
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
1064
Application Fee(s) Check #
.S
li,
(Scale: V-S )
❑ See note on back regarding River Basin rules.
MMFXAA�
i n --.# tf?-&v-4144
M4 i fit A
Permit Offi is Printe Na
- �Z'T—
Signature
Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ff)pr\c'_Mailing Address: Address: .'�_553 0 L• E_A N b0 ?, j71� t VC"
(3 I L__ vV\ , 4 C -Ta rt , N L. 28'fc 3
Phone Number: DO - 5Z1) -5Z`-2-
Email Address: a.c-k �2 a.[ r- e.c-, r
`1 I
I certify that I have authorized Lu n,�,e�
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: ,&A �._AC
at my property located at q3,p v o1 cok
County.
-r
1 furthermore certify that I 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:
44Z�ez&�_
S nature
A-0ha, F__a e' 1 `a.c..iC
Prin or Type Name
N�a rNagE"� -
Title
12.
Date
RECENED
This certification is valid through 2- NOV 2 2 1019
DCM WILMING T ON, NC

M Complete items 1, 2, and 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,
f Delivery
B. Received b tin Name) C. DaOlt
or on the front if space permits.
2� ��
1. Article Addressed to:
D. Isdelive address different from item1? ElYes
LLQ-
If YES, enter delivery address below: ❑ No
3. Service Type ❑ priority Mail Express
❑ Adult Signature
I I IIIIII IIII ICI I i i II I III I IIII I I II I I II I I III
9590 9402 3802 8032 8084 88
El Registered MaiIT"'
0 Adult Signature Restricted Delivery ❑ Registered Mail Restricted
❑ Certified Mail© Delivery
❑ Certified Mail Restricted Delivery ❑ Return Receipt for
❑ Collect on Delivery Merchandise
❑ Collect on Delivery Restricted Delivery 0 Signature Confirmation-
2. Article Number (transfer from service label)
'-' 18 2290 0000 6830 3665
❑ I� Insured Mail ❑ Signature Confirmation
nsured Mail Restricted Delivery Restricted Delivery
(over $500)
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
COMPLETE THIS SECTION
COMPLETE THIS ON DELIVERY
SECTIONSENDER:
A. Sign re
■ Print your name and address on the reverse
X Gt� ❑ Addressee
so that we can return the card to you.
B. Received by rioted Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1? ❑ Yes
1. Article Addressed to:
If YES, enter delivery address below: ❑ No
Tv\-L Uov tC) z:,t
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3. Service Type ❑ Priority Mail Express®
I I IIIIII IIII III I II I II I III I I IIII I II III I II I III
❑ Adult Signature ❑Registered MaiIT^'
❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted
9590 9402 3802 8032 8084 95
❑ Certified Mails Delivery
❑ Certified Mail Restricted Delivery ❑ Return Receipt for
❑ Collect on Delivery Merchandise
❑ Collect on Delivery Restricted Delivery Signature Confirmation*""
2. Article Number (Transfer from service label)
Insured Mail ❑ Signature Confirmation
Restricted Delivery
7018 2290 0000 6830 3658
Insured Mail Restricted Delivery
over$500)
PS Form 3811 ,July 2015 PSN 7530-02-000-9053
Domestic Return Receipt

r
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00
N ct su-p
RECEIVED
DCM WILMINGTON, NC

Complete items 1, 2, and 3.
Print your name and address on the reverse
so that we can return the card to you.
Attach this card to the back of the maiipiece,
or on the front if space permits.
Article Addressed to:
Aj - uV3\),(.. No w
9590 9402 3802 8032 8084 95
Article Number (transfer from service label)
'018 2290 0000 6830 3658
> Form 3811, July 2015 PSN 7530-02-000-9053
LISPS TRACKNG #
11111111111111111111111111111
9590 9402 3802 8032 8084 95
United States
Postal Service
A. Sign re I W Complete items 1, 2, and 3.
❑ Agent ^ Print your name and address on the reverse
X— 0 Addressee t so that we can return the card to you.
B. Received by rimed Name) C. Date of Delivery ■Attach this card to the back of the maiipiece,
or on the front if space permits.
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
1. Article Addressed to:
I
C�3U► W— .
3. Service Type ❑ RMail Express® ( 11lI�III I II I�) I (I I II III' IIII I'I' I I� III III ❑ Adult Signature ❑Regegist Registered MadT°"
❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ?
❑ Certified Maile Delivery j 9590 9402 3802 8032 8084 88
❑ Certified Mail Restricted Delivery
111 Receipt for
❑ Collect on Delivery
Merchandise
0 Signature ConfirmatlonTM
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation I
r Insured Mail
Insured Mail Restricted Delivery
a..,o. 4cnm
Restricted Delivery
• Sender: Please print your name, address, and ZI
Domestic Return Receipt
2. Article Number (Transfer from service label)
�018 2290 0000 6830 3665
PS Form 3811, July 2015 PSN 7530-02-000-9053
USPS TRACK NG #
First -Class Mail f
Postage & Fees Paid
USPS
Permit No. G-10
i 9590 9402 38d2 8032 8084 88
in this box*
I United States
Postal Service
f
A.
ElAgent
X
j ❑ Addre
B. Received b rin Name) C. Date f Del
D. is'deliveryladdress different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail ExpressCw
❑ Adult Signature
❑ Registered Mail—
t7 Adult Signature Restricted Delivery
O Registered Mail Restrict
❑ Certified Mail®
Delivery
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
❑ Coiled on Delivery Restricted Delivery
andise
0Signature Confirmation'
❑ Insured Mail
❑ Signature Confirmation
❑ Insured Mail Restricted Delivery
Restricted Delivery
(over$500)
_
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G 10
• Sender: Please print your name, address, and ZIP+41�1 in thit!
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Daft Raethnd
Dafa DP,,Md
Chtok Fmm
Name of Permit Noldr
Vtndw
Cheek Number
Chtok
amount
Permit Numf»r/Commenfs
Rec f or R f-.VReallxafW
Coi—I
COMmq
Col ..9
CaNann6
Col."Cokmm7
Co1umn8
Colu-9
1202019
12/512019
Eric and Yroa LaChance
Mona Black Marina LLC
USAA Federal Savings Bank
1064
$ 200.00
GP i74807D
GP i74789D _
GP 1.74812D _ - _ -
IGP#74810D
PA act. 8522
PA rct. 8514
12/62019
I ZSM19
Brian and Heather Mikkelson
same
First Citizens Bank
131
$ 200.00
12MM19
12WO19
H5 Constriction LLC
Marsh Walk by The Sea POA
BUT
2418
$ 200.00
BS rct. 9457
12ro/20191
12M20191
Daniel Crouch Julia Glew
I Julia Crouch Christopher Duke
I State Employees Credit Union
1 1005
$ 200.00
IPA r t. 8524