74336D - Ogle

�;CAMA /,KDREDGE & FILL NO. 74336
GENERAL PERMIT Previous permit # -1 + v�-i c °
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued (v-_3 -,1,016
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 %y-4 �A . k � ou t USE{ .1100
❑ Rules attached.
Applicant Name I 4 I (,�Qll 1 051ye, Project Location: County(J__ Z,,..I ck._
Address ` 900 W a,,. 6'A4t i ea Street Address/ State Road/ Lot #(s) /'
City AU k9 fSv'A1 C State_W ZIP 2 Ta✓r�r, n fir.
Phone # I'7y) 957 1 `ialf E-Mail �e� �� •c o^-
Authorized Agent MOW "CJV!t
Affected ❑ CW ® EW APTA ® ES Q PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / ao PNA yes
Subdivision W 1A p,
City i �4� ?('e �.0 r ZIP o'2y1 tp a --
Phone # (1 I River Basin Lv�.�ie i
Adj. Wtr. Body (nat &and/unkn)
Closest Maj. Wtr. Body
Pier (clock) lerI 1111M
■■■■■■Fixed Platform(s)
Finger pier(s)
■■��■■■�■■■�■■■�■■■■
Floating Platform(s)
■��■■■■■■ ■��►111�■■�■■■.♦■■■■■■■■■
Groin length
number
■■■■N■■■■�■���■■■■�■■■N■■■■■■�■
Bulkhead/ 4�prap length 5,C)
MEN
avg distance offshore
■�■■■■1�llilnl�� ■■■pil�ll�®■■■■■■■■■■■■■
max distance offshore
■�■■■■■I�===�11■■■�Ir� �� ��1®!■■®■■■■■■■■
Basin, channel M=
cubic yards
Boat ramp■�■■■■1�■■■�■ill �������■■�■■■■■■■■■ ■■■■■■■■■■■®■111�■■ Beach Bulldozing _-
■■■ ' NO MORE MEN MOMMEME■
- ■■ ■■NIA■■■h■■■■/■■��■■i■���N�����s���l
. . �®����N����� �� ��i���N ��■■ate■■N■����I
Shoreline Length S-U.
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
-T-1-
444
Waiver Attached: no
F 1
XI
A building permit may be required by: TWwN O F
NULk-�,Ctj
T3F_ALJ4 ❑ See note
on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions (N\L (ON l7t 1 I UN
S o r
O_M . %k U o ? 0-4H .0 ZGG . L
a cr L,
"IiI VN
Agent or Applicant Printed Name
Permit Officer's Printed N e
G
Signature * Ple e.r .ad compl4ance statement on bac of
permit
Signature
2'7 19
104711
Application Fee(s)
Check #
Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 441c kcalji
Mailing Address: 13 t ���-t�aK �✓
a-ew Br-'04G-ell, 2
r
Phone Number: 70`/ - f53 - /y8V
Email Address: JWCO &9 le a CCU - C(DA4
I certify that I have authorized H5 Construction LLC
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 139 X A
in ./3/W-gJ4jzc County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit fo enter
on the aforementioned lands in conned to this
permit application.
Property Owner Information:
ignature
�l tc ire Z,,!5. 6�
Print or Type Wame
4 4.L *4'
Title
5 I Air I ZD/4
Date
This certification is valid through / /

16
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
R
Name of Property Owner Requesting Permit: rmit: c 4e-eZ 4C-.7
LVL Z4,4�.`
tl
Mailing Address,
'Iwo
Phone Number:
Email Address:
le
�;4
I P-
I certify that I have auWorized H5 Construction LLC
Agent/ Contractor 0 -T--WtM
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
install boit lift and bulkhead
at my property located at
%
in Aute County. , Kk
FA
i furthermore certify that / 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:
L—ignature
i, C- 4L� Z
Print or Type Warne
C'.Z '4'
Title
40 1
Date
This certification is valid through I I

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION)WAIVER FORM
Name of Property Owner:
le .
Y - Address of Property: 1,390 1Q'-f7wq DIL /),J4Z4Cct
(Lot or Str6et #, Street or Road, City & County)
Agent's Name #: H5 Construction
Agent's phone #: [phone]
Mailing Address: 2164 Holden Beach Rd.
Supply, NC 28462
Z JWi6,Z
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 aredroposing. A description or drawing with dimensions must be provided with this fetter.
f?
q( 11.
I have no objections to this proposal. I have objections to this proposal.
ff 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. Contact information for DCM offices is
available of http:Ilw arr.nccQastalrnanauement rretfweb1crWstafl<lisiing or by calling 1-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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)
SlattQttll'P
Print or Type Name
Mailing Address
Alolel-m
CitylStatelZip
-_eC- I?00- e- v �--
Telephone Nu er / Email Address
Date
(Riparian Property Owner information)
J!Ln� k,
Szb iature
jl-w Cgoc.�G^Gr
Print or Type Name
Mailing Address
City/State/Zip YZ 1%
GG fjrtiJJlL°/2,f/jt�¢i,K �q�llgi �c�
Telephone Number / Email Address
7/0 '?'l a �? 5q
Date � 19 J
ly (Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAWER FORM
Name of Property Owner:
Address of Property:
(Lot or
Agent's Name #: H5-Construction
#, Street or Road, City & County)
Mailing Address_ 2164 Holden Beach Rd.
Agent's phone #: [phone] Supply, NC 28462
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 mustnotify the Division of Coastal Management
(DC* in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at hyp.,Ilwww.nccoastalmanaaement rtet/web/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been noted by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
(Pro Owner information)
Sinc.�ttt-
Print or Type Name
�3 Y- TT
Mailin Addr ss
city/state/Zip 7G fe. p3'3
Telephone Number / &rfiad Address
5•• 0z - fY
Dwe —
(Riparian Property Owner InfoYmatio }
Sigrnarure
uow/I
Aw UI
Print or Type Name
Mailing Add ss
z ye
ity/StatelZip
� �wL��G .R_�•cowt
Telephone Numb r/ Email Address
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
tLo( of
Agent's Name #: H5 Construction
Agent's phone #: [phone]
24, Dk 11b4Aro1JeQC4 WC 2vez-0,
##, Street or Road, City & County)
Mailing Address: 2164 Holden Beath Rd.
Supply, NC 28462
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 descrioiion or drawing wit#• dimensions must be Provided wdh this letter_
I have no objections to this proposal. I have objections to this proposal_
lyyou have objections to what is being Proposed, You must notify the Division of Coastal Manager .W
(DCM} in writing within 10 clays of receput of this notice. Contact information for DCM offices is
availableatht;ia-ltar , .ncco.astaimanagemew.rap+:orb%cm,s -j'f-i sting orbycal/ing 1-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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 157 setback requirement"
(�ogetrtj�Owner Information)
Sign
Print or Type Name
Gty/StatelZip 7►p f f+, !
Telephone Number / if Address
ncrri
zd,%;z
(Ri rear P Owner M do j
.SIy�IIQl!(I"�
Print or Type Name
Marling Add ss
p F/o - ZZS- •
Raeoage, G . R 1L •eDOc
Telaphon©Nu r/Email Address
Char
(Revised Aug. 2014)

CERTIFIED MAIL - RETURN RECEIPT REQUESTEQ
DIVISION OF COAST Ai_ MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
L3 5lL. f
(Lot or Str�
Agent's name #: H5 Construction
Agent's phone #: [phone]
. S:reet or Road, Cfi/ & countv)
Mailing Address: 2154 Holden Beach RG.
Supply, NC 28462
ZS. , 11(v�
I hereby certify thai 1 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 3yyfth this letter.
Yt. 6.
1 have no objections to this proposal. i hay e objections to this proposal_.
if you have objections to what is being proposers, you must notify the Division of Coastal Management
MCAP in writing within 10 days o r . eceipt O this ;ictic . Contac~ imr-w station for 0CM offices ;s
available at y !wwa nc orby calling 1-888-4RCJAST.
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, boat ramp, breakwater, boathouse, orlift, 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.;
__ _.-_C' I do wish to waive the ' 5' setback requirement.
do not wish to waive the i 5` setback requirement.
(Property Owner Information)
Si�rrutrrrc
Print or Type .Name l'
!Mailing Address i'
A044V 13eq
City/State/Zip If &
Ili.0 Pit L�C� 4'D/ c v •--�
Telephone Nurrr�6r/Email Address
k'Riparian Property Owner Information
SY�rrurui•c
cIl ut �►�d'C1GLt
Print or Type Name
Mailing Address
PrE fc�s,{r 2 2
Cris/Siate/Zip• Z. jr �d%G/;-C
Telephone Number / Email Address r �+
Dwe
Duce 1 4
q ! / (Revised Aug. 2014)

=H5=
CONSTRUCTION
P/L
Holden
PROJECT: 138 Tarpon Dr., Holden Beach
P/L
-------------------------------------------- TARPON DRIVE ------------------------
Not to scale

Date Received
Date Deposited
Check From (Name)
Name of Permit Holder
Vendor
Check Number
Check
amount
Permit Numb —Comments
Receipt or Refund/Reallocated
Columnl
Co/umn2
Column3
Column4
Columns
Co1umn6
Column?
Columns
Column9
7/3/2019
7/3/2019
H5 Construction/Matt Hon
Michael Ogle
BUT
2319
$ 600.00
GP #74336
TMc rct. 8759