57398D - PBW

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-iCA/ DREDGE&FILL 5r 398
ENERAL PERMIT Previous permit #tea
❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issuedJQ_
As authorized by the State of North Carolina, Department of Environment and Natural Resources �7
and the Coastal Resources Commission in an area of environmental concern pursuant to 5A NCAC . i [-C o
` d c�. 1 El Rules attached.
Applicant Name Project Lo ation: County New - -e r
Address ;' Street Address/ State Road/ Lot #(s) ` /E(k (u-U SQL;�a i
City- - — -- State ZIP --� I V t J
Phone # ( —) -- - ---- Fax # (----)--- -----
Authorized Agent a
Affected ❑ CW EW L� PTA fES Li PTS
A
Affecte El0EA ElHHF i❑ IH ElURA r El WA ,
❑ PWS: ❑ FC:
ORW: yes no PNA yes / no Crit.Ha�b. s / no
n
Type of Project/ Activity Lx S�,(c-4 �- � w ' L
Pier (dock) length LIP
Platform(s)
Finger pier(s)
Groin length iE
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing_
Other f"AA / —
Shoreline Length ---
i.
SAV: not sure yes na�1
i••���u
Sandbags: not sure yes no✓'
Moratorium: n/a yes no
Photos: yes nq1,
Waiver Attached: yes no` ----L
A building permit may be required by:
Notes/ Special Conditions
4-
Agent or Applicant Printed Name
Subdivision
Ct21P 2CI�2:3
Phone # ( ) Z56 •-4Ul iver Basin L C
Adj. Wtr. Body M D i_, t_ i h n N 1 na /man /unkn)
Closest Maj. Wtr. Body r`L� VA I S1n i G'
t P , :-V i JGi -f P /J- 0 GtLi
W=WJa'"V-MM AjpAJMlJ%JdLnl
ETAWFIRIAMM-0 MUMMER
1r
ul i ME A
Signature *e Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale
See note on back regarding River Basin rules.
1
I (Om-Aov
l/" � � e'-G --
Permit Officer's Signature
4 LOA 0
Issuing Date Expiration Date
��A NrIpt-
Local PlanningJurisdiction Rover File Name

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
pay Iva L�
Mailing Address: ED Bt) a qI3
Phone Number:
��o -�7-JAb
Email Address: G� L> ` f1 hill j CAW
I certify that I have authorized G�Lf' ! l �1► it
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA per ' s
necessary for the fol wing proposed development: &Lwl�
IZ,✓�I,I�L�,r�f ��� ��a ���LIpS
at my prop rty located at `IAA
in L'1County.
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:
Signature
L44ty At �� �L
Print or Typi Name
Title
a6 , 0
Date
This certification is valid through 0 1 � 1 v
P.0. Box 868
Wrightsville Beach, NC 28480
[phone]
6k

40705 `
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FROV A% AC?UAL S..R:£v VA)E UNDER VY SuOERYSCC : RE HvJRA%T ('AS'
(CLEO DESCR'T CS RECOR3E3 q BOOR (5513. PAGE 276011: E_fV �'023'
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner. Jw uL'1 ME
Address of Property:
/l (Lot or S reef , Stre
Agent's Name #: _ L -`
Agent's phone #:.__�1 �yG�
G
'mob
or Road, City & County)
�d���6�
Mailing Address:
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, watt dimensions must be provided with this letter.
Ake— 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 EA,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no ob'actlon 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.
roperty Owne formation)
Signature
P8Ld�� A 1LLB
Pr' I or Type Name
T. �
Mailing Address
l,,/bl>w4hp, ► . 28 ��-- CitylState0if
Telephone Number
06
Date
f/64
(Adjacent Prope weer Information)
Signa ure
'L,V l m�m/3,
Print or Typ ame
l pts �n-
Mailing Address
�✓yiVU`� -DECEIVED
city�sta6 e/L— -
,vk vo -5se _ACT 01 2019
Telephone Number
/9 SL�-
Date
DCM WILMINGTON, NC
Revised 6/18/2012

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:`'--
�,,'/ �j rev
Address of Property: ��reet
or Road, City & County)
Agent's Name #: �'" = � __ _ _ _ _ MailingAddress: bjgpo8
Agent's phone #: �JU 6 , 3liG - s-40*
11ti11�� 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. k_Uc st r�acsc; yr ! -iwmy wr?r 7imw) ,lens must be. provided with th►s letter .
I have no objections to this proposal. __ I have objections to this proposal.
l
if you have objections to what is being proposed, you must notHy the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive EA,
Wilmington, NC, 28405.3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection N you have been notified by CertMed 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. c-
I do not wish to waive the 15' setback requirement.
(Property Owne ormation) (d I n op O er In rmation
Signature ignature
PbL1 �, �� LLB Add K
Pr' I or Type Name Print or Type Name
.61 U)vy nyo, ,/d /W# 0
Mailing Address / Marling Address RECEIVED
Q/�
City/State/Zi City/State/Zip 0 C T 01 Z019
kc 1� 0 -600 -1J 0 0
Telephone Number Telephone Number DCM WILMINGTON, NC
Dare ate
Revised 6/18/2012

Date Date
Received Deposited
10/14/2019
Check From Name of Vendor Check Check Permit Rct. ##
Permit Holder Number amount Number/Comments
F and S Marine PBW Development $ PA rct.
Contractors Inc LLC/David S etrino PNCBank 8115 200.00 GP 57398D 9174D