73529D - Roycroft

y CAMA / QDREDGE & FILL No. 73529 A B CO
• GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue El Partial Reissue 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 C7 0
❑ Rules attached.
Applicant Name CA a=�L 12,WCR0F T Project Location: County ZT;.,. j-,utctc
Address -407 %C-iNTwoo,o LN
City Stated ZIP 2-6470
Phone # ( It0) 754 - 6q E-Mail e,6j%+ O c or.
Authorized Agent RFLY W 1-A ► . V
Street Address/ State Road/ Lot #(s)
Subdivision
City
ZIP
XCW ❑ EW
❑ PTA PFS *TS
AC,W ..rr Phone #
River Basin I_tA.M yr-m
Affected
❑ OEA ❑ HHF
AEC(s):
ElIH ❑ USA El N/A
Adj. Wtr. Body -_'5NAt_c_nrrr_
T2Avct< nat /man /unkn)
❑ PWS:
ORW: yes / no PNA
yes / no
Closest Maj. Wtr. Body S^mr
Type of Project/ Activity
ADS hty-iJ
121P RAP I�F Ci1�E�.T
AOjA,-r_,1T
'i aix
s -r1 a/ c,
B �. �t�_ w n
(Scale:1 )
Pik(dock) length
Floating Pla m(s)
Finger pier(s)
Groin length
number
Bulkhead/ pra ngthO'
avg distance offshore
max distance offshore
Qasin, channel
Boat ramp
Boathouse/
Beach Bulldozing \
Other M-1 % 3 . o0c) -C{ 2
f
Shoreline Length — 4 ooi
SAV: not sure yes no
Moratorium: (0- yes no
Photos: yes ` ^�
Waiver Attached: yes viol
I
A building permit may be required by: CC—•wi7V ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions O 71A 1100 & ALL a T►%t--P- Lo C A t_ 5TAi-r_ _ .9 Fr-DE'R A L
w
R£c ",-A-rtoNs _1f PL11. Ps= t> i V-%P I? AP : rLAAL4_ rzr— Alo FLATTt;R ► "Aw
Age Applicant Prin Nam`(/
Signature Please read compliance statement on back of permit"
jt4ov I L
Application Fee(s) Check #
yL_c� M r C1,4. I xr-__
Permit Officer's Prin ed Name
c
Signature
Issuing Date Expi tion Date

AGENT AUTHORIZATION FOR CAMA P 1IT APPLICATION
Name of Property Owner Requesting Permit: L�_�
Mailing Address:
Phone Number:
Email Address: �
I certify that I have authorized _ � r 4-c
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: —<�l tir r_ i , n-, L�j0a
at my property located at
in rL,.v-) $�J; C LCaunty.
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:
C4, 12
Slgnatu
[`r V c'Cr
�-
Print or Type Name
Vl P C
Title
/-/ I / I )
Date
This certification is valid through 1 i

ADJACENT RIPARIAN PROPE&UAMR §TAT_ EMENT
I hereby certify that I own property'adjacent to f f, ( 1 i2 avG! o�'( `s
/, / (Nome of property Owner)
property located at `7 b `7 /� �Gi fw 4 od �-ar�
(Address, Lot, Block di Ro etc.)
one/�o>r %L�J in k��� �,� N.C.
(Waterbody) (City/Town 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 flU in descrfption below or attach a site drawing)
e
I understand that a pier, dock, mooring pilings, breakwater, boathouse, rift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (1f you wish to waive
the setback you must Initial the appropriate blank below.)
_ 1 do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property ner nformation)
Signature Signature
NirOW
Print or Type Name Print or 7ype Name
LL w S1v
1NaRing Address MaAng Address
N
cityistate2to cityis atell/p
r - Y71- col
Telephone Number Telephone Number
Date Date "
(Revised 6118/2012)

3/Zf
From: Carol H Roycroffrerry L White
407 Lightwood Lane
Shallotte, NC 28470
Daniel Keith McRainey
20 Monroe Street
Ocean Isle Beach, NC 28469
Dear Mr. McRainey,
Approximately three years ago, we sent a request for your signature for an adjacent property
notification/waiver form. You were kind enough to sign and return the form so we could bulkhead and
rip rap property adjacent to you.
After hurricane Florence, we lost a considerable amount of trees and. property on the lot we
have directly adjacent to you. We are working with CAMA not to obtain a permit to rip rap, not
bulkhead, that property to prevent further loss.
Enclosed is the "Owner Notification/Waiver Form with details of the rip rap on our property.
Would you please sign and return it as soon as you are able so we may begin the process of restoring
our river bank?
Thank You,
Carol H Roycrot owner • -COMPLETE
Terry L White, contractor ■ Complete Items 1, 2, and 3. a " ture
a Print your name and address on the reverse 0
X lent C
so that we can retum the card to you. ' ' i L Addressee
■ Attach this card to the back of the mailpiece, B. Recelved by parlor �' of
or on the front if space permits.
t.TZlressed to: D. Is dedvery address ddf tom 1 es ke
It YES, enter delivery ad below: ❑ No
CJ
7-0
lvlo �S� : �AGj
bee,(, TS(c
llllllllllllllllllllllllllllll111� lIIIII o Sarvice Type a ed
9590 9402 4454 8248 7480 22 cwtfaa Mart blued ❑ � for
❑ collect an oevey _
2_ B&_ Number (riansfer from service /sbe!) 0 Coned O tr,�d Md o TM
701 $ ❑ hm ed Mail ReeV4W Quivery Ras4icted Ddtmy
Qb$Q QQpQ coverSlSOOj
PS Form 7 Q 2 S 2994 Domestic Return Receipt

_CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWN911 N©TIFECATION/WAIVER FORM
Name of Property Owner: CQ rt) I 12 o r/ T 0--r4
Address of Property: -LD 7 % ��4? &,d LQ.n e a-90,D A
(Lot or'Street #, Street or Road, City & County)
Agent's Name #: TvY. Ll ,� r 1r, MailingAddrass: 3
Agent's phone _ �q /D} I�,'��,oz1 ,�?� / ,I/� l�L 2'7Y17
1 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 descriation or drawino. with dimensions, must be nr2) i¢ed with tNl 102r.
I have no objections to this proposal. I have objections to this proposal.
H you have objections to ghat is betag proposed, you m"trs fty Elie DA�estan of Coastal Managomant (DCM) in
writit►g wfihin 10 days o1 receipt of this polka, CWrtr 04d"ce ahouN iN mailed to 127 Cardinal Drt" &L,
iNllmingeon, NG, 2840 4846. DGM reprssa►!!a cad 1 be corilhCkd at (910) 790-72f 5, Ko r hse is
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.)
' l do wish to waive the 15' setback requirement. s
I do not wish to waive the 16 setback requirement.
(Property Owner Information)
Signature "
Print or Type flame
Mating Addres
CitylStaie/Zip
/�'/C)I --)�-Y-L��-�
Telephone Number
31s
Date
(Adjacent Property Ow r Info tion) A:
Signature
VF- joo pep
Print or Type Name
Mailing Address
Skal )A , tj(- 2�
Crry/StatsrZip
a1n- �7l- 8�0 l
Telephone Number
�2- 28 -lei
Dare
Revised &1 &2012

E2e 1'.S71 L—.
SLR 9t � rTh( fZI

I
Check
Date Received
Date Deposited Check From (Name)
Name of Permit Holder Vendor
Check Number
amount
Permit Number/Comments
Revel t or Refund/Realkxated
Column!
Column2
Co1umn3
Column! Column5
Column#
Column!
Column8
Column8
42/2019
N RWnRe
(Carol Ro oR Dwk ofAme'a
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TMc,,t 8178