74772D - Smith

;�CAMA / --1 DREDGE & FILL NO. 74780 A B C Q
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 07' H , 1 /U U T o qH . I Z.,00
❑ Rules attached. '
ADDllcant Name J o..0 <. Proiect Location: County I ) f- — " — .. I e--
Address "Po lolY Street Address/ State Road/ Lot #(s) /q30
City '�,kc t(c roe. Staters( ZIP o)?Lf Sq /1'�c� � n� Ira > �. � �✓
Phone # ((-�(D) 54/0 TI$S E-Mail 6 F, u i(vC vU 4,4..—Subdivision
Authorized Agent
City 3 kal(oNc— ZIP �2 �1-110
Affected ❑ CW SEW So PTA y ES * PTS Phone # ( "'- River Basin L ,, h c i
❑ OEA ❑ HHF ElIH El❑ UBA N/A
AEC(s): Adj. Wtr. Body , ; h-,11 a kAt na an /unkn)
❑ PWS: � (�. � G..
Closest Maj. Wtr. Body nc.,
ORW: yes / � PNA yes /,�.
Type of Project/ Activity j n 5j c,(( a— r,
1 ��^ c,l , (Scale:
Pier (dock) length (s k Z. 0
Fixed Platform(s)
Floating Platform(s) I& X G
Finger pier(s)
Groin length
number
Bulkhea prap ngth `()
avg distance offshore_ _
max distance offshore I'll
Basin, channel
cubic yards
Boat ramp
Boathouse/ Btlift_
Beach Bulldozing
Other ^
(•n��fU�;- k
Shoreline Length r
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: s no
A building permit may be required by: _ ISrt/�SwtoKi �X ❑See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) t 1 ff
Notes/ Special. Conditions« ``� .nf/�0S1(��5 1
(71 Tyr✓1� .,_ �.,�.�' f.. ,�� -��� Vv IUJ.� ,/� r.. I�i1� i'^C., F.�r�n,l i3r r�'�[Lo ..� . i-, I"
f"
Agent or Applicant Printed Name
A llvz 11,
Signature"Please read compliance statement on back of permit"
=AL 63 �I
Applic on Fie(s) Check #
Pf�a— /k�r'e.L
Permit Officer's PrintedL) Name
Signature
Issuing Date p ration Date

WG
CAMA / DREDGE A FILL No. 74780 A B C �_ GENERAL PERMIT Previous permit #
New Modification ICompiete Reissue I 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 6-7-H. 1100 T 0144 ,12.-00
Rules attached.
Applicant Name _ U oar 4' �aeke , Project Location: County, 13�., ^�v•_t���— -_
Address__ f'PQ Street Address/ State Road/ Lot #(s) /q30_
City _Vkaolcy4c, Stateq L ZIP . _ o� �clf S� - v nv It S %. St•✓ -- -
Phone # q GQ) $W ASS E-Mail 6eo-,,U-,,,--,[e-mail]
Authorized Agent ": _ City_- _ _S h4.Uo H-e _ _ ZIP
Affected l CW IVEW �,t PTA l tES ;! PTS Phone # (_ '-T'" River Basin
OEA -_ HHF IH UBA I N/A
AEC(s): . Adj. Wtr. Body - J ot�� a�-f?�+�c.i' natgtan /unkn)
PWS:_
ORW: yes / f6' PNA yes /(1V Closest Maj. Wtr. Body - Av"-^�4
Type of Project/ Activity
AOC�A-'4 �+�c�� t��
(Scale: �u-7_pt
T
Pier (dock) length (n kLb':
Fixed Platform(s)
FloatingPlatform(s) (Q'-X 20 t
K' So�1
iJ Z
Finger pier(s)
Groin length !
.y ���n F-�v��
Q•
number
Bulkhea ip gth 40 ' _-
avg dist shore
1
H---qs
w1 ku
max distance offshore
Basin, channel -_
I
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing I t
Other
Shoreline Length _ � r _ _ W q j`W P(e
SAV: not sure yes )({2L tA&.J 6k'A
M.
to
009
1 Jkol dit., Pit .
(1 ?10 nelr d-
�F5n6'%— 1'r-h (WG%\41
Moratorium: n/a yes 4P 'y'30
Photos: yes ® td/
Waiver Attached: Iy no �p
A building permit maybe required by: pr v.�S .r tL Cpy�� °� See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction) I
Notes/ Special Conditions e- T�Q Ipt-&O h,kk\ no; ey CA^ - A� ex-ra c.� stict�s
1 ��aclu '�ct( j+-► 1,11N\ -11 Utae,,A- 1A Gr(AT►1 et Lc."oa, yr 24(e�1 VJU (,M . mo-%n C_pannej
•o— M,- _ 1v2 f►- 1 ta- Irh.� 1
Agent or Applicant Printed Name
Signatur •• Please read compliance statement on back of permit"
IF! --1v3q
Applic on Check #
� �"cr. 13fo1
Permit Officer's Printed Name —
Signature
y 3
Issuing Date dPnon Date

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit
Mailing Address: `, R ox J. �1 ���� l L v T T G
2( 1�
Phone Number:
Email Address: r C ti ,N�+yrr'�t J�� r�^ �� ��•'�
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I I"-' ; 1 ,?Lz- lil! fA/#/
at my property located at
in U' ICt[.yi ivlGf� County.
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
Print or Type Name
_/LI A
Title
Date
This certification is valid through
RECEIVED
N0V 0 4
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to lJ A A� ti 1-1 i c It I`A s
(Name of Property Owner)
property located at 0,u1 /+ f j i" k. ;)141 G v i i t' ..` k i,>
(Address, Lot, Block, Road, etc.)
on ,p�tl(,liiJ, AI�t/t ,in tjrµn Wig% Z., M/V NC.
(Waterbody) (City/Town andior 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 fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
mirnmum 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)
Sig►tut ure
%./4A t -A, rjy Lly
Print or Type Name
P. v. A o .0
Mailing Address
Crty/Stale/Zrp
/ O - o
Telephone Number
---liz-- Ft`--b P i — - —
N/r
(Adjacent Property Owner Information)
Signature
Pfitg or Type Name
Mailing Address
`- 'eze.
Cit ylstate/Zip
IV9/e ytim 14b�4
Telephone Number
l�nlr
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,z /i /". / ,"L
(_Name of Property Owner)
property located at I y ? -� �►" 1k �� �r I/� r i t'v 0/4 1r, (; i i t
(Address, Lot, Block, Road, etc.)
on �l`�rlt;vi.rC" iti vil/l in b; y„ w;`A 41 f i NC.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
R0 l4 ,apI 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)
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.
(Property Owner/Information)
'✓V cys, ,�j'I�'-L! ��
Signature
wKlta�=ti rllL�!Ltl
Print a Type Name
P J li v" J
Mailing Address
City/State/Zip
Telephone Number
Date
(Adjacent PrQ2erty Owner
3d Y 7 v
k ate C
atylst l /gip ee., a u
Telephone Number /
t>a,e
(Revised 6/18/2012)

Date Deposited
Check From (Me -Name
or P~ Holder
Vendor
Check Number
Check
unt
Parndt NumbwlCon n h;
Receipt or Rerun&Reallocatu7
Column2
Columns
COIUM4
cakwof
Colum a
Colu=7
Colum a
Column9 _
Allied Marine Contractors LLC
Curtis Corder
First Citizens Bank
BB&T
7815
2407
$ 200.00
$ 600.00
GP #74763D _ _ _ _
GP 974380D
Tmac rct. 9081
BB rd. 7942
TP rd. 9495
H5 Construction, LLC
Jeanette Spear_
Warren Fischer
Warren Fischer
USAA Federal Savings Bank
1039
$ 400.00
GP 974780D
Allied Marine Contractors LLC
Richard Rose
First Citizens Bank
7728
$ 200.00
GP #71842D
Tmac rd. 9076
Allied Marine Contractors LLC
Dan TaIrlor
First Citizens Bank
7809
$ 200.00
GP #71844D
Tmac rct. 9077
Allied Marine Contractors LLC
Robert Evans
First Citizens Bank
7814
$ 200.00
GP #71806D
Tmac rct. 9080
F and S Marine ContractorsInc.
Amy DeVenoge
PNC Bank
8170
200.00
GP 674548D
ITMc rct. 8296