72326D - Swart

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I�CAMA / ❑DREDGE & FIL�� / No 72326
6RIW ERAL PERMIT V-e` C ��(;14-- Previous permit # A B C
NL✓J ew Modification ❑Com fete Reissue ❑Partial Reissue Date previous permit issued
P
As authorized by the State of North Carolina, Department of Environmental Quality
aq the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (24h 1"WO
❑Rule attached.
Applicant Name ✓�/(/fl(✓�%t Project Location: County W 1 (�[
Addressi SA Street Address/ State Road/ Lot #(s)
City State NC ZIP , ' j �9 . v ( t SE
Phone # ( )yj�� E-Mail !'i'1j� '1 /f� S . Bf'hY Subdivision si)Y1 } ��✓
✓00P. COTAuthorized Agent gala 9 City i ZIP * `a
Affected ❑ cw C vv I A ❑ ES ❑ PTS Phone # (�%�0) 1Rivef
�jBasin L lM'/ b e,—
❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A 1/ G ✓�� n man unkn
AEC(s): Adj. Wtr. Body 1r+�� S
❑ PWS: '
ORW: ves //no) PNA ves //f�iol ' Closest Maj. Wtr. Body
Type of
o✓;�a fna� �i��yr�
Pier (dock)length -:5 ie A :" x
Fixed Platform(s)
Floating Platfor s) h �5
Finger pier(s)
Groin length
number
Bulkhead/ Riprap n h
avg distance �ffs ore
max distance fs re
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other " f i,c-i 5 1 'rainip
c
Shoreline Length '
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
3 1
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(Scale:, )
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A building permit may be required by:
( Note Local Planning jurisdiction) , ,
Notes/ Special Conditions �rjjr/rA
owns
4101
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❑ See note on back regarding River Basin rules.
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1 �9 1 00 J.
Agent or Applicapf Printed Name
Signature " Please read compliance statement on back of permit*"
Application Fee(s) Check # �T
PermitOfficer's Printed ame
Signature
Issu(ng DaExpiration
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JRN-14-2019 07:54 From: To:9108463360 Paee:212
Jan 11 19, 06*04p Joel Klass/B & J Can struc
[phone] p.2
AGENT AUTHORIZATIM FOR CAMA MMfT A"UgATION
Name of Property Owner Requwong p+emlt: Michelle Swart
Mailing Address: 6432 Sassafras Ln.
Ralei h, 27614-9210
Phone Number: _ 5
Email Address: U ��
I certify that I have authorized Joel Klass
Agent/ Consacsor
to act on my behalf, for the purpose of applying for and obtairiing aft CAMA permfts
necessary for the following proposed development replace fl0U�rW dock alum ramQ &crier
at my property looted at 3867 Hic view Dr_ SE
In Brunswick County.
l furthermore certify that / am auftwized to gam, and do in tract grant permission to
Oivision of Coastal Management staff, the Luca/ Permit Gfr/cer and their agents to enter
on the aforementioned lands in connection wrth evaluating infvrmatian r+eieteat to this
permit application.
Property Owner lrftMrjWn:
sigrbature \
Print or Type Narrre
TWO
Date
This ce llfication is valid through Cz/ /

JCtll I+ 1.7. Vim :7.7(J JVCI r%lUCI2H0 0, J VUHSLrl1G
kvIvro-Uu Uv V•'L
I hereby certify thit I own property adjacent M Michelle Swart 'S
(Nance of Property Owned
property located at 3W Hickory View Dr. SE
(Address, Lot, Block, Road, e&—, )
on in _ olive N-C.
(Waterbody) (CWTown alnrd w Corun W)
The applicant has described to me, as shown below, the development proposed at Lthe above
I have no objection to this pr�po�.sal. Ps-'+ �
l have objections to arts proposal.
DESCRIPTION ANDfOR DRAWING OF PROPOSED DEVELOPMENT
(ftd6*WW pr o9 devetopfaent bust W1 m desaripe'on blow or sltscb a a& drewino
WAIVER 10=110N
I understand that a pier, dock, mooring pilings. boat ramp, bmakwaW, boathouse, fik or groin
must be set back a minimum distance of 15 from my area of Apartan access unless waived by
me. (If you wish to waive the setbadc, you must initial the appropriate blank below.)
I do wish to waive the 161 setback requlrernerx.
I do not Wish to waive the 15 seUack requirwrmn .
(Property Owner Information)
Signal"
BAichpllcs S1nrArt
Pri►s or T� Name
6432 Sassafras Ln.
A,F&DbV Addm3
RRaa leiah. 27614-9210
COYISIDWIBP
Telephone Numberl emaii address
Owner information)
or Type Nwrw
Ma,��n,�g Address
Raleigh. NC 27601
) d Lao 016
Tobp4oge N mabv/stnaril address
I- N"2v11
Dam#
(Revised Aug. 20 4)
'VaW for orte calendar year afiar signature"

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Michelle Swart
Address of Property: 3867 Hickory View Dr. SE Bolivia, Brunswick
(Lot or Street #, Street or Road, City & County)
Agent's Name # Joel Klass
Agent's phone * [phone]
Mailing Address: PO Box 279
Supply, NC 28462
hereby certify that I own property adjacent to the above referenced property. The individual
applying far this permit has described to me as shown on the attached draMng_the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
1
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. Contact information for DCM offices is
available at h "o //www. nccoastalmanae�emenLnet/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 Certifred 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)
Signature
Michelle Swart
Print or Type Name
6432 Sassafras Ln.
Mailing Address
Raleigh, NC 27614-9210
City/StatelZip
Telephone Number/Email Address
(Ripoa/WPr perty Owner Inform ion)
Signature
Leslie Brooks
Print or Type Name
3863 Hickory View Dr. SE
Mailing Address
Bolivia, NC 28422
City/StatelZip
Telephone Number/Email Address
Dare
Date (Revised Aug. 2014)

U.S. Postal Service'
CERTIFIED MAILD RECEIP
Domestic Mail Only
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Extra Services & Fees (Check box. add too
❑ Return Receipt (hardcopy) $
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E] Return ReGGIM (electronic) $
1p "H.,18.
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Date ReoeNed
Debt
Deposited Check From am
Name or Permit Holder
Vendor
Check Number
Check amount
Permit Number/Comments
Receipt or RerundiReallocated
Columnl
Column2 Column?
Column/
Columns
Column6
COI m 7
Column6
Column9
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1/27/2019 Joel Klass Michelle Swart USPS Money Order 25661250213 $ 200.00 GP #72326D PA rd. 7329D