76282D - Lisle

ACAMA / I DREDGE & FILL No. 76282 A B C
9ENERAL PERMIT Previous permit#
IAlew lModification ❑Complete Reissue ❑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 15A NCAC 2cso
'R' ❑ Rules attached.
Applicant Name l dS� %�Gt \L� Project Location: County ✓✓�L . c �—
Addre(�ss 1'l0 �'��� n C Street Address/ State Road/ Lot #(s) 2-3
City .6/a State�L ZIP Z� Z05 1 �` ID �, n
Phone # (�� 3U k z5'll6(E-Mail rAi & Z3 V /-w ('c.vr.Subdivision _
Authorized Agent Ukt F' ('w " .- CityT7l��a t �`� h ZIP 2'5* 2
Affected U Cw /<YTA ElES ❑ PTS Phone # ( ) River Basin I ., -e5,6z
AEC(s): 1, OEA i ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body G A[SmAlunkn)
ORW: yes
El/ PWS:
00
PNA yes o
Closest Maj. Wtr. Body k�.Q'-J
/ ` \ `
Type of Project/ Activity (1,GCIL Pkl C4 L�L� �� �� c % \.
Pier (dock) length
Fixed Platforni IT AV
Floating Platform(s) W � w
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ oa n ��
Beach Bulldozing
Other
,
Shoreline Length
SAV: not sure yes IQ
Moratorium: n/a yes
Photos: yes--fl ___ -__
i
Waiver Attached: � ao j ( +-
A building permit maye required by: G� 0\ �.�,., t G r N
( Note Local Planning Jurisdiction 44
Notes/ Special Conditions c t (- \ •i
1
W,
Agent or.Applicant PrinteaName
Signature ** Please read compl�ce statement on back of permit
_ 44- -7&0
Application e(s) Check #
Permit
(Scale: �,J-V S )
❑ See note on back regarding River Basin rules.
dNam� ^�
Signature
2csw n -2
Issuing Date Ex ration bate

Proposed
Boat
Lift
Steven & Bonnie Cox
121 Dolphin Drive
q 10-642-1300 Office
CANAL
14x10 floating dock
UP
Reynolds & Mary Lisk
123 Dolphin Drive
336-301-254q cell
ALUMINUM
OANGVgAY
-15ftl
-30ft
Mike Serafl n
125 Dolphin Drive
410-311-2g31

AGENT AUTHORIZATION FOR LAMA PERMIT-A-PPUCAtI69 '
NEIM&bf Pitt ty'Owner RequeMing Permit: Reynolds & Mary Lisk
.MMlifig Address' 1763 Old Lexington Rd
Asheboro NC 27205
Phone Number; 336-301-2549
EmMI Address: [e-mail]
I ce tify thaYI have authorized Will Richardson
Agent 1 CoDSC�t'QT
to act on my behalf, for the purpose -of applying for anti obtainirad all LAmApermb
necessary for the following proposed developments Docking facility
J - If , -
at My Propdrty loddted at 123 Dolphin Drive Holden Beach NC 28462
-in • Brunswick County.
1 futthe Mdto c6ttify that i am authoNzed fo grant, and do irk fact Wab pemlissiQ� o
Division of'Coastal Manageragnf staf, the Loedl Perrrlit Offrc�-Wd th6lx *?f6rfto To:efiti-T
on the aforementioned lands in connection 'withevaluating information related to ;this
permit application.
Property Owner litforMation:
•A
Sigrlbturo c�
&SOU; Laic M*.ry L--.-sk
Print or Type Name
Twfe
2 20
Date
This certification -is Valid fhrotlgh Marche 31st p 2020

ADJACENT RIPARIAN PROPER�ER STATEMENT
I hffeby certify that I own property adjacent to Reynolds and Mary Lisk 's
property located at 123 Dolphin Drive (Narne of Propel Owner]
on Canal (Address, Lot, Block, Road, etc.)
in Holden Beach N C
(Wabwbody) (CIWTown and/or County)
The aPplicaM has described to me, as shown below, the development proposed at the above location.
Initial here I have no objection to this proposal.
I have objections to this proposal.
vESGRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(1nnYvidual prOWWng development must ffg in descripffon below or affach' a slue drawing)
Installation of lift and docking facility
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.)
Initial. Here f)C- I do wish to waive the 15' setback requirement_
- I do not wish to waive the 15' setback requirement.
Will : Authorized agent)
Print or Type Name
3235 Seaccrest Ave SW
Uaffing Address
Supply NBC 28462
' r-3-36 -&35
Telephone Number
February I8th,2020
Date
(Adjacent Propr wty Owner Information)
Complete
Si e
Print or Type Name
Maflln
ea
Telephone Numbw
,14
Daze
"4Id 51..20 (Revised 611WO12)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
on Canal
123 Dolphin Drive
(Waterbody)
Reynolds & Mary Lisk
(Name of Property Owner)
(Address, Lot, Block, Road, etc.)
. in Holden Beach
(CityiTown and/or County)
I
N.C.
The applicant has described to me, as shown below, the development proposed at the above location.
v 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)
Installation of a boatlift.
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) (Adjacent Property OWn"formatioRy)
Signature
Will C. Richardson
Print or Type Name
3235 Seacrest Ave. SW
MSAdd
u ailing lY,
Ppq6 28462
_
'V6 3tV!6335
Telephone Number
02-19-2020
Date
Signature
PH5 or Type Name
Mailing Addres;
City/State2ip
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Telephone Number
Date
(Revised 611812012)

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■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: f
mr. Mtii (O ' - n
JSb3vi Dr,
Qe-n "Ruck 1 13 27
A. Signature
X ❑ Agent-
❑ Addressee
B. Rece ved by (Printed Name) C. Date of Delivery
1- ? F - 2 v
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express®
rlt Signature
❑ Registered Mail-
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❑ Certified
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❑ Return Receipt for
Merchandise
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❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
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❑ Signature Confirmation
Restricted Delivery
l Ps Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
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D.b R.eeNed
Date D000sited
Ch ck Form
Name of Permd Holder
vw ae.
Chwk Number
Ch.rx
amcunt
Permit Number/C--ft
R.c.lpt or Refund/Reallocatod
Cok—I
C.1-2
C.A-3
Columns-
Calumn7
Columns
Column9
3/19/2020
Willie Clarence RlchardsorVRichardson Gc
Reynolds & Mary Lisle
BBRT
7663
$ 200.00
GP 076282D
GP *76235D
BB rct. 10920
3/19/2020
G6ce Consbuccdon of Brunswick County In
William Cox
BUT
13539
$ 200.00
BB rot. 10918
3/192020
Backwater Marine of NC LLC
Jamie Sischo
BUT
1004
$ 600.00
GP f76277D
GP #762651)
BB rct. 10909
3/19=0
Dale C Funderburk Jr.
same
South State Bank
1502
3 200.00
JD rct. 10393