74366D - Rozier

QCAMA / 1 DREDGE & FILL
N0. 74366 A
B C
GENERAL PERMIT
Previous permit# WA-
NNevw '—Modification ❑Complete Reissue ❑Partial Reissue
Date previous permit issued t�/A
As authorized by the State of North Carolina, Department of Environmental Quality I ' UU
and the Coastal Resources Commission in an area of environmental concern pursuant
to I SA NCAC t
Rules attached.
Applicant NameJWde-T
I r
Project Location: County R ru V1 e fry I C-X-
Attdress qo N B Ar K tX Te ll\ 1" t ll e Rd
Street Address/ State Road/ Lot #(s) 9$ S H
Seek VI S J A
Cttty 1_ Ulh 6V+0 e) State&, ZIP
Phone #(q1O) 9-5?- M3 E-Mail IN r�ZP.(-(gpnG'rr
rbdivision I
Authorized Agent �bj 1
I S U r-1
City urn y ZIP 9L
Vy a
Affected ❑ CW )(EW '(PTA ❑ ES ❑ PTS
Phone # (QIO) 950 -3 q 23 River Basin
AEC(s): El ❑ HHF El ❑ USA El
Adj. Wtr. Body AX V'LJ
na man /unkn)
El PWS:
ORW: yes / f io PNA yes / no
Closest Maj. Wtr. Body —A ZI/''
i
Fixed P1.4floIrm(s)
■■■■■■■■■�\\►V �■ G�I�I�i■■�■■■■■■■■■■■■■■■
Floating Platform(s) 1(0'-X
■■■■■■■■■■■■■■���■■*■■■■.��!su��■■■■■■nn■■■
Groin
Bulkhead/ Ripra)\ avg distance
max dis u
Basin, ch el
cubi27a
B p Boathous oatlift V X u
Beach B dozing
Other
Shoreline Length Sa,
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no (P
Waiver Attached: yes no '
A building permit may be required by: run S I G �< G�`�n1 ❑ See note on back`regarding River Basin rules.
( Note Local Planning jurisdiction) J �+ / j
Notes/ Special Conditions FIUR�?r1p, mock and kyo-- ( / f 4 are, rol 7U PJ'tGroaJ�L 1►'14Z Fe_de-f4 /
.vxro-t S eAack DPl
,agent or Applicant Printed Name }-
Signature ** Please read compliance statement on back of permit" Signature
260-00 O/o9�y ') 1� Za—
Application Fee(s) Check # Issuing Dat
4

VCAMA / i ! DREDGE & FILL No, 74366 A B C / `l
GENERAL PERMIT Previous permit # IIJjA �1
New 'Modification I !Complete Reissue ]Partial Reissue Date previous permit issued —WA
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 7H 2 VU
Rules attat�ted.
Applicant Name_wi a.I Q-----.---_. - - Project Location: County rains 1G�--
Address_i"PAeX_ --UA 11L.- R,d_-. __. __ Street Address/ State Road/ Lot VI SA
City_ L ii er Vo n state L �p--
Phone # ( q._j0)J_a3 E-MailM Wr dZ rr 'Cop91division
/� --- -
Authorized Agent _��Dl l 5 p 1� — - - _-- City--- 5tipp I Ly- _ _ _ ZIP__r-
Affected ❑ CW YEW )4PTA DES ❑ FTS Phone # (ql D) 950 -3 H 23 Wver Basin,
AEC(s): 00EA U HHF 0IH O UM ❑ WA , Adj. Wtr. Body- - xUJLJ --__ nat man_ (u ikn)
Cl PWS:
ORW yes / io PNA yes
Closest Mal. Wtr. Body-,A�ZIN_ty ----
Type of Project/ Activity
CLnIfrLkL�- r)e--✓doc10vir1 �e///.� LV/A tovr, S-
Pier (dock) length— X
�t�z.rV t
Fixed Platforms)
FloatingPladorm(s)
Finger ier(s)
Groin len
numb - -- -- J
Bulkhead/ Ripra lengt _ jI
avg distance shore
max list ce o shore
Basin, cha el
(Scale: )
a
1t
cubit
Bo
Boathous / oat
leach B oz,ng
Other_
i
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no W > — 5l (J fil S I
Photos: yes no I �pL, j (off a- (PC)Waiver Attached: yes rro f Y+� — +� ---/1 --- b io ]6.pi-; A/, - SekvrAe, IJr"
A building permit may be required by: ) run S �) G'� Lin See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) J I /' I ) 1
Notes/Special Cjonditions F io'Otv�r> ��C(�i� rL'tU E'na t''!r are- eio TU 'il(�r0� r►'l j �t'_c����L ( _
()IA►'1YU1
---.------------.----
Agent or AppCDDcarttDDPrirtad Name
Slgrtature 00 Please read complhrtcestatementonback otpermit'e
4 60,00 _- 90qq
Application F*s) ehea #t
Per 's-P ' ted Name
Signature
Issuing Expira

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ��G�-i� LL �i► ��� Dz'`'�
Mailing Address: �c� Y LY,��% e✓ ��.✓ /4-le- �a g
L o-ii36�8'
Phone Number:
Email Address: %rl iAJ ro7Z1 e�,I! nc,• rr. e,
Wr I certify that I have authorized DeA e- /S041 ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAM/ A permits
necessary for the following proposed development:
re S
at my property located at
County.
I ve,
l 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:
lz
/,--
Signature
Print or Type Name
Title
Date
This certification is valid through /.I— / & / / dd;�-4

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property OwnerWA2
Address of Property: x x 2 V JGA- VIJ7-,f 1e, SW -5 aaaL., _ Me- 8'Xy Z
(Lot or Street #, Sheet or Road, City & Co&4)
Agent's Name #: J)'C' J E W., Lte +✓ Mailing Address: yE Z7- 642 oliore c,( 12d
Agent's phone #: 191.0 d 1.2 - O'y0Z Wi l-Mt-vim fe,,-J, N C .2 KY10 -
I hereby certify that 1 own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached dratgthe development
they are proposing. A de IDl i'or:A ia� �i6st be orionride 11 #otter.
1 have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposedy you must nobly the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice Contact information for DCM offices is
available athtta.11www.nccoastalmanagement net/weblcm/staff-/isting orbycalling 1-8"4RCOAST_
No response is canskb red do same as no ob}ectiion X you /rave been no~ by Certr red Mali.
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 any 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
Wk,Dc
Print or Type Name
ly4 `/ 3�R
Mailing Address
ktimAedorj
City/Stator p
Telephone Number/Email Address
D / ad obe
( - 'an 2�6Property Owner Information)
L 6.
I `a r Aerlm& j` jZltro ,�syvo aktJ
Print or Type Name
--ReJ4 SeaA6fR1 t�1
Mailing Address
Su IV Iq AJ 6 .-.2
Citylsta k Ci f�i P i n e e O D %mC1 i t €tin
Telephone Number/Email Address
Date
4
(Revised Aug. 2014)

■ 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:
C,4e L it Or WC- I1
7' �72 1AX /as`Sou�ti
yoa�t, N �bo%
A. Signatu
�—� ❑ Agent
X WAddreSSee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery address different from item 1 ❑ es
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express
IIII
I it
II III
I
I III
O Adult Signature
❑Registered MaiIT"'
ll
I
IIIIII
IIII
III
I I I I
I III
I
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
9590 9402 4674 8323 5955 50
❑ Certified Mail(D
ElCertified Mail Restricted Delivery
Delivery
fa Return Receipt for
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
Merchandise
Signature Confirmation TM'
2. Article Numher (rransfer frnm sarvira lahel)
vlail
❑ Signature Confirmation
7018 3090 0001 8770 3741
vl it Restricted Delivery
Restricted Delivery
- -
-- -
Fo PS rm 3811 July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
■ Complete items 1, 2, and 3. A. Si n ture
■ Print your name and address on the reverse "❑ Agent
so that we can return the card to you. X % A t �1 Addressee
■ Attach this card to the back of the mailpiece, B Received by (Printed N me) C. Date of Delivery
or on the front if space permits.
1. Article Addressed to:
gym �S '0
Kr 14 P/Z, S �
sufP , JV
lll�lllll I'll IIIIIII Illlllll I I l l IIII I
9590 9402 5248 9154 7172 85
2. Article Number (Transfer from service label)
7019 1640 0000 2335
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express(D
❑ Adult Signature
❑ Registered Mail-
0 Adult Signature Restricted Delivery
O Registered Mail Restricted
❑ Certified MZO
Delivery
❑ Certified Mail Restricted Delivery
❑ Collect on Delivery
❑ Return Receipt for
Merchandise
ElCollect on Delivery Restricted Delivery
❑ Insured Mail
4209 Mail Restricted Delivery
Do)
❑ Signature ConfirmationTM
❑ Signature Confirmation
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt

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Date Received
Date ed
Check From (Name)
Name of Fw m tkJdY
Vendor
Chalk Number
Ch-k
amount
Pe t Numbe/Co t.
Receipt or Rerund/Rean«afed
Columnt
Columns
Column)
Cok-4
Column5
Columno
Cokmm7
CokmM
COlumn9
3/12/2020
_ _
Debra Wilson
1 Land to Sea Constructio_n,_L_LC__
Town of Sunset Beach
Wade_Rozier_
LG FCU
2094
175
$ 200.00
$ 200.00
GP *74366D
GP *76269D _
BB rct. 10911
JD rcL 10387
3/122020
Nina Voltaire
First Citizens Bank
3/122020
same
First Citizens Bank
19693
$ 400.00
GP *76119D
BB rct.10908
3112/20201
Michael or Katherine Miller
Michael Mi9er
Wells Fargo
1476
$ 200.00
GP €762780
86 rcL 10910
3H22020
Grego & TraceyJessupG
Jessu
PNCBank
1778
S 200.00
GP €/6270D
JD rct 10386
3/122020
Pippin Marine Construction LLC
lWetis Fargo
1 5403
S 200.00
IGP#76257D
ITMc rct. 10355