74898D - Blake

'�(,CAMA / ❑ DREDGE & FILL NO. 74898 A B C
GENERAL PERMIT Previous permit #
W C 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. i too
ules attached.
Applicant Name � ��` � Project Location: County f
Address OLA5 a Street Address/ State Road/ Lot #(s) Z8
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City t n c:�. .,✓ StateAJjN— ZIP Z Z.(o V (
Phone # (s7kp)7f�' - E-Mail Subdivision nn
Authorized Agent �� c 1� Q4 City nuA, � S� L i�C�. �� ZIP 2y p9
Affected ❑ CW ❑ EW ❑ PTA VS ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
UKW: yes /C.W rNA yes / o
Type of Project/ Activity 1 4
Pier
Fixed
Float
Finge
Groir
ulkI
Basin
Boat
Boad
Bead
Othe
Shon
SAV:
Mora
Photi
Waiv
Phone #
River Basin (.�.y.,✓
Adj. Wtr. Body �RS/^ (�1�A�ne.` na man /unkn)
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(Scale: N T.5
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cubic yards
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ramp
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A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
( SlfG \, c-Lc C lk ❑ See note on back regarding River Basin rule
pp icant rinted Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
-,— -17'r Lr
I , _- 7
Permit Office Name
r�
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Signature
Issuing Dater Ex rat on Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number: LI L " ' al - 3 0 �3
Email Address: -- Gh i ob I a ke Id C AMIA4L . Gal
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: SC'4 e o LL
at my property located at ; ` (�- i 1� C 42 SLf o
in c-ACounty.
I furthermore certify that l 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
©uJtit�-e
Tide
l o
Date
This certification is valid through -5 1 '30 / 2-0
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eE p Best
DmSION OF COASTAL MANAGEMENT
ADJACENT FdPAR1AN PROPERTY OWNER NOTIFiCATIONMAIVER FORM
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ff17li U•A+n Or3Xr:k 8 i,8UGr% zz C76 pWe4. 'OPca �o } 'the • �ci rrv;.dl
. piwii'Kj 'CY liti§ G '' '' 'w - :n nr[i LKr Straws nt ^W 8ttigi-JYeY.l dlvwWl03—" '•�1' 'T'Rn,
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'--jDC*7r wMvia 19 d*Y$ ar �eesipt node+. Gander CAming /1ST.
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WAIVER SECII04
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5i t7:DA t7#PTtt*Itt"!1 04*4vx* Lt area of urAsm +,wil fied ky ma �
y'C+,. •tt,µ�ll Y'r'� 7+L•t°�1'3';.`n y: r.. r1►'II S.A.,�, �#:x :Y+t F.j',�fPC'We blw* GOtf_i*
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(Piopmrti 4wr:�.lhitarer,�atonl i� oat+'1«fl Praprirty Owner lnfor�C4 uonl
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CERTIFIED MAIL . RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street
Road, City b County)
c � (Ant oc 5) Mailing Address:
Agent's Name #' � 6. q
Agent's phone #: '%S3--06 61�- -- �= J cTTL�----
I 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
theyRosing. A description or drawing en
with dimsions must be provided with this letter.
no objections to this proposal. i have objections to this proposal.
Tf yo hav objections to what is being proposed, you must notiffy the Division of Coastal Management
n writing within 10 days of mceipt of this notice. Contact information for DCM of Ices Is
available athttp //www nccoastaimananementnet/web✓cm/statt listing or by calling 1-8884RCOAST_
No response is considered the same as no objection It you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dodo, 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 ive the setback, you must initial the appropriate blank below.)
waive the 15' setback requirement
do wish to
do not wish to waive the 15' setback requirementSZ--
(Property Owner reformation)
---------- ii�
Signat
`�DSePh 'Zk)/,- -
Print or Type Name
/II �t 51
Mailing Address
City/Statemp
-
Telephone Number / Email Address
(Riparian Property Owner Information)
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Signature 0,Lzzjl�
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Print or Type Name
drr 5
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Mailing Address
ti.c�,
Cityl&ata0p
Qq-" '5S-7 /11 Q�ed'nSrW A Tf t,0e0b Q'0"
Telephone Number Email Address
Dare Date
,— (Revised Aug. 2014)

brunswicK county vim uata viewer
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3/2/2020, 12:50:55 PM
DCounty Boundary
Municipalities
Bald Mead Island City
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3/3/2020
AMW Docks and Marine Construction LLC Joseph Blake
AMW Docks and Marine Construction LLGJose Blake
BBBT
5738
$ 400.00
GP 876246D _ _ _ _
GP #74898D _
GP 974899D
BB rcL 11471 _
BB tet 11473
3/3/2020
BB&T
5736
S 400.00
3WO20
tru
AMW Docks and Marine Consction LL Len Preslar Jr.
BBBT
5735
S 400.00
BB rcL 11472
3WO20
Richard Penny Constucton LLC ITammyYarboroucih
I Navy Federal CU
1163
S 400.00
1 GP 176242D
JTMc rcL 9764