74899D - 30

1(;CAMA / C DREDGE & FILL No. 74899 A B C
EN ERAL PERMIT Previous permit # /r
New '❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / 1-'
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC n -7Y 1 '0
e ^ ❑ Rules attached.
Applicant Name \\ 6'efm bt L L U\ ,� . Project Location: County
Address ^^ Street Ad ress/ State Road/ Lot #(s)
City tNJ ^ 5L S ,e ,-A State ZIP Z,-4 ( Ct.P bQ V
Phone # () ice` E-Maik Subdivision
Authorized Agent , City Ou-1- ,sic_ c c ZIP (09
Affected ❑ Cw ❑ EW ❑ PTA WES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / d�- PNA yes (22,
Type of Project/ Activity u
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
ulkhe / prap length �s /
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatl
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: YaD no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Printed Name
i
Phone # ( ) River _ Basin L _
Adj. Wtr. Body S��` V\C_^ ^ na man unkn)
Closest Maj. Wtr. Body ^�L CLA --
.1
(Scale: )v T5 )
OCZ41 { d c. 29" ❑ See note on back regarding River Basin rules.
Signature ** PI ase read co r� ig Iante statement on back of permit*
Application Feels Check #
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Permit Officer' rint Nam
Signature
Z CZ tJ � 2 ZUZO
Issuing Date I Expi&A Date

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that 1 own property adjacent to o y`/` 4 "-
(N me of Property Owner)
property locaf�d at 2 �9 !�'y
(Address, Lot, Block, Road, etc.
on �LJ� Q� l3 'in enT aQ N.C.
(yyaterbody) (Cityrrown and/or County)
The aDDlicant has described to me, as shown below, the development proposed at the above
I have no objection to this proposal. �f
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)
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WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 1 5' from my area of riparian access unless waived by
me. waive the setback, you must initial the appropriate blank below-)
I do wish to waive the 15' setback requirement.
L I da not wish to waive the 15' setback requirement.
Signature
Print or Type Name
Mailing Address
City/Stat+e/Zip
Telephone Number/email address
Date
Information)
Address``
City/statwwp
01,16 -M
Telephone Number / email address
OZIZ,3Iznza
Date*
(Revised Aug. 2014)
'Valid for one calendar year after signature*

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ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIYER FORM
Nara of Prop" Owrtar.
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Data Rac h d
Date Dpsftd
Check From (Name)
Name o/Permit HONW
Vendor
Check Number
Check
amount
Pe —If Number/Commenb
R-WW or Re/und/Reelk a .d
ca—I
Column2
C01-3
Cdumnl
Cok-5
7
CokrmrM
Column9
302020
3W020
AMW Docks and Marine Construction LLC
Joseph Blake
BB&T
BB&T
5736
$ 400.00
GP $76246D
GP l74898D _
BB rct. 11471
AMW Docks and Marine Constriction LLC
Joseph Blake
5736
$ 400.00
BB rct. 11473
3l3/2020
920
AMW Docks and Marine Construction LL
Len Preslar Jr.
8B&T
5735
$ 400.00
GP f74899D _
BB rct. 11472 _
3
Richard Penny Construction LLC
I Tammy Yarborou h
Navy Federal CU
1 1163
$ 400.00
IGP €76242D
ITMc rct 9764