76241D - Munley

CAMA / ❑DREDGE &FILL No. 76241 A B C
GENERAL PERMIT Previous permit #
4New JModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality Oq I �jJ, r Z oO
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
-1 Rules attached.
Applicant Name E v, I c., n tAv ,n \ e �
Address Zy o��_k_� ,, eA4 Jb � d 4e_
City 'A s uio Statehj�._ZIP 2-1 5,
Phone # 33 5 E-Mail
Authorized Agent W ,— �, L � , L�
Project Location: County Z' " � C tL
Street Address/ State Road/ Lotff#(s) (.
Subdivision
City (" ) C—g- cn s i ZIP
❑ CW EW RtPTA ❑ ES ❑ PTS Phone # ( ) River Basin _ 6. �-
AEC se: ❑ OEA O HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Bod n� nkn)
O ❑ PWS: I Y �'�.:� . ( (at ma
1-1,.,.— nn..; XAta.. n,.a., A l \ I \. )
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Agent or Applicant Printed Na e
Signature "Please read compliance statement on back of permit
Application FT (s) Check #
\ �� �• 4 _. 1 r o I L-
Permit0 icer's Printed Name ` /
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Signature
Z. 1 z-7 1 Zoa 0
Issuing Date Expirition ate

All
NCDENR
North Carolina Departmentof Environmentand Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director Secretary
AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FUKM
Date.
Name of Property Owner Applying for Permit: Npme of Authorized A ent for this project:
Owner's Mailing Address:
OC-
Phone Numbei�'�6) 40EX7
A ent's Mailing Address:
Q1B � sw
te iY
2—'9 �
Phone Number Rtu ),S-19—gmc�-
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following activity):
OLArV4 Lows Fief r au(f1u cwp ;116W
For my property located at
This certification is valid thru (date) \L)b Ming!, �,U l
—Property Owner Sig�� e � Date��
u i ~"
127 Cardinal Drive Ext., Wilmington, NC 28405
Phone: [phone] FAX: [phone]Internet: www.nccoastalmanagement.net
1 CIF-P C �
An Equal Opportunity 1 A(6rmabve Action Employer

DIVISION OF f OASTAL MANAGEMENT
ADJACENT RIPARIAN PROP OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: 0 ql c 1m6n�—
(Lot or Street 8, Street
AgdnYs Name*
r icy. 4g n%�L Jii ()
Agent's phone * Qvc�- 5-M -,9ua_
Road, City & County)
Mailing Address:W I� axkch ►>-
� lQ kygs N( 2—t`1(aG
I hereby certify that I own property adjacent to the above referenced property. The individual applying for
this rmit has described to me as shown on the attached drawing -the development they are proposing.
CJ
si I have no objections to this proposal. _ I have objections to this proposal, e
If you have objections to what is being proposed, you must notify the DtW of Coastal
Or Management (OCM) In writing within 10 days of receipt of this notice. Co should bd
—r mailed to 127 Cardinal Drive Ext, tMimington, NC, 28406.3845. DCM repzml MW be
contacted et [phone]. No response is considered the some a# no obJectbn n
C notified by Cartl od Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back w
minimum distance of 15' from my area of riparian access unless waived by me. (if you wish to waive the
setback, you miat initial the appropriate blank below.)
�f I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information))
�"
7I�(i`—>
SSiazure
ri \h.Xr•\\-P-
Print or Type Name
2Vk ��Ax wL,�64 p-
Mailing Address
�he\,xm N( 2-12�5,2�t�1
City/5tete210
-�&(M,6335
Tel hone, Number
72�1-6
Date
,(Adjacent Property Owner information)
Signature
Print or Type Name
Mailing Address
City/Statemlp
LA - 3\la Z5 (i
Telephone Number
Z e-)
Date
Revised V812012

Er - -
p Domestic Mail Only
C3
C3
ibLt btR1.1,11t fli, Z61ti
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Certified Mail Fee $ 3 . 55
t�- $
Extra Services & Fees (check box, add tee aAjqxce)
p ❑ Return Receipt (hardcopy) $
t3 ❑ Return Receipt (electronic) $ W • U
C3 ❑ certified Mail Restricted Delivery $
p ❑ Adult Signature Required $ $0 _ 00
❑ Adult Signature Restricted Delivery $
—00 Postage $0 . 55
-0 $
C3 Total Postage and Fsa$ • 95
$ 10
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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. ``A,^rticle Addressed to: 1
VArY12S Dur``q"n
C�cs�an 6`L�- h Nc
-
133
Postmark
Here
i 1 /28/2020
❑ Agent
❑ Addressee
(Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
A. S
i
X
B. R
II I IIII III II I II II I II I I III III III I III Jill
II I III ❑ a. 5ervlce type ❑ Priority Mail Express®
Adult Signature ❑ Registered MaiITM
❑ Adult Signature Restricted Delivery ❑Rered Mail Restricted
9590 9402 2219 6193 1036 63 eegist
rtified Mail® Delivery
El Certified Mail Restricted Delivery D�¢ieturn Receipt for
❑ Collect on Delivery Merchandise
2, crti .IP Number frransfer from service label) ❑ Collect on Delivery Restricted Delivery Signature ConfirmationTM
017 066El Insured Mail ❑ Signature Confirmation
0 0 0 0 7 4 8 7 0009 lestricted Delivery restricted Delivery
PS Form 381 T July 2015 PSN 7530-02-000-9053 Domestic Return Receipt

CERTIFIED MAIL • RETURN RECEIPT REQUE3jEp
DIVISION OF POASTAL MANAGEMENT
ADJACENT RIPARIAN PROP19M OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
1a i f
(Lot or Street #, Street
Agent's Name #: G-r 1L't- 3:S r\!*Ip
Agent's phone #: %0-- S-IG -gag5
W
Road, City & County)
Mailing Address:(b I U 32QC\) D—
n Yb1Q 2Wi N( Z- %q
hereby certify that I own property adjacent to the above referenced property. The Individual applying for
this permill. has described to me as shown on the attached drawing -the development they are proposing.
t3
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 DIyI n of Coastal
Cr --C Management (DCM) In writing within 10 days of receipt o1 this notice. Corres 9 should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represeh*#* i4w also be
contacted at [phone]. No response Is considered the same as no objection /i" *****en
notified by CertMed Mail.
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 16' setback requirement.
(Property Owner Information)
S
ature
Print or Type Name
Mailing Address
11e ry N( 2'►Zb5-2'��I
CitylState/Zlp
-(06 N -C�33S
'telephone. Number
I-2�-26
Date
(Adjacent Property Owner Information)
Signature
1Aey r '
Print or T�pe Name T-
1 7 T S, 6waKa FbN
Mailing Address 11
Tabor �►�. y1y�Y �
citylStatelzip
Telephone Number
Dare
Revised 6/1812012

-111 Domestic Mail Only
r�
O
o64i3
Certified Mail Fee f 3.5 r14 72
$ 03
Iti Extra services & Fees (check box, add fee a$pp104we)
❑ Return Receipt (hardcopy) $
O ❑ Return Receipt (electronic) $ �� �POstmark
❑ CeRffied Mell Reste� r'y
ricted Delivery $P^ +F Here
0 El Adult $ Adult Signature Re
❑ Adult Signature Restricted Delivery $
Postage
r" 60.5it.
QTotal UoStage and Fges. g� W /26/2020
$ Lbb
(- t TO
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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,
nr ran +h. f—+ if - ..................a_
1. Article Addressed to:
��tvvC,,� \fit 11-��
2-7-7-7 c&�C-k rn
1111111111111111111111111111111111111111111111
9590 9402 2219 6193 1036 56
2. Article Number (Transfer from service label)
7017 0660 0000 7487 0016
PS Form 3811, July 2015 PSN 7530-02-000-9053
A. Sigpature
Agent
❑ Addressee
B. Received by ted Name),/ C. Date of Delivery
D. Is delivery addre different from' em 1? Yes
If YES, enter de ivery address b ow: ❑ No
J. Service Type
❑ Adult Signature
❑ Priority Mail Express®
❑ Registered Mail" -
El Adult Signature Restricted Delivery
❑ Registered Mail Restricted
Wertified Mail®
Delivery
❑ Certified Mail Restricted Delivery
19Return Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
❑ Signature ConfirmationTM
Mail
❑ Signature Confirmation
Mail Restricted Delivery
Restricted Delivery
oo)
Domestic Return Receipt

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Date Received
Date Dp,,itd
Check Fmm Name
Name of Peimlt Holder
Vendor
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P—If Numb-HC--ft
Reca( t or ReNrvl/Reallocated
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228/2020
2/28/2020
Grice Construction of Brunswick County In
John 6 Lisa Harrington
BUT
13622
S 200.00
GP i76240D
BB ra 11464
228/2020
22W020
Grice Construction of Brunswick County In
Mark Hockaday
_ _
BBBT
13623
$ 200.00
_
GP 076238D
BB rcL 11463
2282020
2282020
Grice Construction
David Miller
6B&T
---
866T
13624
$ 200.00
GP i76238D
BB rct 11461
2282020
2282020
Grice Construction
Brian Munle
13621
200.00
-
IGP#76241D
IBB rcL 11462