76202D - Palm

� CAMA / X DREDGE & FILL NO. 76202 A B C
GENERAL PERMIT Previous permit #
14New ❑Modification El 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 CJ 1
❑ Rules attached.
Applicant Name VA I. CCW6 �lU�•�WC, Ll L (w �oD4�i Project Location: County V NV w l G k
Address
City,J % AAk &j (.2l u ^J State N (" ZIP
Phone # () 3o q 2 qp'� E-Mail
Authorized Agent (ti. I%ctc j 6A%l
Street Address/ State Road/ Lot #(s) L oT 2 I&.,,.
(rw"' C_ Mrn.
Subdivision
City Sy N S 6-( Q EA CVA ZIP �R
❑ CW ❑ EW
❑ PTA ❑ ES ❑ PTS
Phone # ( )
River Basin
Affected
AEC(s): ❑ OEA ❑ HHF
�H ❑ UBA ❑ N/A
Adj. Wtr. Bod IL,.a
� — na an /unkn)
❑ PWS:
ORW: yes /6� PNA
yes no
Closest Maj. Wtr. Body
Type of Project/ Activity
! MF2(-f-,uL"1 Shwj'�hPlui
to Q (Lu kQ GT iL\C "T LF
\JN-4 fN"D QUAV"j_
(Scale: tJ
Pier (dock) length _
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshc
max distance offish
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boat
Beach Bulldozing
Other SA JT-,( AIla.S
17) t X ?O� j(6'
Shoreline Length i /Z (
SAV: not sure yes
Moratorium: n/a yes
Photos: yes Cp
Waiver Attached: yes
A building permit maybe required by: aeR C.li ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions JA n► N.A Q 4M(.F car S^&iWA6.S %,,I Lu at 4A(C o�
tguStg.,i j �A Mnc,�� �ZI vS n2My �2(�f WIrM,n�e7cnJ i�iS�L�� o���cF�9(a-2S(•y��(S
/*t%.,7ArT I/' 2-rcitt2AI- A. Ttn•e17A7YM,% I 24 (0-I&ED
­/16.) jet (LsC�i
Agent c5r App&an rinted Name
Signature **PAease read compliance statement on back of permit'
q U U . I, %� m/ >,L
Application Fee(s) Check #
Cn /b
Permito s Printed Name
Signatur
Z- k3 11,2-c� 0 3 I 2a20
Issuing Dale 1 Expir6tionbate

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 'W\`(Y\ 1�C3<3 t �\& t ° '1 � 0—C.
Address of Property: 1, Z lidyi— '34l `-' l
n n a Iof or Street #. Street or Road. City & County)
Agent's Name # , V �J'�Sv Mailing Address: _ D
Agent's phone #: � � 3 2Cl �3 i " I `� S AA C.P 1'1,e iSr � C`A h •
I hereby certify that I own property adjacent to the above referenced properly. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must nofify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at htto.lAvww.nccoastalmanauementnedweb/cm/staff-lisdnaor by calling 1-8684RCOAST.
No response is considered the same as no objection if you have been noted by Certified Mail.
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 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.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information) Ole )pUXJ41-04)1
Signatures--
�i4�t'V�
Print or Type Name - r-
I is )A � �;v `c 3ov
Mailing Address
C4ty/Sta1a1Zi
�t(6•369-2-gf3
Telephone Number/Email Address
//Z /0 Z0
Date
(Ripar' P erty er Information)
ignature
iQ "fA thokAA, -s
Print or Type Name
IVL'va,D�� OAZ �D2
Mailing Address
City/Stateop
Arcj(� Auk) t1of2A14 S �Cv�
Telephone Number/Email Address
�Zo 2 v
Date
(Revised Aug. 2014)

AGENT AUTHORIZATION FOR CAiM1A PERMIT APPUCATION
Name of Property Owner Requesting Permit:a11►Y:
Mailing Address: 1 I �J -- L E�. '�:C
Phone Number:
Email Address:) L')JJ
I certify that I have authorize
Contractor ---T�
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: 1 ri►�� �AN r� �'A�S
} c\
{ Cl, At �� ..Q{�e\ lJ�r-7�V6Dc'lSUt�I.Oa�/
at my property located at \&X� 'Z
In -&oLAc uo«,K-. County.
1 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 InfommUon:
Signature
A h1-4ArrF11S0�✓
Print or Type Name
t
Tme
;7-3 1 ,4-f7
Date
This certification is valid through 1�1 3t i�
within 30 days of your receipt of this notice will be considered as no objection. If
you have any questions on this project, please call me at [phone], or e-
mail me at [e-mail]
Sincerely,
Steve Saieed

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:�A`O\ dc)yi
Address of Property: 1 1>,.A A 0q Uq—
�
n� a at or Street #, Street or Road. City & County))
Agent's Name #. _� !�' J ASt'bN matlingAdd /� �- ll�cPh2rda71 •,
Agent's phone #: Gl(� 3 U°'I — 2-c1
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
they are proposing. A description or drawing, with dimensions must be Provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notdy the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http:lAvww.nccoastalmanaaementnet/web/cm/staff-listino orby calling 1-888.4RCOAST.
No response is considered the same as no objection if you have been noted by Cerbf' red Mail
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 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)
q
Signa
Print or Type Name
Mailing Address
\. i1 M ,� m, >Jgj Moi-L4,o-f(.e
crty/Stare/Zip
(q (o).3o R — 2R(f-3
Telephone Number/Email Address
/%/Zoza
Date
(Riparian Property Owner Information),
Si ature
1-NoInc�-tiacjam,� ETc� X
Print or Type Nanfe
q'o q 6AAA m;14+ 1,Q
Mailing Address
r-pug4f, 4. M-0 2M6<- so7s
City/State/Zip /
g4-eO 4fOz
Telephone Number/Email Address
Date
(Revised Aug. 2014)

41
MIINi.wi
um s �a•
q �aiFi-a
q i••ro
er _
�_-Jws
a w.m�
IN4
--�KTIa.m
�..•cµn
uC tic PG, tl1
v _ t 1. 141
urc11[4•m[x10
IIIIIII��II�IIHIIW�I�II�I�I seiaaC•�i,_,:%e;M,
��
mfugVA.Yw
c,. rrtn.ne cM i�c�n, �mau n[evumvptcauln
��rjuwdw0

DocuSign Envelope ID: 2AF8763F-4D5C-4EBC-846A-EF12A6B82FOF
NC DIVISION OF COASTAL MANAGEMENT
SANDBAG REMOVAL NOTICE
L Bobby Harrelson , understand that sandbags are tenrpoiftrY erosion control
structures that may remain in place for up to eight years after the date of approval if it is protecting a
building and an associated septic system, a bridge or a road. The property owner shall be repoasibie for
removal of any portion of the temporary erosion control strucwre exposed above grade within 30 days of
the and of the allowable time period. Any portion of the temporary erosion control structure that becomes
exposed above grade after the expiration of the permitted time period shall be removed by the property
owner within 30 days of official notification from the Division of Coastal Management.
In this case the sandbag alignment may remain in place up to: Permit No.
Address of the Structure Being Protected:
Lot ¢,Palm Cove Plat 84/81
Sunset Beach, 28468
PropertyOwner: __Y
(Fk Corparatloc or iodividwt}
If the property is owned by a Firm or Corporation give
the name of the officer or authorized representative:
Bobby Harrelson
Prim NUN
L--FaFsaaeaaee,aFE
Sig[triure
2/6/2020
0
If an agent is obtaining the permit on your behalf the following section must be completed in full:
give permission to,_ Tim Jackson
Print weer or Offl= Name Print Agent Name
L et$=/Our agent in obtaining a CAMA General Permit to place sandbags on the property noted
%9F8389a968 UFE
Tim Jackson
Omer or officer signature Print Agent Name

-gins }o &iDa(oid paaeoosse pup jDaloid JegpueS ano' Wled y:)eag
jasunS aqj o32ututejjad �jjom Aue ao};legaq Au+ uo uOls ox uosIDef lull aziaogjnp AgajOL4 1
uaa1uo:) Aevq i1 wogm o1
ZOZ 'Zj tiaenlga j

Date Received
Defe Dp,,Hd
Check From Name
Name or P—N Nokler
V ndor
Check Number
Check
amount
Permit Nu bwlromments
ReceApt w RefundNtcllocefed
Columnt
Column!
Colu-3
Column)
Column$
Columns
Cdum07
Column$
Column9 _
2/17/2020
Palm Cove Owners Association, Inc.
Palm Cove Holdings, LLC
First Citizens Bank
1014
$ 400.00 GP #762020
BB rcL 8819
2/17/2020
Palm Cove Owners Association, Inc.
Benjamin & Cyndi Levine
First Citizens Bank
1015
$ 400.00 GP #76203D
BB rct. 8820
2/17/2020
Palm Cove Owners Association, Inc.
Longleaf Pines, LLC
First Citizens Bank
1016
$ 400.00 GP #76205D
BB rct. 8821
2/17/2020
Palm Cove Owners Association, Inc.
Jill Marie Ronnion Rev. Trust
First Citizens Bank
1017
$ 400.00 GP #76206D
BB rct. 8822
2/17/2020
Palm Cove Owners Association, Inc.
Howard Beach House e_ LLC
First Citizens Bank
1018
$ 400.00 GP #76207D
BB rct. 8823
2/17/2020
Palm Cove Owners Association, Inc.
Donna Conner
First Citizens Bank
1019
$ 400.00 GP #76204D
BB rct. 8824
2/17/2020
Palm Cove Owners Association, Inc.
Finley Efard, LLC
First Citizens Bank
1020
$ 400.00 GP #76208D
BB Mt. 8825
2/17/2020
Palm Cove Owners Association, Inc.
David Tendler & Susan Spratt
First Citizens Bank
1021
$ 400.00 GP #76209D
BB rct 11451
2/17/2020
Palm Cove Owners Association, Inc.
Tatiana McCuen
First Citizens Bank
1022
$ 400.00 GP #762101)
BB rct 11452
2/17/2020
Palm Cove Owners Association, Inc.
Ann Morales
First Citizens Bank
1013
$ 400.00 GP #76201 D
BB rct. 8817
2/17/2020
Charles Ducksworth Money Order
Christopher Miller
Wells Fargo Bank
19-0461121 i
$ 200.00 GP #74891 D
BB rct. 11463
2/17/2020
H5 Construction, LLC
Thomas Holland Jr.
BUT
2473
$ 200.00 GP #74893D
BB rct. 11455
2/17/2020
Jerry Ennett c/o Ennett Marine Constructs Deborah Kalner
Coastal Bank and Trust
2736
$ 200.00 GP #74878D _
JD rct 10965
2/17/2020
Chadas & Christine Boise
Charlie Boise
The Fau uier Bank
26351$
200.00 GP #76214D
JO rct. 10964