74845D - Dancy

S;CAMA / ❑ DREDGE & FILL NO. 74845 A B c
GENERAL PERMIT Previous permit #
5<New ❑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 15A NCAC O� �� L ��
7-1Rulesattached.
�/G�n
Applicant Name K - c Project Location: County � r ^ s w I c l< -
Address h cm C i
City r 6rr','g ;, �� State ►J L ZIP 2.70'3 I �
Phone # E-Mail r u' ti.'nc J n O I • ( �•
Authorized Agent LJ r— -x G r I (_­e_
Affected ❑ CW K EW A PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A
❑ PWS:
ORW: yes /fin _ PNA yes
Street Address/ State Road/ Lot #(s)
7 ;1 j ",
r3G5
Subdivision
city S,^ 'A ZIP
Phone # ( ) River Basin
Adj. Wtr. Body �' ^ i�� �c. C' l (nat AM
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Closest Maj. Wtr. Body uK--
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Agent or Applicant Printed Name
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Signature "Please rea Qmpliance statement on back of permit
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Application Fee(s) Check #
-13I o cL,
P it0 i - Pr'nted N" ^
� 1' 12 02_0
a Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: E �� AA�
P Y q 9
Mailing Address: 4�g. ��
Phone Number:
Email Address: C�r—Y)
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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:
at my property located at / 3D / V , �Stde eJ'Or iy E ,
in _Bf-&LAJ.StJiC 'county.
1 furthermore certify that 1 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
Title
Date
This certification is valid through 36b, �%S
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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
D Rw—Q ' k �
Street or Road City & County-) --
Agent's Name #: Gr 1C't (k� �)*L (A l,�()
Agent's phone #: CMU" S n - q 0R,5
Mailing Address:w+ 3QQ6h ►c`
&,LU,)T-61Q �W1 NC, zt46G
I hereby certify that I own property ddjacent to the above referenced property. The individual applying for
this permit has described to me as shown on the attached Irawi gjhe development they are proposing.
- -Proposal.
N you have objections to what Is being proposed, you must notify the Dly/ n of Coastal
Management (DCM) In writing within 10 days of receipt of this notice. Corr hould bo
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM repress e; also be
contacted at [phone]. No response Is considered the same as no objection y been
notHied by Certified 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 15' setback requirement.
(Property Owner Information)
S' nature
Print or Type Name
N 5�(4 uh6 r�,� 1-
Mailing Address
L K- n us C 2-7 OS)—
CitylState/Zip
`^l 3— —Y92 — H c.e � 2-
Telephone Number
H 2-1
Date
(Adjacent Property Owner Information)
r4Y1AJ,&-
Signature
Ao6er-f 6Ct�/01
Print or Type Name
D i — /U.0 i -I
Mailing f ddre s
No /<Jor1yc y �-D
City/State/Zip
q19 0
gi,
Telephone Number
Dare
Revised &1 &2012

0 Complete Items 1. 2. and 3.
1 Print your name and address on the reverse
so that we can return the card to you.
I Attach this card to the back of the mailplece,
or an the front If space permits.
1. Amide Addresse r\d to: GJ�
Dengiry"V"
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�at,xuyh/ 014 0236cK
9590 9402 221 q 6193
'S Form 3811, JtilyeUl., rSN 7530-0243OD-so53
I Cwpkft Items 1. 2, and 3.
i Print your name and address on the reverse
so that we can return the card to you.
I Attach this card to the back of the mailpleoet
or on the front if space permits.
Article, Addressed to -
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT -
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: r101;LQr
\I c
Address of Property: 13(J � y u r' 5 hU � 0P
(Lot or Street aR, Street or Road City 8 County) --
Agent's Name #: �� lG� `6, pLL(-1 l Mailing Address:tDW+� BQCV—h a>— 3J)
Agent's phone #: CM 5-Ty'9095 0NxAr)T,61Q �WU Nc zvmq
I hereby certify that I own property ddjacent 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.
6
l 1 have no objections to this proposal. _ I have objections to this proposal.
K you have objections to what is being proposed, you must notify the *D1vqnof Coastal
Cr
Management (DCM) In writing within 10 days of receipt of this notice. Coshould bo
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405.3845. DCM represe8T► also be
contacted at [phone]. No response is considered the some as no objection OIPW** boon
C notified by Certlfled Mail.
q�
V1
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.
1 do not wish to waive the 15' setback requirement.
'(,Property Owner Information)
�►�on� �ruco �qqe���
T—
(Adjacent Property Owner Information)
S' nature
ignuture
Print or Type Name
2,c�wZ� 5ict !1'1!4AL!Rrs
Jpriht or Type Name
ewt
Mailing Address
C�)c�)e16 us
Mailing Address
;Zz
C4tateaip
Q4MatwZt
` 7N -V2 ta(6 Z
7ft
T[elleephone Number
telephone Number
Date
Date"
Revised &1&2012

C_
6
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT - --
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: o ► J UJLkr
Address of Property: ' 1 y U
r (Lot or Street #, Street or Road City & Co/u'n-ty)- -
Agent's Name #:l� r t �r 5�PII J%Nq Mailing Address:tDtp�� 32COh D`
Agent's phone #: %13_ 511-9095 C, Wn] 51Q �,X c N(. Z�S` g
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 cjrawin the development they are proposing.
e ,. .. K
R
" 1 have no objections to this proposal. __ t have objections to this proposal
!f you have objections to what is being proposed, you must notify the D*Ivie
of Coastal
rr Management (DCM) in writing within 10 days of receipt of this notice. Correa should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represene6n also be
contacted at [phone]. No response is considered the same as no objection Ifj Asbeen
C notified by Certified Mail. _ W,
1y WAIVER SECTION
V 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.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information)
URd Lcge
S' nature
Print or Type Name
Z(_)�Z% 5�g u 6 r�,C 1
Mailing Address
neA� u5 , NC 2-7 OS)
City/State/Zip '
_70� -Y92 - H LD(n 2-
Telephone Number
Dale
(Adjacent Property Owner Information)
ignurure
��� srn� �. d� G o�•4'
not or Type Name /
fUe�^s /d
a �6r )-,L �Z�r
Mailing Address
*P_
Cate! p�
Telephone Number
17
Date
Revised 611812012

Daft RaealveO
Data D4w,,hod
CMtk Fran
Name or Fwm/t &Wdff
V rww
Cbwk /kanba/
Cn.*
amount
AknbgfC* .. Wft
Race/pa - R.N.&Raa11—W
Cakmml
Column?
COMMS
Cok-9
CoWmn6
7
CM-9
COlumn9
1/312020
Susan and Robert Caudill
Robert Caudill
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1234
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_
Stanley & Barbara James
Coastal Bank and Trust
3001
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3784
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Charles Fox Homes, LTD
Brandon & Whim Sauls
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1 26403
S 200.00
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I BB rct. 9467
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1 Grice Construction of Brunswick County IN
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1BB&T
1 135131$
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