74805 - Kay

2CAMA / ❑ DREDGE & FILL NO. 74805 A B c /��
�ENERAL PERMIT Previous permit # / �.%
FkNew ❑Modification El Complete Reissue ❑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 Q 7 kl . ! O
tt ,, ❑ Rules attached.
Applicant Name Project Location: CoUntyr, _ S _ c �`—
Address 2I d 'S ( Street Address/ State Road/ Lot #(s) O q
City State ZIP 2 O �p ►
Phone # (qU 1-4) '63 0 S E-Mail k ctol, Subdivision (�
Authorized AgentMW4 f���� City �Ac!,\c"c �N ZIP
Affected ❑ CW E)EW �&TA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / .Q�­ PNA yes /
Type of Project/ Activity K.to ku,_ -(�A \ n 7 A,k,
Pier (dock) length
FixedPlatform(s) I?,YI2� (tyua
Floating Platform(s) $ X f C.
Finger pier(s) 3 1 X30
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Phone # ( )
River Basin t_' ^
Adj. Wtr. Body C a-'c, � (naIC2�/unkn)
Closest Maj. Wtr. Body A k �Jw
c,I%�
(Scale: AJ 75 )
■�■■■M■■■■■ \■■/ IlCil�l■■■■■■■■■■■■■■■
M.
MEMO
IM
■a 1.4 w�'� ■■■�■ Wig► w- ■ ■■iiiMMENiiio■■
■■■■■'I NM■M■■■■■■■MEMO M■■■■■■■■ M®M■MM■
o ..
l� n r T 1-1. '-
Agent or Applicant Printed Name
Signatur ** Please read compliance statement on back of permit'*
Apple tionFee(s) Check#
Permit0flJZZes Printed Name
Signatur
Issuing D e Expi ti n Date
+.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: William J. Kay
Mailing Address: 21000 Scottsbury Dr
Phone Number:
Email Address:
Germantown; MD 20876
410-371-8305
wjkayCa aol.com
I certify that I have authorized HS Construction LLC
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Construct floating dock with
aluminum ramp, replace deck boards and install Gazebo with metal roof.
at my property located at 109 Durham St., Holden Beach, NC
in Brunswick
County.
I 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 Information:
Si na re
William J. Kay
Print or Type Name
Title
/
Date
This certification is valid through ! I

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT 14 PARiAN PROPERTY OWNER NQTiFICATIONlWAIVER FORM
Name of Property Owner: William J Kay
Address of Property: 109 Durham St, Holden Beach, Brunswick County, NC
(Lot or Street #, Street or Road, City & County)
A,genr,,s Nara - H5 Construction
Agerit's phone-# 910-80-4391
MaBWVAddress: 2164 Holden Beach Rd.
SW*' 2W2
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 scrintion qr draw, jng, with dimensions, must beprovided with this letter.
/i I have no objections to this proposal. I have objections to this proposal:.
If you have objections to what is being proposed, you must notHy the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact Information for DCM offices is
available at or by calling 1-888.4RCOAST.
No response is considered the same as no objection ff you a been notified bar Certified Mail.
WdVER SeCT40H
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.)
ftla �z - I do wish to waive the 15' setback requirement.
i d +tot wish bar waive the 15' sathack requirement
(Property Owner Information)
Signature
Y fPtliarr►-S.'Kav
Print or Type Name
21000 Scottsbury Dr
Wing Address
Germantown, MD 20876
CJrrap
410-371-8305 / [e-mail]
Telephone Number/Email Address
Date
(Riparian Property Owner information)
S ure
Print or Type Name
Mailing Address
l Wei% Bea, NC C2$ A0 a
CIly!<5tat�dgp
qlq
- q -igss y - ; d .
Telephoner Numbed Emad A Tess
,2 &1 It q _
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER N©TIFICATIONIWAIVER FORM
Name of Property Owner: William J Kay
Address of Property:
109 Durham St, Holden Beach, Brunswick County, NC
(Lot or Street #, Street or Road, City & County)
Agent's Name #: H5 Construction
Agent's phone #: 9W8W4381
Mailing Address: 2164 Holden Beach Rd.
Supply, NC 28462
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.
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 Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at or by calling 1-888-4RCOAST,
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER; SEUMN
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 ado not wishto waive Ahae 115' setback requirement.
(Property Owner Information)
Signature
William J. Kay
Print or Type Name
21000 Scottsbury Dr
Mailing Address
Germantown, MD 20876
Qty/Stafelzip
410-371-8305 / [e-mail]
Telephone Number/Email Address
Date
Property O>vner Information)
Ptint or Type N me
i >i fy r� r
Maili g Address
City/Statelzo
Telephone Number/Email Address
Date
(Revised Aug. 2014)

w
Z
J
W
a
0
a
=HS=
CONSTRUCTION
+/-9 FT. I 8X16 FLOATING DOCK
0-
a
cc
x
m
+/-15 FT. I 12x12 DOCK
x
EXISTING BOAT LIFT
REPLACE DECKBOARDS,
INSTALL NEW METAL ROOF GAZEBO
W. KAY, 109 DURHAM ST., HB
PROJECT: ID9 DURHAM ST./KAY
w
Z
J
W
d
0
1
a

Dan Received
Data D-tftd
Check From Name
Name or Permit Holder
WWI-
Check Number
Chock
ounf
Permit Number/Comments
Receipt w RMun&R*a11ocared
Columnl
Column2
Co1umn3
ColumM
cakamra
Columns
Ce1umn7
Columns
Columns
1/14/2020
1/1412020
1/142020
_ _
_
Francesca Marie Evans & Martin
H5 Construction, LLC _
Lighthouse Marine Construction Inc.
McPherson Marine Services, LLC
Allied Marine Contractors LLC
Martin Evans
William Ka _ _
John and Marcia Stayovy
Coming Federal Credit Union
1D49
$ 200.00
GP #74826D _
GP #748050
GP 874857D
GP 071899D _
GP #74856D
JD rct. 10934
BB rct. 9471
JD rct 10935
BUT
2425
f 200.00
Coastal Bank and Trust
3023
S 200.00
Tmac rcL 9079
Chel & Cara Growl
First Citizens Bank
2061
$ 6W.00
1/142020
JD rcL 8550
HolladayProperties, LLC
Fret Citizens Bank
8WS
$ 200.00
1/142020
1l142020
Grice Construction kN Brunswick CountyInc
e
Jacob Vande rift
BUT
13511
$ 200.00
GP €74846D _
GP €/48WD _ _
GP #74854D _
GP#74803D
GP #71898D _ _ _
BB rrx 9474
1/14/2020
Willie Clarence Richardson/Richardson Cons
Howard Mintz
BUT
7610
9 200.00
BB rcL 9473
1/142020
Brandon Grimes Money Order _
Carolina Bluewater Constwgfion. Inc.
McPherson Marine Services LLC
Gregory J. Darnell
Steve Hill
15unTrust1054
BaneFirsl
16281UN
$ 2W.00
JO ra 10933 _
14142020
Michael L s
BUT
21650
$ 200.00
BB rc19472
1/142020
Charles & Julia Beidelsahies
First Citizens Bank
2039
S 200.00
Tmac ret. 9078
JD mt. 10932
/1 0
same
200.00
GP #74855D