76214D - Boise

)dCAMA / DREDGE & FILL NO. 76214 D
GENERAL PERMIT Previouspermit# i —
lew ❑Modification ❑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 I SA NCAC VV
�j ❑�`%' s attac ed.
Applicant Name a_Ct ✓l Project Location: County__ �JA�/ .(
Address
City.
Phonl #t /��E-Mail
Authorized Agent AJ
Aff t d ❑ CW %1W El PTA El ES ❑ PTS
�l
Stated ZIP 7 �
Street Add�ess/ State Road/ Lot #(s) it
i
t
Subdivision'
City '/C.��' ZIP 2r'�'
Phone # ( / River Basin Cam/ • a
ec e ❑ OEA ❑ HHF ❑ IH ❑ UBA El N/A AEC(s): Adj. Wtr. Body -�Mman unkn
❑ PWS:
ORW: yes kn6� PNA
�;�no Cl
osest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
Bulkhe / Riprap length
avg istance offshore
max tance offshore
Basin, channe �
cubic yards
Boat ramp
Boathouse/ Boatlift�
Beach Bulldozing
Other
r
Shoreline Length
SAV: not sure yes no,
Moratorium: n/a yes
Photos: yes
Waiver Attached: 14es
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
'AM
or ADDllcant Printed Name
/r
(Scale.
❑ See note on back regarding River Basin rules.
Name
Please read compliance statement on back of permit
Application Fee(s) Check #
14-20
Issuing Date fxpiration Date

ADJACENT RIPARIAN -PROPERTY
//OWNER STATEMENT
I hereby certify that I own property adjacent to �G'�r� / iS�-- 's
property located at
on
iAUUMss, LOi,
A z , in
ity/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
/,ZI have no objection to this proposal.
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)
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.
(Pro rt Ow r I formation]
(Adjacent Property Owner Information)
n re
Print or Type Name
Print0 T am p
Laic
Mailing
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City/Stateolp
M iling Addre•
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Cityo/Mo—
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Telephon N ber
Telep one Number
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Date
Date
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(Revised 6118120122))

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ADJACENT RIPARIAN P13OPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to�`�'s
property located at
on
Lot, )OCk, Road, etc.)
own and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
—! Z& I have no objection to this proposal.
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)
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.
(Propert Ow r 1 formation)
tlj�cent r
O ner Info
2�' , 7�-7��
Sign`7"
Print or Type Name
i eL1 /�,41111.l- l) 0:
Maili g Address
Clt}//St8M
Telephon N ber b
Date
"S'i ture
Pnfif Tyvpe Name
M i��hg-�_�Addres Alt
y G
1r M" .r�r rt
city/Stat&z Z
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(Revised 6118/Zf12k
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Data Reeelvad
Date Dpmftod
Check From Nama
Name or PwmN Noldw
Wndor
Cheek Number
Chaok
amount
Ptrtnit Numb-1c. manta
Receipt or Rarundl gocsted
Columnl
Column2
column3
Coumn4
Columns
Columns
Column?
Columns
Column9
2/17/2020
Palm Cove Owners Association, Inc.
Palm Cove Holdings, LLC
First Citizens Bank 1014
$ 400.00 GP #76202D
BB rct. 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 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 rat. 8824
2/17/2020
Palm Cove Owners Association, Inc.
Finley Efard, LLC
First Citizens Bank 1626
$ 400.00 GP #76208D
BB rat. 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 #76210D
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 19-04611211
$ 200.00 GP #74891 D
rct. 11453
2/17l2020
H5 Construction, LLC
Thomas Holland Jr.
BB&T 2473
$ 200.00 GP #74893D
rct 11455
r
2/17/2020
Jerry Ennett c/o Ennett Marine Constructi
Deborah Kalner
Coastal Bank and Trust 2736
$ 200.00 GP #74878D _ _
rct 10965
2/17/2020
Charles & Christine Boise
Charlie Boise
The Fau uier Bank 2635
200.00 GP #76214D
rct. 10964