76215D - Wellmans

CAMA / ❑ DREDGE & FILL NO. 76215 A B c D)
GENERAL PERMIT Previous permit # _
v� ❑ Modification Complete Reissue Partial Reissue Date previous permit issued
As authorised 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 % / i—(
jj „„AA,�� '' ,�� %% ,, (. , J ` —�C1 Rules attached.
Applicant Name t' °�7 ��fi 11 S� C )r '� Project Location: County -l' �— N ��rZ
Address 1' L) & O W &tLM kK�Street Address/ State Road/ Lot #(s)
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Phone # (( 1") ?j I— E-Mail
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Agent or Applicant Printed Name
Signature "Please d compliance statement on back of permit"
Application Fee(s) Check
Permi ffi er's Printed Name
Signa e
Issuing Date Expiration Date

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WELIAUN'S CONSTRUCTION. INC.
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CERTIFIED MAIL • RETURN RECEIPT REQUESTEQ
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: �P jYY y�(�,I1--T lz� L••_____.__
Address of Property:
(Lot or Street), Street or Road, City & County)
Agents Name #:� CYIc'x'r l 5 T Mailing Address:
�n
Agents phone #:
I hereby certify that ► 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 notify the Division of Coastal Management (LLCM) in
writing within 10 days of receipt of this notice, Correspondence should be mailed to 127 Cardinal Drive Frt.,
Wilmington, NC, 28405-3845. DCM representatives can aiso be contacted at [phone]- No respU.nse is
considered the same as no objection if Lou have been notified 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.
(P�eReity Owner Information)
Signature
Print or Type Name
Mailing Address
-Citll at ip (�
�lephone Number !�
(Adjacent Property Owner Information)
Signatztre
Print or Type Name
CA -
Mailing Address
Crty/StateiZip V
Telephone Number
Date Date
Rerisea RAW-10i2

CERTIFIED MAII. =RETURN t��.C�li'T Rlnf�tJES"Tt�F
DIVISION OF GUAS'i'?.;,_ � IAN1 DEMENT
ADJACENT RIPARIAN PROPERI-1 UWNER NOTIFIGATIONANAIVER-FORWI
Name of Property Owner. n t_ T Cj �f.;� r '•
Address of Property:
(! c3t or Rreet Street or P(+=d, laity & 1.'10unW
Agent's kllarne #:�tl
n_1
� or'r 1.3 ----_ Mailing Address:
Agent's phone #: —3 ,�
I hereby certify that I own property ad;ac,erit to the above reterenced ntopi
applying for this permit has described to n-ie =?s sho-tvri on the attached diawi�
they are proposing. A description or rit.4wnW.inrenionsi must be prc`J!o..4.
I have no objections to this proposai. . --_ .- - I bm e objection:: t(; tt?=;
If you have objections to what is tieing proposed, you must notity the Division of Coastal
writing within 1`0 days of receipt of this notice-- Corre3pondenco- should be niailejto i;';
Wilmington, NC, 28405-3845. DCM representatives car, ar'so be contacted at (9101 779t 't::? . Nv
consIdeted the same as no obiectlon if i Flu have pit-'7 no,? t {--Q oy i;e1tified Mail.
WAIVER SECTION
i understand that a pier, dock, rnooring p4ings, breakwater. boathouse. lift. or uruO, - ;t ;jst O;- is
back a minimum distance of 115from my area of riparian access unless warvp<l -'P2 :!).? it
.vist, to waives the setback, you must initial the appropriate blank below.
I do wish to waive the 15' setback rrquiremnnt.
do not wish to waive the -I 51 sett;at k requirernent.
Tmiyefy Owner Information)
Signature
?rinf or Type Name
I) b , 6N 2
1111atling Address
cii�/�,cir`Ecirl@,� in i-i `ram
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`Tplephene Nurr?bpr
!Adjacent Prop" Owres
,altncrure.
Print or Type Name
relepltone Nr�tnher
Date

Daft Raeahod
Dab Dpohd
Check From ame
Name or Permit Holder
VMdar
Check Number
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amcum
Permit Numbar/Comments
Rocelpt a RaniM/RWlocated
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Column2
Column)
C.1-4
C k-5
C.1—nd
COk~7
C.1-8
CWumn9
224/2020
_
Wellman's Construction, Inc. __
Grice Construction of Brunswick County Inc _
Grice Construction
_
Wellman's Construction Branch Banking and Trust
_
Kevin Dunlap BB3T __
Chris Haywood ,BUT
Peggy Hughes BBBT
Derick Reardon BB8
18869
$ 100.00
GP #76215D ($100 credit from 9/9119)
GO #76237D _
GP#74847D
JD rct. 10974
BB M 11459
2242020
13819
400.00
2242020
13510
200.00
BBrct.11458-
224I2020
Grice Construction
13820
>; 800.00
GP#76233D
BBrct. 11460
2242020
Backwater Marine Construction Inc.
.00
GP #74896D
B;a 1 465