75801D - Graham

CAMA / DRED & FILL NO. %38O 1 A B C
ENERAL PERMIT Previous permit#
New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality f `II f U��-' 2p
and the Coastal Resource Commission in an area of,environmental concern pursuant to 15A NCAC �J T►1 00
Pp / ;/ ❑ Rules attached.
Applicant Name �\ ` U � �' h Project
ect Location: County � � �.• � c �•
Address 2�2 Street Address/ State Road/ Lot #(s) 2(pOLD E • ya C��"
City t ` `Uc1(c S� 11P� State_ �)L ZIP Z 1 (� �✓ , vt--
Phone # (—" W 2 68 taZ E-Mail
Authorized Agent p i
Affected ❑ CW CLEW XPTA V'ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UIBA ❑ N/A
❑ PWS:
ORW: yes 4_19) PNA (;;2J no
Subdivision
City`: S a^ a ZIP 2 Fl ii 5
Phone # O River Basin
Adj. Wtr. Body pr W jn Pman /unkn)
Closest Maj. Wtr. Body -A/
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Agent or Applicant Printed Narpe
Signa re ** Please read compliance statement on back of permit **
Application Fee(s) Che k #
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Per Print Name
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Issuing ate Exp' do to

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT n Ilk
I hereby certify that I own property adjacent to ^ Q `� .{1�0��1 �a'`'I s
I,,�.. (Name of Property Owner)
property located at � 6 4 � C • YaC Iry � c'.
(Address, Lot, Block, Road, etc.)
on - in ORK -4Caw,�,� I✓_C , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Io tion.
-TNA'aL 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, boat ramp, 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.)
�hfte C I do wish to waive the 15' setback requirement.
_ I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Si a ure
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Print o�r�yp/ 1 _ �Je no i-J9-y
M it �ng Address AL ��, I
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ary6o4/zip6G 2 QS6.2
Telephone Number/email address
Date
(Adjacent Property Owner Information)
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(Revised Aug. 2094)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to ^ O` (IPA 10 l� /�► Gfot-� A�'( s
Name of Property Owner)
property located at o2 G 0 C F—
(Address, Lot, lock, Road, etc.) , r
on --LC� , in lock,
�cf'(.i�►n'0 /�/ C� N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
NraL f 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)
dne
WAIVER SECTION
understand that a pier, dock, mooring pilings, boat ramp, 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�' np ture
ncl u /� 6r-e,-ha-I
Print or Type aY� 1r
ame
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City/ tat�/zip 662 — 0?6 2
Telephone Number/email address
Date
(Adjacent Property Owner Information)
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Date U
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(Revised Aug. 2014)
*Valid for one calendar year after signature*

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: PD, 1A) 0 P
Mailing Address:
�t T-1/9
li
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Phone Number: t9e�(`R" 2
Email Address:
I certify that I have authorized Qt r
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: C c t / J7106A
Rn'f) 41 P Y^ .
at my property located at -4' Z ��6A _D� - l 06
in { , ruaW J4 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 I ation:
Signature /
Print or Type Name
Title
Date
This certification is valid through
13465
RECEIVED
DCM WILMINGTON, NC
MAR 1 7 2020

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Date Rncalved
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3/2612020
H5 Construction, LLC
Thomas Jordan
BB&T
2488 $ 200.00
GP #76104D BB rct. 10851
3/26t202O
Ralph & Colleen Graham (1 of 3)
same
Wachovia
1205 $ 200.00
GP #75801 D BB rct. 10923
3/26/2020
Ralph & Colleen Graham (2 of 3)
same
Wachovia
1204, $ 200.00
GP #75801 D BB rct 10923
3/26/2020
Ralph & Colleen Graham (3 of 3)
same
Wachovia
1207 $ 200.00
GP #75801 D 88 rct 10923
3/26/2020
Oceanside Management LLC
same
First Bank
3108 $ 200.00
GP #76276D 88 rct 10925