68542D - Bormann

�yAMA / ..- DREDGE & FILL bv$ ,
`:8542 A B C
GENERAL PERMIT Previous permit #
^New _- Modification --Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
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and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC LJ N : R © O
j ❑ Rules attached
Applicant Name 1 i I O1V U � (jOY (\/\ "'1 VA Y1
Address I L) 15 I. �I o re br,
City S4�'({ T !FA(� StateAL(_ ZIP ,
Phone # (SK) 'Z) S' _73SI E-Mail
Authorized Agent S(D \m Y)U m
Affected 9 `W TAW HPTA ❑ ES ❑ 5
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UIBA ❑ N/A
❑ PWS:
Project Location: County (�YVVI.� W I l K
Street Address/ State Road/ Lot #(s)
Its3 li,.5kwe br
Subdivision `
City angqst 1 jl ter ti zip a8`'i { 8
h � (1(o) %yV Rivgr Basin (,061 b-W
Adj. Wtr. Body (-%t VI lA \i (nat /c�1a /unkn)
Closest Maj. Wtr. Body Al 1 w��
Signature ** Please read compliance statement on back of permit **
1� & 00 f 0 0 17 g
Application Fee(s) Check #
Issuing Date
^r.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: r—
Mailing Address: 5 l�
✓; r3-04e 14
Phone Number:
Email Address: j Soeg , jxj
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: LAJ C 1 7) IF
/T�Ov L- 4 I ---------------
at my property located at
in rBe-I WI'Ck County.
l furthermore certify that l 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:
Sig ure
Print or Type Name
Title
Date
This certification is valid through I I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTIBOATIIOUSE)
I hereby certify that I own property adjacent to () rMf s I )► f Vl n L Y1Y1S
property located at) ) 3 I V OY-VvI
(Name of Property Owner)
M
3i
-� (Lot, Block, Road, etc.)
on `�l Y1 k S �'1'C� � �
CGZyt in t i�( iilC �Q-� , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatliffi/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. * Rvacs ( K t-k Ce
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
--------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT;
(To be filled in by individual proposing development)
(Applicant Information)
151�0 r-4/) S1loyc> Ty.
Mailing Adcfress
City�tazaop��
Telephone Number
a 1 IZ)II
Date
aIf4 L /
or Type Name
Telephone Number
��C/0—/7
Date
Information)
.V4�ssi

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIE"OORING PILINGSBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to 0 S ' t� 6o Y rMo n's
I ' �
(Name of Property Owner)
property located at�
—�' (Lot, Block, Road, etc.)
on k_. Q1Q-CU'Y
in SU�Aj!�e4 IlQ.C
�►' 1 , N.C.
(Waterbody) �( (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatliifi/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. -yTlQ 6tgz I h �� ck_'Q
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement
------------
ESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
---------- ----------------------___-------
(Applicant Information)
Mailin4Aess
�VIS�f�C�, tiIG 28�-� nQ
CGtydtate/Zip
Telephone Number
9112111
Date
(Riparian Property Owner Information)
Signature v�
Print or ype Name
`1 t q 620 11 5`z 3 773 4.0
Telephone Number
Dat

CAROLI NA BLUEWATER CONSTRUCTION
Custom Beach, Mainlan4, an4 Golf Course Homes
Complete Design / Engineering / Buil4ing
6934-9 Beach Dr. 5W, Ocean Isle Beach, North Carolina 28469 [phone]
JINKS CREEK FEEDER CANAL
17'-8"
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15'-0' Setback
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L 21'-0„
Parcel #: 256ND00330
Owner. Barry & Karen Wishon
7608 The Pointe
Raleigh, NG 27615
LOT 30
Lot 31, 1513 North Shore Drive
Sunset Beach, NC
CAMA-Pier Plan
N79'30'31"E 49.94'
LOT 31
5,405 SF
16'-r
8' x 16'
1 I
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Floating Dock
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w/ 10" Piles
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3
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1 a a
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1
15'-0" Setbadt
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1 MEAN HIGH WATER LINE
1 ALONG BOTTOM
EXISTING BULKHEAD
/—TNS
Open Deck AEove
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coeraa o.0 rmoe
1
1
. POOL
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IEbvet
5.9
1
3
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15.9
"+
Shaded Area is Roof Area to be
1
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Guttered. DAeaed. & Piped ■
o Rock Infiltmt- Basin
2.070 SF
•
Fbuce Apo•e
1ip
SLAB RE ]A . Ibua AOp"a•
SLAB
— -- -
a}
C.VMW Oe YAb— 6.0
Landscape Area
Parcel #: 256ND00332
Owner. Thomas & Dianne Bormann
1515 North Shore Dr
Sunset Beach, NC 28468
LOT 32

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:'T�C m K S /J lg rJ I
Date: 0 q /'L 61 [7,0
Describe below the HABITAT disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
im act amount)
tem im acts
amount
Dredge ❑ Fill ❑ Both ❑ Other
I LI
GDredge
❑ Fill ❑ Both ❑ Other Ek,
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

WIRO
Date Received I Date Deposited Check From (Name) Name of PemUt Holder I Vendor Check Number Check amount Permit Number/COmments Receipt or RdandrRNlloeated
10/2/2017 Carolina Bluewater Construction Thomas Bormann BB&T 18379 $200.00 GP 68542D SF rct. 5040D
10/2/2017 Backwater Marine Construction David Szymanski BB&T 3060 $200.00 GP 68541 D SF rct. 5039D