69046D - Barclay

'qICAMA / ❑ DREDGE & FILL �� y "J
GENERAL PERMIT
!1New -Modification ❑Complete Reissue ❑Partial Reissue
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources u 1•�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC O� 1 I . 1 -n b
Applicant Name NU) �ay C l at k
Address i pl {(��.5,, Neci� RB O
City iVJIInAIRdl-V1 StateN& ZIP2�LVJ
Phone # () Z3rrI--,,�LD E-Mail
Ed Authorized Agent L
Affected ❑ CW )6EW ATA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHP ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: es no PNA yes
❑ Rules attached.
Project Location: CountyNe t v }1a" pv ey
Street Address/ State Road/ Lot #(s) `7 f l p e s
t%,1 V li-I o a.&
Co
Subdivision1
city W I I M I ZIP 2/��{
me hhone # (I IV )ZSLr &(.OZRiver Basin 61A (,I t,
Adj. Wtr. Body (nat m unkn
Closest Maj. Wtr. Body
Type of I I.
1
..
■IRC�■■■I ■■■■ ■■■I ■
�ix Platform(s)
MENNEN' 000
No
MEN,
1110MINEEN
OEM
ON
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Agent pli, P ted Name
Signature PI read compliance statement on back of permit''*
$20 o CP H
Application Fee(s) Check #
Pe�gitOfficer's Pri Name
// ,
i natu e
Issuingr Date' Expiration Date

Date
Date
Check From
Name of
Vendor
Check
Check
Permit
Receipt #
Received
Deposited
(Name)
Permit Holder
Number
amount
Number/
Comments
F and S Marine
3/27/2017 Contractors Ned Barclay PNC Bank 6177 $200.00 GP 69046D CS rct. 3614D

Pat McCrory
Governor
NCDENR
North Carolina Department of Environment and Natural Resources
N.C. Division of Coastal Management
AGENT AUTHORIZATION FORM
Date: /
Name of Prooerty Owner Applying for Permit:
L,Y0 l
Own s Mailing Address:
r✓n� nLZk
bll,i t4aNl C .
Email: n ehmtaN, 9,+°1_' f : Zt1wti
Phone lam_ 3 0)
John E. Skvarla, III
'?IE CAE
' MAR 202017
Name of Authorized Agent for this Project:
Agent's Mailing Address:
Mlrr0 , 140,
Wrightsville 130ach N 284,30
Email: [phone]
Phone
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all Cl�MA P rmits n essa to install or construct the following (actiyityl:
��q� -ice w AV)), Z kilr��
For my property located at It Al2 m
C S 9''rQ ViO 0l4�w AAA.
P.O. Box 868
Wrights4ille Beach, NC 28480
Ili [phone]
This certification is valid 1 year from (date) �%11it1 9 ,' �-P FLsveA
` A1lb7v 49 kwl�
Property irwner Si ature DatevX�l �b
}
127 Cardinal Drive Ext., Wilmington, NC 28405 �
Phone: [phone] FAX: [phone] Internet: www.nccoastalm;
RECEIVED
An Equal CpportunKy `• Aflamative Acton Empbyer flCM W ILMINGTON, NC
MAR 2 0 2017

.v�♦V
1 ,
•s
A ? •�
a I �
feet 200
meters
a,107,yi AeX Avy
d6A
1 7* )v17
F&S Marine Contractors, Inc.
Complete Marine ConstructiorltLtD
For Over 40 YMM WILMINGTON, NC
CAPT. ED FLYNN DURWOOD SYKES
Piers, Floating Docks, Pilings, Bulkheads,
Boat Lifts, House Pilings, Repairs
P.O. Box 868 Phone/Fax: [phone]
Wrightsville Beach, NC 28480 email: [e-mail]

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: NOT
Address of Property:
t ` '
1✓r�ri►i nC r�l, u c 2T
✓ ,
(Lot or Street #!Strl
If)
Agent's Name #: lG 11
Agent's phone #: V' L�1 r 5aj-
or Road, City & County
o,�
Mailing Address:
hereby certify that 1 ovin 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 (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION ff
A)!
I understand that a pier, dock, mooring pilings, breakwater, boa ouse, 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)
ire
Print or ype Nam
Mailing Address
City/StatefZ'
Telephone Number
I AMu4 ;1V17
Date
Pr party O Informations
Print or Type Namb
?03
Mailing Address
A,�1„P�� y<< 1IrD
City/State/Zip
Telephone Number
Date
Revised 6/18/201;F—CEiVED
-(:;M WILMINGTON, NC
.A 2 0 2017

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 900 -9#Q
y) lrtY� Ile
Address of Property: �✓>1?kl nCn /] ✓e •
(Lot or Street #, Street or Road, dity & County
Agent's Name #: Mailing Address:
Agent's phone #:
hereby certify that it own property adj.acent to the above referenced propery. 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.
t! z 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 (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certifi Mail.
WAIVER SECTION t
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.
(Property Owner Information)
�re
Print or type Namef
Mailing Address
Pp7)KJ# i M �1
nCijtyylSt'/a�)Dtel Z�
jTeleph0— one Nu� ber
1&)Mt# �Vl�
Date
(Adjacent Property Owner or nation)
Sign ure
A" 41,"d s
Print or Type Name
10- -4 lw�- /)"/
Mailing Address
City/State/Zip
Telephone Number
M", -)�j7 RECEIVED
Dale DCM WILMINGTON, NC
Revised 611812012
2 0 2U1 r