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51,CAMA %DREDGE & FILL
GENERAL PERMIT Previous permit # A B C( D
New _ Modification Complete Reissue CPartial Reissue Date previous permit issued
As aut orized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC V
I ` ules aL=c1Wd.
Applicant Name h Project Location: County
Address V in Streets Address/ State Road/ Lot #(s)
City my� State�L ZIP p11) l�� 5 � 1
Phone #10—)1C_-1no -,57�%g t-Mail Subdivision G l I
Authorized Agent City ZIP
Affected ElCw PTA )4S PTS Phone # ( River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body at man unkn
❑ PW
rt Closest Maj. Wtr. Body
ORW: yes t" no PNA yes / no
Type of Project/ Activity ' ^i
Pier
Fixe,
Floa
Fingi
Groi
Bulk
Basir
Boat
Boat
Beac
t I
Shor
SAV
Mon
Phot
WaiN
(Scale: ! )
—Elm
Platform,(s
ing Platform(s)
„: length..
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SEE
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l'
%Was
■■■ME
MEMO■■■■■■■■
■■■■E■■■■■■■■■■■■■■
ramp
w■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
-iBulldozing
mom
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N■■ill■■410E
/line
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Length
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yes
10iii
COME
11"EMMERME
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r Attached: Yes
A building permit may be required by: j
( Note Local Planning jurisdiction)
Notes/ Special Conditions
�ent or Applicant rinted Name
ai l e ** Please r fiance statement on back of
_1
❑ See note on back re g rding River Basin rules.
n IA-� IV i •,o I-H I
-4 z� 0
Application Fee(s)
Check # Issuing
IJ
Date
,,F o-9
/I "PJ5- day
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner. GG45fiy 1(�- 4- 11N0A )3 (=ASGy
Address of Property: S"re EEC
(Lot or Street #, Street or Road, City & County)
Applicant phone #: 9 19 - 9 aa- `i `l8l Mailing Address: ^%o.1 PATE7ow)/ ke>A1b
Ga�-ns 13�1�o tUG A-75-2
I hereby certify that I 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
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.net/contact_dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.)
T I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property On Information)
Signature
L�n/1>q S . CA-SEY
7Z►�y n��u� i3 - t�sey T�
Print or Type Name
Mailing Address
(ft>1.aSt3 D/LD NL A-7573 a
Citylstate/zip
q l g- 9
Telephone Number
1-ate- 201-)
(Riparian Property Owner Information)
Signature
y
Print or Type Name
'3 1,5 X� 4 om 04vz-
Mailing Add►ass
61-AX7,0N,7SZe
CitylStatel7io
Telephone Number
Date Date
gig- 2C17
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Rrty�c;vd R , C�SEX /Z f- ZiA dA R , < iAStGY TfL
Address of Property: %y ) LI � �r2g r "r 5�,2>c C,Ty / / --
(Lot or Street #. Street or Road, City & County)
Applicant phone #: (" i J - -? `►- & 5-3�
Mailing Address: 166 PA"tIE Tow N -Ro.4 D
roCA1�4oR� IJ& a75,70
I hereby certify that I 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.
1' 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. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact-dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.)
a
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop Qwn�er Information)
Signature
)24yN,oN� i3 , CA � P,)y _J�Z
Print or Type Name
Mailing Address
City/State2ip
Telephone Number
D`1- 2�R- �[v �'7
Date
(Riparian Property Owner Information)
a
Signature
on0Q- J , 11-7; P_h
yt
Print or Type Name L
707�' t/fA
Mailing Address
City/State2io
Telephone Number
Date
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �Ay,,,o,,, p E, + Lip. o q 0, CAS F ma's
(Name of Property Owner)
property located at 1 D � �I "1 -LbS'T�-� ET
(Address, Lot, Block, Road, etc.)
on CAHO� , in S'- iZF C,1r/ NC , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatjork
r 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.)
�- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Qwrier Information)
(Adjacent Property Owner Information)
Signature L/n/d ,$ 13,
Sign e
S
RaymbNn 13, c4siax - is
D YA V1 d
I /�I �� j1
Print or Type Name
/2,.4 d
Name
Prim or r--
/ C l ► ' `
5 �y e e
Mailing Address
Mailin Address
(jDOSRoR-o NL
City/State/Zip
City/State/Zip
�t17- UO -q'f9l
Telephone Number/email address
Telepho a Number/email address
07- �81- 3-00
o �-
Date
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to (v4yw .,� L �N�g Cas c� s
(Name of Property Owner)
property located at 7J �� �{ � 7=" S"-rrZe �r
(Address, Lot, Block, Road, etc.)
on L in cxrz , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
J----.� 1- �►
P
Signature z--,W DR Ig , A5
j? y '> u , (fAm;t
Print or Type Name
Mailing Address
NVL �� s3a
City/State/Zip
115- `l �o-9y�1
Telephone Number/email address
0?- 38 -;Lbi7
(Adjacent Property Owner Information)
Sig �ptur n
A0E7TL /O wG2S
Print or Typ /JName
� r -6_u&& D /t_ bAl oo/L
Mai4�l'ng Address
(i 4 �LT- 4.1
City /'S eat t /Zip
Vllq - 300
Telephone Number/email address
7 a 9. ;42 / 7
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 0 1 - IS? - a-f 17
Name of Property Owner Applying for Permit:
i3 . (:�4SEVje Lila-OA a- CAsF,-Y-
Mailing Address: (�
IOG N-m7ot-M
GyL63 13 o►Za N (- X753 b
I certify that I have authorized (agent) -J;u #TO*,,) y opf to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) S&A W,4L L ,
at (my property located at) 70 7 4 7+4 VT12r.cT .S ukp Crry N c
This certification is valid thru (date) 16- a �- 9617
N
Property Owner Signature " Date
NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: t Ll
Date -
Describe
/
Describe below the A81TAT 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)
impact amount)
temp impacts)
amount)
CN\j
-� '5
--? S)�
Dredge ❑ Fill Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Date Received
I Date Deposited Check From Name
Name or Permit Holder
Vendor
Check Number
I Check smount
I Permit Number/Comments
Receipt or RetundrReallocated
8/10/2017
H5 Construction
Paul Larkin
BB&T
2046
$200.00 GP 69325D
BS rct., 4643D
8/10/2017
McPherson Marine Services
James Banks
First Citizens Bank
1047
$200.00 GP 69367D
BS rct. 4644D
8/10/2017
Overbeck Marine Construction Inc
Chris Strickland
SunTrust
4884
$200.00 GP 69380D
CS rct. 4754D
8/10/2017
Island Contracting Inc
G.C. Huddle
BB&T
28051
$200.00 GP 69384D
TM rct. 4648D
8/10/2017
Coastal Dredging LLC
Raymond and Linda Casey
BB&T
5682
$400.00 GP 69103D
TM rct. 3581 D
8/10/2017
Graycliff Enterprises Inc
Middle Island POA/Charles Hardee
Bank of North Carolina
87076
$400.00 GP 69382D
TM rct. 2646D
8/10/2017
Coastal Marine Piers Bulkheads LLC
Preston E. Davenport Jr.
Wells Faro Bank
21591
$200.00 GP 69386D
CS rct. 4756D