69143D - Cape

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'ENERAL PERMIT Previous permit # A B C
New I ]Modification t ]Complete Reissue LIPartial Reissue Date previous permit issued
As authorized 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 I SA NCAC O �f� /G UU
/ � Quw�c
]itules attached.
Applicant Name Cla(V. r Af -�./tS(t �qu`�'�. Project Location: County d4nuVCX-
Address ` 2 3 5 G�nnr+r�L^� �� _ W •+bo(N/Street Address/ State Road/ Lot #(s)
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Phone # d (U ) 332 - y Y E-Mail _ Subdivision
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Affected OEA � HHF U O IH UBA U N/A
AEC(s): Adj. Wtr. Body\\-Y--- _ C(ee,k tat man Junkn;
PWS:
r Closest Maj. Wtr. Body _. .F...
ORW: yes (no) PNA yes /no
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Type of Project/
Pier(dock)length
Fused Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
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SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: l j' O ` �J� n4
( Note Local Planning jurisdiction)o '1 // J
Notes/Special Conditions Jt�V �Q tJ�j�-► , 166e) cul all 0
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Issuing Date Eration Date

[ CAMA / I DREDGE & FILL
GENERAL PERMIT Previous permit #
New Modification _]Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized 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 J�l. �bt�tiJ
Co
Applicant Name C—G d-)c ?U C
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f'iy
/J� 1 Rules attached.
Project Coun t'(aIna Vf'<
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City State Al( ZIP 403 T,
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Phone # ( ) River Basin
Affected
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❑ N/A
Adj. Wtr. Body \`Wt- ' �me.k Cat ')man /unkn)
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
q()o
Application Fee(s) Check #
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Permit icer's Prippd Nam
1
Signature
(0 kn1
Issuing D e I Expiration Date

WIRO
Date Received
Date Deposited Check From (Name)
Nome of Permit Holder
Vendor
Check Number
Check amount
Permit Number/Comments
Receipt or Refund(Reallocated
6/6/2017
North American MO/Enc Reed
Eric Reed
Banc First
113533255
5300.00
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SM Cape Fear
Public Utility Authority
Stewardship. Sustainahility. Service.
May 16, 2017
Mr. Brooks Surgan
Division of Coastal Management
North Carolina Department of Environmental Quality
127 Cardinal Drive Ext.
Wilmington, NC 28405
Subject: CAMA General Permit Request
Pump Station 10 Force Main Replacement Project
New Hanover County, North Carolina
To Whom It May Concern:
Cape Fear Public Utility Authority (CFPUA) is submitting information for a CAMA General Permit for construction
activities associated with the proposed Pump Station 10 Force Main Replacement Project (Figures 1 and 2).
Project Purpose
CPFUA operates and maintains a large wastewater collection system. To maintain the integrity of the collection
system, CFPUA has implemented a robust Asset Management Plan that influences all activities and decisions of the
Authority. The Pump Station 10 force main, which is one of the key assets for CFPUA, conveys wastewater from
much of the downtown area of the City of Wilmington via a 30-inch force main to the James A. Loughlin (Northside)
Wastewater Treatment Plant (WWTP). The Asset Management Plan indicated that the probability of failure for this
force main was high based on the condition and age of the force main. Additionally, due to size, location adjacent to
surface waters, and a lack of redundancy for event management, the consequence of failure is also high. Therefore
the primary purpose of the proposed project is to implement the results of the CFPUA's Asset Management Plan to
prevent a serious failure of this key asset and to protect the environment by improving collection system reliability.
This will be accomplished by replacing the 49 year old Pump Station 10 Force Main. It is important to mention, in the
event of a break on the new force main, the existing force main could be put back into service as a redundant route
to prevent a multi -million gallon spill to surface waters. This option is not part of this project but will be looked at as an
option for future projects.
Project Description
The alignment of the proposed force main starts near Pump Station 10 and follows the existing gravity sewer line
(progressing east and then northeast) for approximately 975 feet. At that point, open cut trenching ends and
horizontal directional drilling begins (Plan sheet OOC-02). The directional drilled segment crosses underneath Smith
Creek and the Martin Luther King Jr. Parkway (MLK Jr. Parkway), passing between the bents of the MLK Jr.
Parkway, and underneath the entrance/exit ramp. Directional drilling will terminate inside the fence of the WWTP
(Plan sheet OOC-03). From this point the open cut trenching will resume and follow the WWTP plant road until
connecting to an existing force main. The total length of this force main route is approximately 4,000 linear feet,
including 1,900 linear feet of pipe installed by horizontal directional drill methods.
RECEIVED
DCM WILMINGTON, NC
MAY 3 0 2017

Environmental Documentation
An Engineering Report/Environmental Information Documentation (ER/EID) was approved and awarded funding by
the Division of Water Infrastructure on March 10, 2017. As stated in the letter of approval, the project is below the
minor construction activities outlined in 15A NCAC 01C.0408 and was deemed exempted from inter -agency review
and preparation of additional environment documents is not required.
Agency Correspondence
Cultural Resources
This project was reviewed on the SHPO website (http://gis.ncdcr.gov/hpowebn and the National Register of Historic
Places (NRHP) and no known structures or historic districts were located within the Study Area,
Federally Protected Species
HDR obtained and reviewed a list of federally protected species for New Hanover County from the U.S. Fish and
Wildlife Service (USFWS) website (http://www.fws.gov/raleigh/species/cntylist/new hanover.html), which was last
updated on April 2, 2015. HDR conducted on -site visits in August 2014 and determined the Study Area only exhibits
habitat for the northern long-eared bat and no other federally -listed species. The northern long-eared bat roosts
singly or in colonies underneath bark, in cavities or in crevices of both live and dead trees (typically > 3" dbh) and the
Study Area has areas of forest that meet these criteria. A USFWS IPAC self certification letter was submitted on May
2, 2017 (see attached).
Landowner Notifications
Landowner notifications were mailed April 20, 2017. Notification letters and delivery notification confirmation is
attached to this memo.
We are requesting a CAMA General Permit through your office to construct the proposed project. If you have any
questions or require additional information after your review of enclosed information, please contact me at
craig.wilson(o)cfpua.org, or (910)-332-6474.
Res ctfull/y,
�G
Craig ilson, PMP
Sr. Project Manager, CFPUA
Attachments: $400 Payment to North Carolina Department of Environmental Quality
Figure 1. USGS Topographic Quad: Castle Hayne
Figure 2. Project Vicinity Map
Figure 3. Environmental Features
Regulatory Review Plans (resized to 11" x 17")
Notifications to adjacent landowners/delivery confirmation
USFWS IPAC Self Certification Letter
RECEIVED
DCM WILMINGTON, NC
MAY 3 0 2011
CFPUA Page 12

ra Ir+ Figure 2
Cape Fear Public Utility Authority ; Pump Station 10 Force Main Replacement I CAMA General Permit Application

Legend Z..r- - T
—� Proposed 30" FM Replaceme • 1 , ! ,
O Pump Station 10
J
1
• f .
• 1 1 7 • • • • r • •
l
•
Topographic Quad: Castle Hayne
IM)l
Figure 1
ority I Pump Station 10 Force Main Replacement I CAMA G p"cation
DCM WILMINGT N, NC
MAY 3 0 2017

27
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_ Legend -,
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Hydrant
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.` ® Pump Station
��So Force Main(Proposed)
• � t
Force Main
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April 24. ZM 7, 10.52 ni 0c60,.d. Leh with trd-dual WILMiNGTON. NC 28401
Available Actions
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See Less /\

CERTIFIED MAIL
RETURN RECEIPT REQUESTED
April 20, 2017
Break M LLC
1508 Military Cutoff Rd
Suite 204
Wilmington, NC 28403-5730
To Whom It May Concern:
Cape Fear Public Utility Authority (CFPUA) is applying for coverage under a CAMA General
Permit to replace an existing pipeline as shown on the attached project map. The specifics of the
proposed project are described below:
Replace an existing force main in -kind via trenching along One Tree Hill Way, then traversing an
undeveloped parcel located behind the 23`d Street Building commercial property; the line then
becomes a directional drill segment underneath Smith Creek and MLK Jr. Parkway; passing between
the bents of the MLK Jr. Parkway and underneath the entrance/exit ramps. The directional drill
terminates inside the fence of the James A. Loughlin Wastewater Treatment Plant (WWTP). This
project is adjacent to four property owners. The project is located within the City of Wilmington
close by the intersection of Martin Luther King Jr. Parkway (US Highway 74) and North 23`d Street
in New Hanover County.
As an adjacent riparian property owner to the project described above, CFPUA is required to notify
you of the project in order to give you the opportunity to comment on the project. Please review the
attached information.
Should you have no objections to the proposed activity, please check the appropriate statement
attached and sign, date, and return within 10 days to:
Mr. Craig Wilson, Project Engineer
Cape Fear Public Utility Authority
235 Government Center Drive
Wilmington, NC 28403
craig.wilson Lfpua.org, or (910)-332-6474
Should you have objections to this proposal, please send your written comments to:
Mr. Brooks Surgan, DCM Field Representative
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
This notification is being sent to you to adhere to DCM's permitting requirements, per 15A NCAC
07H .1600. The Division of Coastal Management must receive written comments within 10 days of
receipt of this notice. No response within 10 days of receipt of this correspondence will be
interpreted as no objection.
RECEIVED
DCM WILMINGTON, NC

If you have any questions on this project, please contact Craig Wilson with CFPUA at 910-332-6474
or email at [e-mail]
Sincerely,
Jessica Tisdale, CE
Environmental Scientist
I have no objection to the proposed project as described in this correspondence.
I have objections to the project as presently proposed and have enclosed comments.
Signature
Date
Comments:
DCM WILM NIG ON, NC
MAY 3 0 2017

Tracking Number: 70163560000079385679
Product & Tracking Information
Postal Product:
First -Class Maii`
DATE 8 TIME
Features -
Delivered
See Available Actions
LOCATION
April 24, 2017, 11:03 am Delivered, Left with Individual WILMINGTON, NC 28403
April 22. 2017. 7:31 pm Business Closed
April 22, 2017. 9:41 am Business Closed
0
0
_=ii 22.2017. 7:40 am Arrived at Unit
K0
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<
No m
v 00
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0
WILMINGTON. NC 28403
WILMINGTON. NC 28403
WILMINGTON, NC 28403
See More \/
Remo

CERTIFIED MAIL
RETURN RECEIPT REQUESTED
April 20, 2017
Cameron Company LTD
PO Box 3649
Wilmington, NC 28406-0649
To Whom It May Concern:
Cape Fear Public Utility Authority (CFPUA) is applying for coverage under a CAMA General
Permit to replace an existing pipeline as shown on the attached project map. The specifics of the
proposed project are described below:
Replace an existing force main in -kind via trenching along One Tree Hill Way, then traversing an
undeveloped parcel located behind the 23`d Street Building commercial property; the line then
becomes a directional drill segment underneath Smith Creek and MLK Jr. Parkway; passing between
the bents of the MLK Jr. Parkway and underneath the entrance/exit ramps. The directional drill
terminates inside the fence of the James A. Loughlin Wastewater Treatment Plant (WWTP). This
project is adjacent to four property owners. The project is located within the City of Wilmington
close by the intersection of Martin Luther King Jr. Parkway (US Highway 74) and North 23`a Street
in New Hanover County.
As an adjacent riparian property owner to the project described above, CFPUA is required to notify
you of the project in order to give you the opportunity to comment on the project. Please review the
attached information.
Should you have no obiections to the proposed activity, please check the appropriate statement
attached and sign, date, and return within 10 days to:
Mr. Craig Wilson, Project Engineer
Cape Fear Public Utility Authority
235 Government Center Drive
Wilmington, NC 28403
craig.wilsonAcfpua.org, or (910)-332-6474
Should you have obiections to this proposal, please send your written comments to:
Mr. Brooks Surgan, DCM Field Representative
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
This notification is being sent to you to adhere to DCM's permitting requirements, per 15A NCAC
07H .1600. The Division of Coastal Management must receive written comments within 10 days of
receipt of this notice. No response within 10 days of receipt of this correspondence will be
interpreted as no objection.
RECEIVED
DCM WIL.MINGTON, NC
MAY 3 0 2017

If you have any questions on this project, please contact Craig Wilson with CFPUA at 910-332-6474
or email at [e-mail]
Sincerely,
Jessica Tisdale, CE
Environmental Scientist
I have no objection to the proposed project as described in this correspondence.
I have objections to the project as presently proposed and have enclosed comments.
Signature
Date
Comments:
RECEIVED
DCM WILMINGTON, NC
MAY 3 0 2017

Tracking Number: -,1-83580000076385882
Product & Tracking Information
Poesy shod.._:
:A.t a Ityt
Apri125 2017, 3M Wn
Available Actions
—LLt 'IaM
Qtllvcic7, Indivvd kV Pickod UV at Postal
:aaity
Delivered
See Awml:jL— Actions
1NILMINOTUN, NC 2M3
YlL-6111.3TCN. NC: 794:16
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RECEIVED
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
April 20, 2017
NCDOT
Nick Drees, District 3
300 Division Dr.
Wilmington, NC 28401-8883
To Whom It May Concern:
APR 2 4 2017,
DISTRICT 3
Cape Fear Public Utility Authority (CFPUA) is applying for coverage under a CAMA General
Permit to replace an existing pipeline as shown on the attached project map. The specifics of the
proposed project are described below:
Replace an existing force main in -kind via trenching along One Tree Hill Way, then traversing an
undeveloped parcel located behind the 23`d Street Building commercial property; the line then
becomes a directional drill segment underneath Smith Creek and MLK Jr. Parkway; passing between
the bents of the MLK Jr. Parkway and underneath the entrance/exit ramps. The directional drill
terminates inside the fence of the James A. Loughlin Wastewater Treatment Plant (WWTP). This
project is adjacent to four property owners. The project is located within the City of Wilmington
close by the intersection of Martin Luther King Jr. Parkway (US Highway 74) and North 23`d Street
in New Hanover County.
As an adjacent riparian property owner to the project described above, CFPUA is required to notify
you of the project in order to give you the opportunity to comment on the project. Please review the
attached information.
Should you have no objections to the proposed activity, please check the appropriate statement
attached and sign, date, and return within 10 days to:
Mr. Craig Wilson, Project Engineer
Cape Fear Public Utility Authority
235 Government Center Drive
Wilmington, NC 28403
craig.wilson(a)cfpua.org, or (910)-332-6474
Should you have obiections to this proposal, please send your written comments to:
Mr. Brooks Surgan, DCM Field Representative
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
This notification is being sent to you to adhere to DCM's permitting requirements, per 15A NCAC
07H .1600. The Division of Coastal Management must receive written comments within 10 days of
receipt of this notice. No response within 10 days of receipt of this correspondence will be
interpreted as no objection.
RECEIVED
DCM WILMINGTON, NC
APR 27 2017

R
RECEIVED
APR 2 4 2017
DISTRICT 3
If you have any questions on this project, please contact Craig Wilson with CFPUA at 910-332-6474
or email at [e-mail]
Sincerely,
Jessica Tisdale, CE
Environmental Scientist
I have no objection to the proposed project as described in this correspondence.
�I have ob-ections the project as presently proposed and have enclosed comments.
Signature
y-25-17 Date
Comments: iPfrz 5C 5-el
RECEIVED
DCM WILMINGTON, NC
APR 27 2017

To Whom It May Concern:
North Carolina Department of Transportation (NCDOT) has no issue with performing maintenance work.
However any new proposed lines will need to go through the encroachment process(The yellow line).
This would include the proposed force main. If any further information is required feel free to contact
me.
M
P)2
K. Drees
55
RECEIVED
DCM WILMINGTON, NC
APR 27 2017

RECEIVED
APR 2 4 2017
DISTRICT 3
7 7 Legend
N
Hydrant
Manhole
Ops Pump Station
Force Main (Proposed)
3� Force Main
Gravity Sewer
Water Line
Parcels
0 150 300 600
Feet
& 7
Begin Directional
k 4
Dr ;I
V
•
4.
New Hanover
Humane Society
Tie Into Existing,
N 23rd St Force MainjW_
An
3> Alternative 1 -Alignment 1 (Preferred)
7.0
V Figure 3
bp iz 0
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Cape Fear P,bh, UtOy Authority I Pump SWt,,, 10 force M­ Replacement I Engineering R,qorVEn,­,,enta1 Information Document

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Surqan, Brooks R
From: Tisdale, Jessica <[e-mail]>
Sent: Friday, June 02, 2017 10:06 AM
To: Surgan, Brooks R
Cc: Williams, Eric (Sunset Beach)
Subject: RE: CAMA General Permit Request for Pump Station 10 Forcemain Replacement Project
Here are the receipts from the post office.

3
U.S. PostalService"'
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
For delivery information, visit our wefasite at wWrv.t,sps.con
P5 farm 3800. Apr'! = r' 1i aa` SftROverwfor Instruction$
U.S. Postal Service"
CERTIFIED MAID' RECEIPT
`' Domestic Rfail Only
rot dt-,41%.rery information, visit Our WC-bSite at W&VWttsps r.0171 �.
1111111111111srrw u1VJ*d 4i 1rAXK&1.1M
PS form 3600, April 201.5 P it: 7Sxlorc w;` See Fleverw for Instructions
U.S. Postal Se vi
CERTIFIED M)
Domestic 41dil Only
For delivery information. vi
U.S. Postal Sery
CERTIFIED M
Domestic blail Only
For delivery information,
f�fas®af� �rnrfanrra,,..
PS Form 3800. April 2015 f SP4

From: Surgan, Brooks R [mailto: brooks. [e-mail]]
Sent: Friday, June 02, 2017 8:32 AM
To: Tisdale, Jessica
Cc: Williams, Eric (Sunset Beach)
Subject: RE: CAMA General Permit Request for Pump Station 10 Forcemain Replacement Project
Jessica,
Can you send me scanned copies of the certified mail receipts please.
Brooks R Surgan
Field Representative
Division of Coastal Management
North Carolina Department of Environmental Quality
910 796 7270 office
Brooks. surgan(a)ncdenr.gov
127 Cardinal Drive Ext.
Wilmington, NC 28405
"'Nothing Compares
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Tisdale, Jessica [mailto:[e-mail]]
Sent: Thursday, June 01, 2017 10:51 AM
To: Surgan, Brooks R <[e-mail]>
Cc: Williams, Eric (Sunset Beach) <[e-mail]>
Subject: RE: CAMA General Permit Request for Pump Station 10 Forcemain Replacement Project
Brooks
Attached are the emails we have sent to Mr. Vassar, who is the owner responsible for the parcel owned by Daytime
Programming (Screen Gem Studios). We have had multiple communications via email, phone and in person meetings
regarding his signature on the letter (with or without objection). He has received all information about the project.
I think we have done our due diligence by addressing his issues.
Attached are the email communications. He has had many days over 10 days to sign the letter but has not returned it. The
noise of the project has been communicated by an in -person meeting with CFPUA and HDR representatives; it has been
very cordial. He has verbally said he will sign the letter but we have not received anything to date. I hope to get the letter
this week or next but not sure what to do if that does not happen.
Please let us know if this situation is within the bounds of holding you back from issuing the general permit. I feel it should
not.
Thank you,

Jessica
From: Surgan, Brooks R [maiIto: brooks.surgan(c)ncdenr.gov]
Sent: Tuesday, May 30, 2017 2:48 PM
To: Tisdale, Jessica
Subject: RE: CAMA General Permit Request for Pump Station 10 Forcemain Replacement Project
Jessica,
I just realized I referred to a Major Permit in my last email, what I really meant was a General Permit. I'll wait to hear
back about your meeting with the adjacent landowner.
Brooks R Surgan
Field Representative
Division of Coastal Management
North Carolina Department of Environmental Quality
910 796 7270 office
Brooks.surgan(@ncdenr.gov
127 Cardinal Drive Ext.
Wilmington, NC 28405
'Nothing Compares
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Tisdale, Jessica [mailto:[e-mail]]
Sent: Friday, May 26, 2017 2:21 PM
To: Surgan, Brooks R <[e-mail]>
Subject: RE: CAMA General Permit Request for Pump Station 10 Forcemain Replacement Project
HDR Employees:
Use the "Download Attachments" button after opening this message in Outlook to download attached files
Non-HDR Recipients:
If you are not an HDR employee and this is your first time using Slingshot click here and follow the prompts to set your
password.
Returning users click here to Download (files: 04_IFR SET 05-05-2017.pdf;)
Notice: The link in this email will only work for up to 30 days (as set by the sender). If you need access to these
files for longer, please download and save a copy locally. Recipients of forwarded emails WILL NOT have access
to the files using this link.

From: Tisdale, Jessica
Sent: Friday, May 26, 2017 2:15 PM
To: '[e-mail]'
Subject: CAMA General Permit Request for Pump Station 10 Forcemain Replacement Project
HDR Employees:
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CAMA_General_Permit Application_SUBMITTAL_05262017_No_Plans.pdf;)
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Mr. Surgan,
Attached you will find the portfolio pdf application of the permit we are requesting. I have placed paper copies in the mail
today. I will send the plans separate, as they are over 32 MB.
We have one landowner for the CAMA permit, Daytime Programming (Gem Studios), that is asking lots of questions
regarding the project. Once our engineers and CFPUA have had an in -person meeting with this landowner next Tuesday,
we will forward you the signed landowner notification.
Please call if you have any questions,
Jessica
Jessica Tisdale, CE
Environmental Scientist
ONMIEQ
19t 7•I01?
HDR
D 919.232.6654 M 919.360,8460
hdrinc.com/follow-us

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DREDGE & FILL �p \� A B C D
GENERAL PERMIT Previous permit # � Y
t�New Modification ❑Complete Reissue _Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources � f� �/�
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (; �T
% Rules La ed.
Applicant Name C` ' / �� Project Location: County
r
Address_ 5 1� tv A Street Address/ State Road/ Lot #(s)
City � 5' State AL -ZIP Q
Phone # (1 66 Z-� E-Mail Subdivision
Authorized Agent inFOGilifr4 City ZIP
Affected CW ElEW ❑ PTA �S p PTS Phone # (_ '- /'ver Basin �-
AEC(s): OEA ❑ HHF ElIH ElUBA El N/A Adj. Wtr. Body �� w an nkn
PINS:�". ,
ORW: yes / no PNA yes / Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) len h
Fixed Platfori
Floating Plat
Finger piers
Groin length
numbe
Bulkhe�a Ri
avg dist
max di
Basin. chann
cubic y
Boat ramp
Boathouse/ I
Beach Bulldc
Other
Shoreline Le
SAV:
Moratorium
Photos:
Waiver Atta,
(Scale:/"� �U I )
::SEE■
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)rap length
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A building permit may be required by: &� �C
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Pageht or Applicant Printe0ame -
Sighm a "Please read compliance statement on back
0 o;
f 0
Application Fee(s) Check #
Issuing Date
❑ See note on back regarding River Basin rules.
-- /Q /f.
Expiration Date

Date Received I Date Deposited
Chock From (Name)
I Name of Permit Holder
Vendor Check Number
I Check emmnt Permit Number/Comments
6!7/2017
Edward or Bonnie Gore
same
Sharonview Federal C L
3251
$200.00 GP 69140D
6/7/2017
Grice Construction
Peter Griffith
BB&T _
t66&T
11284
$200.00 GP 69238D
6/7/2017
Grice Construction
Frank Ward, Jr.
11282
t200.00 GP 69233D
6/7/26W'I
Holden Docks & Bulkheads
Town of Holden Beach
CresCom Bank
2996
$400.00 GP 69232D
6/7/2017
James or Mary Hartsell
-
same
— - - --
SunTrust
2173
--
$200.00 GP 231 D
69
6/7/2017
Grice Construction
_
Mom's Revocable Trust
BB&T
11283
$200 00 GP 69234D
6/8/2017
Jerry Enn_ett
Richard Stanley
Coastal Bank & Trust
641
$200.00 GP 69182D
6/8/2017
Paul or Christine Minervini
--
Rich Balot
Marine Federal Credit U
2216
$100.00�minor, 146 Oceanview Ln., NTB
6/8/2017
Frank R. Bellini
same
LG Federal Credit Unior
7239
-
- --
$200.00 GP 69141 D
6/8/2017
Carolina Bluewater Construction Co
Robert Purcell
_
BB&T
17781
$200.00 GP 69240D
6/9/2017
Will Richardson
Wrenn Patterson
BB&T
6735
$200.00 GP 69239D
6/12/2017
Permit Pals
Michael Ervin
CresCom Bank
1580
$400,00 major, 10 Monroe St., OIB BrCc
6/12/2017
Permit Pals
Julie Elkin Fisher
CresCom Bank —
1578
$400.00 major, 6 Monrose St, OIB BrCo
6/12/2017
Permit Pals
Alonzo Pringle
CresCom Bank
1579
$400.00 major, 8 Monroe St, OIB BrCo
6/1212017
Permit Pals
Michael Green
CresCom Bank +_
1577
$400.00 major, 4 Monroe St, OIB BrCo
6/13/20171
Allied Marine Contractors/Hal Fogleman
Louis Cox
First Citizens Bank
5734
$400.00 GP 69183D
6/13/201) 7�
Allied Marine Contractors /Hal Fogleman
Donald Waters
First Citizens Bank
5733
$600.00 GP 66324D
Receipt or Refund/Reallocated
BS rct. 4626D
SF rct_4269D
SF rct. 4266D
SF rot. 4265D
JD rct. 4264D
SF rct. 4268D
JD rct. 3869D
On! JD rct. 4209D
BS rct. 4629D
SF rct. 4272D
SF rct 4273D
SF rct. 4274D
SF rct. 4651D
SF rct. 4275D
SF rct. 4652D
J D rct. 3871 D
JD rct. 3870D

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: t') rf 7
Date: Describe below JHLIT'AT/disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
Habitat Name
TOTAL Sq. Ft
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
includes any
disturbance.
Excludes any
Disturbance
total includes
disturbance.
Excludes any
Choose One
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount)
Dredge ❑
Fill ❑
Both
Other ❑
D�
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to L o u k S God is
(Name of Property Owner)
property located at C hd 42- ) Q o� . ,
(Lot, Block, Road, etc.)
on �G �I , in �14AI P1, z-,,,�Q , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:
Mailing Address:
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 / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
I do wish to waive that setback requirement.
------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
(Riparian Property Owner Information)
Signature
J � Sc Ht.os S N/lzit,F
i 3/1
Print or Type Name
Telephone Number
Date

ADJACENTRIP �ItI vN PROt'ERIA 0 tit It -,1 \ I I III N I
(1 OR 1 Pll:lt tl(NIIt1NG 1'11JN(;.utio,4'll !I I Ito, I r I if )( %I I
I hereby certify that I own properly adjaceII1 1►► la4 (•7k
(Name of Property (honer)
property located at
(IA(. Block, Road, vie.)
can jt'Gt (<LG,L� .,.__..__,_.._....... , inN i
(Waterbody) (Town and/or County)
Applicant's phone if: Mailing Addresta:
Ile 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 / boatl►lt / boathouse
must be set back a minimum distance of fifteen feet ( I V) from my area of riparian acce"s unleas
waived by me. (If you wish to waive the setback. ,you must initial the appropriate blank
below.)
Ai/ I do not wish to waive
I do wish to waive that setback requirement.
-------- ----------------------------------------------------------------------------------------------------------
DE'SCRIPTION AND/Olt DRAWING OF PROPOSED DEVELOPMENT:
(To be f filed in by individual proposing development)
-- -----------------------------------------------------------------------------------------------------------------
(Inforrnation for Property Owner Applying (Riparian Property Owner Information)
for Perrnit)
5 g aturc
--
Mailing Address
Telephone Number
11:C"s(R19• s rews
5i L vtiArv* 5'�.N `
Print or 'I N lk Name
a I0t yfut 8,1t:,(,0
.Fvlcphonr Numhcr
Signature I)ate
Date

Y60 I-
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