75864D - Simpson

?? UAMA / ^DHEDUE & FILL NO. /)864
GENERAL PERMIT Previous permit # A B C
New —'Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As auth rized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission In an area of environmental concern pursuant to I SA NCAC // 1
(DRules attached.
Applicant NameJ_i� S 0� Project Location: County_ runSwtCAC-
Addressp
-7 10l D��►k _ I � K0� Street Address/ State Road/ Lot #(s) �'J � w' eitU'\
City____- MVnre __ State ZIP ri VC
Phone # ('`Y)�� — 3U _Mall �!�_ Subdivision
MAKI ty. �(qtl
Authorized Agent �.. Ci ZIPDcw tom">0PTA *S DPTS Phona� �3624 River Basin L.ti"ber
Affected ❑ HHF ❑ iH D USA Cl N/A
AEC(s): O OEA Adj. Wtr. Bodytl'�Q� St ou�l net /unkn)
D PWS: J
ORW: yes 16ro) PNA yes / no Closest Maj. Wtr. Body —
Type of Project/ Activity ^611 UO 4v 914-V
Pier (
Fixed
Road
Fingei
Groin
,CB.lkh
Basin,
Boat i
Boadi
Beast
Othei
Shore
SAV:
Moral
Photc
Waive
pia 11, A l i ie.r e.xte-t\ S 411 ov\ Jane
r (Scale:
..
■
■■
r�i■i■M■■
bIN
S �
■�1
�■■
■
■
-
r
W
1!
!" iitfi
! =7
IPA
■■■■■■
■■■
■■■■
■■■MEMOS
■■
■�■0L
11
!►'A
No
■■■
ISM
O
tt■■■i■i■■■■■■■
1� , a
.
'
■
■■i
■i
!
■►var�
Iw�
.
■■■■■■■N■■■■■■'
tan
_Y■
C_
■■■■
,
11r■
la`inw�iV
■
lit
,�/�
`i.■i�+�
■
■■
(�w�W��,ra
■
ii■iu
�IL
F''
■
■■■�
1
�
►y
..
.<
<�i■
■■■■
■■■�y
RI■li�'
Y110
ii11�.
A,�
r
I�■■YY
■r
�:1•�
�J".�rc:.t/��
■■■■il
481;
i1�a■
�i�.�f
�,��,
ti
SEEM
Ems
■
A8111,ME
■■sill■■�
NONNI
Mk
am
MEMO
... A
not sure yes
:Orium: n1a yes no
ye
m
r Attached: yesii uZi
MEN
r
�—I,
MEMMEMEMENE
..
EMO
I
`1
I
■■■■
■■i■■■■■
1
�i1�/lfili
I11
■■■■i■■
i■
t
,
t`■���!1�■
�:
MEN
No
—Mi
. •
�;���1l:a
.
■ .
�ME■
�i■■M
,
I�
d
w■�■
i
l
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions At
��Il1�.RA1R:�ti�■�>o
Agent or Applic
N
Application Fee(s)
S e
e
n ote on back re arding er B in rules.
Pd
r An 1r ,C -t' e M— m I to a1 f u
av►4 Qt r tl rtluwov\ S
MOWP1� r� r,ll'nl..} +j, t In
read co pliance statement on back of permit
- - ----_ _-----CCQQQh�leck#[�
Perms fficer' nted Name —
Signatur
Issuln Date
Du"
Expiration Date

CAMA / .. DREDGE & FILL No. 75864
GENERAL PERMIT Previous permit # % B C °
New El Modification LICompiete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality � + Z CO
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
Applicant Namep Aky �'
f S ()�
Address 7 f o) 1'V�ocq'tn M)11 P-01,
City Monroe, State ZIP_�91 i
Phone # (IPY) d9l " 3itl—i_Mail ---
Authorized Agent M-I/'1 nQ,
Affected ❑ CW `i W 'X PTA �,I�S ❑ PTS
AEC(s): ❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
GAgent� or Applticanr6t Printed�Nadme
&L5 u, Ai+
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
n ❑ Rules attached.
Project Location: County %�,f-LAr%swtCA<—
Street Address/ State Road/ Lot #(s) 3 re)116 to
ri ve-
Subdivision
City ig ZlP a8y&57
Phone # (q D ) �aJ ".Vi2 ( River Basin L—u rAb ex,
Adj. Wtr. Body M On-t or-.- x �1 S1 Vq tl nat man /unkn)
8&V) L,l ri' n Vj uf- M tt1`
Pented Name
ra
Signatur
30 27/3 a aoc;�v
Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: S-1-noon
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized���--
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits J
necessary for the following proposed development:
at my property located at 3Cb.Z
in &,gJCfl County.
1 furthermore certify that I 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:
S gnature
Print or Type game
D w ►�
Title
Date
This certification is valid through _/__-V /x_
N

So

crock
4/1/2020
4/1/2020 1 Maritech, LLC
Fredericka Goldberg
Bank of America
2411
$ 400.00 GP #75871D
BB rct. 10858
4/1/2020
4/1/2020 !Grice Construction of Brunswick Cour James & Ann Casey
BB&T
13703
$ 200.00 GP #76236D
BB rct. 10857
4/1/2020
4/1/2020,Grice Construction of Brunswick CouiiTwiford Family Trust
BB&T
13705
$ 200.00 GP #76234D
BB rct 10854
4/1/2020
4/1/2020 Grice Construcion of Brunswick Coun Kenneth Johnson
BB&T
13706
$ 200.00 GP #76109D
BB rct. 10853
4/1/2020
4/1/2020 AMW Docks and Marine Construction Bob Branan
BUT
5770
$ 200.00 'GP #75854D
BB rct. 10852
4/1/2020
4/1/2020 B and B Coastal Construction Corp
Longleaf Pines
(Jill
Wells Fargo
1131
$ 400.00 iGP #76279D
BB rct. 10914
4/1/20201,
4/1/2020; 1B and B Coastal Construction Corp
Marie Ronnion Rev. Trust
Wells Fargo
11281
$ 400.00 GP #76281D
BB rct. 10917
4/1/2020
4/1/2020 B and B Coastal Construction Corp
'DaVID Tendler & Sausan
Pratll Wells Fargo
1130
$ 400.00 GP #75803D
BB rct 10915
4/1/2020
4/1/2020 B and B Coastal Construction Corp
Tatiana McCuen
Wells Fargo
11291
$ 400.00 !GP #76280D
BB rct. 10916
4/1/2020!
4/1/2020 !Allied Marine Contractors LLC
Alex Simpson
First Citizens Bank
8794
$ 600.00 GP #75864D
BB rct. 10406
4/1/2020
4/1/2020 Allied Marine Contractors LLC
Bryan Beddingfield
First Citizens Bank
8797
$ 400.00 GP #74648D
BB rct. 10407
4/1/2020
4/1/2020 Allied Marine Contractors LLC
Jonathon Adams
First Citizens Bank
(First
8793
$ 200.00 !GP #75861 D
iBB rct. 10808
4/1/202011
4l1/2020IAIlied Marine Contractors LLC
Randy Moffitt
Citizens Bank
8798
$ 200.00 IGP #74649D
BB rct. 10405
4/1/2020
4/1/2020 Allied Marine Contractors LLC
Lisa Moulton
First Citizens Bank
8795
$ 200.00 !GP #75859D
BB rct. 10403
4/1/2020'
4/1/2020 Pattishall Construction LLC
David Pattishall & Kim Davidsc BB&T
2180
$ 600.00 'GP #76222D
JD rct. 10328

rJ
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to / SQ 's
property located at 3ma (G'n-(Name of Propefty Owner)
(Address, Lot, Block, Road t���
on in Ci�,�/ N.C.
( aterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
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)
6 L� I IC 6eoJ
mk- -e 1 �014o"
Wc 1, ticw hA6/
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.), t e6 Y1off�
I do wish to waive the 15' setback requirement. QPP\
�140JI do not wish to waive the 15 setback requirement.
z;
(Prope O er Information) (Adjacent Property Owner Informati n)
Sig {{ /� Signatuw
Print or T pe Name Pnn r Type Name
Mailing Afac'A­- $ii0 MailingAddkreSTs 1�^ lUc z e Y6
City/St/at�el m/Zip City/Staatte/Z' 1
-p V Ci ��
Telephon N ber/email address Telephone Nu er/email address
'7y. z40 2�
Date Date* '
`Valid for one calendar year after signature* (Revised Aug. 2014)
kn

■ Complete items 1, 2, and, S
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: n
,Suta�ufl K.vj4�n�%vol�l :W�'� r f.
&ope ?
6100'J
A. Signature 4 :
El Agent'
X��` ❑ Addressee
B. Received by (Printed Name) C. Date of Delivers
D. Is delivery address different from item 1?
If YES, enter delivery address below:
Yes
0 No
3. Service Type ❑ Priority Mall Express©
❑ Adult Signature ❑ Registered MailT`"
❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted
Certified Mail® Delivery
9590 9402 3952 8060 7433 42 Certified Mail Restricted Delivery ❑ Return Receipt for
❑ Collect on Delivery Merchandise
'� 3.. O Collect on Delivery Restricted Delivery ❑ Signature ConfirmationYM
le _ i _ ,w t....,.,4. . Trn c+f r frn cAt't//(` R lahPl1
2, 'A", ., -0 Signature Confirmation
7 01, 7 3380 0000 8631 11 Jr-4 )stricted Delivery Restricted Delivery
.r
PS Form 3811, .July 2015 PSN 7530-02-000-9053 Domestic Return Receipt