75866D - Dollar

2�C-ItaNERAL
N-A / DREDGE & FILL
PERMIT pa ugVieissue
a—afflkl— Mo&i"tfon Complete Rc*swe
,k� try ttve State of Nonh Carchena. I?ePaJtmint of Envlronrnerw� Qua)rty
and the COastai Resources Cornmason sl an area Of ertvirw"mai concem pursuant to I SA NCAC
:' ,.; ; , () q B C C
f -ey) 1L ,elmd * _
Date previous permit issued_ �.
kulcs star
Applicant Name DW , Ijo I l 0.r Proiecc Location: Carty
Address � S we3�" SS �ca,�.al ��� y �' Street Addrraal Slice Rwd/ Lot ff(s) �
Gry L�1 �� StateVC, zip ; 9 ytp� Phone # (T�J� 7/ 7 � r--ma�1 Subdivision
C pv, 9 � 0 ' '�3 city fait k- 2Sta►.,� zip
Aut>1orl:ed Age" Kara � gyG S
C I CW
Afiected -
YV TA Es rTs Phone r (4 ) `� �l '{9� Z River Basin_
/
AJ`G(sj. C O[A HJHIF IM UTA N-A n— r „kr
<— Pvts
OKW: yes kAo ) PNA yes
Type of Project! Activity
Fired Platiormis) 11� _ .'� .
FiUJKJrgatb PrMt1g) J 2-1 WI f�L
Lr Y` p•orlt, —
ru Tiber
Bulkhead,' Rp*spncIrrh
svg distance oflsharr
nmm distxx• oRV,orr
Bu+n C�h
cubit yard,\
Sou rwrp \-
5"IfIcsrra, BasctA
Power Buillmong _
No 4,
Adl Wtr Body T I A IAj
Nnat na �
Closest Mal, Wtr. Body AZLL)
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TW-
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y
Uar 1 T j 1 1 1 AVi
SAV not sate Yes
Noruorarr n;a no Ka
Ph AI O--sue
Wa
ver Arrsrhod yes �[iio _ s 0(1ye
A hOOng vemdt may be mepu` wedd toy
( N(x* t oral Planning fur sdiction )
Notesi Special Conditions rUfL/S_ 0 � V , `zop
CGa1K 4^ 1• a��. lrxttj 4 1l 47 �—
At— Or Afpka-4 Pr ,,led Naas
P X"
S. rwkoft • • Piease read compliance statement on back of perms
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Apt
d
`
cl -1
all lu . Ll �+► 0
pf+vt
See note on back regardirl R".r Basin rules
Per-rriQfgeaf'g hix`�'
Sgnz-ure
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YCAMA / DREDGE & FILL
-. GENERAL PERMIT
Flew :]Modification DComplete Reissue
No. 75866 A B C
Previous permit #
E Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality —7N • 120O
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Name 1 t+� l ��) `a� Project Location: County 13rxn.! Jw �11L
Address S W es�- �sla,,ol �r� V Street Address/ State Road/ Lot #(s) S a M
City Oqk-�JOY4 State /JCIZIP 9 9 yb5
Phone # (I/L) u T 41112 E-Mail � Subdivision
Authorized Agent Kara M C p/'(t (o, 1 / 0 — �V " /'Z'City k �SIao r ZIP -3 Iu
J�l '
Affected ElCW XW
�TA ❑ ES ElPTS Phone # (RN0 )g T K5�lZ River Basin LuM Per
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body�ciYl S CA.610. (nat ma /unkn)
Pws: �..�,� �
LJ
ORW: yes) PNA yes / no Closest Maj. Wtr. Body
Type of Project/ Activity 1(,e49/4te +:I,)
Pier ( '*�
Fixed
Floati
Finger
Groin
Bulkh
Basin,
Boat i
Boath
Beach
Othei
Shore
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tr Attached: Yes ��iy:�llf■■EnEnR:�■■■N■■O■■■Wrl1�■■■■N■
A building permit may be re
quired by: �� �Z�Slah ❑ See note on back regarding River Basin rules.
nAgent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
9;00' co gcj$5
Application Fee(s) Check #
gc,#, 8rih
Perm' Officer's PrintedName
Signature
W I
Issuing dat& Expirati Date

s
AMA / C 1 DREDGE & FILL
ENERAL PERMIT
lew Modification ❑Complete Reissue ❑Partial Reissue
No. 75866 A B C
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality .7H . 1200
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
L j (� ❑ Rules attached.
Applicant Name ! ( \ �� I I ar Project Location: County 13r KIN.'w �
Address LS we -S +- _T aQ ,ol Dove Street Address/ State Road/ Lot #(s) S u r"-Q_
City �Qll�- State A/(, ZIP g q& .
Phone # (Y/ H 7� E-Mail Subdivision
Authorized Agent Sara W LAU fov, V0 — ,yy3- 3/JZCity cA k 2qa ZIP �-3165'
Affected ❑ CW f w *TA DES ❑ PTS Phone # (qI) )14 7/ `f 9I Z River Basin Lumk—(—
AEC(s): ❑ OEA /❑HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body N V1 � (h q (natfma /unkn)
❑ PWS:
ORW: yes <r o PNA yes / no Closest Maj. Wtr. Body
Type of Project/ Activity I( epl4ce T[0 h
Pier (
Fixe
Float
Fing
Groin
Bulk
Basin
Boat
Boat
Beac
Oth
Shor
SAV:
Mor
Phot
Waiv
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A building permit may be re
qui d by: Da k =Sjgn Ci ❑ See note on back regarding River Basin rules.
® �r_e I*kw
Agent or Applicant Printed Name
Signature * Please read compliance statement on back of permit's*
CID aOlg5
Application Fee(s) Check #,
9C*1 Sr in k'
Perini Officer's Print Name
Signature
1 2vZb I ao?-U
Issuing at Expirati n Date

AGENT.AUTNORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit
Mailing Address 95 J' e'S-t lZ�aw� py lyL _
Phone Numbe; : Q l Li 6 ` Z
Email Address:
I c;ertifv that I have authorized 1 �-
ttAc 11-�er✓`s?r� r ''Y\. �rN1�rt �G .Sa+►N
Agent 1 Contracl(x
to act on my behalf, fur the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed developmen':
at my property located at
inCounty -
i furthermore certify !hat 1 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 ;he aforementioned lands in connection with evaluating information related to this
Permit applrcatior
Property Owner Information:
i J)4'
sigvratu�
Prat or �Vype�rm
True
t '_ -L
©ate
I his certification is valid through

Replace 16 x 12 floating dock
Legend
95 W Island O
Feature 1
Feature 2
Foature 3
4 SETBACK
A
r ��

■ Complete name 1. 2, and 3.
■ P"A yox narre and axiress on the mv0r"
so tt,at wb can ratUM ire card to y.O,.
■ A,aWn this card to the back of the msNppsca
_or on the fraru it epeoe vwmft.
t. /Vttt7M /4odrew+d UK
p o�
Oft 124 a)c.-
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3590 9402 3542 7305 6972 01
2_ AMMa hRatl ars'Liw ftm lIa vko aw
17 ?380 0000 8629 5300
PS Form 3811. July 2015 M M30-02-Goo-tiw
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a — Race vw by tFrMa
Cam— ❑ Ag"
❑ AdcMS"
Uwe of Dolmy
D. bd�IrNIN f �n tarn 1? ❑ Y" --
tf Y[S, *'W deri.er-y 060VA t:elow: Q `I:.
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Wnecuo FWum PWAPt

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER FORM
Name of Property Owner
Address of Properly `-- 2-$ -A 8-28z S-1.9 . Gkr---Jft-t 151And�(,k lc 1t10�n�
(t nt :ar Sheet tk, St'eet of Road Ciy & Cx)untyi $/1IN'1[y�'4iG
Agents :%ame !s VJW0' &kC
Ag"t's phone *: _ " 11 ��1i.7►
Mailing Address 101 N
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 drawvvg_the davaloprn m
they are propo". A descriDbon or drawing with dimensions must be txovtded wdh this letter
- I have no objections to this propom►1 I have (A*clit)Iis to this proposal.
If you have objections to what rs being proposed, you must nntify the Division of Caastat Managernent(OCAI) in
wasting within 10 days of roreipl of this notice. Correspondence should be rneilod to 127 Cardinal Drive Ext.,
Wilm/ngton, NC, 28405-3845 DCM representatives can also be confactod at [phone] No response is
considered the same as no obiectron it you have been notified by Ceri+hed ,Nall
WAIVER SECTION
I understand that a "I, dock, mooring pilings, breakwater, boat•louse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. ilf you
wish to waive the setback, you must infttal the appropriate blank belav )
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement
(Property Owner Information)
,5ignanire —
--=1 / h
Pnnt or Typo Name
9 s- %u_
Mading Address
Telephone Number
nor
(Adjacent Property Owner Information)
`l��rrrtlurr ' T
Printtcw Type Name
_ 7.7 �1,
_�I��►d �I".
Madnig Aridr�ss
Crfy/S atw✓Zip ' 5
`161-
To(©ph WO Number
-I-le
Dare
Revised 611&2012

CERTIFIED L • RETURN RECEIPT REQUEOTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner-
,__2cqb&n TMQ1 �Q.trr
Address of Property- L - 2-6 ' A 15 --282 S-18 qfwhVjjisLlryd . OM��t.WM1
l�.m (La or Str W S. 3treat or Road C�ky b Comm�rMr��Y,1C
Agent's Name ae: _ .. w �'�" 1 Mating Mdraes. TA N • 'i�I •
Agent's phone tt: �'•-��1�► _ NL a�'$�+�j1�1
I hereby certify that i own property adjaceM to the above refsrenced property The individual
890yev for this psrrttit has described 10 me as shown on the attsctad dnwm,4 _the daveiop rot
they we proposing. A deocrkohon or dr2tYVing. 'th dimensions must be Wonted with tftis Fetter
I have 110 nNections to this proposal. I bavt objections to this prnl ml
# you Arw otytctions AD what is b*hV proposed, you nwst nowy am DMOM o(comew
10-0
W946V WOWn 10 dart of rwsgx of Ws nonce. Cwn'�pq b 1lf CandMW bM! Earn.,
�, NC, 2AI�Oli-30s.7. DCN era V" can SW 10 cortheW at IMy 0127 d� No w E u covasldthd ON *and et no M DAOif bws Ohre nodt/ad ft comid gs
WAIVER SECTION
I understand that a pier, dock, mocxirg Pilings, breakwater, boathouse, Ilk or groin must be set
back a minimum disrhartce of 15' from my area of riparian &Neese !,balsas W&tved by me. (if you
wish to waive the setback, you tMl3tst initlwtl the appropriate blank bstoW,)
, I do wish to waive the 15' setback rettuirerrtent.
I do not wish to waive the 15' setback reequiremeni
(Property Owner 111*M anion) (Adjace* Pnp" OWnsr 111hWine"
g yre Vgnatura
h .�! Lor rype Nam t
Pr�nr or ypQ
r
DWI
I nd �c
r � g 71• 3 j cc' 7
&1 ?Of2

Deb Recetved
Deft Deposited
Cheek From JMWW
Name of Pemtlt Holder
Vandor
Check Number
Check
amount
Perms Number/Comments
Cokow"
Calutm7
Column3
COkMww
Cokwwg
Column!
Column?
Column8
VMWO _ CuVAm Yrd Homes try Ken Kiser _ Mark Huff
4(//2020 Mc PherrnServices. son Mae LLC DOW
4/72020 Zimmer Management Company (t of 2) ZAC LLC
4! 020 Zimmer Mana ment Company of same
creeCem Bw*
AM
2965
290,00
GP 6748MID
OP9158M _
OP 075874D _
Pp5S7
fart CBw*
faltlmne
South Sfata Bank _
_
S 200.00
7208
70771
$ 400.00