75877D - Dail

CAMA / ,DREDGE & FILL No. 75877 A B C
GENERAL PERMIT Previous permit #
New ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued _
As authorized 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 r (► ley
Applicant Name `-' `"
`A, El Rubs attached.
!)1 � � � _ Project Location: County �c S It-? 6t/
Address 30 sb �j Street Address/ State Road/ of #(s)
CiG-t- State A/C- ZIP 7eytl}
Phone # ffLa) 3D R E-Mail Subdivision _
Authorized Agent �/,� �1 •��yvYG. City t ✓ T// ZIP
❑ CW (> EW �TA ❑ ES ❑ PTS Phone # ( ��. River Basin W ,
Affected ❑ OEA HHF ❑ IH ❑ USA ❑ N/A �jAM �� 6-1 St'
PWS:
AEC(s): Adj. Wtr. Body na unkn
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ORW: yes /(.fio ) PNA yes /� Closest Maj. Wtr. Body L .�
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Signature * Please read co Hance statement on back of permit
Application Fee(s) Check #
er fficer's Printed N me
Sign r i le7�
sluing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
f1
Name of Property Owner Requesting Permit: L,a i t -k n Da l
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
g i t ` 8<7 - L369
Agent i uonvaaor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: �i _r ' Earr- j0i c-r
at my property located at
in V f ,i 10 U) County.
1 furthermore certify that 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 the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Sig re
Print Ir Type Name
Title
1 I 010
Date
This certification Is valid through / t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby cenity that I Own property adjacent to —i iii
Property locates at (Name of Property Owner)
`T<<
(Address, Lot, Block, Road, etc.)
on l � j t I . In I - I- N.C.
fWaterbody) (Cityand/or County)
The aPP"r t "as described to me, as Shown below, the development proposed at the above
location.
AC OT I have no Objection to this proposal.
I have objections to this prcposai.
ueSCRIPTiON AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must tiff in description below or attach a site drawing)
I understand that a pier, cock, moon A6VER SECTION
must be Set g piiings. boat ramp, breakwater, boathouse, Iift, or groin
back a minimum distance of 15' frcfn my area of riparian access unies waived by
me. (if you wish to waive the setback you must initial the appropriate blank below.)
1 ac swish to waive the 15' setback requirement.
I do net wish to waive the 15' setback requirement.
(Property O nfo -
- � (Adjacent Property Owner t ormat3on)
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arr,V or Type. Na; M,
Print or Type Name
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-= X 1 r ' �4 i Soaking Address
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Telephone �iumber'emad address
are 'A- t - is
'Valid fOr one calendar year after signature' (Revised Au .
g 2014)

-�=cr Lclrlian Dad Pr6j'e-,ft
3b5o 3rd5treet
6ttrf CA �� , Nc a8qq5
RECEIVED
APR 13 2020
DCM WILMINGTON, NC

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Daft RacWvad
Daft
Check From
Name of Permit Holder
V.I.W
Check Numbw
Chock
amount
Permit Numbedr is
t w Refund/Raal/ocated
Columnt
Columns
Column)
C.A-4
Cohunns
Columns
C01umn7
Columns
Column9
5/512020,
5/5/2020
5/512020,
__ 515/2020
5/512020.
0'
515I2020,.Jessica Mend
5!5/2020 Allied Marine Contractors LLC
5/5/2020 Jerry Ennetl0 of 2)
5/5I2020 Jeny Ennell (2 of 2)
5/5/2020' ES Freedom, LLC
515/2020 F and S Marine Contractors Inc.
same
AI Gribben
Carlton Dail
Carlton Dail
, Enc Sabourm (ES Freedom)
Tommy West
State Employees Credit Union
First Citizens Bank _
Coastal Bank and Trust _ _
Coastal Bank and Trust
Bank of America
PNC Bank -
1073
_ 8911
3088
3038
200 00 'GP •748830
200.00 GP 174815D _ _ _
_ 200,00 ,GP i74877D
200.00 GP i75877D
:JD rat . 10832
JD rct. 10833 _
�JD rq. 10333
1593
85681
i 200.00 t3P i75847D _
S M0.00
PA fd 10751
32