74556D - Summer

e+ -,-- 1, 4u,-_ L-i I I i V V
CAMA / �IDREDGE & FILL
�. GEI'11ERAL PERMIT
New ❑Modification ❑Complete Reissue ❑Partial Reissue
No. 74556
Previous permit #
Date previous permit issued
A B C O
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 1)"7N . 1500
NA 9 Ft t-i ❑ Rules attached.
Applicant Name 5tAMMER IZE5`7tLl-C Cky Per-QL S Project Location: County /\/E v4 flANoyER
Address 21 I 5tA.,Ii.AtA :%_ h2E ST RID Street Address/ State Road/ Lot #(s) 2 4
City WILM�n1Cn70�/ State�ZIP 29405 Sl�►��,Lrz REST RD
Phone # CLI ) 2.(A - 200"1 E-Mail /1A Subdivision /J�A
Authorized Agent C 4A tt F—LAtA City W 1 LM 1 n/G-To w ZIP 2 ? Q-C s
Affected ❑ CW X EW X PTA ❑ ES ❑ PTS Ac�eNtPhone # (1111 ) 81 q - 427 5 River Basin W 01 TF OAK
❑ OEA ❑ HHF ElIH ❑ USA ElN/A
AEC(s): Adj. Wtr. Body CR[ G vc oF F A I W W na /man /unkn)
❑ PWS:
ORW: yes / PNA yes / Closest Maj. Wtr. Body A I W w
iNOMINEE
■■
�7rEElv�i�iCLZ�l■i
���!'�111
��=�!�7!■■■1�■■■
■■■■■■■■
■■■■■■■■■■■■
■■
■■■■■■■
�,- _(,_ IF I �-�----
Agent or pplicant Printed Name
Signature Please read compliance statement on back of permit
# 4w -- � 140 9
Application Fee(s) Check #
Permit Officer's Printe Name
Signature
I z�l g 2 0l 9 4 Z119 z ozo
Issuing Date Expiration Date

dA
---'"��ElP
= 12'51' WW
49'95
32 PG 24
N/F El GRAVEL
SUMMER REST
LANDING YACHT
OWNERS AMC
S 25'28'06"
zap w 39.22
20M
16.2'
y PILINGS
(TYPICAL
oo
N W04'27" E
49.71
3P N/F
BARBARA
GUARD
S 25'42' 14" E
�54.39
FLOATING
DOCK
BULKHEAD
25085.00 SF 0.58 AC
DB 1303 PG 198 TRACT 2
LOTS 14 & 16 SUMMER HAVEN
MB 2 PG 122
3823.51 SF 0.09 AC ABOVE PNHW
LOT IS SUBJECT TO
PUBLIC TRUST
COASTAL WETLANDS /
NORMAL HIGH WATER (PNHW)
MAF25H (PRELIMINARY —PENDING
GRASS DCM APPROVAL)
I MARSH MARSH
GRASS GRASS
4.
D= GRA55
D &LIFT
1
ON
Lw MOM LOT SUBJECT
B�" TO UBLIC TRUST
B" WATER DEPTHS BY SURVEY
b ,zg 0LOW TIDE
cD
>>� %P
/ O MARSH R
cRAss
DREDGES o
BASIN
DEED LINES `'�.
MARSH
DB 1303 PG 211 "�, GRASS
THIS PROPERTY LIES WITHIN A SPECIAL
FLOOD HAZARD AREA AS SHOWN ON
FEMA FIRM
COMMUNITY PANEL #3720315700K
MAP REVISED 08/15/2017
LEGEND:
EIP = EXISTING IRON PIPE
ERB = EXISTING REBAR
STATE GRANT UNE # 1168
AREA BY COORDINATE METHOD REF 131 IS39 ED MAY 12 1817
_`ANDSEED— ' 13
50 25 0 50 100
GRAPHIC SCALE
DEED LINES
DB 1303 PG 211
MAP
7R 3 60.26
S 84 44'25' E

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: _ /�afr�50-� p'ec)is Rts� I. L (,_
Mailing Address: Ll y vP-C Sa- " ,
Phone Number: °` 1 p - Z�� - to c) j
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
necessary for the following proposed development: al i t r%yc_ c. prr u x
10
at my property located at
in Nt— �4--�,(' County.
/ furthermore certify that / 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:
Signature
Print or Type Name
Title
Date
This certification is valid through ! /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that i own property adjacent to _ la�r�` 3�^ �� --L") 's
(N me of Property Owner)
property located at �� � ��"`��� � �- (2�
(Address, Lot, Block, Road, etc.)
on �'L� in 0.,N "1-, 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, 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 sdOack, you must initial the appropriate blank below.)
-do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property caner Information) (A Prop rt Owner Information)
- <;77
Si n lure 7ta aw ure
Print or Type Name Print or T pe Name
Oct -
Mailing Address Mailing Address
City/State/Zip City/State/Zip
910 -?�`1- Z�
Telephone Number Telephone Number
Date Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ���+-r3d�.� K-1eWt1:
's
property located at �) vl S�ti,,,.,,r Property Owner}one,,, (Address, Lot, �I(Nam�eof
,,etc.)
in "-Iv.
(Waterbody) �`U`1 N_C.
(City/To wn 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 AND1OR 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
f
lings, breakwate, boathouse,.�' minimum distance of 15' from my area of riparian accessr
runless wa ved�byrme �(if You set back a
the setback, you must initial the appropriate blank below.) ( You wish to waive
,- I do wish to waive the 15' setback re
quirement.
1 do not wish to waive the 15' setback requirement.
(Pro a Owner Information)
(Adjacent Property Owner Information}
Si ure
Print or Type Name
Print or Type Name
Mailing Add a��-1�111�tZ
I — NZ M i! Address
City/Statelz
41 - Zy �-, o'j Cit /State i
Telephone Number
J LTelephone Number
Date 1
Date
(Revised 611812012)

,Sion WW 214 Sum RCA Rd-
' - -- Serving *s ICY
Z I� ;plk t Harrison 'Pablo
with Hart' l$bad Investam for the 214
a p,mit; permission to deposit
c ywds of drWp spoil on PID: R063W