66349D - Jackson

CAMA % E-DREDGE & FILL V1a - •I�, '�� r {" �i
A B
iENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources 7 ti
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC }
�y O Rules attached.
:Name 6 0 � �, t �-SG Y Project Location: County ��J rS,.ALi T L
1(a C Uv`f'_ • Street Address/ State Road/ Lot #(s)
State zip in 9 L
( aw n) _IME-Mail Subdivision
BdAgent V((. TnL . C �nv1`3 Mom3oh City zip�Zqb
❑ cw ;t'E Arm 'KIES Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A Adj. Wtr. Body AY1 (nat
❑ PWS:
des / no PNA yes / no Closest Maj. Wtr. Body
Project/ Activity
:k) length _/
xform(s) IV X �•1
Platform(s) x 1 L
igth
nber
Riprap length
distance offshore 0
x distance offshore
not sure yes
iurn: n/a yes n
0 no
kttached: yes no
ig permit may be required by:
Local Planning Jurisdiction)
2Own 6� 1�0'ltyl Reut� .
J+ 7 L
.14
regarding River Basin n

2/23/2016
2/25/2016
Brent & Sherrie Turner
same
Wells Fargo
3869
$100.00
minor fee, Lot 4 Chestnut S
2/24/2016
2/25/2016
Daniel Shirley/Overbeck Marine Construction Inc
Labo_ccetta and Stokely
SunTrust
4580
$450.00
GP 66332D for Labocetta Q
major fee, Stokely, 512 N.
2/24/2016
2/25/2016
Michael Afify/ANA Builders Inc.
Carl & Jennifer Sandlin
TO Bank
7774
$100.00
minor fee, 656 Spot Lane S
2/26/2016
3/4/2016
Vamams Docks & Bulkheads Inc.
Emma Mims & Jeri Adams
BB &T
7082
$200.00
GP 66304D
3/2/2016
3/4/2016
J. Michael Randall
Joel Winegarden
NC SECU
2867
$100.00
minor fee, 38 Porpoise Plac
3/2/2016
3/4/2016
MO/Brandon Grimes
Lawrence Parks/Parks Family Leasing Co.
Wells Fargo
17-335656415
$200.00
GP 66341D
3/2/2016 3/2/2016
3/2/20163/2/2016
3/2/2016 3/2/2016
3/3/2016 3/4/2016
3/4/2016 3/4/2016
Stephen Conway/Southeastern Coastal Const. Co
Darrell Erny/Lighthouse Marine Constr. Inc
Will Richardson/Richardson Construction
Randy Mosley/Allied Marine Contractors LLC
Charles Riggs & Associates
Timothy Moore
First Federal
9778
$400.00
GP 66339D $200
Howard Ramsey
GP 66338D $200
Bob Barnett _
B of A
5769
$400.00
GP 66340D
Lee McConnell
BB &T
6275
$200.00
GP 66303D
Kevin & Wendy Longenecker
B of A
8168
$200.00
GP 66271D
John and Janel Brogan
First Citizens Bank
14449
$100.00
minor fee, 140 Walter R. At'.
3/4/2016 3/9/2016
Hobie Buifington/Boatzright Inc.
David & Ellen Surprise
First Citizens Bank
2262
$200.00
GP 66344D
3/4/2016 3/9/2016
Hobie BuffingtonBoatzright Inc.
David Young/Gejan, LLC
First Citizens Bank
2249
$200.00
GP 66342D
3/4/2016 3/9/2016
Kim Loucks & Carolyn Hirst -Loucks
same
Security Savings Bank, SSB
584
$400.00
GP 66337D
3/4/2016 3l9/2016
H5 Construction/Matt Hon
Rene Litalien
BB &T
1444
$200.00
GP 66335D
3/7/2016 3/9/2016
MO from Calvin Muncy
Oak Island Beach Villas
USPS money order
23494660885
$100.00'
minor fee, 1000 Caswell Bc
3/7/2016. 3/9/2016
Stephen Conway/Southeastern Coastal Const. Co
_
Tom Tomlinson
First Federal
9782
$400.00
major fee, 304 Gull Road, h
3/8/2016 3/9/2016
Jimmy North/Coastal Marine Piers Bulkheads LLC
JBurrows Smith
Wells Fargo
20730
$200.00
GP 66347D
3/8/2016
3!9/2016
Clrff Pender/Solstice Builders LLC
MO from Brandon Grimes
Mark Clements/Clements Marine Construction
Ben Goetz
First Citizens Bank
12549
$200.00
GP 66190D
3/10/2016
Kim Morgan
BancFirst
204490240
$200.00
GP 66212D
3/11/2016
John Tinney
First Citizens Bank
4041
$600.00
GP 66358D
3/11/2016
3/11/2016
David Logan/Logan Marine Spencer Jackson Coming Federal Cred UnUnion
Will Richardson/Richardson Construction Michael Serafin BB &T
Michael Serafin
Robert Kean & Carol Keane same Wells Fargo
George Montague & Barbara Montague Grover Dillon III B of A
Kevin SmithJCarolina Yacht Club same South State Bank
Timothy Gray II & Courtney Gray J.W. Lawson NC SECU
Carolina Lifts Inc Robert Williams CresCom Bank
Jimmy North/Coastal Marine Piers Bulkheads LLC Nancy Gerald Wells Fargo
Jimmy North/Coastal Marine Piers Bulkheads LLC Philip Brown Wells Fargo
Jerry Ennett/Antinod Construction Inc Butch Smith B of A
Charles Riggs & Associates Inc. Scott & Sheila Schriver First Citizens Bank
Treehouse Holdings, Inc/Four Seasons Mgmt. Serv. same South State Bank
_ 5466 $200.00 GP 64654D
6269' $400.00 GP 64725D $200
GP 57306D @$200
1214 $400.00 GP 66334D
8622 $200.00 GP 66357D
41255 $100.00 renewal fee, MP 69-09
3676 $200.00_GP 66351D
3/14/2016
3/14/2016
3/14/2016
3/14/2016
3/14/2016
1035
$600.00 GP 66353D
3/15/2016
20767
$250.00
major fee, 13 Bahama Drive
3/15/2016
20768
$200.00
GP 66359D
3/15/2016
4154
$200.00
GP 66309D
3/17/2016
14460
$100.00
mirror fee, 7080 Seventh St
3/17/2016
1519
$100.00
mod fee, MP 35-16 NHCo
3/17/2016
Chris Mordson/VCC Inc.
;Don & Davie Jackson
BB &T
3796
$600.00
GP 66349D

NC Division of Coastal Mgt. Habitat Impact Com
Applicant: 4 vJ �'av--So vl
Date:
Describe below the HABITAT disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FI
(Applied for.
(Anticipated final
(Applied for.
(A
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
di:
Habitat Name
Choose One
includes any
Excludes any
total includes
E)
anticipated
restoration
any anticipated
re.
restoration or
and/or temp
restoration or
tei
ternp impacts)
impact amount
ternimpacts)
ar
L
Dredge ❑ Fill 9 Both ❑ Other ❑
0
O "
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Properly Owner Applying for Permit: d>oh
Mailing address: _ q Ze � tl , A �0 yle
W ,e,Av�,-( v i I I— IV
Phone Number:
I certify that I have authorized Vex- B41141h) �"r `I
Agent / Cohlractor
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of e-,x
at my property located at
in
13n Hl 6.4 L- tC_
132 SAW l=o4a :54
County.
This certification is valid through / /'YT' &--
Date
(Property Owner Information)
Signature
�Ut1 6Gk30A
Print or Type Name
Ow r%4.&
Titre
121; j I Le
+- Date
9zk — 19� — -ac, 4u

ADJACENT RIPARIAN PROPgRT"Y OWNER STATEMENT
I hereby certify that I own property adjacentto T
r a = f ll JNarne of Property Owner)
property located at n t �'' L�.16. ` s '321
n (Address, Lot, Bixk, Ro en g, etc.} -
(Waterbody) (City/Town art or County)
The applicant has described to r„e. as shown below, the development proposed at the above
location,
I have no objection to this proposal.
l have objections to this proposal.
D ! AND/OR DRAWING OF i ji 1 �-
-
rq
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
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For delivery information, visit our website at www.usps.com®.
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WAIVER SEC 1e M� !�- a v
I understand that a ter, dock, mooring pilings, boat
P p 9 ouse; lift. or groin
must be set back a minimum distance of 15' from my area of nparlan access unless waived by
me. (if you wish to waive the setback, you must Initial the appropriate blank below.)
I do wish to waive the 15, setback requirement.
l do not wish to waive the 15' setback requirement.
(Property Owner Inform a" (Adjacent ProPerty Owner information)
r �
Si- alure 2 L' Sianarure" .,

SUPPLY PO
SUPPLY, North Carolina
284623590
3613950462-0098
02/29/2016 [phone] 11:10:30 AM
Sales Receipt
Product Sale Unit Final
Description 01y Price Price
CLEMMONS NC 27012-9159 $0.49
Zone-2
First -Class Mail Letter
0.70 oz.
Expected Delivery: Wed 03/02/16
00 Certified Mail $3.45
USPS Certified Mail #:
70151520000328536271
Return Receipt $2.80
Label #:
9590940212405246277439
Issue Postage: $6.74
Total
$6.74
Paid by:
Personal Check $6.74
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aDomestic maii only
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ru
`0 CLEMMONS K 270124
m
tdl Certified Mail Fee
$3.
$4.1
fU Extra Services & Fees (check box, add lee as appropnate) G462
Return Receipt (hardcopY) $ ^ G
M ❑ Return Receipt (electronic) $ ( ( O1 POstm,
O❑Certified Mail Restricted Delivery $ • Her(
O Adult Signature Required $
Adult Signature Restricted Delivery $
p Postage ru 90.49 02/29/21
$
Lr) Total Postage and Fees
s
$6.74
t17 Sent To 01
O Sittreet an Apt. No , or b, `BobVo.
Cy, t e, ZIP+4•
P_ rnrvlvr�-,, ,w- a-�vt
Bill#:1000203931901
C1erk:01
All sales final on stamps and postage

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Tracking Number: 70151520000328536271
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9590940212405246277439
DATE & TIME STATUS F ITEM
LOCATION
March 3, 2016 , 11:45 am Delivered
CLEMMONS, NC 27012
Your item was delivered at 11 :45 am on March 3, 2016 in CLEMIVIONS. NC 27012.
March 2, 2016, 10:56 am
March 2, 2016. 8:13 am
March 2, 2016, 8:03 am
March 2, 2016 , 8:02 am
March 2. 2016. 12:50 am
March 1, 2016, 7:24 am
March 1, 2016 . 3:09 am
February 29, 2016, 11:08
pm
February 29, 2016, 4:32 pm
February 29, 2016, 11:09
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Acceptance
CLEMMONS, NC 27012
CLEMMONS, NC 27012
CLEMMONS, NC 27012
CLEMMONS, NC 27012
GREENSBORO. NC 27498
GREENSBORO, NC 27498
CHARLOTTE. NC 28228
CHARLOTTE, NC 28228
SUPPLY. NC 28462
SUPPLY, NC 28462
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Tronlr An^+knr DorLe!nnn Mannnp Inrnminn Parkana_q

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Z)Gn � k)ziie 7gJ4b'-\ 's
(Name of Property Owner)
property located at ) 3� 50f\QA 5 "• 'f" V3-7
(Address, Lqqt, Block, Rnczg--
etc.)
on r a n J b - , in Ny1.c , 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
ti
t-ee 0 -0
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ca
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ertified Mail Fee
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- 4�
xtra Services & Fees (check cox, add fee a prop te)
❑ Return Receipt (hardcopy)
$
❑ Return Receipt (electronic)
$ -
Postmark
[]Certified Mail Restricted Delivery
$ ---- fT—:t,:—
�(
Here
[]Adult Signature Required
$ ) (. ) (
❑ Adult Signature Restricted Delivery
$
'ostage
$ii.71
A3 i 11 ` 2 (-
iotal Postage and Fees
$b.90
to SentTo-Tu,,•-h o rf �lAe i /,( cc>k
ri ------- -- --- L.LJ'-- ---
� Street and Apt. No., o O Box No.
WAIVER SECT �(�y-s�a� , Z + C en q �gy
I understand that a pier, dock, mooring pilings, boat r
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
J
l�
ature _
i. or\ e �c tks� n
Suture* (� k"n doc"'��
Print or Typq Npme . , ,
Print or Type Name

PLANNINe AND INSPECTIONS
I 10) ROTHSCHILD STREET
-HOLD-F-W BEAGH., K 28462
P-MONE. 91OD-642-6060
raxt: upte"
0
Voterence TO:
Ccmnwnts:

AI�JACEN REPAlIAN PRQPERTY OWNER STATEMENT
I hereby certify that l cwn property adiacent to ► bra f�+�E�GS[�+. 's
(Name M property Owner)
prupe�ty kx;ated at �J 5' -- e?-, �� ` a 7
rt -
(Address, LqtBlock, Ro d, etc.)
on _ (� n .� f in 3"1 -rl ZgQ c ?\ N.C.
(Waterbody) (Clty/Town and/or County)
The applicant has described to me, as strewn below, the development proposed at the abova
location.
I have no objection to this proposal.
l have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or grain
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 do not wish. to waive the 15' Setback requirement.
(Property Owner Informatlan)
E La�
nature
i. t r1 s i c tk-5
(Adjacent Property Owner Information)
Print or Type Nomo
gel ;l 1 4n e. V
Print ar Tj� �"Jy�me • ��
0 !© ,C=_C'��

MUFISMUK VVUIILy Ilk—, k.�1I0
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PIN: 2D1618402560 PARCEUD: 232PD001 OWNER: JACKSON DON E7 DAVIE N

T
Psa Etts•e
i� f 4tsa t„
IXCL— Tax
Tax l.,t No.
Verited yy 1
by
Brunswick County"Re911ter of needs
Robert J. Robinson
Inst E13184 Book I30:Pags 513
osl14/1999 04:21ps RecR 135St
1'::rrrl Iller'Mier V".
Count). FJ1 11::• day of
Mail after recording to itmmwjw ppzp it
WTTW IT t'iffiixe r mA
This instrument ues prepared by Benedict J. Del Re' jr., Attorney at Law
Brief d:s;riptM,n f„r the itdrx
Lots 86 h 87 Canal
NORTH CAROLINA GENT KLU lY<<IRRAN7-Y I)I-ICI)
THIS DEED dude this «+ day of May
aita `TOY.
Larry T. Nettles and wife,
Garland G. Nettles
40 IS
RfT
i o 7 A 1 iD . c16 Kt �0 1 _t
1999 , by and Lt,.w..n
t:xASTE%
Don Jackson and wife,
Davie H. Jackson
395 Lynn Cove Road
Asheville, NC 28804
Eottr to soot-pr" Meek r.c e.ea rarer: +a—. stereo. —44 it .
DDropristr, ,iurartrr or califs, nq. r"rFcrittun cr 1i4riMrahiy.
The deai'U'l"iorl Singular, plural
and Grantee as zzsed herein shall inriudt: <aid incrti s. th
shall air hvirs. sucrrssurx. and assittim. and
all include Singular. truscu}ine. feminine „r muter ;
x rrginrcd by context.
WITNESSETH- that the Grantor, for a valuable considrra+::,r Sit=tl L•q the l:rau:rr. the receipt of uhfr'r. is hereby
atknnuledged has and by tixse presents dues rtnt, i:ar uit:. aril and c„trey nui,t e. h. r.ry it, f h
F A
ve"t"}n Lit ur iwrrr} of land xilnated in the Cif} <.{ fee pimple. a./ that
Brunswick iockwood golly t
r,•vaty. N.,rih <'an4inu ::rd m.at• i
;:;tiru.�rl}• dra+�iiL.z} fol}nxs;
CANAL LOT NUN+SERS EiGei'iy-SiX (86) AND £IGHTy-SEV£N 187) , on
CANAL "D" and fronting on Sanford Street, according to a survey
of the Canal Development of Holden Beach Realty Corporation, by
Gerrit C. Greer, R.L.S., a T-sp of which is duly recorded in Map
Book 6 at Page 232, records of Bruns -wick County, Said iOtS having
the metes, bounds and Iccatior. as s?tcwn on said nap.

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PIN: 201618402560 PARCEUD: 232PDO01 OWNER: JACKSON DON ET DAVIE H