66383D - Piccirillo

CAMA / ❑ DREDGE & FILL 1 0 / .OoNOG 66383 A B
IENERAL PERMIT Previous permit #
New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources
>astal Resources Commission in an area of environmental concern pursuant to 15A NCAC
+ )� ules attached.
Name_ _ t (� 1 Y� 1� Project Location: County a t%, 4 W ( �L
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State `SI
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dAgent /v\�� h1f\���p'� ktea, S V,
❑ CW EW XPTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
�s / t o PNA yes / 0
'roject/ Activity 2 Y Cl lk
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J Ienkth .5
permit may be required by:
cal Planning Jurisdiction) i
Street Address/ State Road/ Lot #(s)
Subdivision t _ �u
City
Qh' lc &V1 ZIP
Phone # ( )�3, " "-i ' 'River Basin L VIM
Adj. Wtr. Body w at r
Closest Maj. Wtr. Body
l�
(Scale:
❑ See note on back regarding River Basin ru

... ,W-016
3/182016
31'2./2016
3212016
. _..... Mary Ric
John 8 Mary Richardson
same — -- —
B of A
Wells Fa o
r9
First Bank
6740403431
15028
_
$100.00 minor fee, Lot 4 ChestnutSt. Ext NTB One JD
55400.pp �GP 6666633665D � b�tr
3/182018
3212016
Peter Mueller _
Edward Hathaway ___
3/182016
3/182016
3212016
3/212016
3/212016
3212016
3/=016
3232016
3212016
3212016
324/2016
324/2016
3242016
3/242016
324/2016
3242016
Brently & Sherrie Turner same _
JRW/RDW Inc _ Louise Mengel _
Charles Wafters, Jr. same _ _ _
F & S Marine Contractors Inc Richard & Laura _Fisher _ _
F & S Marine Contractors Inc Dennis Farrell _ _
F & S Marine Contractors Inc Dennis Farrell---.-.-
Town of Carolina Beach same
Mike GallanVANA Builders Inc Mo Afify
Richard or Erica Penny same
Antinan Construction Inc �Ed Ball
Proper Building Group Inc - Ed Hill _
Bradford Stevens same
Rhonda Wooten/Town of Holden Beach same IBB
Mike Conard/Coastal Marine Construction Inc Michael McDaniel
BB &T
8125
$250.00 major fee, 9197 Schuyler Drive, Calabash BrCo
$200.00 GP 66372D
SF r
PNC Bank
5239
RM
PNC Bank
5194
$450.00
GP 66371D_9
RM
PNC Bank
5198
$150.00
RM
BB &T
66194
$100.00
minor fee, CB 16-03 IKM
TD Bank
USAA Federal Savings Bank
7823
782
$100.00
5200.00
minro fee, 9 Hunter Heath NTB Ons
GP 66370D
JD r
JD(
323/2016
3/232016
324/2016
3242016
324.2016
B of A
First Citizens Bank
NC SEW
&T
_
_ 4163
1829
1037
28499
$200.00
$100.00
5200.00
$400.00
GP 66307D
minor fee, Lot 4 Majestic Oaks, Hampstead PN
GP 64727D
GP 66360D
JD i
JD r
SF i
SF I
3242018
3/242016
3/252016
First Bank
10169
$200.00
GP 66380D
JD r
HIS
016
Chris Conaway/Conaway Marine Construction Georgia Rasmussen
B of A
1223
$200.00
GP 66381 D
SF
328/2016
Rock Solid Construction Linda Piccidllo
CresCom Bank
1527
$200.00
GP 66383D

NC Division of Coastal Mgt. Habitat Impact Com
Applicant: L'%V46,
Date: 3 A M V
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
tem impacts)
impact amount)
temp impacts
an
,
6`1v/
Dredge El Fill ❑ Both El Other ix
a (l
-�'� I
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 LAMA PERMIT APPLICATION
Name of Property Owner App)y ng fo pew t Ckv
Da n2
Mailing address: PO R O x -2,a q
-�5hCL 1 aSL
Phone Number: qJ o -- a 3 (-1 '/-7 (o
I certify that I have authorized `u Jig
Agent 7 Contractor �o
4A "_
to act on my behalf, for the purpose of applying and obtaining all LAMA permits
necessary for the proposed development of J1jZ 1jjJ
at my property located at T V LtV�
in
County.
This certification is -valid through
Date
(Property Owner Information)
dw-il
Signature
L v� d-0- PI GG [ ,', 1 [0
Print or Type Name
Dwki
Title
9lnFI1
Date

—
A13
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: L �0.
Address of Property:1 `47 Vic, JU Souhcr Ski � ��ceGn z5jt
(Lot or Street *, Street or Road, City & County)
R.oLk Y J06 a n
Agent's Name #: iZnck Sold Go„s4ruJ;Qt�
Agent's phone #: 9/0 -a 3 1 -1 q7 „
Mailing Address. 2I�L �0 y ) � a y
S6I�,, I1, Nt- 2K455
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 drawing the development
they areeppr posing. A description or drawing with dimensions must be provided with this letter.
1 have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405.3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
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 setback, you must initial the appropriate blank below.)
i do wish to waive the 15' setback requirement.
c"�)S . 1 do not wish to waive the 15' setback requirement.
(ProVerty Owner Information)
Signature
Print or Type Name
14-7 VANd fund RU
Mailing Address
0 Ce�c n 51e
r,4-1cf-F-17—
(Adjacent Property Owner Information
Signature
Print or Type Name
Mailing Address
\-.c,\N- � N c_ a Ts J

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Or
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■ Complete items 1, 2, and 3.
■ 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 Ge) SInkS
�o`V4-rh, --41e Lowes SE
�—elak1d, N a `fs/
A.
r/Siiggnature
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❑ Agent
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❑ Addressee
B. Received by (Printed Name)
C. Date of Delivery
lU
D. Is del ve�«iiress i m item 1?
❑ Yes
)rYES, erDterde} ess elow:
d r
❑ No
FEB 2 5 2016
3. Service Ty�t�tp�e,,
Priority Mau F; -es®
I
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I I
I II(
II
I I I III
II1II
( III
III
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Restri�ed D�Jwery
❑ Certlif
❑ eli stryred Mni rtestricted
9590 9402 1443 5329 1865 47
ed Mau1}�
❑ Certified Mail ery
DDelive
❑ Return Receiptfo,
❑ Collect on Delivery
Merchandise
2. Article Number (Transfer from Service label)
❑ Collect on Delivery Restricted Delivery
❑ Signature ConfirmationTM
7 015 1520 0002
4184 1339 livery
❑ Signature Confirmation
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
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Domestic Return Receipt
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Domestic Mail Only
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Forinformation,it our website at
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Certified Mail Fee
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$
Extra Services & Fees (check box, add foe )
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❑ Return Receipt (hardcopy) $ 1 } } }
Return Receipt (electronic) $ $(} Ift
Postrnark
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❑Certified Mail Restricted Delivery $
Here
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❑ Adutt Signature Required $.-
❑ Adult signature Restricted DelM1rery $
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Postage
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$
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Total Postage and es
$ $6.7A"t
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