76503D - Kuipers

LAMA / ❑ DREDGE & FILL N? 76503 A B
VA ERAL PERMIT Previous permit #
w ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environmental Quality O / / ^ C)
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC H GCJ
❑ Rules ched.
: Name O4 /A% Project Location: County
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BK 4627 PG 1736
DOC# 20014613
2. The financial costs of any repairs or improvements made by the owners of
one property shall be the sole responsibility of the party making such
improvements or repairs unless the owners of the other property agree to the
same in writing.
3. In the event that the Party of the Second Part elects to make improvements
pursuant to this AGREEMENT which are not shared with the Party of the First
Part, then the Party of the First Part, as the owner of the parcel to which the
dock is attached, agrees to sign' any applications for County, Town or CAMA
permits needed to obtain authorization for such permits, PROVIDED,
however, that neither party shall be responsible for arty costs, penalties or
damages incurred due to improvements or repairs carried out solely by the
other party; and, each party agrees to inderrinify and hold the other party
harmless from any such costs, penalties or liabilities.
4. The parties agree that the provisions of this AGREEMENT, together with the
Provisions of the JOINT DOCK USE AGREEMENT recorded in Book 4413 at
page 157 and the AMENDED JOINT DOCK USE AGREEMENT recorded in
Book 4469 at page 317 shall become and hereafter be an appurtenance to
both properties, binding on the current owners as well as their successors or
assigns.
IN WITNESS WHEREOF, the Parties have set their hands and seals as of the
date written above.
��F E R rg rC'
RY =
M
ichaelal pens PUBLIC
ea
ord Kuipers%inr0iU�trt+�t`��ti�`�
A94404` Arra—AW,6 - ISeaij
Robin S. Hansley
SEfr D&A'AVj9F1�_ _ (Seal)
George S. Hansley, it

BK 4627 PG 1737 DOC# 20014613
NORTH AROLINA
� _COUNTY
I, the undersigned Notary Public, do hereby certify that Michael Hal Kuipers personally
appeared before me this day and acknowledged the due execution of the foregoing instrument
for the purposes therein expressed.
WITNESS my hand and notarial seal this day August 2Q0v`F11RrS /z,
My Commission expires: �'—1 g-'-vo R
%-
Nota ry ubiic NOTARY
PUBLIC Z
,/;;I/COUtt
NORTH AROLINA
COUNTY
I, the undersigned Notary Public, do hereby certify that Tammy Stafford Kuipers
personalty appeared before me this day and acknowledged the due execution of the foregoing
instrument for the purposes therein expressed_
WITNESS my hand and notarial seal this �'lday of August 2 `£Z�X` S�c�if
My Commission expires:
Notarf ubiic _ NOTARY =
PUBLIC r
C 0 U t Nk�\
NO TH CAROLINA C
COUNTY \
I, the undersigned Notary blic
Han ey, II personally appeared befo
foregoi instrument for the purposes
WITNESS my hand and notarial
My Commission fires:
do hereby certify that Robin S. Ha
me this day and acknowledged the
therein expressed.
day of August. 2016.
Public
and George S.
execution of the

BK 4627 PG 1738 DOC# 20014613
ADDITIONAL SIGNATURE PAGE ATTACHED TO SECOND AMENDED JOINT DOCK USE
AGREEMENT BETWEEN MICHAEL HAL KUIPERS and wife, TAMMY STAFFORD KUIPERS
and ROBIN S. HANSLEY and husband, GEORGE S. HANSLEY, II.
f
r [Seal]
Robin S. Han ley ,
nsley,
)"1 �s Seal]
George . ansle .
NORTH CAROLINA
PF�JDRTZ. COUNTY
{, the undersigned Notary Public, do hereby certify that Robin S. Hansley and George S.
Hansley, II personally appeared before me this day and acknowiedged the due exec-ution of the
foregoing instrument for the purposes therein expressed.
WITNESS my hand and notarial seal this --nay of August, 2016.
My Commission expires:
Notary P tic
17O
i
Notary Pub1+C
Fender County fires
^My Commission Ezp
0712012019

Bailey & Busby, PLLC
Attorneys at Law
Stephen C. Bailey 14865 US Highway 17 (PO Box 818) wlvw.bail ybusby com
Charles T. Busby Hampstead, NC 28443 stephen(a,bailevbusby.com
910.270.8830 charles(@,bailevbusbv.com
910.270.8831 (fax)
Offices in Wilmington and Hampstead,. NC
THIS DOCUMENT HAS
BEEN RECORDED
ELECTRONICALLY
ou,r recce,

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADiACEN T RiPAtRiAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner
Address of Property: a 1 ��a rn ANotZ�lt_� d E. li lQ
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Mailing Address. -
Agent's phone #:
t 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 are proposing A description- or drawm with dimensions must be rcvided with this letter.
t �I have no objections to this proposal I have objections to this proposal.
If you have objections to what is being proposed, you mustno(ify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 1?7 Cardinal Drive Eft,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response 's
considered the same as no ob ection if you have been notified by Certified Mail,
WA!VEP SECT!0N
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
�aCC a^ TTiinl�i Jm uiSiai Ce of iS fiJi?i my area of riparian access LnieSS waived by me. ;,','you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
�5 1 do not wish to waive the 15' setback requirement
(Property Owner Information) I(Adiace t Pro Owner I ormation)
Signature Signature
d�,*le s P�
Pant or Type ,Jame Priid or Type Name
��Iurr
Mailing Address Mailing Address
//^ 1 /
a,4AA,, nl/ . 2,) Y'/

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT �( lC 6`u{PA_d r
I hereby certify that I own property adjacent to ;�
property located at
S I (Nc�ChA O Prop.rty �iwrnr�
(Address, Lot, Block, ,, cad, at
on a �Pt 1C�itC in
(Water y) tPtyrT own andl r Countyj N.C.
The appli^ nt has described to me, as shown below, the development proposed at the above location.
P' 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 - - ....'-
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 setbac , you must initial the appropriate blank below.)
LY
!'Ldo wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adja nt Property Owner Information)
Signature St nature
Print or Type Name Print or Type Name
Mailing Address M'lin AddrW l �,��

1 hereby certify that I own property adjacent to
property located at
on
(Waterhody)
(Nance of Pr
­At)L )
The arplicant has descr,bed to me, as shown below, the deveiopment
Proposed at the above locatron.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED pEyEbDP
(Individual proposing development must rill in descriptfo"? bsr., or atta MENs t$ d p yin9)
WAIVER SECTION
1 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 setba rr'y��ou must initial the appropriate blank below.)
PITtlo wish to waive the 15' setback requirement.
__ I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adja t Pro rty Owner InformAtion)
Signanu'e
Sign lure
),J
Print or T �
ype Name
Print or Type Nance
Mailing Address — q�Z �'�/% OSS1 Pt� p
Mailing Address
City/State/7l" - 2FL-OA) N c- ZZZ`f 4

BK 4627 PG 1735 - 1738 O 4
DOC# 20014613
This Document eRecorded: 09/01 /2016
Fee: $26.00 DocType: AGMT 12 50:02 PM
Pender County, North Carolina Tax: $0.00
Sharon Lear Willoughby, Register of Deeds
prepared by and return to: Charles T. Busby, P.O. Box 818, Hampstead, North Carolina 28443
NORTH CAROLINA
PENDER COUNTY SECOND AMENDED JOINT DOCK USE AGREEMENT
This Agreement is made and entered into this �ay of August, 2016, by and
between MICHAEL HAL KUIPERS and wife, TAMMY STAFFORD KUIPERS, herein
collectively referred to as Party of the First Part, and ROBIN S. HANSLEY and
husband, GEORGE S. HANSLEY, II, herein collectively referred to as Party of the
Second Part.
THIS AGREEMENT AMENDS the JOINT DOCK USE AGREEMENT recorded in Book
4413 at page 157 and the AMENDED JOINT DOCK USE AGREEMENT recorded in
Book 4469 at page 317, Pender County_
Party of the First Part is now the owner of the property referred to as Lot B [2121
of Port Sea Manor as depicted on plat entitled "VAN PALA INVESTMENTS, LLC",
recorded in Map Book 48 at page 73.
Party of the Second Part is now or will become the owner of the property referred
to as Lot A [2141 of Port Sea Manor as depicted on plat entitled "VAN PALA
INVESTMENTS, LLC', recorded in Map Book 48 at page 73.
As the current owners of the properties affected by the above -referenced
AGREEMENTS, Party of the First Part and Second Part wish to affirm the provisions of
said AGREEMENTS and to add to said AGREEMENTS the following terms and
conditions:
The owners of either property shall be entitled to make improvements or
repairs to the dock; provided, that no improvement or repairs are allowed
which would interfere with the rights of the owners of the other property to the
use of the dock or which would negatively affect the structural integrity of the
dock. Specifically, either party shall be entitled to construct a boat lift
..i;----. — « — __. , .. —i,nnt to this.

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Name of P—If Noldar
VwKbr
Chaoa NUmbw
amount
Permif Numbar/Commenb
MoI f wRefund ?9allocafad
mlfs
C01-4
CYNam16
Cdumne
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1 C.I.M. _
CW-9
_C Fletcher Ferguson
_
BUT 249.4I $ 200.00 GP #76194D
BB mt 10471
rrs Bulkheads LLC FM White Jr.
Wells Fargo 23330, $ 400.00 GP #75846D
PA rct 10759
of Brunswick Cour Jerry Hutton
BUT 13859 $ 200.00 GP #765221D
BB rct 10472_
ie LLC Leroy Offman
First Bank 1288 S 200.00 GP #76295D
JD rcL 10835
insley Michael Kuipers/Stan Hansley
First Citizens Bank 5824 $ 200 00 GP #76503D
JD rcL 10192
ractors_LLC Charles Denton
First Citizens Bank 8998 $ 200.00 GP #76502D
JD rcL 10191
rectors LLC i Will Bumette
F
FCB 8999' $ 200.00 GP #76501 D
Coastal Bank and Trust 3227 200.00 GP #78296D
JD rd. 10190
JD rct 10836
Construction Inc. Aoott and Yuki Prescott