69133D - Fisher

.LAMA / ❑ DREDGE & FILL ` �`1 A B
iENERAL PERMIT Previous permit #
New --Modification❑Complete Reissue [:]Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources ''%
;oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC (- I ❑Rules attached.
t Name /M A4 ;s. t / Project Location: County
'� �``Z, �' ooA& GIB tl r. Street Address;/State Road/ jLot #(s)
State" ZIP
[ �!j E-Mail AA�-r�- n 9 G-)^0 j 1Ov"Subdivision
ed Agent , {. �G� Mc City U4015 k(k ZIP
❑ CW NEW
PTA ❑ ES ❑ PTS Phone # (J3) (65 %L 6i(ver Basin Ll� iO
LiOEA '❑ HHF El H ElUBA El N/A Adj. Wtr. Body c G10 c J� (nat /I
❑ PWS:Al on
Closest Maj. Wtr. Body —�&�—
yes / � PNA yes / !'l
• - 1'ATi���►'S�7iV�.'�L•�l�uufn.�a���..■•�
Platform(s)
mgth
amber
id/ Riprap length
g distance offshc
ax distance offsY7
:hannel 1
ibic yards(
mp
use/ oatli LS_�_
Bulldozing
ne Length 7 D
notsure yes
)rium: n/a yes d°%
J-J-yes rnnoTI
Attached: yes no
ding permit may be required by: 01
(Scale:I(%- Z
❑ See note on back regarding River Basin

5/19/2017
-----
- —/
Palmetto Marine
Mark Fisher
First
INlli Va.■
3411
A111V11116
$200.00
V-VQI$CAAtT
GP 69133D
Construction Inc.
Palmetto
Savings
Bank

NC Division of Coastal Mgt. Habitat Impact Coml
Applicant: bVXV C 5-E�1-01y
Date: c) 5 `( -7 / -�, 0 (%
G l ( 3'�—
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
FII
(Applied for.
(Anticipated final
(Applied for.
(Ar
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
dis
Habitat Name
Choose One
includes any
Excludes any
total includes
Ex
anticipated
restoration
any anticipated
res
restoration or
and/or temp
restoration or
ten
temp impacts
impact amount
temp impacts
arr
I
V V
Dredge ❑ Fill ❑ Both ❑ Other 5
1, 1
( � 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 0

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mark Fisher
Mailing Address: 2119 woods End Drive
Eastover, NC 28312-9295
Phone Number: 910-273-9004
Email Address: rAK1-' 1'l'fq e cLo1. LDk
I certify that I have authorized Palmetto Marine Construction, Inc.
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: installation of boat lift
at my property located at 30 Dare Street, OIB
in Brunswick
County.
I furthermore certify that I 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:
gnature
mark-, ; 1 Sl-18
Print or Type Name
h o ✓rye Du) N& r
Title

CERTIFIED MAIL - RETURN RECE
DIVISION OF COASTAL MAI,`-,
ADJACENT RIPARIAN PROPERTY OWNER N o
Name of Property Owner: Mark Fisher
a
ca
Address of Property: 30 Dare Street, OIB, BrunswiO o
(Lot or Street #, Street or Road o
C3
Agent's Name #: Palmetto Marine Construction, Inc. Mailin m
Agent's phone #: [phone]
r�
V
Postal
CERTIFIED o RECEIPT
Domestic
For delivery information, visit our website at www.usp-T
CHA t9 T 12, 24
Certified Mail Fee -+c
$J.wJ �t
$
Extra Services & Fees (check box, add lee ' te)
❑ Retum Receipt (hardcopy) $
rr11 r'
❑ Retum Receipt (electronic) $ Sri -
Post
rr1U�r
❑Certified Mail Restricted Delivery $ SQ k)k
HE
❑ Adult Signature Required $ 0.191A _
❑ Adult Sijnature Restricted Delivery $
Postage $0.49
$
04/12/;
Total Postage and Fees
$6.59
$
Sent To
-------------------------------------------------lam---�----------------
Street and- --ryy O_BoXNo. -----------.
City, State, ®
—
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I hereby certify that I own property adjacent to the aboi
applying for this permit has described to me as shown on
they are proposing. A description or drawing with dimensions must be provided with this letter.
. 0~ I have no objections to this proposal,
If you have objections to what is being proposed, you must,
(DCM) in writing within 10 days of receipt of this notice.
avaHableatfrrr �::I�✓ir�w.riccc�as2afroarIa( erfIC,",r.rrey'�eb-er)�!
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No response is considered the same as no objection if yoc
WAIVER SECTIOI
I understand that a pier, dock, mooring pilings, boat ram[
be set back a minimum distance of 15' from my area of ri
you wish to waive the setback, you must initial the appr,
1, L1 - I do wish to waive the 15' setback requirE
do not wish to waive the 15' setback r(
(Property Owner In rm tion)
Signature
Mark Fisher
Print or Type Name
2119 Woods End Drive
Mailina Address
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Mark Fisher
Address of Property: 30 Dare Street, OIB, Brunswick County _
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Palmetto Marine Construction, Inc. Mailing Address: 2678 Mount Zion Road
Agent's phone #: [phone]
Little River, SC 29566-7412
1 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 drawing, with dimensions, must be provided with this letter.
I 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. Contact information for DCM offices is
available at 1er�reL3:tic-tiweblcm-staff,_irstrr?q orb y calling 1-888-4RCOAST.
No response is considered the same as no objection If you have been notified by Certified Mail.
''VVAiVER SECT 1014
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
J I do wish to waive the 15' setback requirement. Tolt
I do not wish to waive the 15' setback requirement.
(Property Owner Inf rt ation)
Signal urc
Mark Fisher
Print or Type Name
(Riparian Property Owner kiformation)
Signature
Edward McArdle
Print or Type Name
2119 Woods End Drive
Mailing Address
3827 Chevington Road
Mailing Address

DRAWING NOT TO SCALE FOR PERMITTING PURPOSES ONLY
TOP OF EXISTING SEAWALL
3'x16'
10' Setback Ramp
T
Floating Dock
16'
10'
Setback
O
O
New
12'6"
Boat Lift
O
O
12 6