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'NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: (DC) �` 1 �.h (� d Permit #:
Date: � � J f C-7
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied. for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
\-7 V "t
p
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both (l Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
2/15/2017
2/15/2017
Bobby Keith
Gore Bobby Keith Gore NCSECU
East Coast
Engineering Bobby Keith Gore First Bank
2127 $100.00
2008 $100.00
comments
GP
67961 D
GP
67961 D
SF rct. 3560D
SF rct. 3561 D
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East Coast Engine. ring & Surveying, P.C.
ENGINEERS- ERS•SURVEYORS
November 7, 2016
Mr. Sean C. Farrell
Division of Coastal Management
NC Department of Environment and Natural Resources
127 Cardinal Drive Extension
Wilmington, North Carolina 28405-3845
Subject: Bobby Keith & Audrey Owens Gore
5601 Bertha Court SW, Ocean Isle Beach
General CAMA Permit Application
Dear Mr. Farrell:
As discussed during your phone conversation last week with Christopher D. Stanley, PLS of our firm,
please find attached check #2008 in the amount of $100.00 to cover the additional review/site fee for the
General Permit for the subject project.
Should you have any question or require any additional information, please contact our office at your
convenience.
Sincerely,
Sabrina Bennett Babson
Engineering Assistant
Enclosures
PC: Keith & Audrey Gore, Clients
File: 1668 (Gore - CAMA General Permit)
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Bobby Keith Gore
Mailing Address:
5601 Bertha Court SW
Ocean Isle Beach, North Carolina 28469
Phone Number: 336-407-8301
Email Address:
I certify that I have authorized East Coast Engineering & Surveying, PC - Christopher Stanley, PI,S
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Minor/General (Dock) LAMA Permit
at my property located at 5601 Bertha Court SW
in Brunswick County.
1 furthermore certify that 1 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
Bobby Keith Gore
Print or Type Name
Owner
Title
East Coast Engineering & Surveying, P.C.
ENGINEERS• ERS•SURVEYORS
October 17, 2016
Ms. Holley Snider
Division of Coastal Management
NC Department of Environment and Natural Resources
127 Cardinal Drive Extension
Wilmington, North Carolina 28405-3845
Subject: Bobby Keith & Audrey Owens Gore
5601 Bertha Court SW, Ocean Isle Beach
Minor CAMA Permit Application
Dear Ms. Snider:
On behalf of our client, please find enclosed a proposed Minor CAMA submittal for 5601 Bertha Court
SW, Ocean Isle Beach, Ocean Isle Beach, within Brunswick County. The submittal package includes the
following:
1. One (1) original of the CAMA Mino
2. One (1) copy of our design plan, on
3. One (1) copy of our design plan, on i
4. An Agent Authorization Form auth(
property owner's behalf;
5. Copies of the October 3, 2016 letter
riparian property owners of the propo
6. A copy of the executed Non-Objectioi
7. Check #2127 in the amount of $100 tc
If you have any question or require any additic
Sincerely,
C to act on
he adjacent
Christopher D. Stanley, PLS
Director of Surveying Services
111W.Orlo
East Coast Engine _�ng & Surveying, P.C.
ENGINEERS•PL `NERS•SURVEYORS
0
Return Receipt Requested
October 3, 2016
Jonathan R. & Marianne M. Gore
Post Office Box 7422
Ocean Isle Beach, North Carolina 28469
Subject: Bobby Keith & Audrey Owens Gore
CAMA Minor Permit Application
Dear Mr. & Mrs. Gore:
Mr. & Mrs. Gore have retained our firm to apply for a pier and dock permit with the North
Carolina Division of Coastal Management. In accordance with the Division of Coastal
Management's (DCM) rules as an adjacent riparian property owner, you must be notified of this
permit request.
Enclosed is a copy of the Adjacent Riparian Property Owner Notification/Waiver Form for the
proposed project, and a drawing we have prepared describing the proposed pier and dock.
If you have no objections to this proposal, please check the space provided on the enclosed form
and return it to our office within thirty (30) days of receipt of this notice. Any comments
regarding the proposed project should be directed to the Division of Coastal Management. Such
comments will be considered by the Department in reaching a final decision on this application.
No comments within the thirty (30) days will be considered as no objection.
Should you have any question or require additional information, please contact our office.
Sincere ,
_ (`hrictnr�hPr Cf�nln., U7 C
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOOREVG PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to
Bobby Keith & Audrey Owens Gorg
(Name of Property Owner)
property located at 5601 Bertha Court, Ocean Isle Beach, NC
(Lot, Block, Road, etc.)
on Atlantic Intracoastal Waterway in Ocean Isle Beach, Brunswick County , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 336-407-8301 Mailing Address: 5601 Bertha Court SW
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that.a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
JI do wish to waive that setback requirement.
----------------------------------------------------------- --- & ----------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
5601 Bertha Court SW
?Mailing Address
(Riparian Property Owner Information)
Signature
— , , , Jonathan R. & Marianne M. Gore
24400019
440001904
440001
440001
24400018
0
24400017
2440001501
24400015
Isle Beach ETJ
440001502
24400030
2440001402
2440001401
24400028
244OW14 \ 244OW1301
PIN: 107510458174 PARCELID: 24400015 OWNER: GORE JONATHAN R ETUX MARIANNE M
ADDRESSI: ADDRESS2: PO BOX 7422 CITY: OCEAN ISLE BEACH STATE: NC ZIPCODE: 28469
PARCELDESC: TR-2C .75AC PLAT 36/511 DEEDDATE: 1/22/2007 DEEDBOOK: 2559 DEEDPAGE: 0624 PLATBOOK: 0036
PIN: 107510456088 PARCELID: 24400017 OWNER: GORE JONATHAN RUSS ETUX GORE MARIANNE M
ADDRESS1: ADDRESS2: PO BOX 7422 CITY: OCEAN ISLE BEACH STATE: NC ZIPCODE: 28469
AARCELDESC: PARCEL A .90 AC PL 34/341 DEEDDATE: 8/15/2015 DEEDBOOK: 3688 DEEDPAGE: 0726 PLATBOOK: 0034
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