68070D - Taylor

,MA / ❑ DREDGE & FILL 11� �j,�Iv •��
NERAL PERMIT
v ❑Modification ❑Complete Reissue ❑Partial Reissue
a3 A B
Previous permit #
Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources y
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 0 Rules attached.
Name VVN T� { Project Location: County 4iAA-7
771- (T YV � `'_C k 001 � � _
'-4M 1nt'4/Z4i 1,-•( State VC ZIP Z
E-Mail
ad Agent
❑ CW EW PTA - ES ❑ PTS
❑ OEA Mil' C11H J USA ❑ N/A
❑ PWS:
yes / c PNA yes / (0 i
Project/ Activity
- lha �'Vk( cl 1) ( .
ck) length (r--
1
atform(s)
Platform(s)
!ngth
amber --
id/ Riprap length -
g distance offsho
ax distance of ore
hannel
ibic
Boatlift
3ulldozing
G
ne Length 0
not sure yes
>rium: n/a yes
yes
h d•
Street Address/ State Road/ Lot #(s)
(C" C0 Yes. q,
Subdivision t i
City ()(2AAn � it—�Jt Li( V1 ZIP
Phone # ( 9(0) b" V River Basin Wm
Adj. Wtr. Body G1M
Closest Maj. Wtr. Body 11
(Scale:
RM
Attac a yes
117.
Jing permit may be required by: I QVl/1/� d ((QL�Y�� ❑See note on back regarding River Basin

NC Division of Coastal Mgt. Habitat Impact Cam
Applicant )I-YV\ tov—
Date: Q�;/ j� j201 -I
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
to
tempimpacts)
impact aarmount
_temp impacts)
ar
D vA
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 ❑

Comments
3/14/2017
Money Order
from Joel Klass Jim Taylor
Wells
Fargo 17-
Bank 554036582
$200.00 GP 68070D BS

WA
AA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue. Governor James H. Gregson, Director Dee Freeman. Secretary
Date Dec. 30, 2016
Name of Property Owner Applying for Permit:
Jim Taylor
Mailing Address:
726 Bluff School Rd.
Kernernersville NC 27284-8041
t�e� re�"5 � � �\r✓
I certify that I have authorized (agent) Joel Klass
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary, to
install or construct (activity) replace floating dock & ramp
at (my property located at) 18 Concord St. Ocean Isle Beach, NC
This certification is valid thru (date)`Z—
*0002—v
Yrope Owne iguature D to
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
n Equal Opportunity 1 Affirmative Action Employer - 50% Recycied \ 10% Post Consumer Paper

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Jim Taylor
Address of Property:
18 Concord St. Ocean Isle Beach, NC Brunswick
(Lot or Street #. , Street or Road, City & County)
Agent's Name #: Joel Klass
Agent's phone #: [phone]
Mailing Address: P O Box 279
Sumly, NC 28462
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 are proposing. A description or drawino with dimensions must be provided with this letter.
I have no objections to this proposal. ► <" _ 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 _ = _ or by calling 1-888-4RCOAST. 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.
1� I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner information)
Signature
_,Taylor
br Type Name
? ff School Rd.
00, ddress
_K4gWville, NC 27284-8041
cn)MAkIzip
V V VUCli17iA� ` r It r ��� �?r^^_" • '
Signature _
Ruth G. Chewning
Print or Type Name
3909 Hemsbury Way
Mailing Address
Rayleigh, NC 27612
City/Statelzp

Joel Klass dba B &J Construction
P. O. Box 279 Phone: [phone]
Supply, 28462 Fax: [phone]
Dec. 30, 2016
Ruth G. Chewning
3909 Hemsbury Way
Rayleigh, NC 27612
Dear Ruth G. Chewning,
SUBJECT: REPLACING FLOATING DOCK & RAMP
We are obtaining permits to replace the floating dock and ramp, for Jim Taylor. Attached
is an adjacent property owner notification/waiver form, which is required by CAMA
(Coastal Area Management Act).
Please initial I_ = l;s, sign and return to us by mail, fax or email.
[e-mail]
If you have any question please don't hesitate to call me My C-Phone: [phone]
SPAT .T.
Wl"
k ► rd�
Thank you
Joel E. Klass
r

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