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Home My WebLink About69233D - Ward"CAMA / DREDGE & FILL 'ENERAL PERMIT 'New ;Modification LlComplete Reissue El Partial Reissue A Previous permit # 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 15A NCAC o ► 1 , 1100 ❑ Rules attached. t Name �r�h �/\%^ �- Project Location: County ('A<1Aq C g�p Street Address/ State Road/ Lot #(s Ci Vy�e State ZIP `' '��j �%i 0 Nl rat , Subdivision ed Agent C v�sc h a� City av a '�!7 Wt �jp q m1 �, zip All ❑ CW A ` PTA DES ❑ PTS bone (� ) .J ! - 1' -! d I � River Basin ✓V� ❑ OEA ❑ HHF ❑ IH ❑ UBA El N/A Adj. Wtr. Body C�. �'l(ll�C (nat /G ❑ PWS: yes / 06') PNA yes / Closest Maj. Wtr. Body Al WVA4 Project/ Activity =k) length aform(s) Platform(s) i nber OPOMIM was Wkwe Pig, re ho ��"':■■:W,,.,rs�■■: ��r1l��■■i�ia;i )ic ip se/ oatli +)' illdozing a AMP - Ta7■a`iWN 1,1�I■■■■■■■■�■■■� ■S!1'ilYiili��l■■■ ■■■■■®■■■1 (Scale: t - I nral Planninv luricrlirtinn) ❑ See note on back regarding River Basin n ■ CompleteiteKi 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 mailpteft or on the front if space permits. Article Addressed to: 5s 2Ss`ll�y 111111111111111111111111111111111111111111111111 9590 9403 0603 5183 4333 53 ?. Article Number (Transfer from service ❑ Agent of Deliver Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Express® O Adult Signature O Registered Mail— ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restrict i�Certified Mail® Delivery ❑ Certified Mail Restricted Delivery VV%tum Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery O Signature ConfinnationTi ❑ Signature Confirmation 7 015 0640 0006 3682 1768 acted Delivery Restricted Delivery 3.9 Fnrm 3R1 1 - Anril 9n15 PSN 753n-n9-non-gn53 Domestic Return Receiot 6/7/2017 Grice Construction Frank Ward, Jr. BB&T 11282 $200.00 GP 69233D 6/7/2017 Holden Docks & Bulkheads Town of Holden Beach CresCom Bank 2996 $400.00 GP 69232D 6/7/2017 James or Mary Hartsell same SunTrust 2173 $200.00 GP 69231 D 6/7/2017 Grice Construction Mom's Revocable Trust BB&T 11283 $200.00 GP 69234D 6/8/2017 Jerry Ennett Richard Stanley Coastal Bank & Trust 641 $200.00 GP 69182D 6/8/2017 Paul or Christine Minervini Rich Balot Marine Federal Credit U 2216 $100.00 minor, 146 Oceanview L 6/8/2017 Frank R. Bellini same LG Federal Credit Unior 7239 $200.00 GP 69141 D 6/8/2017 Carolina Bluewater Construction Co Robert Purcell BB&T 17781 $200.00 GP 69240D 6/9/2017 Will Richardson Wrenn Patterson BB&T 6735 $200.00 GP 69239D 6/12/2017 Permit Pals Michael Ervin CresCom Bank 1580 $400.00 major, 10 Monroe St., OI 6/12/2017 Permit Pals Julie Elkin Fisher CresCom Bank 1578 $400.00 major, 6 Monrose St., OI 6/12/2017 Permit Pals Alonzo Pringle CresCom Bank 1579 $400.00 major, 8 Monroe St., OIE 6/12/2017 Permit Pals Michael Green CresCom Bank 1577 $400.00 major, 4 Monroe St., DIE 6/13/2017 Allied Marine Contractors/Hal Fogleman Louis Cox First Citizens Bank 5734 $400.00 GP 69183D 6/1312017 Allied Marine Contractors /Hal Fogleman Donald Waters First Citizens Bank 5733 $600 00 GP 66324D I 99?-T 299E 9000 0+190 9`t0Z SLLT 299E ■ Complete items 1, 2, and 3. A. Signature ■ -Print your name and address on the reverse ❑ Agent so that we can return the card to you. XC 0 � _;_ 'jj ❑ Addressee ■ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. Date of Delivery or on the front if space permits. 1. Article Addressed to: 11111111111111111111111111111111111111111111111 9590 9403 0603 5183 4333 60 2. Article Number (Transfer from service label) 7015 0640 0006 3682 PS Form 3811, April 2015 PSN 7530-02-000-9053 D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No ,j. Service type ❑ Adult Signature ❑ priority Mail Express® ❑ Aduit Signature Restricted Delivery Certified Mail® O Registered MailTM ❑ Registered Mail Restricted ❑ Certified Mail Restricted Delivery Delivery +A3tetum Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery ❑ Signature ConfirmationT" 0 Signature Confirmation 1775 cted Delivery Restricted Delivery Domestic Return Receipt : NC Division of Coastal Mgt. Habitat Impact Computer She ;ant: V j o' V -ibe below the HABITAT disturbances for the application. clues should match the name, and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. at Name • Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) impact amount) temp impacts amount) Dredge ❑ Fill ❑ Both ❑ Other ( 5 1 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both 0 0ther ❑ A� NCDMR North Carolina Department of Environment and Natural Resources Division of Coastal Management 'at McCrory Braxton C. Davy Governor Director John E. Skvarla, III Secretary AGENT AUTHORIZATION FORM Este: ime of PIpperbilOwner Applying for Permit: Na a of Authorized --Agent for this project: Nner's Ma17g Address: 3 macro r- _— �A,.r T ale lone Number (-110 ) -6 Z o - 29 4 Z Agent's Mailing Address: 0C4sa075k Phone Number Al� T CKA ,�— ;edify that I have authorized the agent listed above to act on my behalf, for the purpose of applying r and obtaining all CAMA Perot? necessary to install or construct the following (activity): w my property located at 3 a 06�. s its certification is valid thru (date) �N) Lei )� S� Property Owner Signature Date CERTIFIEp MAIL. • RETURN RECEIPT REQUESTED DIVISION OF COASTAL. MANAGEMENT ADJACENT RIPARIAN _PROPERTY O\WNE\R NOTIFICATTI�O-NIWAIVER FORM rcA Name of Property Owner: _�Q.� ��._• "� Q— --- - -- — Address of Property: (,Lot or Street #, Street dr Road, City & CounTV -- Agent's Name Il: `\ "V �5�-�\� Pl Malling Add ass:. _ _ A ent's phone ll: %6 t� - Lv J_ U g -- I hereby certify that I own property adjacent to the above referenced property. The individual applying for this nennit has described to me as shown on the attached drrawingjhe`development they are proposing. I have no obicctions to this proposi,l. I hove objections to this proposal. If you have objections to what. is being proposed, you must notify the Division of Coasts! Management (I)CM) In writing within 10 days of receipt of this notice. Correspn0ence• should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represe074*08 can also be contacted at (910) 796-7215. No response is considered the same as no objection # you i beef) notified by Certified Mall.WAIVER SECTION 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 riparlan 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. I do not wish to waive the 15' setback requirement. (Property Owner In ortnation) — djarent arty Owner Information) Signature Signal tire � Print or Type Namo Pint or Type Name 1 Mailing Address Ci1y1Stata/Z1p telephone Number r-% I, —11 Moiling Address City/State/Zip Telephone Number v