76510D - Campbell

•LAMA / I DREDGE & FILL N9 76510 A B
GENERAL PERMIT Previous permit#
Vew ]Modification ❑Complete Reissue ]Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environmental Quality
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 12 Uo
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t Name
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ed Agent
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❑ ES ❑ PTS
❑ OEA
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❑ UBA ❑ WA
❑ PWS:
yes r no/ PNA yes
uesa c e
Project Location: County Z /"-
Street Address/ State Road/ Lot #( )19
Subdivision
City Qrkc.,LS L-f- i,�uc ik ZIP
Phone # ( ) River Basin
Adj. Wtr. Body Arc.
Closest Maj. Wtr. Body Q VJ w
Project/ Activity\ yy-�C!40f-N' & J,C nc, c .\ . u� (\t �-\GAFF,
cv C t �e ✓ (Scale: N Z
:k) length K CJ
ttform(s)
Platform(s)
igth
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J/ Riprap length
;distance offshore
x distance offshon
cannel
>ic yards j
ip
se/ Boatlift
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illdozing
i
e Length J�O
not sure yese
cum: n/a yes n L
es n
kttached: /des no
rig permit may J�e' kuired by:
Local Planning lurisdiction) -
/\ l( j 1 C, V c 4L\ ❑ See note on back regarding River Basin ri
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Mail - Brock, Brendan O - Outlook
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit C hA- C( rz S A M P)EE-Z-L
Mailing Address: �� L _Sq DP I — ( 0i/ZcLr--
C-"4C l` J t, F ,UC- d 1 Kr r - S-7 2 7
Phone Number:
Email Address:
I certify that I have authorized 1 r UZ, S4
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at i � 3 E - Ss/e
) �c--*Ct. NC
in _ Ht tv-J w , c K County.
furthermore certify that l 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 I
��4RLl=s L.
Print or Type Name
Title

................... .
.... . ......... ...
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Aaent's NNurn8 d1
Cvjaiting I I i -
t ' ere! coriiiij `.hat ! ovin property 8dict sent to hte^m vn atfiacid dra%4jina the devetoPmeru
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•,-,lT;t; Qi �#2tSr �33rBi3i� t�eno
is CCSGT:3�i to
f t ••.• �S 3
ey arc prc;:ass. A c3e_.
^t
- , - ou'ecii©ns to ty�� �3roE�as�:. objections s,� .�:s �Fosr.�. C
ave UO 3
_ �rto � Slt� Ddvl�+�Caastel �e�►®r�r�ntr
e %oszs ®:si llt ^.fin t��t3es �r L►�¢orr'Macst for 3G:19 OfN s is
IFYOU . t A, v j 6 C>: c. J t o • +�iUf- s.
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fBi,� ,: L E'Tia'� i�/cr.�ltt-f�fi�sa ,� �r F:
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,?''fc- �l'on: 1 s flc• J r�t;r:ra a. as a tCGi;�'d r .s d'i:'1 .;a �r s _� Y ,.
pp ,�. mat. rar"p, h:�ter. boathouse, or fits must
'.ty?i�vs'.4a s�ii`a fi, P; r ti�Ci�� !?'.Zt3iing p.iings, ; C t`Uc^•.wed by rile. k3i
}Svin r`al aifi'a f3i i'*,P iir^.+ii c cc �'3 �,c' s._
r.11M distant Qs °i �. �` z ti'y �y �y �e�tA :e! cn lri3w�
r• A i .--. .!``' f°iq vi the ay+�jap iu(L ble:i":C EJvW�J•�
1 to �.JciVt: ?"tt1 S�`ci;e^.L'c6, 1rGL ciEf'� �•_:y• fk'^
t eta v ish to LIVOWa the 95' Setback requirement- -'
t'F-!vF i it23 S. 9IVC L.♦ �..--....,��
-- - vcTzatzfP e
iVJcfiing Address r.
tRiparian PV013e7W Ch'jner in'CVTaQVcn)
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Print cr �; Marrsiv�A G

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: G 4e-l"C_O,�-
Address of Property
=
(Lot or Street #, Street or Road, City $ County)
Agent's Name #: %�' c� )t � i� �_ Mailing Address: /%� 44f
Agent's phone #: 15�
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.
ff you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in wafting within 10 days of receipt of this notice. Contact information for DCM offices is
available at htta://www.nccoastaimanaaement netlweblcmistaff-listing or by calling 1-888-4RCOAST.
No response is considered the some as no objection if you have been noblied by Certiited Mail.
WAIVER SECTION
I 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.)
-tom
I
do wish to waive the 15' setback requirement-
I do not wish to waive the 15' setback requirement. 3
(P O/j�w�pn�er///I%nformation) (// (Riparian Property
/ Owner Information)
Signature \� 4Sialture
Print�or Type Name /PW nt or Type /Name
r
�1
Mailin Address Mailing Address

Columns
6/11/2020 Loons Bryan_ same _ FCB _ a02o i 200.00 jGP i76505D
6/11/2020 Jerry Ennett - _ Andy Darden ,Coastal Bank and Trust -- 3121 S 200.00 GP i78504D
8/11/2020 Lighthouse Marine Construction Inc. Doug Jackson Coastal Bank and Trust 311 S 200A0 GPi75884D
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6/11/2020Charles Fox Homes, LTD Patrick and Claire Joyce Branch Banking and Trust _ 27042 $ 200.00 GP #74582D
6/1112020 AMW Docks and Marine Construction LLC Charles Campbell - BUT _ 5890 $ 200.00 GP #76510D
6/11/2020 CLTMC, Inc. Joseph Lyons FCB _ 1082 $ 200.O0 GP #76422D
6/11/2020 Palmetto Marine Construction Jerry Cobb First Palmetto Savings Bank - 5350 $ 200.00 GP #76413D
8/11/2020 Coastal Marine Piers Bulkheads LLC Meyers and Cameron Wells Fargo 23359 $ 200.00 GP #76525D