38546D - Brown

CAMA / a DREDGE & FILL j'
3AENERAL PERMIT Previous permit #
-'New 'Modification Complete Reissue Partial Reissue Date previous permit issued
sized by the State of North Carolina, Department of Environment and Natural Resources
Zoastal Resources Commission in an area of environmental concern pursuant to 15A NCAC U r'
❑ Rules attached.
it Name � DW N _ _ Project Location: County 0IJC•
s 16 t- Ne � 4f
P/N4 State L- ZIP
zed Agent /,Ow f r'
❑ CW )�EW ,[ PTA )US ❑ PTS
❑ OEA ❑ HHF IH ❑ UBA 7 N/A
❑ PWS: ❑ FC:
yes V PNA yes ,_no Crit. Hab. yes / no
Project/ Activity
:ubic yards_
amps
ous atl'
Bu �zjng
line Length
r/
Street Address/ State Road/ Lot #(s)
Subdivisi � ��
City 7 ZIP
Phone # ( �.-- ver Basin
Adj. Wtr. Body . +~ /at
Closest Maj. Wtr. Body 41
(Scale: '
■N Nr' �/E _S■■MON
See note on back regarding River Basin

Date
Check
Check
Received
Check From (Name)
Name or Permit Holder
Vendor
Number
amount
Permit NumbeNCo
1/15/2015 Inlet View Bar & Grill
The Point, LLC
BB&T
2630
$100.00 renewal fee, MP 185
1/15/2015 Antinori Construction, Inc.
Rocloff
B of A
3439
$200.00 boatlift, 543 Chadwic
1/15/2015 Certified check, from Francisco Zarate
Sunset Beach Holdings ll, LLC
BB&T /First Colonial Branch
5006872655
$100.00 transfer fee, MP 42-(
1 /16/2015 F and S Marine Contractors Inc.
Brady Semmel
PNC Bank
4269
$250.00 major fee, Airlie Rd,
1/20/2015 Carolina Marine Construction, Inc.
Dolphin Bay HOA
First Bank
9458
5300.00 renewal fee, MP 117
Inlet Point Harbor HOA
mod fee, MP 160-05
Tangle Oaks Yacht Club Inc.
renewal fee, MP 24-1
1/20/2015 Western Union Money Order, Brandon Grimes
Randy Brown
Wells Fargo Bank
17-135019699
$400.00 1 of 2 for GP 38546[
1/20/2015 Western Union Money Order, Brandon Grimes
Randy Brown
Wells Fargo Bank
17-135019697
S200.00 2 of 2 for GP 38546[

yC Division of Coastal Mgt. Habitat Impact Computer Sheet
pplicant: 0.1n JnLk) tti Permit --
late: ' _ Z Q )15
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
)und in your Habitat code sheet.
abitat 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/o
temp impact
amount)
�A)
Dredge ❑ Fill Both ❑ Other ❑
I
,
Dredge ❑ Fill ❑ Both ❑ Ot
�55
5
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 ❑ Other ❑

Pat McCrory
Governor
North Carolina Department of Environment and Natural Resources
Division -of Coastal -Management- — _
Braxton C. Davis John E. Skvarla, II
Director Secretary
AGENT AUTHORIZATION FORM
Date:
Name of Property Owner Applying for Permit:
Owner's Malting Address:
Phone Number Wtl Z ?,f r2 2 y
%-2°'rs'
Name of
Authorized /riized Agent for this project:
Agent's Mailing Address:.
Phone Number( )
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
For my property located at
This certification is valid thru (date)
roperty Owner Signature
Date

e� (Name —of Property Own
(Address, Lot, Block, Road,'etc.)
wraWrooay) (City/Towif and/or County)
ne-app1iic t-ha�s escn o-metes-s - own -tree ow; the-development-proposed-at-the-abovelaatior -
!� I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must flit In description below or attach a site drawing)
lei
w ��t
Rowe
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, oIgr in 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.)
A
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owp r Information) (Adjacent Prgperty.Owner Information)
k
,,.. ,.�.., r
arne �
9 14
Mailing Address �// M in Address Ar C-

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: �d 3 `� 3� << f/, �G �� �, /� y /V1
(Lot or Street #, Street or Road, City & County)
Agent's Name #: �'//� - ,� y�' f) Zy Mailing Address:
Agent's phone #:
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 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 whatis being proposed, you mustnotify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Arintor pe Name
9z /
Mailing Address
Proms Owner Information)
Print or Type Name
/ yg /e /pl ,, A
Mailing Address

It'VVILT f /r rJ60A
3,0 3 4 5F-4 s --
SvfF �(,�
i
C d'
r
Ak
t
'Oti
Jo �-- - -
2