65090D - Gordon

gr
',CAMA / L7 DREDGE & FILL �/ (5 �I
GENERAL PERMIT 1O
Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue
Date previous permit issued
prized by the State of North Carolina, Department of Environment and
�oastal
Natural Resources Q
Resources Commission in an area of environmental concern pursuant to I SA NCAC
tw LC7� j) V 4 PO +v
it Name
❑ Rules attached.
Project Location: County ►) < 0 y�
Y l ( 45 U n V1'
Street Address/ State Road/ Lot #(s)
'D Jd 0 Gv�S state R4C . ZIP2�5Z4
10 3 � t- I S'{`
E ro >3 Fax # ()
Subdivision
:ed Agent ' PsrQT1 PJ OK
C
City v t-r— COA1 zip ZK4
❑ CW WW ;JPTA ❑ ES ❑ PTS
Phone # ( - - ""--` River Basin t-lY"
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body CANp L,5' O` CG (nat A
❑ PWS: ❑ FC:
yes CVJ PNA yes n + Crit.Hab. yes /�
Closest Maj. Wtr. Body�%n" SDt1Np
F Project/ Activity_ f to S a l j'�1�/I�t1 U,
(Scale:
ck) h
:ngth
mber
SV)k.lprap length �c
g distance offshore 1
uc distance offshore
cannel
yards
np
ise/ Boatli
ulldozing
e Length fi ( C;�r'
not sure yes
s: not sure yes
ium: n/a yes
yes
4ttached: yes
ng permit may be re

UrNM l-,An A UAlly l f]VGK LU9 TUr YYIRV
Date
I
Check
Check
Received
I Check From (Name)
Name of Permit Holder
Vendor
Number
amount
Permit NumbeNG
1/15/2015 Inlet View Bar & Grill
The Point, LLC
BB&T
2630
5100.00 renewal fee, MP 18
1/15/2015 Antinori Construction, Inc.
Rocloff
B of A
3439
5200.00 boatlift, 543 Chadw
1/15/2015 Certified check, from Francisco Zarate
Sunset Beach Holdings II, 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 11
Inlet Point Harbor HOA
mod fee, MP 1604
Tangle Oaks Yacht Club Inc.
renewal fee, MP 24
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
5200.00 2 of 2 for GP 38546
1/21/2015 Coastal Earth Works Inc.
Avery Bates
First Bank
4191
S400.00 GP 65089D
1/22/2015 Clements Marine Construction
Chris Barclay
First Citizens Bank
3700
$250.00 major fee, NHCo
1/22/2015 Charles Riggs & Associates Inc
Taylor
First Citizens Bank
13772
$100.00 minor fee, NTB 15-I
1/22/2015 Charles Riggs & Associates Inc
Badaw
First Citizens Bank
13831
S100.00 minor fee, NTB 15-1
1/22/2015 Charles Riggs & Associates Inc
Fitzpatrick
First Citizens Bank
13832
$100.00 minor fee, NTB 15-I
1/22/2015 Charles Riggs & Associates Inc
Mghari
First Citizens Bank
13833
$100.00 minor fee, NTB 15-1
1/22/2015 Allied Marine Contractors, LLC
Larkins & Klausmeier
B of A
7143
$350.00 1 of 2 $250 major N
Caison
2 of 2 mod fee, MP
1/23/2015 Carolina Marine Dredging Inc
Old Chimney HOA
First Bank
1084
S250.00 major mod, 42-97, 1
1/26/2015 By Design Coastal Homes
Aligator Bay Enterprises
BB&T
1075
$100.00 minor fee, NTB 15-1
1/26/2015 Bald Head Island Ltd.
same
First Citizens Bank
1500
$100.00 renewal fee, 172-8-1
1/26/2015 Maritime Place HOA Marina Assoc
same
First Bank
123
$100.00 renewal fee, 143-11
1/26/2015 Charles B. Gordon, Jr.
Brad Gordon
Four Oaks Bank
1043
$400.00 GP 65090D
1/26/2015 Allied Marine Contractors, LLC
Hobby Greene
B of A
7111
$400.00 GP 65075D

HC Division of Coastal Mgt, Habitat Impact Computer Sheet
Npplicant: v,-6't. / �er Vo 0�-
)ate: ( Z 6 (5—
Permit #:���
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
ound in your Habitat code sheet.
iabitat 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 fine
disturbance.
Excludes any
restoration and/,
temp impact
amount)
Dredge ❑ Fill ABoth ❑ Oth
v
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

p.2
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Bever'y Eaves Perdue Braxton C. Davis Dee Freema
Governor Director - Secretai
AGENT AUTHORIZATION FORM
Date:
Name of Property Owner Applying for Permit Name of Authorized Agent for this project:
.. B P,&8 C- C,&a�j. i t- Ck AahNOR1
Owner's Mailing Address;
X Or, rltes
_ r"DU N.0
Phone Number (- I 2-1- :313 k
Agent's Mailing Address:
any HA ai-S
�geek Rd
mc. kso N iil l l e, IBC..- r 5Lt0
Phone Number q cj 3W,- 55!�,,D
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):
to re—plo c e
For my property located at I O 3 15t 5tA. VRr C ►� H I� �( .
This ce ation is valid thru (date)
72- 28-15
Z —7 t
Property Owner Signature Date

CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
r-DAY
Address of Property: 10 3b s rf ( 11 A )J . C . C, SJUA)
(Lot or Street*, Street or Road, C & County)
Agent's Name # ��) N D 21 Mailing Address: 2-79 kAQ 1 S Lee -el
Agent's phone#: AID -33(7-SS(�l� ��. _J , SDNUi���, N.C. 2�5yp
1 hereby certify that I own property adjacent to the above referenced property. The individua
applying for this permit has described to me as shown on the attached drawing the developmen
they are proposing. A description or drawing with dimensions must be provided with this letter.
L)Kat.)) N19 ON !�'Lk
I have no objections to thi proposal. I have objections to this proposal.
K 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. 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.)
W• 2 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr erty ne Info ation)
Signature
Print or Type Name
(Adjacent Property Owner Information)
Signature
pp
U Mf r)yy\ R U 1'CiQ__S 5 .�
Print or Type Name
Mailing Address
��s �JeluNe� �2
Mailing Address

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: O� �OI'd r\/
Address of Property: 10 36 - )SI- S+. S kYf Ci4�1 )v .0 . 0 nJs IDC-)
(� (Lot or Street #, Street or Road, City & County) II
Agent's Name #: �+ 1�n-�nae-I Mailing Address: ��y f� S
Agent's phone #: 510-&- oo-6Sc7D K�. SGC.�`Soly✓i Ile N C. 2gSy�
I hereby certify that I own property adjacent to the above referenced property. The individuE
applying for this permit has described to me as shown on the attached drawing the developmer
they are proposing. A description or drawing with dimensions must be provided with this letter.
DeaL.J l o ON k�ik
I have no objectionthis proI have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) it
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ezt
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response h
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.)
�—L—
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
t� eriy Mwer tormation) ( j acentnt Property Owner Information)
Signature Signature
- �y-fADri
Print or Type Name
COrd1 q AJ kN-Ot,.l I V s
Print or Type Name
L/ q (o 1<; r, h"e j pd .
Mailing Address
Mailing Address