65198D - King

CAMA / ❑ DREDGE & FILL
F
NERAL PERMIT
w ❑Modification El Complete Reissue ❑Partial Reissue
Previous permit #
Date previous permit issued
65.
zed by the State of North Carolina, Department of Environment and Natural Resources --t_ r 12ev
:)astal Resources Commission in an area of environmental concern pursuant to I SA NCAC
u es at/tta��ched.
Name 4-e / Project Location: County Ale44 17loy 1,
V% ,''✓>h
State Ile ZIP r. / 1
#
d Agent
/Fax
❑ CW
KEW
P-IfTA
❑ ES ❑ PTS
❑ OEA
❑ HHF
❑ IH
❑ UBA ❑ N/A
❑ PWS:
❑
FC:
es / no
PNA
yes /
0 Crit.Hab. yes / no
Project/ Activity ( 00-*P5'6*l.
Street Address/ State Road/ Lot #(s)
1?2.1 S�t4 /1w .
Subdivision
City V {/ 1 �►M %'y5 %�TJH ZIP 21f
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permit may be required by: AIA eB , See note on back regarding River Basin ru

Date
Received
Check From (Name)
Name of Permit Holder
Vendor
Check Check
Number amount
Permit NumbedG
3/30/2015
Telecommunication & Industrial Consulting Ser.
Time Warner fiber optic cable crossing, BRCo
B of A
62120 $400.00
GP 65177D
3/30/2015
8%31/2015
Rachel Boling
Ray or Mary McGowan
Phil Boling
First Citizens Bank
6520 $200.00 GP 65135D
5679 $100,00 mod fee, MP 293, E
1195 _ $100.00 minor fee, New Rive
1275' $100.00 minor fee, 23rd Ave
20362 $200.00 GP 65136D
_
Duke Energy Progess/Brunswick Steam Plant
Wells Fargo Bank
313MO15
Christopher M. Whelan
same
Charles Schwab Bank
4/1/2015
Howington Properties LLC
same
BB &T
4/1/2015
JRW/RDW INC
Tom Denney
First Bank
412/2015Money order for Brandon Grimes
Patricia Welfare
Wells Fargo Bank
59747265100 $400.00 GP 65169D 1 of 2 F
4/2/2015 Money order for Brandon Grimes
Patricia Welfare
Wells Fargo Bank
59147265090 $400.00
see above entry
4/2/2015 Money order for Brandon Grimes Christopher Lemmons
4/2/2015 Money order for Brandon Grimes Jenna Black
Wells Fargo Bank
59147265111 $200.00
59147265408 $400.00
9560 _ $600.00
2136 $200.00
GP 65168D
Wells Fargo Bank
GP 65175D
GP 65173D & GP 6
GP for 1215 N. Shc
4/2/2015
Carolina Marine Construction, Inc. Walker @$200 & Kehaya Q$400
Mark L Dalen Matt Reinhardt
Charles Riggs and Associates The Peninsula at Topsail Island
Fred or Sylvia Bums _ North Galleon Bay Owners Assn.
Vamams Docks & Bulkheads Inc lJohn S. Casey III
First Bank
4/6/2015
BB &T
4/6/2015
First Citizens Bank
13975 $100.00
mod fee, MP 39-09
4/8/2015
BB &T
_ 555 $100.00 renewal fee, 97-09
6981 $200.00 GP 65179D
20060 $400.00 GP 65180D & GP 6
4863 $250.00 major fee, BrCo.
1144 $475.00 major fee, PN Co
4790 $100.00 mod fee, MP 162-0!
27366 $100.00 renewal fee, MP 40
27370 $100.00 renewal fee, MP 12
27369 $100.00 renewal fee, MP 16
3617 $200.00 GP 65184D
4/8/2015
BB &T
4/9/2015 Coastal Marine Piers Bulkheads LLC JWillard Buffkin & Kevin Dolan Wells Fargo Bank
4/9/2015 Double S Farms Jetter Lewis First Bank
4/7/2015 Kim Quinn same First Citizens Bank
4/10/2015 Beam & Associates lseawst Camping Resort, Inc. BB &T
4/10/2015 Town of Holden Beach same (Holden Beach Harbor Maintenance, dredge) BB &T
4/10/2015 Town of Holden Beach same (Harbor Acres, dredge) BB &T
4/10/2015 Town of Holden Beach same (Heritage Harbor, dredge) BB &&T
4/13/2015 Richard A Lehrer/Anna Romero -Lehrer same SunTrust
4/13/2015 Island Marina Enterprises LLC same First Bank
4/13/2015 Capital Creek Investments, LP Seaside Bay LLC transfer to Timothy Scott Bullock Bank of the Ozards
4/13/2015 Bennett Brothers Yachts, Inc. 'same BB &T
4/13/2015 Porch Conversion, LLC BB &T
4/13/2015 Land Management Group, Inc Port Cape Fear Associates _ First Bank_ _
4/13/2015 Lanier FamLC Wayne Lanier, Redds Cove B of A
ily II L
4/14/2015 Charles F. Riggs & Associates Earl and Shelly Johnson First Citizens Bank
4/14/2015 Charles F. Riggs & Associates Hark Properties, LLC First Citizens Bank
4/1412015' Carolina Marine Management CB Marina_ First Bank
4/14/2015 ;James and Cathy Angell same BB &T
4/16/2015 Archie McGirt and Janet Batten same First Citizens Bank
4/16/2015 Mellinee and John Hunt same_ NC State Employees' Credit Union
4/20/2015 R. Burak Erem same B of A
4/20/2015 Charles D. Carmen Jr. same Piedmont Advantage Credit Union
4/20/20151Southeastern Coastal Construction Co. First Federal
2004
$100.00 transfer fee, MP 36•
2602
$100.00 transfer fee, MP 63
17843
$100.00
renewal fee, MP 90
4468
$100.00
minor fee, SC 15-01
45299
$100.00
renewal fee, 128-9E
1251
$100.00
mod fee, MP 03-07
13985
$100.00
minor fee, Topsail E
13979
$100.00
minor fee, N.T.B/Or
2070 $100.00
620, $200.00
79411 $600.00
transfer fee, 137-12
GP 65188D
bulkhead permit
3562 $200.00
GP 65139D
719 $200.00
1029 $200.00
9440' $200.00
GP 65185D
GP 65197D
GP 65198D

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
applicant: (114V �.yih� Permit 7 J
)ate:
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ound in your Habitat code sheet.
DISTURB TYPE
ilabitat Name I Choose One
Dredge ❑
Fill ❑
Both ❑
Other 9'
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 171
Other ❑
TOTAL Sq, Ft.
FINAL Sq. Ft.
(Applied for.
(Anticipated final
Disturbance total
disturbance.
includes any
Exdudes any
anticipated
restoration
restoration or
and/or temp
temp impactts
impact amount,
(.4�
/ 6 Lou_
Maits
MHCDG
Tyler Crumbley
LPO
DW Review
Owner
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
Disturbance
disturbance.
total includes
Excludes any
any anticipated
restoration and/o
restoration or
temp impact
g
0
0

NCDENR
North Carolina Department of Environment and Natural Resources
IcCrory Donald R. van der
error Secretary
AGENT AUTHORIZATION FORM
of Property Owner Applying for Permit: Name of Authorized Agent for this project:
is Mailing Address:
tQ�\ odd A ,ir-
m;V\,\>J� S
tYl�� �y v� �G 1 h� � iY10.C_ • C., 0�'�
Agent's Mailing Address:
2-
Email: SCDt°ltUC4G , Nf, C-o"
Phone C qLJ e-3ey 2:7 _-�
'y that I have authorized the agent listed above to act on my behalf, for the purpose of applying
id obtaining all CAMA Permits necessary to install or construct the following (activity):
l ,:, /9 i " . r L
act Site Address: � CQ_ { , M rL oCL P U e
(l�(✓yit't\( Vl, AlC,
Prope wn Signature
Date*

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ame of Property Owner: evr V-- t 14kP y�
.ddress of Property: ;? S c�,l� �0� (Y1QN PTC.. IAA < iVl in) h No.) Ac ww 2r C
(Lot or Street #, Street or Road, CAy & County)
,pplicant's phone #: (9 L65H -7 - 41 ,t E5
Mailing Address: �S� t curd
��� Wolc�►�`�4nan, kc,
v � -
hereby certify that I own property adjacent to the above referenced property. The individual applying for this pe.
as described to me as shown on the attached drawing the development they are proposing. A description of draw
iith dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
f you have objections to what is being proposed, you must notify the Division of Coastal Management (DC.
n writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive'.
Viimington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response h
onsidered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distanc
5' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the
ppropriate blank below.)
� t-4— I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
Prope'Te Ver Information)
>ignature
K k tZ L
Tint or Type Trame
(Riparian Pro erty Owner Information)
Signat
aj
Print or Type Name
to (L.1trL1,I t CST' Vf— t0�
vlailing Address
Mailing Address

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