65765D - Owens

''CAMA / 7 DREDGE & FILL
GENERAL PERMIT
Previous permit #
New ,Modification LIComplete Reissue
L Partial Reissue Date previous permit issue -
rized 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 U)
❑ Rules
it Name a t14 I tj I e-.JL 0 V IfAC s
"�attached.
Project Location: County_TI .9/
.4 w (
Street Address/ State Road/ Lot #/(s)
Z rt/,/3 vt llM /
Stag-_ ZIP
0) .7-76-A33Fax # ( )
Subdivisio ciiv
:ed Agent Z 4 -
City ZIP c�
❑ CW EW (,} PTA ❑ ES ❑ PTS
Phone # ( River Basin
ElOEA D HHF ElIH ❑ UBA ❑ N/A
Adj. Wtr. Body
/% at
ElPWS: ElFC:
yes no PNA` yes / no Crit.Hab.
yes no�' Closest Maj. Wtr. Body v
OEM
■■■ONE ■■& MMEMID■Mr■1
■a■■■■■■■■■EM■■■■■■
MEN mmomm■■■ONEEN■
MM■■■■■■■■MMM■■■■■■i
NE MOVENNINE
)ic yards
rip
se/ Boatl
Length ' - I v
not sure yes no
not sure yes n
ium: n/a yes
yes Ano,
lttached: yesL
- ofs Gt1 i._
(Scale: / A
ig permit may be required by: // I"L-�o I ❑ See note on back regarding River Basin ri

0/ 1 y/Lu I J 8/L9/-101Rloic vvebt lul vvubt UOORS
8/21/2015 8/24/15 NC Baptist Assembly
8/21/2015 8/24/15 Johnnie S Hawkins Jr
8/21/20151 8/24/15 John King
8/24/2015 North Carolina Coastal Federation
8/24/2015 8/26/15 Christopher Lutterloah Sr
8/24/2015 8/26/15 Donald and Joanna Reich
8/24/2015 8/26/15 Bald Head Island Limited LLC
8/24/2015 8/26/15 Bald Head Island Limited LLC
8/24/2015 8/26/15' Pippin Marine Construction LLC
8/24/2015 8/26 1/ Edwin or Sandra Bartlett
8/25/2015 8/26/15;Bald Head Island Limited LLC
8/25/2015 8/26/15'Lanier Family Limited Partnership
8/25/20151 8/26/15 LLBBD, LLC
8/25/2015 j Connaway Marine Construction
8/27/2015 Waterfronte Villas Owners Association
8/28/2015 _ Joseph and Lara Milligan
8/28/2015, I Paul J. Schadt
8/28/2015 Allied Marine Contractors LLC
8/31/2015 Charles Riggs & Assoc.
8/31/2015 ,Charles Riggs & Assoc.
8/31/2015 'Village of Bald Head Island
9/1/2015 Allied Marine Contractors LLC
9/2/2015 Dominick and Maureen Owens
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Bill and Ann Crumbley
GP 64740D @$
John Aldridge for NC Baptist Assembly
_
First Citizens Bank_
5436
$100.00 renewal fee, MF
Specialty River Woods Go Steven Woodcock
Butch Saunders
_
Wells Fargo
?NC State Employees Credit LIM
393
14
$400.00 major fee, 1 mil,
$200.00 GP 64786D
same
First Citizens Bank
15880
$475.00 major mod MP
same
BB &T
11651
$100,00 renewal fee, PN
same
JBB &T
5294
$100,00 minor fee, 209 (
Bruce Marek, representative
First Citizens Bank
1523
$100.00 renewal fee, MF
_
Bruce Marek, representative
First Citizens Bank
1522
$100.00 renewal fee, MF
— —
ChHughes_
—
Wells Fargo
—
3483
$200.00 GP 64795D
same
US Trust
7167
$250,00 major fee, 44 Pi
Bruce Marek, representative
First Citizens_ Bank
1521
$100.00 mod fee, MP 17
Donna Lanier
B of A
34483
$200.00 GP 1161 Spot L
David Jones
Four Oaks Bank & Trust
1283
$200.00 GP 64761D
Dale Osborn
B of A
1069
$200.00 GP 64800D
same
North State Bank
1721
$100.00 mod fee, MP 84
John Odum
NewBridge Bank
6197
$200.00 GP for 1244 Rig
same
BB &T
4962
$100.00 minor fee, 840 (
Rick Woodard
B of A
7756
woo.00 GP 64799D —as
Joan Lee
major fee, 514 E
Robert Iffiddson, Sr.
First Citizens Bank
14147
$100.00 minor fee, 6902
Pamela Everhart
First Citizens Bank
14148
$100.00 minor fee, 1707
Chris McCall, asst. manager
PNC Bank
58324
$200.00 2 renewals, MP
Sue Todd
B of A
7715
$800.00 GP 64742D @$
Lee and Carolyn Harrington
GP 64796D @$
Thad Cable
GP 64797D
same
BB &T
5091
$200.00 GP 64765D
1 ---
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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: �� �I I✓1 �,�L �'�lr2
Date:
Describe below the HABITAT disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
F
(Applied for.
(Anticipated final
(Applied for.
(/
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
d'.
Habitat Name
Choose One
includes any
Excludes any
total includes
E
anticipated
restoration
any anticipated
re
restoration or
and/or temp
restoration or
to
tempimpacts)
impact amount
tempimpacts)
ai
,, /
t AV
Lik
I/
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 ❑

/- oT 8
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Applying for Permit: 400 M/ ✓/e-/� (�4j L NS
Mailing address:
Phone Number;
I certify that I have authorized
O 1. Y S
D - 276 - /633
Agent / Contractor
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of 0`'/y'/Z 'f A)a S �Gao
,(/nWn'� �006/C
at my property located at Z0 8 Z,I Z- 4� T V,
in �GN j0 Cy /L County.
This certification is valid through
Date
(Property Owner Information)
Signature
o i✓I / sty/ C /� �GJ G /✓—S
Print or Type Name
Title

, 18
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ej,"- sS
(Name of Pro erty Owner)
property located at _ a ©� d6,2 L e- � S 14o ti 7-�
^^ // (Address, Lot, Block, oad, etc )
on YJ%6in�i1q �/l�G=/� in %��G/�O N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. ,
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
D'
i,\"
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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)
^I
i
Siggn�ature L= r✓S
Print or Type Name
(Adjacent Property Owner Information)
Signature* I
Print �rrT pe 9me

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to —bon, "Y-u6 ,ugh 5 s
Name of Property Owner)
property located at 197- As r p �f,p
(Address, Lot, Block, Road, etc.)
on in N . C' N.C.
(Waterbody) (City/town an/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner I{n�formation) (Adjacent Property/ Owner Information)
0'44� "ew
Signature Signature
Print or Type Name Print or Type Name