65065D - Surf

�GAMA / ❑DREDGE &FILL
3ENERAL PERMIT Previous permit# A
lNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources a a
:oastal Resources Commission in an area of environmental cgncern pursuant to 15A NCAC [J /T
tules attaehed.
it Name � a W N G !' >v {�. f ( �,,�,_ Project Location: County C..
n QiF C Statei`Jc_ ZIP KLI
Fax#( )
:ed Agent /U ,A-
❑ CW ' � EW / X ] PTA ES ElPTS
OEA LiHHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes / no j PHA yes / no Crit.Hab. yes / no,
F Project) Activity
Street Address/ State Road/ L9t #(s)
Subdivisiop
City V ZIP t
Phone # ( "�""'� River Basin
Adj. Wtr. Body ,a} / (nat /
Closest Maj. Wtr. Body
4
(Scale N /
ck) length
!ngth
mber
d/ Riprap length
g'distance offshore
ix �ctance offshore
bic yards
np
ise/ Boat
e Length
not sure yes Lr�
s: not sure yes / nA
ium: n/a yes
yes go
4ttached: yes
ng permit may be required by:
VO
❑ See note on back regarding River Basin r

Date
Check
Check
Received
Check From (Name)
Name of Permit Holder
Vendor
Number
amount
Permit NumbeNf
Allied Marine Contractors, LLC
Bleu Water
B of A
7154
$400.00 GP 65078D
2/2/2015 A'N'A Buildiers, Inc
660 Spot Lane
TD Bank
7072
$100.00 minor fee, Surf Cit
2/3/2015 Dawn Edwards Griffis
same
BB&T
229
$100.00 minor fee, SC 15-1
2/3/2015 Coastal Dredging, LLC
Clinton & Corinne Parks
BB&T
3752
$200.00 GP 65031 D
2/3/2015 Coastal Marine Piers Bulkheads LLC
Bill Scott
Wells Fargo Bank
19997
$200.00 GP 65092D
2/4/2015 Clements Marine Construction
Hamilton Wells, Charles Hocking
First Citizens Bank
3697
$200.00 GP 65088D
2/5/2015 Cape Fear Riverboats, Inc.
Riverside Partners
First Citizens Bank
48727
$400.00 major fee, Water
2/6/2015 Boatzright Inc.
Kevin Thomas
First Citizens Bank
1826
$250.00 major fee, NHCo.
2/6/2015 Overbeck Marine Construction Inc.
David Starbuck
SunTrust
4394.
$400.00 GP 65095D @$2C
Sean Crane
GP 65094D @$2C
2/6/2015 John Anagnost and Kathleen Jewell
Same
Wells Fargo Bank
3794
$100.00 renewal fee, 128-'
2/11/2015 Ingram Bros., Inc.
Page
First Bank
3980
$50.00 NTBEX 15-04
2/11/2015 James and Jennifer Lupi
same
SunTrust
4095
$100.00 minor fee, Surf Cif
2/11/2015 Wellman's Construction, Inc.
same
BUT
12135
$50.00 SCEX 15-05
2/11/2015 F and S Marine Contractors Inc.
Sweeny
PNC Bank
4308
$250.00 major fee, NHCo
2/12/2015 Coastal Land Design, PLLC
Tidal Walk LLC
B of A
5023
$100.00 mod fee, MP 56-C
2/12/2015 Maritime Coastal Construction LLC
Ronald Knedlik
CresCom Bank
2047
$200.00 GP 65055D
2/12/2015 NC Coastal Federation, Inc.
Carolina Beach State Park/James Helms
First Citizens Bank
18154
$400.00 major fee, NHCo.
2/12/2015 Isenhour Construction Management, Inc
Isenhour Homes, LLC
Capital Bank
106596
$400.00 major fee. BrCo
2/12/2015 Cape Fear Engineering, Inc.
Port City Advisors, LLC
BUT
25958
$100.00 minor permit SB C
2/16/2015 Holden Dock & Bulkheads
Lockwood Folly, PDA
First Community Bank
6134
$200.00 GP 65056D
2/16/2015 Maritime Coastal Construction LLC
Sam Seltzer
CresCom Bank
2049
$200.00 GP 65057D
2/17/2015 Snow Marine Construction & Dredging Inc.
William Howard/Marcia Sanderlin
BB&T
2922
$400.00 GP 65097D
2/17/2015 Thornton Builders & Investments LLC
Ashley Goodman
BB&T
1787
$200.00 minor fee, NTB Oi
James Turley
minor fee, PN, @;
2/17/2015 CJL Partners Inc.
Chris Majewski/Sawgrass Point
Trust Atlantic Bank
3045
$100.00 renewal fee, MP E
2/18/2015 F and S Marine Contractors Inc.
Brook Taube
PNC Bank
4326
$400.00 GP 65098D
2/18/2015 F and S Marine Contractors Inc.
Derek Winstanly
PNC Bank
4325
$400.00 GP
2/19/2015 Ray Martin McGowan/Mary Jaye McGowan
Duke Energy Progess/Brunswick Steam Plant
Wells Fargo Bank
5672
$100.00 mod fee, MP 293,
2/20/2015 New Hanover County General Account
Carolina Beach Renourishment Project
BB&T
309104
$200.00 mod fee, MP 138-
Mason Inlet Relocation Project
mod fee, MP 151-
2/20/2015 Southeastern Coastal Construction Co.
Dean Painter
First Federal
9388
'
$250.00 major fee, NHCo.
2/20/2015 Charles F. Riggs & Associates
Heritage I
First Citizens Bank
13892
$100.00 minor fee, NTB, C
2/23/2015 Backwater Marine Construction Inc
Barker
BB&T
1826
$200.00 GP 65058D
2/23/2015 Town of Surf City
same
First Citizens Bank
63274,
$200.00 GP

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: flaW K 0 `I �v / � 6 Permit #: �' j D�
Date: - z3 — 0' 7
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremel
found in your Habitat code sheet.
Habitat 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 fir
disturbance.
Excludes any
restoration anc
temp impact
amount)
//
4�
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

Pat McCrory
Governor
AEW
*A-
NCDEHR
North Carolina Department of Environment and Natural Resources
N.C. Division of Coastal Management
AGENT AUTHORIZATION FORM
Date: 'z-/ / c� l i5
Jame of Property OwnerApplyingfor Permit:
'moouJn O7 rjNrt C1 N
)wner's Mailing Address:
P o ox a'+ "1 S
S u r Gi
John E. Skvarla, II
Secretary
Name of Authorized Agent for this project:
Agent's Mailing Address:
mail: !i�0.r nod g fowncitsurf 4-f y, Lang Email.
hone (q 10) 3 2Q- y+ 131
Phone
certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
1r, and obtaining all CAMA Permits necessary to install or construct the following (activity):
IOQd l (IA al o,:f-K a� Sourid.Sjcle l--)rArK
or my property located at 51—i Roland Ave-
SU r -� Ca ±:j , tv G 2944S
its certification is valid 1 year from (date)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to IEyoo r Bees 's
(Name of Property Owner)
property located at S i 3 � �� � r� d 4 V�
(Address, Lot, Block Road,etc.)
on 5 n �rci (fC)CA5*,CL� , in �Uri CiI J W , N.C.
(Waterbody) (City/Town and/oir 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)
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 d not �ish to waive the 15' setback requirement.
(Property Own&Anforrr aflon) (Adjacent Property Owner Information)
./ l/i
olgrnuiuia v
1©w N 3V' Su
Print or Typ ame
i'o x ay --CS
Signature *
S IAl i e �ioo the e s
Print or Type Name
513 ►' olavid A\Je

�e\eo e ' S 19'30'42" Y
Gr0r S 21'23'22" W
o� Site 4 0' W 38. e
IIM!' jj
1 8
VICINITY MAP N.T.S. 18'14" • S''�'F�>h1
38. >
Legend: "�£�^'
S 06'54'24"
0 Existing Iron Pipe 3 e(�y "• } .- r
0 Existing Iron Rod S 21'53'46" prop
Bench Mark 18
36.89' r S a
S 01.33' 26' W ,�
33.70' de
S 00'51'56" E 1 ,
41.82'
Ile
/ 1.01 Acres6 43.1'
11
Alp p.
�O/ProP°Sed
� F
WEPAD
FB
pOOM
PLAHMO DEPT-
Note: Any and
all developmental
restrictions Lot 31R
(Federat, State, Long Point Estate
Locol, P.O.A•, Section 3
H.Q.A., Deed, MB 48 Pg 128
Etc.) must be
verified with the
nnrtiac
510
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t it 53'.cc;
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Bench Mark
Nail in Tre
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$
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