64700D - Smith

/ ❑DREDGE &FILL CAMA
iENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 4 11 Vo u i
Rules attached.
Name hV)m Project Location: County_B(�JV6VA
3 Stre Addriess/_State Road/ Lot #(s)
State ZIP4 � 1 L u ( V"I 'F A V f2
kL) d Fax # ( ) Subdiv' 'on
A Agent 6 qks,y-, N t ix o N U � `^y 2 C ZIP
El CW W PTA ❑ ES El Phfdhe l ( �17U t 7 7 River Basin
OEA ❑ HHF ' ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Bodtna
❑ PWS: ❑ FC:
t r
,es no ` PNA yes no Crit.Hab. yes no Closest Maj. Wtr. Body
Project/ Activity
k) length
S) l2 x to
ar(s)
gth
fiber
RipIlength
distance offshore
distance offshor
rnnel
c yards
a
e/ Boatlift
(dozing ly
ZAAA0 Li Ix
Length
not sure
yes no
not sure
yes no
im: . n/a
yes no s
yes
F5.0
:[ached:
yes
(Scale:
g permit may be required by
=ill
jY 0 Y"(SWI%%(.. (A� . ❑ See note on back regarding River Basin
. I „ I I - i -1 t ,

7/16/2015Morgan or Erica Mehler
7/17/2015 7/20/15 Stanley or Sharon Stubbs ,same
7/17/2015 7/20/15 Richard or Sharon Love ,same
7/17/2015 MGM,Antinori Construction, Inc.
7/17/2015 '.Ho an Dock & Bulkheads
Highland Shores HOA Park Sterling Bank. -
B of A
Wells Fargo Bank
Chris Mohr B ofA
Anna Odam & Rufus Yates _ CresCom Bank
David Brinkley BB &T
Patricia Welfare _ Wells Fargo Bank
same BB &T
same 7
Michael O'Hem BB &T
Lennon Smith
Geneveive Cassese
Matt Hendrix BB &T
David & Ann Sneeden First Citizens Bank
1017 $100,00 renewal fee, MP 1
_ 48591 $200.00 GP for 1304 Carol
14341 $200.00 GP 64712D
3780 $200.00 GP 64715D
2181 $200.00 GP 64697D
11791 $200.00 GP 1400 Point Hz
17-213876532 $200.00 GP 84717D
10394 $200.00 GP 65041D
1121 $100 00 renewal fee, MP 6
6063 $600.00 GP 64698D (8$2f
GP 64700D @$2f
GP 64699D @$2f
2017 $200.00 GP 64701D
3856 $200.00 GP 84756D
7/17/2015 7/20/15 Atlantic Coast Industrial LLC
7/20/2015 Money order from Brandon Grimes
7/20/2015 Robert or Candace Rice
7/22/2015 MHCDO River Bluff Holdings LLC
7/2212015 Richardson Construction
7/22/2015 Backwater Marine Construction Inc
7/22/2015 Clements Marine Construction Inc

C Division of Coastal Mgt. Habitat impact Computer Sheet
plicant: �A
Srvu�
ite: I Z L
Permit #: 4�—to'
:scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
ibitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tegnp 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/oi
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
Z
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 ❑
N n.

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
Dee Freeman
Secretary
AGENT AUTHORIZATION FORM
Date: 7 - 13 —1 5
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project_
e-iZ Dr1 %3 h
n -N1 leh w , � � -T� 1 �`IO YCr 50Y1
Owner's Mailing Address:
Agent's Mailing Address:
3a35 �c�c'reSt ��'e. S�J
Phone Number9 L L 2 -2- 4 7a to Phone Number (9I0) 367 — O 331
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):
(my property located) at
This certification is valid thru (date)
Property Owner Signature Date
0-8s

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORLtiG PILVVGS/B0ATLIFT/B0ATH0USE)
I hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at Nye,_ _5 VJ 6 �t q N
1 I (Lot, Block, Road, etc.)
on V4 , in �mmSW 1 c_ i'� , N.C.
(Waterbody) (Town and/or County)
Applicant's phone#:91D i0J- '7a(-Mailing Address: &'9(00 Ms-Sti)'1Ail► Rd . N\14
1C
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (151 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 not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION ANWOR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
New) )dc��inc� cock z; ra-yy\? :
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) /
3135 Liacye5� Ny-
Mailing Addresst Signature
City/St t !Zi Print or Type Name

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PM MOORING PIL lNGB/BOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to Le n n m 5m % is
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on �V4 , in ZYl M5WI C-k , N.C.
(Waterbody) (Town and/or County)
Applicant's phone 010 "01$7 —+IoZ Mailing Address: &IR&O
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (151 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 not wish to waive
�I do wish to waive that setback requirement
DESCRIPTION RIND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be fdted in by individual proposing development)
N �10a- Jdock � MWV�
- a d Yaw i n
(Information for Property Owner Applying
for Permit)
3l35 ZPACYC4 Nve, SW
Mailing Address
City/Sttt"Zi
(Riparian Property Owner Information)
Sienature
Print or Type Name

28'3
16'7
ape of work: Replace ramp and
sting dock
- - - - 35'4
M
IM
New Float
16'
NTS
4' -- F
New Ramp
25'4
123 ft +/-
nerd P17A
-- 65' --- - -
Lennon Smith
Frckina PIrmnt