65192D - Shaver

DENR CAMA Daily Check Log for WIRO
Date
Received
Check From (Name)
Name of Permit Holder
Vendor
Check Check
Number amount
Permit Number/C
4/16/2015
Archie McGirt and Janet Batten same
Mellinee and John Hunt same
First Citizens Bank 7941 $600.00
NC State Employees' Credit Union 3562 $200.00
bulkhead permit
4/16/2015
GP 65139D
4/20/2015
R. Burak Erem
same
B of A 719 $200.00 GP 65185D
Piedmont Advantage Credit Union 1029 $200.00 GP 65197D
First Federal _ _ 9440 $200.00 iGP 65198D
TD Bank 4936 $100.001renewal fee, MP 31
CresCom Bank 2087 $200.00 GP boatlift 6393 M
Wells Fargo Bank 20158 $250.00 major fee, NHCo
B of A 7363 $250.00 major fee, TB, PN
Marine Federal Credit Union 185 $200.00 GP 65170D
BB &T 1889 $200.00 GP 64601D
4/20/2015
Charles D. Carmen Jr.
same
4/20/2015
Southeastern Coastal Construction Co.
King
4/20/2015
Charles Douglas Wilson or Carolyn Wilson
same
4/20/2015
Maritime Coastal Construction LLC
Coastal Marine Piers Bulkheads LLC
Allied Marine Contractors, LLC
Kayla Midgett
Backwater Marine Construction Inc
Thompson
Tatum
McLeod
same
Frank Pope
4/21/2015
4/17/2015
4/21/2015
4/21/2015
4/21/2015
Clements; Marine Construction
Dan Smith
First Citizens Bank
3779
$300.00
GP 64612D @$20
4/22/2015 F and S Marine Contractors Inc.
4/21 /N15 Charles D Carmen Jr
4/22/2015 Willie Clarence Richardson
Lucien Ellison
MP 65-07 renewal
Williams
PNC Bank
4450:
1029
5995,
$400.00 GP 64611 D
$200.00 GP 65197D
$2,000.00 GP 65122D @$40
GP 65190D @$60
GP 65191 D @$40
same
Piedmont Advantage Credit Union
_
Town of Holden Beach
BB &T
James and Jane Warren
Mable Buchanan
Elliott W. and Francis H. Shaver
GP 65192D @$40
Judy H. and Paul C. Starks, Jr.
GP 65193D @$20

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
010
Date: L I
/ZA
Permit #: �5�clz-
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
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 final
disturbance.
Excludes any
. restoration and/o
temp impact
amount)
Dredge ❑ Fi14 Both ❑ Other ❑
'5c)
b
Dredge ❑ Fil Both ❑ Other ❑
b
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 [I
Dredge ❑ Fill ❑ Both [] Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

-4,41FIA '
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
Dee Freem<
Secreta
AGENT AUTHORIZATION FORM
Date: /l -- 7—1
Name of Property
-plerty Owner Applying for Permit: Name of rA�uth IQ' rued Agent for this project:
p
Owner's Mailing Address:
117 Tu,nc'6r-
IA1)1 A P�910..CL KI �
Phone Number 9/6-3o-;RN 36
Agent's Mailing Address:
�I.. �q (4.
Phone Number i 6 -6 3
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtainina all CAMA
(my property located) at
to install or construct the following (activity):
This certification is valid thru (date) 4 l
le 2-3 /�
Property Owner Signature Date

�/k
CIRTTF ,D 'YiA�T -• RFTITCy RFCFrf 12FQT.-FSTFT.I
DIVISIt`>` C) CtST.'i: v1ACFi4''
�1uJ:�cr�iT Rr t �: N. PROPERTY O VNNER STATFIME T
0124t I c Iv a a4jac4jjt Tc7 __
propr:rty located at (Natne Of Prupe-rwy Owner,
oil
�ixferbcdy; ��own and�� ,���mtyl
t�.priica tt l s Pt -,an e :#;Mailing f
-He,'Site has &ser bee' tc, rr:e as ,-hcwp below k dLveiapme� � 1br
.�CL�t- 4 0 �P.s�1
„t oelsre r, prni r.�s7n at..f:az. location,
im9 X hav-- no oajectic:ie to the propose;_
DESCRTII-Tz()N A -NI -D'UR DRAINING OF PROPOSED DEVELUNMEN T:
!Irzdruiau t �rr�p•��irz; de�edvFrn�nt friu,s /zIl in d . cripzYrm bedow yr attach a ,sift clac wind;
Tf you have ahjertfcns to what is being proposed, you must ,Ot; y the Divisiuz {1I C�>3stai i�la sa;eloeni �17Ch� 9..
��r'CNI e days to receipt of this entice. Cerres.nOudeZce Should be mailed to I,?? Car-iina: Jsivc c#. 'lin,il� to.
!)("i I representatives can also be contacted at (xtt"=) ^96- 2i5_
iJ rCC SGiiS�' IC Ci:t;cit3erec ttae Sa;txe dS nc rrh'�+r if
vcu have becr�tgtizc; hs^Crrtfied ?11ai!
.
(PrapertY DD(�Wner�In�jformation)
K�La 2C?it�
• .g AllCaFtSS
AJ&Q- m C--
(Ripariayy�,rctpe
T'e r anze
Maiti-nn- i " r%ss ��

MCIj:_.. k6t-_J
CRR-r F D Y ATL --. RETT; i:i`y RF C ET ''T FtI,f1L ST D
DIVISION OF COAST �'�,
� U,l:ACI��N'I` RTI'A ��L ti FRt�1'-EI2T.F ONVNIER STA.` 'FIM- ;N I'
.lie e y wri i; r '_bit o��;n Properi a4ja m- o
t'.4'
property ioc.,-jted at
oil � (r,oi Vock,Ruac.
Tt. l phoned: ((own and-io Collat )
_ a.p� .tG�nl s ` _..
e,/S.te has described to rr-e G t - .
a ; he Nr_ below t?;•: lcprne..t helsi�e �mnc�syn at. �tl
�? 4i
t?nd T hay w na shje, .ic.as } trle p.coosc�;. proposing i�scaticn,
___--------------- _
DESCRII'� ON A -DIOR DRAWING OF PROPOSED DEVELUPy:ENT,
!.Irtdivdduul. proposifln devduprxr.eRt musi J"" in descriptin:z below or attach a ,site drawing
Tf ycu have abjectirns to what is being propased,Mvou roust to# fy the lliv
:ttisiun of Coastal iYlat�agelueni (37GN i�
�v;L?
iltin iu clays of receipt of iiai no#?re. YOU
si-ould be mailed to ? Carlini', Drive Fx#. wiTmiilgto.
c:'1i representatives c-in also be contacted at {`Sty} 796;`2i5.
itio reM)GtleC is c llsit3c:ed the sa;tke:ts n Gh'�Ct?t+f% if vcu huve been pgiifi l h Ccxitfari ?S'Iail
(Property CWner Information)
Ik
Si�ttah:rt=
MaiErg Address
—kI C�
17. PrD erty Owner. Informatio:

;. i
f/

16'
Existing float - ----- 16'10
1 Boat Lift
11'6 ---� i6'9- F--3'=:�1- 23'4
Existing Dock
- 16'
16'10
117 Tuna Dr.
Ja_11 ______