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Home My WebLink About63993D - Kirkman DENK LAMA Uall GneCK LOg Tor WIKV Date Received Check From Name Name of Permit Holder Vendor Check Number Check amount I Permit Number/Comments 6/25/2014 Backwater Marine Construction, Inc Cra�ci Bra; - 1557 -_- - - $800.00 GP 63296D (T$400 Jim & Mary Beth Yeager_ _ -- GP 63297D �$200_ GP 63167D $200 - John Lassiter 6/25/2014 Charles Fox Homes, LTD Ralph Patterson _ t 19381 $200.00 - GP 63295D 6/27/2014 6/27/2014 NCWRC wire transfer 0000070743 _ Tommy Perry_- _ 70743 $100.00 mod. MP # 138-13 Karen Z. _Perry - _ 5201 $100.00 GP 63976D - 6/27/2014 Custon Island Homes by Ken Kiser LLC James Geiger Gruen and Zack _ Herbert -& Louise Rust Donald Thompson 2387 $200.00 GP 63977D 6/30/2014 6/30/2014 7/1/2014 Maritech, LLC Adam C Knierim - �1826 $400.00 - GP 63956D John L. Clark _ Timothy U. and Diana B. Glasson Charles F. Riggs & Associates Inc. 4549 _ 972 I 13529 I _ 39886 1808 _ 9315 3608 6740400592 _ $200.00 GP 63152D $400.00 ma'or fee Brunswick Co. minor fee TB minor fee, NTB GP 63298D GP 63974D GP 63925D 7/1/2014 7/1/2014 $100.00 Eastern Builders of the Carolinas Inc _ _ Wells Faro ��- First Citizens $100. 00 $200.00 $200.00 $200.00 7/2/2014 R an D. Cooper . __ _ _ Jim and Janie Crouch Dinkins _ - Chris Butzko Gail Wamsley Catherine Kelly $100 credit_ - Middle Island Communit Dock y Carolina Bluewater Construction, Inc_. _ __Ace George Land Rosemarie K Jones Wells Fargo Cashier's Check to B and B Construction _- ---- - - --Middle Bruce Marek American Marine Const Inc. Charles Riggs & Associates F and S Marine Construction Advance Properties LLC Western Union Mondy_Order - - Western Union Mondy Order Willie Richardson/Richardson Construction Allied Marine Contractors, LLC Derek D Wright James L. Canady Wells Fargo Money Order Clements Marine Construction Inc Clements Marine Construction Inc -- - - William C. Gore, Jr John L. Pierce & Associates PA Seashore Realty Group, Inc.-_- LarrLRice Construction Brandon Grimes _ Brandon Grimes Stanely McCauley Rentals Coastal Marine Piers & Bulkheads LLC Coastal Marine Piers & Bulkheads LLC Thomas M. and Suzanne M. Hodell Backwater Marine Construction, Inc Charles Fox Homes, LTD Backwater Marine Construction, Inc Holden Dock & Bulkheads _ Holden Dock & Bulkheads - - - - - Hon construction & Concrete LIC _7/2/2014 7/2/2014 7/2/2014 7/10/2014 $1.053.00 GP 63955D@$153 + $47 MO# 11, GP 63926D @$600 GP 63927D $200 - --- - GP 63981D 1357 ? 85590 13512 3862 1579 17-011962641 - . $400.00 $100.00 $50.00 GP for nprap GP 63976D SC Ex 14-08, Pander Col 7/10/2014 7/10/2014_ 7/10/2014 7/10/2014 7/10/2014 7/10/2014 7/10/2014 7/10/2014 7/10/2014 - 7/10/2014 7/10/2014 7/11/2014 7/15/2014 - 7115/2014 7/16/2014 7/17/2014 7/17/2014 7/18/2014 -- �Ry - -- Tomm Pe Devincenzo Coleman Parks Mike Riley - - Ronnie His _ Carol Hai h - -- - Craig Long -- -_- - - First Citizens PNC Bank BB&T Wells Fw o 117-033118103 Wells Fargo BB&T - 8 of A Wells Fargo - First Federal Wells Fargo First Citizens First Citizens $200.00 $200.00 GP for Waynick Blvd GP 63988D GP639810 GP 63299D 99D -- .. GP 63300D r@$200 $100.00 $200.00 5687 - $400.00 GP 63963D @$200 Gary &Rachel Moss - - - - - 1130 Canady Ave. TB _ Gieselman William Kelly Wolfe Hard _- -. - Frankie Walker Heritage I, LLC_ William Ardito Brian Forehand Brian Forehand Paul Ellison Paul Ellison - Alan Campbell Martin 124 W. Third St. OIB Joel Martin 133 Lions Paw HB Herbert Swain Sim son Watford - -- 6569 6778 _- $200.00 _ GP 63982D $100 00 renewal 4-05 1181 14 818390335 $100.00 renewal 158-06 minor fee, NTB 319 Bay Circle $100 00 3507 $200.00 GP 63989D 3506 2546 36440 $200.00 $200.00 $100.00 GP 63990D GP 15 Monroe St, OIB minor fee, Surf City PNC Bank 1 Vantage_ South Bank Coastal Bank & Trust BB&T Wells Fargo Money Orde Wells Fargo Money Orde Wells Far o Bank _ Wells Fargo Bank 3449 $100.00 modification MP 64-04 2079 $100.00 minor fee NTB 1915 New River Inla 59125196944 59125196933 GP 63987D 7/18/2014 _$500.00 $500.00 GP 63987D 7/18/2014 2925 $200.00 GP 63929D 7/18/2014 19677 $100.00 GP 63992D 7/18/2014 Wells Fargo Bank 19681 $100.00 GP 63992D 7/22/2014 B of A 1375 $100.00 minor fee, 2664 Island Dr. SC 7/24/2014 BB&T 1590 $200.00 GP 63967D _ 7/24/2014 Branch kap:nkdnj & Trust 19438 $600.00 GP 63965D 7/24/2014 BB&T 1591 $200.00 GP 63968D 7/30/2014 First Communit Bank 5830 $200.00 GP 63969D 7/30/2014 First Community Bank 5831 $400.00 GP 63971 D $200 - 811/ 14 GP 63984DA$200 - Brian Kirkman BB&T 1073 $200.00 GP 63993D C Division of (Coastal Mgt. Habitat Impact Computer Sheet )plicant: & - Y�A -t' " cw , ate: �` ZLt j y Permit #: .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 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 Tina disturbance. Excludes any restoration and/c temp impact amount) 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 0 Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ NCDER North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue Braxton C. Davis Dee Freeman Governor Director Secretary AGENT AUTHORIZATION FORM Date: femme of Property Owner Applying for Permit: Name of Authorized Agent for this project: ( �, Owner's Mailing Address: a60-6iFk 9 'Dr tot Gw.e ikasbo yn 0c,, pqy 0 Phone Number. Com �?tQg b Agent's Mailing Address: 3 Os, fz� by so Phone Number L l�a 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): For my property located �_S s ___ CA q(>r'[ This certification is valid thru (date) r Property Owner Signature Date 10 /7 HAND DELIVER ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGSIBOATU BOATHOUSE) I hereby certify that l own property adjacent to an Aim �. ►�J f1JT (Name of Property Owner) property located at�►�rvfZ (Lot, Block, Road, etc.) on —,in N.C. (Waterbody) (Town and/or County) Applicant's phone #ik �_ � W)lail�ing Add �5o i rJ � G r --9--7 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 (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 not wish to waive Jl' ✓ I do wish to waive that setback requirement. ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) Mailing Address 401vo '7I t rCk Ak_ (9*W City/State/'Lip TAphone Number ` j— (Riparian Property Owner Information) Ak&140. Signature are, Print or Type Name �Telephone Number HAND DELIVER ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PZEB/MOORING PIIING.SIBOATUMBOA7210USE) r I hereby certify that I own property adjacent to p tij fProp�54 }ne 's ( ,� j� (Name of Property Owner) property located at�g Mmi �2 `6 (Lot, Block, Road, etc.) on in Otep s 6 14e- AIL'-- N.C. (Waterbody) (Town a"or County) Applicant's phone#:Ub P70elJAddress:Iy�/'& �rj�' He has described to me, as shown below, the deveiopr> he is proPt)siag at that krAtion, and, l have no objections to his proposal- I undcrstmd that a Pkz"rOOnng Pilings / boatlift / boathouse must be set back a minimum distance of 5fbmn feet ( 151 from my area of arcMS untess waived by me. (If you wisb to waive the setback, vow rsast initial the appropriate blank below.) i'AgAg wish to waive I sin wish to waive that setbk requirement. DESCRIP'TIOP AN"R DRAWING OF PROPOSED DrA%0PM9W: (To be filled in by individual propasin9 derdopment) (Information for Property Owner Applying for Permit) j' 1&&l ®,rl�tr�ue- L& Mailing Address cw.A 5M �c City/State/Zip 333 ?�62— ,'9a 0 L r Date (Riparian Property O%Yner Information) f '— S tare Print or Type Name Telephone Number ra 7;;�A !:S�C= Date