63295D - Patterson

DAMA / ❑ DREDGE & FILL (� •r
iEN ERAL PERMIT Previous permit #
New ❑Modification [-]Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources t - obu
�astal Resources Commission in an area of environmental concern pursuant to I SA NCAC T uulles attached.
Name Project Location: County%ti1ii
1W Wild
State ZIPZ,}
ad Agent tM
CW 'AEW PTA ❑ ES ❑ PTS
OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
PWS:
Project/ Activity
ck) length_
1(s) 7� ©�
ti I )' u/
!ngth
amber
�d/ Riprap length
g distance offshc
ax distance offsh
hannel
ibic yards_
mp
use/ Boatlift
ne Length V
not sure yes no
igs: not sure yes i no
>rium: yes no
(yes) no
s.�--
Attached: yes 10ino
❑ FC:
Street Address/ State Road/
Lot #(s)
Subdivision IV
City ZIP�-
Phone # (flo ) 08 River Basin Lam► K'
Adj. Wtr. Body lye t wU) (na
Closest Maj. Wtr. Body
(Scale: 1 y
ding permit may be required by: �i� r1� ! e 'E See mote on back regarding,River tBasin

15'6' 12' I
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6'
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LIFt
3
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I 124' -
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Existing
Gazebo
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17'xI�'
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-- - - - -
65 6° I
Reuse lift
/pole for dock
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Proposed I
5'x2o'
Dock
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o � Reuse ifft I
0 a' pole For dock
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Proposed I
4x8 Landlriy I
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1
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Grose Line
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Existing Bulkhead

ULNK LAMA Ually uneCK Loq for vvIKU
Date Received I Check From (Name) Name of Permit Holder Check Number
6/18/2014 Gnce Construction of Brunswick County John Teague_ 9702
6/19/2014 Hammocks at Shallotte Pointe LLC _ 1053
6/20/2014 Villaver Law Firm Steven Villaver _ _ 5992
6/23/2014; Bank of AMoney Order Brandon Grimes 1139200122
Brandon Grimes 1139200122
6/23/2014 Carolina Marine Construction, Inc Cord Grass Bay HOA 9105
6/23/2014 Reggie W. Barnes Jr 1200
6/24/2014 Ch I F R' & A
amount
of MP #93-08
$497.00 Vio# 14-03D B & B I
+ GP 63955D ($47)
40 $0.00 GP 63957D
$100.00 Transfer fee #70-09
ares . iggs ssociates Inc. Giles Jeffreys & Lee Thornton 13510 WOU.00 GP 63952D @$200
Jason Dixon & Lee Thornton GP 63954D $200
6/24/2014 Richard L. and Erica J. Penny
6/25/2014 Clements Marine Construction Inc
6/25/2014 Snow Marine Construction & Dredgi
6/25/2014 Elite Homes By Forrest Taylor, Inc.
6/25/2014 Grice Construction of Brunswick Co
6/25/2014 Kleigh M. Prevatte _
6/25/2014 Backwater Marine Construction, Inc
6/25/2014 Charles Fox Homes, LTD
Mike Turbeville & Greg Colner GP 63953D $200
Inc Charles Ashley Mann
_ Cableu, LLC
H & H Construction
H & H Construction
Mike Cecil
Crat rady_
Jim & Mary Beth Yeager
John Lassiter
Raloh Patterson
535
$200.00
GP 63924D
3488
_
$650.00
GP 63962D $400
$250.00
$200.00
Major fee (Smith) @$250
Major fee (Mann) NHCo
GP 63973D
2839
_
80461
9710
$400.00
GP 63958D $200
GP 63959D $200
1001
$200.00
GP 63960D
1557
$800.00
GP 63296D $400
_
__
GP 63297D @$200
_
GP 63167D @$200
19381
$200.00
GP 63295D

X Division of Coastal Mgt, Habitat impact Computer Sheet
applicant: �� y/� Permit #. (3z� s
)ate:
�
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer
ound in your Habitat code sheet.
iabitat 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 fin.
disturbance.
Excludes any
restoration and.
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
l
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 Q Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

F 0

i
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis
Governor Director
AGENT AUTHORIZATION FORM
Date: �, 12jI `t
lame of Property Owner Applying for Permit:
RTP�}e�.s��
)wner'sMnail11i11ng Address:
1
)ol Arrow.vd LN.
LQV ens, ;C-
'hone Number f—�
Dee Freeman
Secretary
Nam of Authorized Agent for this project:
11II
Clades Fob l4vai 5
Agen1t's Mailing Address:
CNar6q Fvx �6ow-,5
b or.
010-11 1.40 pell l � NL 2 oy(11-1
Phone Number ( 9(o ) �9 C o 90 23
C,,t fr ytv S (�D 0 �Aes�vn err mes , ec►,�
certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
)))C' r and obtaining all CAMAPermits necessary to install or construct[ the/ following (activity):
%e"oy¢ cNp-44((-rII�� �, Qt�C� �I►X Pj` �I 1torm+ azdc)
or my property located at 15 C (eyen 5 rx-(. D c Put I s 1 v e -A, N C ?B Y& I
its certification is valid thru date)
Ii T
Property Owner Signature
�-F N
Date

Postal
MAILT. RECEIPT
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Total Postage & Fees
$ $6. 70
A6/02/2014
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Sent To �"
T�,AI,4S 7, VOX) as775I
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or PO Box No.
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PS Form 3800. August 2006 See Reverse for Instructions
'Daits
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Ronnie Smith
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For delivery information visit our
website at wwwusps,*
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06/02/21
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City, State, ZIP+4 OAt v'
PS Form :rr August 2006 See Reverse fi

■ 'Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
T2 ("S ,—e��
2-v 76 ✓ l ,J � -h LA
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X C�kAddressee
B.R by (Pri ted Name) C. Date off Delivery
Is delivery address differe em 1 - 0 Ye
ES; -enter rvery address below: WNo
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RECEIED /
DDM WILMINGTON, ND
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4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7013 1090 0001 2546 9785
(Transfer from service label)
102595-02-M•1540
PS Form 3811, February 2004 Domestic Return Receipt
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
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1. Article Addressed to:
be PH AR ; rC--,soA),
A. Signature
�,jj1 El Agent
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xv ❑ Addressee
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If Y r9nterdelivervaddress•behiw: ❑ No
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2014
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❑ Registere ipt for Merchandise
El Insured Mail
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2. Article Number 7013 logo cool 2546 9808
(Transfer from service label)
PS Form 3R11 FAhrijgry 9nn4 Domestic Return Receipt
102595-02-M-1540