61640D - Simpson

JCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
_'New ❑Modification '—Complete Reissue ❑Partial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
p G�RUIes attached.
nt Name f ' 1 L S j ( )4 Project Location: County �u
ZIP
0 UA Fax #
zed Agent C l'-S ��C (tC�j plc d } {iQ
j CW , EW 'PTA ES PTS
OEA HHF IH — USA ] N/A
PWS: ] FC:
Street Address/ State Road/ Lot #(s)
Subdivision
City (yJti< 1!;L-&tjO ZIP 7 K4,
Phone # ( ) River Basin Ly o
Adj. Wtr. Body l Vy W l
yes / no PNA yes / no Crit.Hab. yes / no
Closest Mai. Wtr. Body I� k&) VJ
if Project/ Activity _ A i rw J + ?
i'L �- N' j (Scale: (/ /
ling permit maybe required by: (� hh _ ❑ See note on back regarding River Basin
— --— --- .1. i // .V-K' r....,,, ii. .n. .\� .

DENR CAMA Dailv Check Log for WIRO
Date
Received Check From (Name)
10/14/2014 Samuel W. or Tracy Clary
10/14/2014 Coastal Marine Piers Bulkheads LLC
10/15/2014 Edward Stokes Parrish or Margaret Waller Parrish
10/15/2014 First Community Bank certified check
10/1/2014 First Community Bank certified check
10/15/2014,Connaway Marine Construction, Inc
10/16/2014!Richard L. or Erica J. Penny
10/17/2014'MoneyGram/Brandon Grimes
10/17/2014 Western Union Money Order/Brandon Grimes
10/17/2014 Western Union Money Order/Brandon Grimes
10/17/2014 Allied Marine Contractors LLC
10/17/2014 Samuel W or Tracy Clary
10/17/2014 John Allen Odham III, Nancy Odham
10/17/2014 Holden Dock & Bulkheads
Name of Permit Holder
Vendor
Middle Sound Marina
SunTrust
Ken Kolling/transfer to Shawn Nasseri
Wells Fargo
Historical Society of Topsail Island
PNC Bank
Maritime Coastal Const./William Thomz Moneygram Payment Sys. In
Maritime Coastal Const./William Thome Moneygram Payment Sys. In
Amanda Chaney & Lee Thornton
B of A
same
USAA Federal Savings Bank
Wells Fargo Bank
Paul Fornwald
Wells Fargo Bank
Wells Fargo Bank
Daniel Winfield
B of A
same
SunTrust
John Gray Hunter, Jr.
PNC Bank
Simpson
First Community Bank
Check
Number I
Check amount
I Permit NumbeNCoi
4139
$100.00 renewal, MP 164-07
19854
$200.00 transfer and mod., MP
804
$100.00 mod. Fee, MP 86-05
35069222
$50.00 returned check fees/ch
35067797
$400.00 to cover GPs 63273D I
6852
$200.00 GP 64096D
716
$200.00reissue GP 63924
59098505697
$400.00',
17-081677370
$200.0011,GP 64097D ($800 tots
17-058990188
$200.00
6873
$200.00 GP @346 Admirals Cc
4142
$100.00 mod. Fee, 164-07
946
$100.00 minor fee, 406 N Shorf
5928
$200.00'GO61640D

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(dame of Property Oh
Address of Property:
'A
. CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Lot or Street #, Street or Road, City 8t County)
Applicant's phone #•-I a--13U4 Mailing Address: 0. i ti'
i nereoy cemry mat I own property adjacent to the above referenced property. The individual applying for this 1
has described to me as shown on the attached drawing the development they are proposing. A description of dra
with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (D
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Driv
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response
considered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION'
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distal
'15' from my area of riparian access unless waived by me: (If you wish to waive the setback, you must initial ti
appropriate blank below.)
I do wish to waive the 15' set back requirement_
I do not wish to waive the 15' set back*uirement.
IWpne information)
Signs �
1 ll �m
Print or Type Rame
r Ci(Gl pr 8CiLIClax,
Mailing Addreah
j� (
Riparian Property Owner Information)
JA_
Signature
4.*V/Q /eCtc, CreC<cZ
Print or Type Name
2b/,� Catro )a/s f �,e
Mailing Address
L, ) I� -)

,_k
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner.
Address of Property: _ Q CLA \ Iv eS+ \; a C_VA4 ,b f � Q ,
(Lot or Street #, Street or Road, City 8t County)
Applicant's phone #:_d Qx4 I L, Mailing Address: .p) \ S 0. to t� t' r Rct u c
MCnrt; � .' iVC 3 FBI! O
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
has described to me as shown on the attached drawing the development they are proposing. A description of dr
with dimensions. must be provided with this letter.
r/ I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (I
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drn
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response
considered the same as no obiection if you have been notified by Certified Mail
WAIVER SECTION`
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum dicta
'15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial t
appropriate blank below_)
/ I do wish to waive the 15' set back requirement.
y �a I do not wish to waive the 15' set back requirement.
(Riparian Property Owner Information)
Si
Print or Type Name
ID-15 N cL is e- r- �o 0 - &�4 60
Mailing Address J Mailing Address