62624D - ABC

CAKIA /—~ DREDGE & FILL �\ 21
iENERAL PERMIT Previous permit #
'4ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ted by the State of North Carolina, Department of Environment and Natural Resources
>astal Resources Commission in an area of environmental concern pursuant to 15A NCAC �� • �Z
j �,[� Rules attached.
Name - InyrsiTys C/O & 1.�1I1' Project Location: County
State�� ZIP Za'2iD2
d Agent
❑ CW ❑ EW ] PTA P ES ❑ PTS
OEA ❑ HHF /❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
r
es / no PNA yes, no, Crit.Hab. yes / no
Project/ Activity (
c) length
gth
fiber
' Riprap length_
distance offshore
distance offshore
nnel
c yards
e/ Boatlift ti X
Ildozing
Length 1 (1
not sure yes no
not sure yes (no
im: IS
yes no
yes no
ttached: yes no
g permit may be require
Street Address/ State Road/ Lot #(s)
Subdivision
City *k��C tAO-5�ad
Pne # p(t
zip
ZIP ZD"1
�U Y V1-6 River Basin LU Yh
Adj. Wtr. Body W W (nat4
Closest Maj. Wtr. Body A'lk,� LAJ
J'1
(Scale:

ApplicanA—K- &p low . shy<s., co � � �I � (s
/ _ Permit #: Date: �Z�Z4-D
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
found in your Habitat code sheet.
Habitat Name
TOTAL Sq. Ft.
(Applied for.
DISTURB TYPE Disturbance total
Choose One includes any
anticipated
restoration or
tempimpacts)
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 fina
disturbance.
Excludes any
restoration and/c
temp impact
amount)
Vv
Dredge ❑ Fill ❑ Both ❑ Other
5�
Dredge ❑ Fill ❑ Both ❑ Other
I L
I 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 ❑ Other ❑

■ 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:
2. Article Number
(Transfer from service /al__
PS Form 3811, February 2004
A. Signs
❑ Agent
❑ Addressee
�R'y (Printed
,Name) I C. Date of Delivery
D. Is delivery address different from item 11 ❑ Yes
If YES, enter delivery address below: ❑ No
3. ice Type
lop
Certified Mail ❑ Exips Mail
❑ Registered ❑ Return eceipt for Me handise
❑ Insured Mail ❑ C.O.
4. Restricted Delivery? (Extra Fee) Yes
7010 3090 0003 7156 2-%35
Domestic Return Receipt 102595-02-M-1540
i
m
CO �
N N
e
t
N\
6R
hLLo�
H 1
ir
'a
ru
C� ru
IT
O
�� .'a

� I
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis
Governor Director
AGENT AUTHORIZATION FORM
Date:
Name of Proty Owner /Ap 1 'ng for Permit:
Owner's Mailing Address:
2 _ ��
Phone Number 14
Dee Freemar
5ecretan
Name of Authorized A eLI,
this project:
�
Agent's Mailing Address:
Phone Number
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):
_ s o --2 z-�J��O�J
For my property located at c� — 7,i2!2
This certificab is valid thru (date)
Property Owner Signature Date

rti
tw
liV, 441V�1,114 ;-44F,
rl
HIM
!womb
--r P44 om

August 8, 2013
Richard Brackin
345 Serenity Lane
Holden Beach, NC 28462
This letter is to inform you that I have applied for a CAMA Permit for a
dock and boat lift on property at 347 Serenity Drive, in Brunswick County,
town of Holden Beach, N.C. and owned by ABC -BD Investors. I have enclosed
a copy of the drawing of my proposed project.
Please initial the appropriate blank and return a copy of the form to me at
the address below.
If you have any comments on my proposed project, please contact the
Coastal Representative listed below. No response within ten (10) days is the
same as no objection when you have been notified by Certified Mail.
Holley Snider
127 Cardinal Drive Ext
Wilmington, N.C. 28405
[phone]
Sincerely,
Danny Sparkman
1843 Pintail Ave SW
r-I m , KI/" 7QA47
U.S. Postal Service
CERTIFIED MAIL,.. RECEIPT
(Domestic Mail Only,
No Insurance
coverage Provided)
For delivery information visit our website at www.usps.com ,

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: . ABC - D 6 I t"ESTO R S
Address of Property: 34? SERA my b 1z l v c
(Lot or Street *, Street or Road, City & County)
Agent's Name * bhNaY s Phi k�q�
Agent's phone #: 910
Mailing Address: 1843 e1e4- ri iL ME.
SLAef►'y, C 284462
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are pr .ng.
j% t have no objections to this proposal. I have objections to this proposal.
K you haw objections to what is bent proposed, you must notify the Division of Coasts/ ManagerneM
(OCAn in wrf ig w0ph 10 days of race" of this nodce. Contact informe0on for DCM oRices is
a„aNable at or by calNng 1-d&a-4RCOAST. No
nwfflonse�oonsldMnd A* sonic as no of kefiFon K you haw been nodMed by CvttRed Mail.
WAIVER SECTION
i understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 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 wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(P Information)
�..►T
Signature
,giBG- !30 IayESTo �5
Print or Type Name
2 ,'7 5r CR 16AJ 4 xi of
(Adjacent Property Owner Information)
Signature
Print or Type Name
3'15 S'CS.C-►IT r La�►E

i
Id,
pj�-l., O U
Nri
\Y
c