61691D - Kellis

00,
LAMA / DREDGE & FILL V
vENERAL PERMIT Previous permit#
New ❑Modification - Complete Reissue ❑Partial Reissue Date previous permit issued
brized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
iftules attached.
it Name . Y P ! Project Location: County :"
t� Street Address/ State Road/ Lo #(s)
14� A State q< ZIP _ � � 1
Fax # O_ _ _ Sub i 'sion
zed Agent i -t i ZIP
CW EW PTA ❑ ES ❑ PTS l � ( I U `4 U' G S River Basin U Y
i
OEA HHF IH C UBA ❑ N/A Adj. Wtr. Body O&V I (nat
PW5 = FC:
yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body V
A Project/ Activity
(Scale:
lock) length
pier(s)
length
umber
:ad/ Riprap length
vg distance offshore_
iax distance offshore
channel
ubic yards
rmp
ruse/ BoatliftX
Bulldozing
ne Length
.
not sure
yes
gs: not sure
yes
mum: n/a
yes
•
yes
Attached:
yes
0
ling permit may
be rer
/ C --- :.J f7....J:r --

Permit #: W 0
Scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
)itat Name
1
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/or
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 ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
M V- Is = 23I

66-456-531 1861
ID SURVEYING y�
TSW
DLINA 28462 DATE
05
2,�
�o
DOLLARS
LIU) ^�
100 2 3 3 3t1° 018 L

NGDENR
Noah Carolina Department of Environment and Natural Resources
Division of Coastal Nianagerient
,dv Eaves Perdue ,lames H. Gregson
arnor Director
AGENT AUTHORIZATION FORM
uate: �#• 2`I- t3
e & Property Owner Applying for Permit:
Ai-L. 1,<EL-L15
er's Mailing Address:
neNumber ;'40', 799' '795.
Dee l=reerrian
Secretary
!Jame of Authorized Agent for this project
Agent's Mailing Address-
31 S HoLA£J 130Y-H lea_._ -
2s,r62
Phone Number l } Sid - 5635
rtifv that I gave authorized the agent fisted above fo act on my be", att, for t'?e purpose of appiyir
and obtaining all CA>',AA Permits necessary to install or construct the following (activ:ty):
r property located) at 15 K Toi e, _ j -, No oc4
is certification is valid thr~a (date)
2�9zz- y 3
Property Owner Signature Date
RECEIVED
DCM WILMINGTON, NC

SIN- of
C 40'Ve L
or '? Coy
by cerllf) that i own
I rani �A _. n;
hax-R no oh-jmtjc4's do �� qrw"aF _�
c tit T ? the m.
kIbeb4ing y.. tat t of
'c skid be maikd to l'Z 7 Cwd*a Dri
w My Elt svcrlo
t'ta c! #per. ►, I br4(-.*V?oor., �rx"'it,
.� ���
rtl•. area � ;W`� uvI •• v'i by t ,c. tj.f-vi:r %ssh to wai ow s ack- yow I
k . Est}mac thl d{' sscl hock requirni
RECEIVED
DCM WILMINGTON, N
I domet ;� > aI ; 4 t o r+� r er., J U N 0 3 2013
0 4.L j<E" !j

April 25, 2013
Fred Dellinger
PO Box 256
Huntersville, NC 28070
This letter is to inform you that I have applied for a permit for a boat lift
on property at 154 Tarpon Drive, in Brunswick County, town of Holden Beach,
N.C. and owned by Carl and Lisa Kellis. 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, NC 28405
[phone]
ncerely,
Danny Sparkman
1843 Pintail Ave SW
Supply, NC 28462
[phone]
0
Ln
rn
Ln
r-
rn
o
�._.
O
M
Return Receipt Fee
(Endorsement Required)
0
Restricted Delivery Fee
r7l
(Endorsement Required)
Rostmaric
APR � f� Z013

May 2, 2013
Dalton Black
156 Tarpon Drive
Holden Beach, NC 28462
This letter is to inform you that I have applied for a permit for a boat lift
on property at 154 Tarpon Drive, in Brunswick County, town of Holden Beach,
N.C. and owned by Carl and Lisa Kellis. 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, NC 28405
[phone]
Dann
�parkman
1843 Pintail Ave SW
Supply, NC 28462
[phone]
VS. Postal Services
CERTIFIED MAIL- RECEIPT
(Domestic Mai/ Only; No Insurance Coverage Provided)
For delivery informati—
0 Ln
mPostage $
C) Certified Fee �2 / © N
cJ
qY
Cl Return Receipt Fee Q� rn
� (Endorsement Requiretl) a
Restrcted Da1W Fee ,
C1 (Endo s©ment Required)
" I Total Postage & Fees

■ 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:
b � L-rr,,J PSC'A�1�
5 -ram is JbIz
A. Signature
T Agent
JCIr� iY�! k ❑ Addressee
B. Received by (Pri �) C. Date of Delivery
l45-=k13
D. Is delivery address different from item 17 O Yea
If YES, enter delivery address below: X No
3 Type
Cert'rfied Mail ❑ F�cpress Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted DeNvery? (Extra Fee) ❑ Yee
2. Article Number
(7 011 1570 0000 3753 1610
Rwsfer from service lab
PS Form 3811, February LL2004 f°laturn Receipt 102595-02401-1540
■ 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:
C
1 F-EQ tov Ei=-lA f Y,—FP-
�p a 1?*x zs6
-70
A.
❑ Agent
❑ Addressee
C. Date of Delivery
Is delivery address different from item 1? 0 Yea
If YES, enter delivery address below: a Alo
3. Soce Type �...
Certified Mail 13 Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) Cl Yes
2. Article Number 7011 1570 0000 3753 1504
(Transfer from service Obe
PS Form 3811, February 2004 102595-02-M-1540

CAMA / ❑ DREDGE & FILL N? 616 41
ENERAL PERMIT Previous permit #
ew 7Modification OComplete Reissue F-Partial Reissue Date previous permit issued
oNt
d
thorized by the State of North Carolina, Department of Environment and Natural Resources „�b
he Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
attached.
Project Location: County _
Street Address/ State Road/ Lot#(s) - -
a. �. ,art. a�.,> •a:, . _l Itr... c
F #RTIM4,,1. MUZ
E
ted �CW
A
C OEA ❑ HHF
1H
Q PWS:
L F
ye / rro „' M.
yes no
s of Project/ Activity
(dock) length ___
er pier(s)__ _ a
In length
number -
,head/ RiPmp length
avg distance offshore_
max distance offshore
n,channel
cubic yards _
: ramp
:hou>1Rl Boadift__ X
:h Bulldozing
er
Wine Length
nat sure
Yes .
{bags: trocmin : }iyN;', no
atorlum: ilb
E-7i
0
✓eh Attached: yet
I )ft .,'
Aiding permit may be requir'e"d� bb
es/ Soecial Dandkions
DES ❑PTS
Ll URA L7 N/A
Crit.Hab. yes
b (IVA d 6d]
PnKe"'W (yam[ _�
Adj. Wtr, Body
Closest Maj. Wtr. Body
IFF
4
ZIP,
River Basin
(Scale: ' s Zi
See note on River Basin rules
fj"h tng «U