76468D - Tammaro

CAMA / ❑ DREDGE & FILL N9 76468 A B
BEN ERAL PERMIT Previous permit #
Vew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environmental Quality 12 O
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC -
�(� ❑ Rules attached.
1J Name \ n:^�nnof0 Project Location: County (�JASvc %C.�t
QO `qU5 Street Address/ State Road/ Lot #(s)2� r+- Seta
State .lC ZIP Q�L
E-Mail , �\' Q- Sfn ()A � /�, , t oM Subdivision
�d Agent
)4CW ❑ EW ?I PTA • ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
(es / r+Q PNA yes / 4P
Project/ Activity m�,v
:k) length k� ' (%}
tform(s) Jt Y %H
'Iatform(s) j5 �
igth
nber
I/ Riprap length
distance offshore-
( distance offshore
annel
is yards
p
;e/ Boatlift
Length
not sure yes �}
um: n/a yes o
yes o —
,ttached: es no
ig permit may be required by:
_ocal Planning jurisdiction)
c.\
n
City zip 2Sta"
Phone # ( ) River Basin LJ r 1
Adj. Wtr. Bod00
Closest Maj. Wtr. Body Mw�
M.
lk� n.,•� o� ,><, C`dck �l (Scale:
❑ See note on back regarding River Basin

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: J a�+�✓ G u ru —
Mailing Address: 1� t3 GXnS
�ay�(l� Sc��✓ /vc 3?)o3 to
Phone Number:
Email Address: `1O �"n✓ �' -�� rn `��"�`'�� ` (�' `�`�
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and,obtaining all CAMA permits
necessary for the following proposed development: [V<<ti 0 lc
1pf J T-
at my property located at `'r t 'e & ��� I % � -� "'� l� /1!L
in g curs" rhh County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
signature
Print or Type Name
Title

ADJACf=NT RIPARIAN PROPERTY OWNER STATUENT
I hereby certify that I own property adjacent to �Y,rr /�- t'►'►i►'' c"'i 5
(Name of Procerty Owner)
property located at
on
--. --- ---- - In , N.C.
„�.
itylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development most fill in description below or attach a site drawing)
WAIVER SECTION_
l understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
mintmum 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.)
� L 'y I do wish to waive the 15' setback requirement.
I do not wish to waive the 45' setback requirement,
(Property Owner Information) (Adjace Property Owner Inftion)
Si cliche sign --
;T(_J ID 'y 11i co TS f
Po",or Type Name r� Print or Type Nerrte
e t..ttlxn Arlrlroea

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to SaL /a-f m� ry s
(Name of Property Owner)
property located at �' �€'u C vu� i/1 ,S v n n C1 /l�G c� 8yG� --
(Address, Lot, Bloc , holk, etc.)
onra in , N.C.
(Waterbody) ity/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above location.
i have no objection to this proposal.
I have objections to this proposal
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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.
I do not wish to waive the 15' setback requirement.
P arty Owner information)
i nature _
i
Nnf or Type Name
D Qok Fib
(Ad'acent Property Owner Information)
S, nature
Print or Type Nsme�
Maifina Address
-61- A J1---

DocuSign Envelope 10: 72639D85-A8FB-4792-A5FC-OFC2A134206E
ocuSlf;it EnreiOpe ID. b46C561 1-3�41' •:-6.`-;iCBF `A=7 c
OFFER TO PI'RCILASU ,.%%►1 C OtiTRACT
IConsult "C,aidelina:" (Form 2G) for guidanet in camptctin, thi. fvrml
I ar. ttu:tbk cottstd�tatxm, the receipt and ►ct al �ttll'ztitenc� of .•Itu:lt tr hCrbs a.krtoty tcttgeti Litncr offers to �trh:t+c :iru1 Se ilcr
ttpeu xc cptata c avrtCS l0 scit and come} tlx Pmperty on Ur ten
1=>.1 ..,nditionc of this (JlTcr "I C Ir+ettlCtsC and Comr t, s attd am
rKn�-
all. tdum ur ttl0di(ication m'v'� Tn :tc�,rd incc vt tth tic tcmts +tngcllar tIL 'COP ,
(. TERMS AND DEFItiI'It0�5: 17x tctttt5 listed bCkw suit have Itx n.->pecu%c nt�aning gn;.n them ac cct ttarttt adl:treut to
kr �_ licvin John ZtintKrttSChild. Hammil }irtxrnvch'eid keudra
,1
b "Haver'-
}ohn 1 atnrnam . _
ThC i~rop:rt,' Shtil inc lde all that real csts c dcy�nbcd bclCv togtthcr with ail appttr,ttar+�cc ltkitto tt> l,Sutg
tlTw rrnprv. GTtCs=ti to,--ticd thereon arts The fi\nm!z and pzt• anal propert` Itstcd trt Yarwrtph5 and : betoa
NOTE: If the 1'tapcm moll tttclttdc a [wrtufacturetl ltts bik j 1Kictrct�i. R:tccr attd ti,ll:r'shottid cvttstdcr iut:IUdLtg tlx;
11.tnuftn�.lurtd Itiabiicl Hnrnc rmvicirn in rite Addrion Pmvtsaom .Addculu:u I)uurd0=d Form _ A': I '1 a rh this nT.t
itrcct Add�css: _- _ 321' Se area Avcnuc ` \h
-- 7.ip: 2ti•i42
Cia 4°ppl`- —
�O'anl\: BritttYw Nk North CaToluu
tir i IT- i nhefnttticntll 1t:thorm' OVCr MXCG 7nnin_. school dtstncts. ttttl:Gcb :uKI 11011 deli, CrN mm dtffcr from adds` C KtKSltFI
i.zpj r)crvcription- IComplctc.41J. applicabIC, STtbdiCLSiOD'CCI]{j<)tLLirtttiTtt TAn•k" d
Pu Refetrtxx. LVLl:sul 30 Rlpck;$e,"+ion
as 1
ilep.. n �,n 1�.1t R.'t i 'Suds 1 at P:tcv s t _I31
T x Pl?dJIM Or Othcr i&ntifa':ttann nnn*%-,r of T`� Pr+Fct?? Ts 23U!►1tit►53
t )tttrr dr sttrtpuo t 1.34► c-1 TANGl.MOOD Pf 1T 1:131 i - '
Same or all of -hc pTnperr rrmt+c dcsLrsbcd to !):vd LI-xA. . ___-- 3111u, :r Paec
f47
°s�,� �f`7>r
j ri:73.,C Price:
S' 111#It 01 im)d to l..S Doll. apart iltc fulltils w9 lerlm
c twCN1lM► 13Y lll L llILIGENt� FF.F n;tdc p .able and de':i,crd to 5:llcrtn the I1i;cutc Date.
S
3.INN1.IN1 BN' INITIAL L.ARi`'LSU MONLN' llt i'►ySf1 :ttatic .abIC 1=►d dcli.crcd to Fct rote Arem,
='f' he L. ^;ch 1 pctu,ru ,tcc>ti �olTi.••ia! bank ctteit t a.�
immed it: f:trarnph .t 3 - .
uatnlcr. rlccttvtuc (rutsfir, Flil fFli a ith this offerClR X+n ithin fn c t5) dwc of the
Effective Daic of this Cotitr -t.
P1Y t.*%f)i)i o\-*%l.) F.AR\T..ST mt:)NF.y DFPOSIT rtad.: "'ahlc and &lit-crcd to F-ccrtm
Agctu narwd m Paragraph 110 tr.:jatL uificrd bxnk clxi:6, wtrc t``.unfcr it ckctrujwi
tr;atefer no later than 4 p nt on
TIME 13ELYG OF THE ES tiE.4'C'E
BY ASSIAWT1ON of the unpaid prncip:u balance :rr'd .17 ob'.rrations of scilcr i>n tlac
c"iswig ivaldb) secured deed of Lrubt un Or pmpcnut ac::crd:tacc .vilh Lk a:rschcd
Low A. aimption Addcndttm %Stnndird Form ? 4(—T)
BY SF.I.I.FZ FiNANCI`C- in :+. zord twc %iTh the anaChcd Sclict Firfancine Addcrtdunl
1 1.1ndard F(,nn : %S• T )
BY BUILDING DL:PC)tii:' to accordan_c With Itr_ ytt:s_ncd '.:vv C'ommxtion .Addendum
(Standard Form ? Ai-Ti
L3.kLA-NCL of the Punhasc ?ncc to ,: t L :tI Settictnettt 1!,cmc or aU of which ma-- br
with the proccc&r- of a WA Iran I
Should Bttvcr I at to delnsr CitaiCT nc� lh�C D:thence Fcc or am- .nmii F;trwv %-So % : XWII bN :'tcir uu: darts. or Ss3Culd ha. i 0 k o:
other ftmdc mid tn• Fhwcr he d:chnnnred foram r ron. ;» ttC irLgitution upon ..high 111 pa% rant rs d'.rv+r. Atetr SI�tII 3t� one (I
htrkiz day aftrr vrti!tcn rxmc: m dciitcr etch official :Gina: check- u irc trtttcfCr Or el�yrpnic lrirt5fer f0 tlt pthCC to Ux ttiC=Y Bu.cr
da�s MI timeh d`liv crthC sonj a cd ft)n& , -Iicr chill lrn c tti richt L) tcrmirttic tlltl COMna tyk)n H rittC►t nOti�t t0 Ru• C►

n 1 r,f Cvtrtzt w �� ✓ �-�.
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'WhiteKehaya
Bank of erica
24Z4
S 4W.W
Vrs/ti4rZu _
Rtrct. lurt3D
rust
same
Fidelity1022
---- --
$ 400.00
GP i76519D
---
BB not, 11532
-
BB rct. 11527
David Butts
BUT
10146
$ 200.00
GP 876464D
GP #76518D (one check written for $800 split between two
Gary and Martha Pope
BUT
7461
$ 400.00
its)
BB rct. 11531
GP #76517D (one check written for $800 split between two
Gary and Martha Pope
,dson/Richardson Cc James McMillan
BUT
BB&T
7461,
7757
$ 400.00 Its
$ 200.00 GP #76462D _ _ _ _ _
BB rct. 11531
BB rct. 11530
V II
same
Aquesta Bank
1593
_
$ 200.00 GP #76468D _ _
BB rct. 11529
,oil
sWcdon, LLC
Judy Garst
Shepard Broadfoot
Aquesta Bank
CresCom Bank
1592
3201
$ 200.W GP #76549D
$ 200.00 GP #76463D
BB rct. 11528
rB—B—rct. 11534
Lion, LLC
'
Daniel Clements
Nathan Faulkner
FCB
BUT
_
-
269
88351
$ 200.00 GP #76560D ---
$ 200.00 GP #76559D
)_rct. 10821
II JD rct 10820
- - ---
Construction Co
Diane and Dave Rodgers
South State Bank
-
11849
$ 200.00 GP $76470D
KE rct. 10783
A 1 1 C
same
same
BBBT
South State Bank
6495'
1 5
$ 200.00 GP #76586D
$ 200.00 GP #71873D
JO rct. 10819
JD rct. 10847