54042D - Kountz

: CAMA / .. DREDGE & FILL '
3E11tERAL PERMIT Previous permit#
aflew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
lrized by the State of North Carolina,Department of Environment and Natural Resources �f
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7I 4200 �p��
['Rules attached.
It Name 5e it it y/ V-—Celt A /<0 u,'1'L Project Location: County R>e ii d Scv,c/C
L�./ 2 k21 s >A) Lfi N e Street Address/State Road/Lot#(s) _5/,/vC-
cfelL�, State 1)1 C ZIP 2FY62
I.(11a 7 tf{, - Y9 j ax#( ) Subdivision
:ed Agent City ZIP
C CW SEW G.PTA DES- ❑PTS Phone# ( ) River Basin L vn4
❑OF_A ❑HHF ❑IH UBA ❑N/A Adj.Wtr. BodysY//AI y/Z j. eg ee/t at
PWS: LI FC:
yes / rig PNA e no Crit.Hab. yes / no Closest Maj.Wtr. Body /�y t''hi
f Project/Activity Fa' op -I, ei�A_ /J70cic
(Scale:
>ck)length S 1
n(s) /2 ' 7 ' - -.L-.. — —
i
>ier(s)
mgth I I 1 - ' L
imber " Li
I
�_._._�_ yI :..„,..(+
id/Riprap length (. it
g distance offshoreI It i 'Iz
ax distance offshore , _' j q i
hannel IC v"
ibic yards hi
u I _
mp
te : , / _ .._
use/Boatlift vi 4,A('
3ulldozing ,t
I ,
J I
f
ie Length 9 7 ; �� i 4 ,! i Le*
not sure yes b {
;s: not sure yes I {
rium: n/a yes e- ! y ,pi, L
yes t7 !l /2 f .i.J L�J N 1 I
Attached: yes 51
ing permit may be required by: ez,,,.,Sc.ide k ii,.,r/f n See note on back regarding River Basin r
.1, . ) / r ii , -.- - - - ii , 1, _f; —

LOCATION MAP
Barry L. Barber, certifiy that the survey shown hereon was made in 1115
cordance with the Minimum Standards of Practice for land surveying
North Carolina. one l'
r•O��`` CAR Q/ °o rtatwn
C / 11111„ ,,,' A'''� 1
3r L. rber, P.L.S. L-3027 Z;'�QQ` 91�=; •,2
ry z : SEAL
L-3027 = 112E
<,9 '' 0 SUR\6kC (4" NO SCALE
\\ If,ff ill fl.i.11 IMUI.111,�
4 Lot 85
.a,,
A'' Thomas C. Robinson and wife,
\,� Myrna Robinson
�S' 445 Kristen Lane
2088/493
Map Cab. 26, Pg. 186
yam 332 Lockwood Lane
\ Supply, NC 28462
ck, ' N
4 / \ s o
Lot 86 \ SO,
/ �'
Jerry L. Kountz and wife, o
\7.> C.)Sara C. Kountz .S cz
o
447 Kristen Lane 4
N
2599/198 N / V-
Map Cab. 26, Pg. 186 \
N
N 447 Kristen Lane N
/
Supply, NC 28462 N;' V,
->7�
Lot 87
79 NORMAL HIGH WATER LINE i
Frank E. Trusheim, Jr and wife, 7•76 "-
Jean M. Trusheim r449 Kristen Lone \1887/333 Map Cab. 26, Pg. 186 \N' _-13
0•
7377 r:hnnnalcir1p flrvp /,� ..

Lakes of Lockwood POA
2606 Jessica Lane SW
Supply NC 28462
June 5, 2009
To Whom It May Concern:
RE: 447 Kristen Lane SW
Supply NC 28462
Jerry L. & Sara C. Kountz
The Lakes of Lockwood Board met on June 4, 2009 and reviewed the permit
application and project drawing(s) for the approximate 75' pier, 6' wide with
7'x12' floating dock for the above referenced address and property owners.
The Board has no objections to this project going forth.
Sincerely, -
Richard G.S
President
Lakes of Lockwood POA

ADJACENT RIPARIAN PROPERTY OWNERS
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Jerry L. Kountz's property located at 447
Kristen Lane, Supply, NC, Lot 86—Lakes of Lockwood on Stanbury Creek in Brunswick
County, N.C.
He has described to me as shown in the attached application and project drawing(s), the
development he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
er-7 deee 4/14.0214
signature
- ( 1J
Print or Type Name
?1e: W%
Telephone umber
- � f oP
Date

- --- — JWU,tn 1 .
OMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
1
a items 1,2,and 3.Also complete A. ature , r LA 1...) !
estricted Delivery is desired. C
r name and address on the reverse X ��? 4 U.S. Postal Service
e can return the card to you. B.�- dyed bted ame) C. Da..o CERTIFIED MAIL, RECEIP
is card to the back of the mailpiece, fI eRii rlz ,1ej =
a (Domestic Mail Only;No Insurance Coverage
front if space permits.
D. Is delivery address different from item 1? I u-i For delivery information visit our website at
Tressed to: _ If YES,enter delivery address below: P."r ;v�- www-us
Millim 0459
It, Postage
2_ Ck6,,,j(ve15r
p Certified Fee 117
Dr i ) 0 Return Receipt Fee Po
3. Service Type o (Endorsement Required) 1
NC 0 Certified Mail 0 Express Mail Restricted Delivery Fee
P I L ❑ Registered ElReturn Receipt fr ED (Endorsement Required) 1111111111
g (, ❑ Insured Mail 0 C.O.D. u)
Total Postage&Fees
4. Restricted Delivery?(Extra Fee) i15j?Qj_
co tTo
"be` 7008 0500 0000 3882 507 o _____ �` Y1n
xm service label) / �QMf,�S-_rL r//�J/I�c,
o Street.Apt,No.:
---------------.C-..P.
No. L
•MPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
........................................
terns 1,2,and 3.Also complete A. Signature 00,August 2006
See Reverse
tstricted Delivery is desired. X
lame and address on the reverse t%� a '�—a U.S. Postal Service
can return the card to you. Becelved by(Printed N e) C. C CERTIFIED MAIL„.,
card to the back of the mailpiece, D, RECEIPT
•ont if space permits. cp
`� t m (Domestic Mail y- ,
D. Is delivery address different �. For delivery information visit our website at www us s,
sse to: 1 t) Po If YES,enter delivery add�ss below.. < 11 r. • . P
L Po f iy R J 'a
T OL C O
LA,K e ) p.- i.O Li(CAA � N� frl Postage
�Ot� Certified Fee I_I i
t .r
J1 5 5 r c °` 4 3. Service Type ` O Return Receipt Fee Postrn
(Endorsement Required) Hen
5L..10 Certified Mall ❑ Express Mail Restricted Delivery Fee
P , 1 0 Registered 0 Return Receipt I p (Endorsement Required)
/�J G ( 0 Insured Mail 0 C.O.D. czi
al 0 Y 10 L Total Postage&Fees•71 I)Sj?Q/?IJI)
4. Restricted Delivery?(Extra Fee)
er 7008 0500 0000 3882 5039 co sar.tro1
i service label) o Street, L. -�`.5... n• ,�,o ckui)u Uc,1 II
1, February 2004 Domestic Return Receipt f�- or PO Box No. -y
Ciry.State,ZIP+ �C_L_� �[-�'-S-S -�h_--�(�"
• Li
C , gy4
PS Form 3800,August 200t,
PLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY See Reverse for
ms 1,2,and 3.Also complete A. Signatu.-
U.S. Postal Service
:ricted Delivery is desired. / .Y h CERTIFIED MAIL.:: RECEIPT
me and address on the reverse � f, (Domestic Mail Only;No Insurance Coverage Pro
n return the card to you. D; iro
i
B. -d by('rinfed e) C. 1 For delivery information visit our website at www.usps.c
nird to the back of the mailpiece,
it if space permits. �' ,' .t2i,t ru
S Y 6
D. Is delivery address different from item 1? CO
ed to: If YES,enter delivery address below: CO PostageMillenn/� I m s 04.5
9
i- //(�/.--• RDk✓S0,, Certified Fee
p !17
/, 1 r Return Rwrninr care__.__

102�
JERRY L KOUNTZ 66-112/5:
SARA C KOUNTZ / /
447 KRISTEN LANE (0 0
SUPPLY,NC 28462 «
ito Me°1[[c/ 4)' /NIL
zr
ct, el
�Q G B54 AND 2ScCOM) '�
BB$cT ,.epQ-BANK BBT BBT.Wm gPa
��L�����0/
,for G
1:0S3iOLL20:0005297L9727 0LO2
Vic. _ t r2 --- ,_.,;,.- =-t„ : ,- :_ . , ,, .,_ P . ..
JERRY L KOUNTZ 099
SARA C KOUNTZ 66-112/
KRISTEN LAN
E
5-4 P/O
SUPPLY,NC 28462
ita wylez,; e 4 N/ ,d</r) I $ is a, o 0
o
�yc.t C�L� e-
i Q" Oollats 21
BB&T BRANCH 6PPN ON TRU OM2N Y 11111 l.4
p 1-800-BANK BBT BBT.com ixn c o 6
-7or eA rh/� Pe l 1. ,1- j�nattve D-
1:053LOLL20:0005297L9727 0009 7 01