76561D - Kotz

1,1: /V.3111 A B C LW
GENERAL PERMIT Previous permit#
XNew Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC to 111. i J OO
{�� �/,,{� Rules attached.
Applicant Name Eei N-I st b Na F-"'" Project Location: County (JC/A//1001 ovv.V
Address 4310 Lev rilisf(.v(Faor4 Street Address/State Road/Lot#(s)
City Iwt,n t0/L--. . State W ZIP ?%P4 O
Phone#(q?Q)SIB 344E-Mail /Wncirbjatz•e�w)otl.(epi Subdivision �—
J
Authorized Agent T acy_MJIe/1h City ZIP_/
Affected CW WEW N PTA r NES a PTS Phone# (Ito )al/Inf�Clltiver Basin(.ate
OEA HHF _ -_ - ��•
AEC(s): PWS IH U6A WA Adj.Wtr.Bodyisik4 1L__ f 7/man./unkn)
ORW: yes 4 , PNA/J®/no Closest Mal.Wtr.Body
�_-1-�Lw - t�
Type of Project/Activity 4/7,Ll fU /20,cfr e'it ienefV 7,11,// r/7
(Scale: IJT )
Pier(dock)length -- t./7W11N�
• Fixed Platforms)q0 Cr
Floating Platform(s) — ? ( ne a
Finger piers) -- .�l• / t'/sLra litive
Groin length ._. V4tle, W
number _. Veto
"+"
Bulkhead/Riprap length— ereffi
�� AA)
avg distance offshore
mu distance offshore �`
Balm,channel �- �=r. K __ c• GtF1
1NM i Millb HIIsbrov'd l
cubic yards — (� d� �-PrnprctlHlc'Ed kit and
Boat ramp f i obsefvechal plortle(WI
Boathouse/Boatlif ——
Beach Bulldozing -'-- /
Other I RIPP Oat sn /
swa* ,-aeeocs (colt fAVAr J� yy�ty� /
Shoreline Length (bs�+ '� s _ PXQf �1.,.t/-- /✓
SAV: not sure yes ® I I I ,�'0
Moratorium: Na yet 4310�1-ao hs
Photos: yes �B/ .Vet{- C 11
Waiver Attached: e __.____ _: s. •_. .----,----
A
building permit may be required by: N(A✓/l #lows (Wi�/ See note on back regarding River Basin rules.
(Note Local Planning Jurisdiaan),,�j,�7,,'Qn ,// �yy I
Notes/Special Conditions Lt'j,C('K(�,S 7il.I2['//� A4 i tr�di ,fipS �y , ,e ,I///l tied]
Q.a /vnr k,/,'v goo s F/),,- k ss- ova,.rime/ dl/i n il'12utGj deck rig
Ilracsn McGinley( (8.13•aao, _ PfrecAmco
isgent or t a.. Permit Officer's Pnnnt�tedd""Naanie---
� ��►./
ure ease t on back of permit•• iS gnatu�
9 ?�-'� C./JLG ,./.- I_ -- .—I— I- --

CAMA/ ❑DREDGE & FILL N° 76561 A B
iENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environmental Quality Dastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 0 1 N, a co
El Rules attached.
Name
e o f'(-f 4 & N a Acy V c Project Location: County !\/(W Hil 0 b V`Q '
1(31 Q La i, v d i S'l v-r-{ (v✓-1 Street Address/State Road/Lot#(s)
i j 0,Y11±1 y` State NC ZIP Aqii
(C1110 ) 51) 344 S E-Mail (1GnC / 1/UI eq 1at1 (p1 Subdivision
:d Agent l(O( MC Ca irin J City ---- ZIP
❑CW ®EW IN PTA 2-ES ®PTS Phone# (110 )a 19 11 C A fitver Basin CUExFt
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 4 S Vett C t-e a (c Ol e
❑PWS: I tti 1�
Closest Maj.Wtr. Body
yes no) PNA ®e / no
'Project/Activity j/, c .l-6f 17111171# nr
i.
(Scale: rJT 5
ck)length — iC cc r1,L t�. 1
atform(s) qt.' 5 r I
�+`/ a 1
Platform(s) i� ;v '' 0 ' '
:ngth I : ' -. i ri
tuber L.._.... 1
1 w , I
d/Riprap length �i 'I ; �._: E ; 1 P"'
g distance offshore ` 1 a
ax distance offshore t r .n;l�,c
hannel --- 1 1 1" 1 1 , ........ i ,,., 41
::_. : . ,
, , , , , Animido.l. ,4„ 6,„.;,,,,,, , ,
,
ibic yards 1111
'—,-' 0?CSedtiKC8 /
mp i {OrVCI I IV �I '
ir�use/Boatlift ` F
I
•
III
3ulldozing { I
.2 SF cleti cn I i
i h fiecvnd .
Sta,rs-cyr a.E e55 r IQ I1IIIIIIIIH /
ne Length le -i MI riM ! (g , " { V 1
not sure yes ® '- f
x-ium: n/a yes . 15 1 ._. I..A �
Yes �, (._ t t v � r
Attached: es 6 I 1
ring permit may be required by: W /kik-1 fr (c(y/IVC, - I See note on back regarding River Basin
--I - .. Inn a n I Pin I ricflirtinn) I A r / F/
, . / /1 A

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Kgr,i WA-tiC.Y /moo l Z
Mailing Address: 43I0 L r el, 3LVfy Cr
WIt 4I"JG rit,)f NC, 28909
Phone Number: 910-5 Ir 2L— 344,5
Email Address: nQV1C b kO-Z Gel jvia,i I, Com
I certify that I have authorized I g4aY tic CULtcN
Agent/Contractor
to act on my behalf,for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
wkter.biDg y KYRK u4UN
",_CK (I'8.5o 1 f`f'.) rIi QUV?Fo,em 6 x 30'1
/
at my property located at 1310 L.AVICA-u 5 BLUFF COoi-i
in NEW JhMOV t_ County.
I furthermore certify that I 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
NilNcY KoTZ
Print or Type Name
O WN6lZ,
Title
1 t WP
Date
This certification is valid throughJ�lL 1_2 ,3

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to 'EN) ¢ 1N/CNCY A O Z 's
(Name of Property Owner)
property located at LOT 3 Tiff SLUFF ki 1R'Mlyt.S EN
(Address, Lot, Block, Road, etc.)Wif Isic.EY egirt, , in NEW &WOVfL COL [`I' , N.C.
W
(Waterbody) (City/Town and/or County)
the applicant has described to me, as shown below, the development proposed at the above locatior
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 o a ach a site drawing)
666 Aqr cvTieAtolmG5
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set bac
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to wa
he setback, you must initial the appropriate blank below.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Property Owner Information) Adjacent Prope er Info o
.4-621),LtLif
Si lureNan Lttel-g
Signature
_nni nr Tuna Names _ _ . Prittor Type Name _

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
iU t s
I hereby certify that I own property adjacent to elf C(Name of Property Owner)
property located at O Block, Road, etc.)
(Address, Lot, N N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
VI 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 o a ach a site drawing)
5e6 Agrnc TrAtowG5
WAIVER SECTION
Iunderstand ithate of 1r5'f from myock, oring pilings,area of riparian access unless
boathouse,waved byift, rme.'n must be set back a
(I you wish to waive
minimum distance
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.
(Property Owner Information) (Adjace Property,Owneq Information)
Signature Signature
Print or Type Name Print or Type Name / e_
"min i iirnii5 �Itit t�.DtiY-� ` :3C L° LA l�iz+�S /�L. L;° r

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All flood, wetland, and mean high waterlines scaled from m
3 JMap Book 51 Page 283. yOvog:11;r:Atts1,1
fNo Ra 3OR�f(ICgN naN
Purviance (Whiske ) Creek VICINITY MAP N.
•
9 vt-- ..— P, K Ia8 P19 E
L S 2z' KHak la
—
" -- 1,1 � �
-
__----- ----'' -iO' - - ''� \-�
-- " 1-- — � 162.8 ,,-' �;,-' \
ean --\•-:,
H' iigh . _ --'WaterLne N imi
TAre
- T \ond Vane LAND TO e E Or- pFD k
WA . �e� MAN Meth
0 Lot 3 O� �V CK (51 NE.
0.
0.39 Ac. -5E
L ��
N r / �\
N 11.1' p11111111111fl1_— --TG
_75' COD Setback —
Deck o,.ch y e 4))
—-" co \
z I Lot 2 \
I
proposed a� \
'o
Lot 4 Prop /4 The Bluff at Trails End \,
o Dwelling (''' MB 51 Pg 283
"he Bluff at Trails End NII � 0 "�- .o.
MB 51 Pg 283 Z 1 of porch J io' /
0 = S 56'58'55" E /
M1CN-P-�� ul� o ��F °o��- - 39.09'
M I55 °'= / I \9 E \ N
\� /
4 /
COO co G-i�`) \�\
/ \
\// __— Ds?.. P 'K-, KEN Ft 6 NRyu e- \ \I
— ——/ '0- KO T Z. ; Lot 1
10' Utility Easement
91 DENCE i
Lauralis Bluff Court
(40' Private R/W)
i
Scale: 1"= 40' 05.5

Check
I Man Nam*of Permit Holder Vendor Check Number amount Permit Number/Canmenb Recalpt or Refund/Reallocated a
*�
*q Column4 CoWmn6 ColumM Column? Columns Columns
Tim Bell 'Lumbee Guaranty Bank 5327'$ 200.00 GP#76466D BB rot.11535
same FCB 1687'$ 200.00 GP 877822D JD rct.10824
ruction,Inc. Ronald and Sarah Seawall ,First Bank 12821,$ 600.00 GP#76575D PA rct.10259
motion,Inc. Deborah Gassen First Bank 12819,$ 200.00 GP#76588D PA rot 10262
;o1Z same FCB 5266'$ 200.00 GP#76561D PA rct.10263