77835D - Taylor

CAMA / DREDGE & FILL NC 77835 A B C
iENERAL PERMIT Previous permit# ......_
New I :Modification .1Compiete Reissue :.....Partial Reissue Date previous permit issued_ __
zed by the State of North Carolina,Department of Environmental Quality
pasta!Resources Commission in an area of environmental concern pursuant to ISA NCAC T7i1, 1200 ----
,, ,- Rules attached
,,_.
Name retle-ear.Thipff" Project Location: County 11/4*.itrt_si.e1V4/
- ..__. .._ _ _
--i RjeS C./Y.8-4)0;E, Street Address/State Road/Lot#(s)
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(qio 13i 4,70 1 __ E-Mail leWegi)rini21184 we IAA,,:ein Subdivision .....—
e Ager--t titi.(i Ca,.c r oc-C 4ev liken( City ---- ZIP -----
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ing permit may be required by Aifript_c_railiAt See note on back regarding River Basin rule
Local Planning jurisdiction) 4,
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1CAMA/ ❑DREDGE & FILL N9 77835 A B
3ENERAL PERMIT Previous permit#
'lew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environmental Quality
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 'V7/1. 120 0.-
„ ❑Rules attached.
t Name I<<al'VJ/� Project Location: County ,&-k'" 4vIOV'er
f.;_keS: °e A/k Street Address/State Road/Lot#(s) S4h�I Ifl ti U State (VC zip254/ /
i
(to ) 1311.70 I E-Mail:rLt«rermrnrlyd yre 05,com Subdivision
ed Agent Oct Ca yOrOC ,Spud 619e. /41i City ZIP ��L
❑CW C�SEW I PTA ❑ES ❑PTS Phone# ( — jam"—"' River Basin ItAfir
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❑PWS:
yes / PNA yes /® Closest Maj.Wtr. Body A/44 c>•,/
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Ing permit may be required by:/I4G4 cite r it' See note on back regarding River Basin i
Local Planning lurisdictionl ., _

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ArV4.014•141• ri6.6.1 II I 10601%1111....r"t I 1%011 I ',kora vinevo" t...1%1111. I rat i1.-.0 1 t>4.111
Name of Property Owner Requesting Permit: -72_ CC6-- a 1/eh/-
Mailing Address: 3PaCitS 1 be,
ilviitios4on' WC 284 )1
Phone Number: 9/6 .2j 1- 77(5
Email Address: r-e_ ixcca2r mtlid-eci raft (611-A-
certify that I have authorized IV IC-k- Ca•Valocciti j1:511A-1k, eye 'War r/
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: c et) 5:2-2-
ck, -t5
at my property located at 3 2 RIeS m,
in Nit 1/1/ hotAlOounty,
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:
rfc•—. //6;
Signattii-o-/
-e-oe C cc, I aAll r
Print or Type Nam
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Title
.
.4„1. O 3 2_3

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Propety Owner)
property located at
� (Address, Lot, Block, Road, etc,)
on 0 �.0 ��t�'i-..'-- , in ('.�: l ,tom :''.- t" . N.C.
(Waterbody) (Ci�rlTown 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 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_
Owner Information)
(Pr ) (Adjacent Property weer Information)
1° « e.174. 7° er)
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Type � PS �i + P nt o( type Afeeme
it g Address tAddrs
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City/ t C /S
2K31 770 / Oi/,tateip_ hp, f - oc,, cz

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
's
(Name of Property Own
property located at Owner)
(Address, Lot, Block, Road, etc.)
on
in , N.C.
(Waterbody) (City/Town and/or County)
The 4,licant has Fcnbed to me, as shown below, the development proposed at the above location.
I a e no objection to this proposal.
Irio/' 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.
(Pr. . -rty • er infom,atio ) (Adjace t P Owner Info
h(-14. -14k C---)
� e
i lure
C(
P t or T .- ame 00)Gl
rint or Ty Name
t Address p 41 de
Mailing A less
t v I zn c_ O �J j�Jp l�li(e Tf3A O C 2 * //
C te/Zip, C y/State/Zip

Cheek
or(Name) Name of Permit Holder Vender Chalk Number amount Permit Number/Comments Receipt or Refund/Reallocated •
n n3 Column,' Column5 Columns Column? Cohenn8 Column9
Bulkheads LLC Dale Ardizzone Wells Fargo 23505 $ 200.00 GP#77858D KE rct.10790
Kel and Tano Faille Charlotte Metro 1719 $ 200.00 GP#77853D BB rct.11543
ine Construction LL Linda Weber 'BB&T 5930 $ 200.00 GP#76597D BB rct.11533
NC LLC Richard Reuhland BB&T 1117 $ 200.00 GP#764840 BB rct.11544
rst./Daniel Shirley Jordan Messick ;SunTrust 5365 $ 600.00 GP#76543D PA rct.10267
rst./Daniel Shirley Melissa Hardin SunTrust 5366 $ 200.00 GP#76577D PA rct.10266
,LLC ]Rebecca Taylor Wells Fargo 1025 $ 200.00 GP#77835D PA rct.10269
ruction,LLC Kevin Driscoll Navy Federal CU 1167 $ 200.00 GP#76587D PA rct.10264
ny Roger Hudson First Bank 1446 $ 200.00 GP#76544D PA rct.10268
ine Construction LLC Alison Marshal BB&T 5964 $ 200.00 GP#76487D 'BB rd.11549
same The Fidelity Bank I 6413 $ 200.00 GP#76483D BB rct.11547
actors Inc. Webster Trask PNC Bank 8787 $ 200.00 GP#76477D KE rct.10792
arvices,LLC Perry and Darlene Mansfield First Citizens Bank 3433 $ 200.00 GP#76432D Ben rct.10299
arvices,LLC George and Karen Brake 'FCB 3432 $ 200.00 •GP#77622D 'Ben rct.10300
II Gary Godwin BB&T 2002 $ 200.00 GP#76448D Ben rct.10298
tors LLC Chns and Nancy Sweeney FCB 9243 $ 200.00 GP#76436D Ben rct.10297
actors Inc. 1Pipers Neck 29,LLC PNC Bank 8788 $ 200.00 GP#76478D KE rct.10791
ine Construction LLC Beverly and Patrick Wright Rev.Ti BB&T L 5951 $ 400.00 GP#76485D BB rct.11548

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN P PERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: -t C C G� Q 1 O '�
3z2- f--& e s C 1 WI NC 2 it
Address of Property 1
(Lot or Stree #, Street or Road, City&County)
Agent's Name#: Mailing Address:
Agents phone#:
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 proposing.A description or drawing,with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext,
Wilmington, NC, 28405-3845_ DCM representatives can also be contacted at(910) 796-7215.No response is
considered the same as no objection if you have been notified by Certified 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
wis 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.
(Grope Owner Informati•n) (Adjacent r e caner In rma - n)
S ature 9 S ature
_ I e s-,,-. 1,0 I L-C.•OA Zto-ti- ____EALLLA__640D -f7(
Print or Type Name Print or Type Name
3��- Crt is ��e �� 3 ZG Plke E-S CifiEk h R_
Mailing Address / Marling Address
1�l rU i n o n l_ `� 'I1 ti14 it,e, ToAl C LW"
City/State/Zpi C te/Zip

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
WeixName of Property Owner: CC 1 (- (t)
zz � /�
Address of Property. 3 P�C e S C- 1�-'Q k_ bc . W) j. /VC, .I8/. I i
(Lot or Street 4, Street or Road, City&County)
Agents Name#: Mailing Address:
Agent's phone#:
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 proposing. A description or drawing, with dimensions, must be provided with this letter.
_L__I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response is
considered the same as no objection if you have been notified by Certified 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.
I do not wish to waive the 15' setback requirement.
(Props Owner Information) • Adjacent Property Owner Information)
74---t, Z'ef-C / 06-7/1 rA,D (-li.
Si nature
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�<-t_be CC Ic-- 1 a ' 11 )-dclt 1
Print or Types 3 Print or Type Name
`3-2_ 2_ {ci s C f L b Zit r lug ail
1 Mailing Address I `/ Mailing Address
hi l inl l/� for) NC )ST 1/ I k) C 1
City/State/Zip V City/State/Zip � i �� i
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