77682D - Obday

Check
Dab Received Dab Deposited Check From(Name) Name of Pormft Holder Vendor Check Number amount Permit Number/Common's/Common's R. Receipt or Refund/Reallocated
Column) Column2 1 Column3 Column) Cokmm6 Column' Column7 Column' Cokunna
10/30/2020 Term Mocha/sod _..__ Robert Rabin __. _BBBT 14048 1_ 20000 GP 0778660 BB rot 12428
10l302020 Permit Pals Eugene Mu1iNM CrsaCom Bank -----
.__.._._.._._.—_ _. _.. Cor _... 2450 S 200.03 GP 0776640 BB rot 12426
10/302020,. HBCorntrucaon LLC_..__ ..___...... WaMer6 Delia Taboo B86T 2450 S200.00 GP a77661O 'BB rot 12429
10/30/2020__ ___ __ AMW Docks end Mono.Con65roo6on LLC __. Edward Arid Use Mr/there BBC" _ �,98 E 200.WGP'778BOD BB rot.12498 �
10/3N2920 David Goon Money Order Robert Obder ---FCB 300469813 S 60000 OP a776B20 8B rot 12600 ..

HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ROb, fz/ Oil dek ' 's
• (Name of Property Owner)
property located at /1? J / tSt d�� L„ (5L&d
(Lot,Block,Road, etc.)
on in OCC'_6/L 4 Brgt-CA ,N.C.
(Waterbody) y (Town and/or County)
Applicant's phone#: ! 7/ J,ma!9- Mailing Address: /3/k Zit.
He has described to me,as shown below,the development he is proposing at that location,and,I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(I5') 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 not wish to waive
, 1-- •I ` ti I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
0 kapthl el Se as#
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
(L-'-- - -
_ thigi___ CY-antet-k#41. e# .
Mai fng Address Signature
___Plike_c S ,UDC, ,L loly {11 4 .`Tr �.
Cit /State/Zip Print or Ty Name
0 � � 7L/ __- 9 t'3( g -) I 6, 316
Telephone Number Telephone Number
(0. ILI'. LO
Signature Date Date

4
HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) /
I hereby certify that 1 own property adjacent to Ob I 1 OLOla. s
( ame of Property Owner) J
property located at /2,7 VA. OE VOGt/LG/
(Lot,Block,Road, etc.)on , in OL ALL /_ £ cIL,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: 7/t 2/(347Znailing Address: /3/i l '':'e '6.4r
. v /T':Ja .4< C. 2�j45
He has described to me,as shown below,the development he is proposing at that location,and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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 not wish to waive
e „iti ,� I do wish to waive that setback requirement.
T DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
01),D,LA),A3 gAd Seo
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
--494°2N cawing/AK a
Mailing Address gnature
irlerAfe caS Ai.e_ Amy ___----,
01. ‘vt
ity/State/Zip Pri oir Type Name
&CV) 6AI c7A/ /77 - b'r & /9A
Te ephone Number Telephone Number
/p —i zr
Signature Date Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date /6- o9 - ô
Name of Property Owner Applying for Permit:
4/)f-P-1 j
Mailing Address:
Cct kir -P4 cot
/7104rcvS ,/Uc', 2g'/oy
I certify that I have authorized (agent) 110.0 Of Cr to act on my
behalf, for the purpose of applying for and/ G1
obtaining all CAMA Permits necessaryr� to
install or construct(activity) 130e-/� /t d On)e Q e� O KO/-
at(my property located at) 1� o/ts©1,Ad' Or 4% C
This certification is valid thru (date) ��.— - .
VOk-le?1 I -o gv
Property Owner Signature Date
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OLCAMA / ❑DREDGE & FILL 74-MVJ N° 77682 A B C
ENERAL PERMIT Previous permit#
�`—% JNew •❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued /
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Reso ces Commission in an area of environmental concern pursuant to I 5A NCAC 0'f'1'
-1 l l O U - U�Ik I Z 00 .
` - ❑Rules attached.
Applicant Name 1 �e r ��CY� Project Location: County t ^y.r,c IC.
Address --Lc') Ur2- CO,r M6,,,A � � �r // � Street Address/State Road/Lot#(s) � J��
,City S State 4.[ ZIP 2 (t&f'1 (); J u,,n_ CAv6
Phone# (]j ) (p21 (572.-I E-Mail Subdivision (S(�
Authorized Agent � ..k(k ��k(� City C(-I-� . .c_- e ct_c k ZIP 2// �S"A(o
IltCW WEW PTA )ES PTS Phone# ( ) River Basin �^^be-I� r.
id C.
Affected
ElOEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body_______
y C6.1..t. (na /man /unkn)
❑ PWS: (�
ORW: yes /� PNA yes /� Closest Maj.Wtr. Body "e"'rVL Q�
Type of Project/Activity l�p,�S�f`,_,,r (1,-�w 6._A �.Q c Ok elC�oLit�"^ -C C"1\k _
a,
(Scale: S )
Pier(dock)length (,Y ) 2 rr<< �!Fixed Platform(s) lZ.` (Z ` �• • •n� mm� a — ijm ' k� ! -s��■
Floating Platform(s) 1 0'lt2CJ� v�■■�■■� t
Finger pier(s) _ III !ill
I tI
Groin length II IIlII
4 f
number -f j
Bulkhead/Riprap length t .*11
- 111•11 • 1 t t li liMMIIIIIIIIIinummil 1 ni--avg distance offshore 1 ■�■■■■. ■■■ii+ ®'1 a� •
max distance offshore • � •••• + ' ����.•.�i 1INIIii .
i1iiuu��1�•���
Basin,channel I IUUi \ 1 M _ 1
cubic yards �•�� _ eil• ������•91111 wit
Boat ramp ������—~ Hiiiiil
•i
,.� _.
Boathouse/Boatlift _ . �.........Ill ' ......._
E
IIIIPBeach Bulldozing IIIII , 1s 9
Other ••■■■ •••■■ iAIIIIIIIEIII
�_: `� 11101 rail rir�
�
HIIIIIiII iiii ,‘ . IA IlIIIIIIII1
: :
1 „
Shoreline Length_ TSt _ ? Z;_ ` 4•4
SAV: not sure yes -.-.- -. v - -
III
Moratorium: n/a yesn i .. `2:W�A
Photos: yes }_ ?q , �k
Waiver Attached: yes. ,no i J 1
A building permit may beMe'quired by: V(,tlne. k s1A CG( '/1 . I— See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) ` (� \ L
Notes/Special ConditionsC 0 \\]U 1 G r `f ,1 � /A`-3U `++ k`\ �'- CO--)\L 1 C.p.-�' C t 4'
`� i A``� J C� i c,C Imo-�. C. , ',t c.�i t n �� -P1i,C.ec, ,Q_., ['�,c ti c ( ,,rtis
i
Agent or Applic,rt Printed �j7 PermitOffic ' edd Na (
.../-(‹.
Sign a Please read compliance statement on back of permit** Signature
tUWG� —4 U300Li(09q) / 22 2c�2c, 2/Zz1 ZOZ.I
App i tion Fee(s) Check# Issuing Da Expiration Date