77688D - Plummer

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7CAMA / ❑DREDGE & FILL N9 77688 A B C CP
GENERAL PERMIT Previous permit#
"-) New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 6/4• I ""]�
"'CJ
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC —I�
',Rules attached.
Applicant Name J G--) ' A�r� 0U ,i^-c.'l Project Location: County /�^s , L
Address 'f'k`4 I( a (,�c k t Y , Street Address/State Road/Lot#(s) l r S' f
r
City lit-`J�Q, A h State n1'- ZIP 2-7'(0l1
Phone# (l( () G--(Q ( l'(Dct E-Mail e(v M r "n,Nc.; I•co(-^ Subdivision
Authorized Agent r...--��,,,. . A,�,`, City Oct ( J-L acc-< I ZIP ? 1/4•( L. 1
❑CW 0 EW 0 PTA ❑ES ❑PTS Phone# ( ) River Basin L L-e—
Affected: EA 0 HHF ❑IH 0 USA 0 WA lc"( `�\L an /unkn)
AEC(s) Adj.Wtr. Body
❑ PWS:
Closest Maj.Wtr. Body
ORW: yes� PNA yes62
Type of Project/Activity LI t,—.4 S--r.c Y 'i Q, t C ` ki,'.1'",-' - Svc G..C,v~^�
_ (Scale:
Pier(dock)length _
Fixed Platform(s) I I ��� �
Floating Platform(s) \ 2 t
Finger pier(s) 1.
y J�Or
Groin length 'ii i t! \ I'� ��r
! I t,
number �._.._...._ �'�-.__.._. �
fi
Bulkhead/Riprap length i } I -e_14
avg distance offshore i i II
max distance offsho Ii
i ! ;
Basin,channel I
1I
I'-
cubic yards
,&•w' rya • w •AA ups a• 1av&• • ;
Boat ramp
�������,��,��,t 1, ' l,t,i�
Boathouse/Boatlift V :161ili �'�' - - i ''�i
r _1\\ Vitilf. ttit L.I.\,�` r�ay_i• -A.� Ili lANj -I
Beach Bulldozing n --- -I- —, I ' it � L
Other < -.c� O 4 r �. t.... I.
�i ,c a 1" I
GO1 yld K(/ t i
i M13 j;
1 4 I I
Shoreline Length 50 (1- E 1 7 i 9
SAV: not sure yes no 'j n ^S
�! ! 1 _
Moratorium: n/a l./ no ❑i
Photos: yes i �.. + �4I ... ++d^"- '✓.... N 1
Waiver Attached: yes / ---
A building permit may be required by:T ..u. U\ OCCA` (NC A- )(ac 11 . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) j.� ` \ ,( ' 1
Notes/Special Conditiogs) Lit) (1-�(1vV- C„�A1".,,►?.e\. cv�S kA O� Cu7 `D,vf,�` >\?\)VSACE
/-i- -\ Lr LkU✓' pn 5( 4yt_ rok, ,u U 6-c, , v6,`4_ vrat{ e IrO-s-/3-1i c( ®
..c,40, Q.e..a. ,eil.k14, 5aA mui b..& u t( -ko i(AJA---e"
5.42.e. tk---k--K c\N.... _ "--\--- --....\--- rb(L-'
Agent or Applicant Printed Name Permi i r s rimed Name �'It`1(___
Signature Please
��reac�a�rnpliance statement onbac of permit" Signature
�OV (5f IU Z q Z OZU 1(fZef(20�
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Issuin D e x iration Date Application Feels) Check#

•
•
Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief,certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar-Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the
Wilmington Regional Office(9 I 0-796-72 15)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2020-01730 County: Brunswick County U.S.G.S. Quad: Shallotte
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: Jay Plummer
Address: 716 Tadlock Drive
Raleigh,NC 27614
Telephone Number
Size(acres) Nearest Town Ocean Isle Beach
Nearest Waterway Atlantic Ocean River Basin Lower Pee Dee
USGS HUC 03040208 Coordinates Latitude:33.89707
Longitude: -78.398(13
Location description: The site is located alone the Atlantic Ocean at 415 E 2nd Street,Ocean Isle Beach, NC 28469
Description of projects area and activity: : The Proposal is to place sandbags alone the Atlantic Ocean beach.The sandbags are
required due to beach and primary dune loss due to Hurricane Isaias and to protect the applicant's residence and property.
Applicable Law: ® Section 404(Clean Water Act,33 USC 1344)
❑ Section 10(Rivers and Harbors Act,33 USC 403)
Authorization: Regional General Permit Number: 198000048
SEE ATTACHED RGP GENERAL AND SPECIAL CONDITION'S
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with your submitted
application, drawings and the attached Special Conditions.Any violation of the attached conditions or deviation from your
submitted plans may subject the permittee to a stop work order,a restoration order,a Class I administrative penalty,and/or
appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide and/or regional general permit
authorization is modified, suspended or revoked. If, prior to the expiration date identified below, the nationwide and/or regional
general permit authorization is reissued and/or modified, this verification will remain valid until the expiration date identified below,
provided it complies with all requirements of the modified nationwide permit. If the nationwide and/or regional general permit
authorization expires or is suspended, revoked, or is modified, such that the activity would no longer comply with the terms and
conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or are under contract to
commence in reliance upon the nationwide and/or regional general permit,will remain authorized provided the activity is completed
within twelve months of the date of the nationwide and/or regional general permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify,suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Resources(telephone [phone])to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C.Division of Coastal Management in Wilmington,NC,at(910)796-7215.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program,please contact Greeorw Currey at 910-523-1151 or Greeorti•.E.Currev()usace.armv.mil.

• CURREY.GREG Dy4114."9"edb
CURREYGREGORYEUGE
ORY.EUGENE.1 NE.1051 0 1 1950
Date:2020.10.2 3 16:1 7 13
Corps Regulatory Official: 051011950 0+0o Date: October 23,2020
Expiration Date of Verification: November 23,2020
A.Determination of Jurisdiction:
1. D There are waters,including wetlands, on the above described project area that may be subject to Section 404 of the Clean
Water Act(CWA)(33 USC§ 1344)andror Section 10 of the Rivers and Harbors Act(RHA)(33 USC §403).This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process(Reference 33 CFR Part
331). However.you may request an approved JD.which is an appealable action,by contacting the Corps district for further
instruction. Please note,if work is authorized by either a general or nationwide permit.and you wish to request an appeal of an
approved JD,the appeal must be received by the Corps and the appeal process concluded prior to the commencement of any
work in waters of the United States and prior to any work that could alter the hydrology of waters of the United States.
2. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements
of Section 10 of the Rivers and Harbors Act(RHA)(33 USC§403)and Section 404 of the Clean Water Act(CWA)(33 USC§
1344). Unless there is a change in the law or our published regulations,this determination may be relied upon for a period not to
exceed five years from the date of this notification.
3. ❑ There are waters,including wetlands, within the above described project area that are subject to the permit requirements of
Section 404 of the Clean Water Act(CWA)(33 USC§ 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
4. ® A jurisdiction determination was not completed with this request. Therefore,this is not an appealable action. However,you
may request an approved JD,which is an appealable action.by contacting the Corps for further instruction.
5. ❑ The aquatic resources within the above described project area have been identified under a previous action. Please reference
the approved jurisdictional determination issued . Action ID:SAW-
B.Basis For Jurisdictional Determination:
C.Remarks:
D. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants,or anticipate participation in USDA programs,you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service,prior to starting work.
E. Appeals Information for Approved Jurisdiction Determinations (as indicated in A2 and A3 above).
If you object to this determination,you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed
you will find a Notification of Appeal Process(NAP)fact sheet and Request for Appeal(RFA)form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Philip Shannin,Appeal Review Officer
60 Forsyth Street SW,Room 10M15
Atlanta.Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps,the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5,and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by

It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence. CURREY.GREGORY.EUGEN Digitally signed by
C U RREY.GREGORY.EUGENE.105101 1950
Corps Regulatory Official: E.105101 1950 Date:2020.10.23 16:18:28-0t'00'
Gregory Currey'
Date of JD: Expiration Date of JD:
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at
http://corpsmapu.usace.army.mil/cm apexlf?p=136:4:0.
Copy furnished:
Brandon Grimes(B&B Marine Construction,LLC)
Curt Weychert(NC DCM)
Brendan Brock(NC DCM)
Rob Mairs(NC DWQ)
Kathy Matthews(USFWS)
Maria Dunn(NC WRC)

SAN-2020-01730
SPECIAL CONDITIONS
1. Prior to any construction, all derelict coastal armoring geotextile material and other debris must be
removed from the beach to the maximum extent possible.
2. During construction, trash and food items shall be disposed of properly either in predator-proof
receptacles, or in receptacles that are emptied each night to minimize the potential for attracting
predators of piping plovers, red knots, and sea turtles.
3. In the event the structure begins to disintegrate, all debris and structural material must be removed
and deposited off-site immediately upon coordination with the Service. If removal of the structure is
required during the period from May 1 to November 15, no work will be initiated without prior
coordination with the Corps and the Service.
4. All personnel involved in the construction activity shall be aware of the potential presence of piping
plovers and red knots. Before start of work each morning, a visual survey must be conducted in the
area of work for that day, to determine if piping plovers and red knots are present. If shorebirds are
present in the work area, careful movement of equipment in the early morning hours should allow
those individuals to move out of the area. Construction operations shall be carried out at all times in a
manner as to avoid antagonizing shorebirds while allowing them to exit the area.
5. Any work should only take place during daytime hours, after sea turtle volunteers have finished all
morning patrols and marked any nests for avoidance. Work should not be conducted within 50 feet
(on any side) of a sea turtle nest marker.
6. If a new sea turtle nest is laid after the date of permit issuance and before work is conducted, please
contact the Service and NCWRC for further consultation.
7. Vehicles should access the beach as close to the work area as possible, to limit travel down the beach.
8. Vehicles should travel on wet sand, to the extent possible.
9. If any nests are uncovered, then all work must stop. Notification should immediately be made to
NCWRC's sea turtle hotline [phone]), as well as the local sea turtle volunteer coordinator and
the USFWS (919-856-452, ext. 20). Work should not resume until after the sea turtle volunteers are
able to manage the nest and eggs. Compliance with the measures outlined here do not provide any
regulatory relief, if a nest is damaged or destroyed.

Action ID Number: SAW-2020-01730 County: Brunswick County
Permittee: Jay Plummer
Project Name: 415 E 2nd Street/Ocean Isle Beach / Brunswick/Jay G Plummer
Date Verification Issued: October 23, 2020
Project Manager: Gregory Currey
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Regulatory Division
Attn: Gregory Currey
69 Darlington Avenue
Wilmington,North Carolina 28403
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

10/6/2020 ., 415E 1st St-.----- ogle Maps
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U.S. Army Corps of Engineers (USACE) Form Appecwod
APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT OMB No.0710.0003
33 CFR 325.The proponent agency is CECW-CO-R. Expires:01-08-2018
The public reporting burden for this collection of information,OMB Control Number 0710-0003,is estimated to average 11 hours per response,including the time
for reviewing instructions, searching existing data sources,gathering and maintaining the data needed,and compieting and reviewing the collection of
information.Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense,Washington Headquarters Services.
at ,,-..-alex.es.i.tiTtixackkg-iplgrmatign,ci.4103g7s !� tl.rr;.Respondents should be awere that notwithstanding any other provision of law. no person shall
be subiect to any penalty for falling to comply with a collection of information if it does not display a currently valid OMB control number.PLEASE DO NOT
RETURN YOUR APPLICATION TO THE ABOVE EMAIL.
PRIVACY ACT STATEMENT
Authorities:Rivers and Harbors Ad,Section 10,33 USC 403;Clean Water Act,Section 404,33 USC 1344;Marine Protection,Research,and Sanctuanes Act,
Section 103,33 USC 1413;Regulatory Programs of the Corps of Engineers;Final Rule 33 CFR 320-332.Principal Purpose:Information provided on this form
will be used in evaluating the application for a permit.Routine Uses:This information may be shared with the Department of Justice and other federal,state,and
local government agencies,and the public and may be made available as part of a pubic notice as required by Federal law.Submission of requested information
is voluntary,however,if information is not provided the permit application cannot be evaluated nor can a permit be issued.One set of original drawings or good
reproducible copies which show the location and character of the proposed activity must be attached to this appfrcatior(see sample drawings and/or instructions)
and be submiceo to the District Engineer having iunsdictiort over the location of the proposed activity.M application that is not competed in full will be returned.
System of Record Notice(SORN). The information received is entered into our permit tracking database and a SORN has been completed(SORN tA1145b)
and may be accessed at the following website: v(Erva ORNs1m ""j�wde SORN-Artirie view An:®S7p1'afl4 j y,gap
(ITEMS 1 THRU 4 TO BE FILLED BY THE CORPS)
1. APPLICATION NO. 2. FIELD OFFICE CODE 13. DATE RECEIVED 14. DATE APPLICATION COMPLETE
(ITEMS BELOW TO BE FILLED BY APPLICANT)
5. APPLICANT'S NAME 8. AUTHORIZED� AGENT'S NAME AND TITLE(agent is not required)
First 11V-i Middle- Cr Last-�u IY' "i g it-- First- {pstikta00 Middle- Last- 61 M IC
Company- j I Company-
E-mail Address- a t l M t{Qk°�`CO E-.nail Address-
6. APPLICANTS ADDRESS: 44 9, AGENTS ADDRESS:
Address- 7 t 6 TibLs.0�- Pt' I Address-
City o 6 state e- zip-Z76/1/country-USA City- State- zip- country-
7. APPLICANT'S PHONE NOs.w/AREA CODE 10. AGENTS PHONE NOs.w/AREA CODE
a. Residence b. Business c. Fax a. Residence b. Business c. Fax
C76-6969
( STATFNT OF AUTHORIZATION
t 1. I hereby authorize. /JieAPali/ G i t to act in my behalf as my agent in the • of this application and to furnish,upon request,
supplemental information in support of this permit application, If
�ATURE OF APPLICANT DATE
NAME,LOCATION,AND DESCRIPTION OF PROJECT OR ACTIVITY
12. PROJECT NAME OR TITLE(see instructions)
13. NAME OF WATERBODY,IF KNOWN(if applicable) 14. PROJECT STREET ADDRESS(If appicable)
,Ar z- AJ- 7v C3C.ft%,A) Address 9, - 025-r-�-Sf Sr;
�f ft. t
15. LOCATION OF PROJECT OC�_���� Q_� �'/gyp
Latitude:44 Longitude:=W
City- (�C State-' Tip-Z8'/6
16. OTHER LOCATION DESCRIPTIONS,IF KNOWN(see instructions)
State Tax Parcel ID 2zi4 N F e Municipality a Rio vsi icstt CAWAffil
Q
Section- Township- II .. --s,J' Rant (fir / yo �'� 4/t r3.r1T'Z4///67
ENG FORM 4345, MAY 2018 PREVIOUS EDITIONS ARE OBSOLETE. Page 3 of 1

.17. DIRECTIONS TO THE SITE
rSi
A cz4.r --v rgek-0--7 � ! /s '/A #6 7 � -2:1 S r�
A� - -Jai - A/°44x, 2 ?// iS Ef5'1'
18. Nature of Activity(Description of project,include all features)
�tU, e .. of A hers o�
Ole cOri-A -F)
x l'� C:dT ri4 C—E
19. Project Purpose(Describe the reason or purge of the project,see instructions)
f 6 C/ ✓ 4:' ' 4:AO S/.C)A) i4�' t� fjd/Vl (4.4 7
A Jd& /t1/F/61171 g�4t�
USE BLOCKS 20-23 IF DREDGED AND/OR FILL MATERIAL IS TO BE DISCHARGED
20. Reason(s)for Discharge
21. Type(s)of Material Being Discharged and the Amount of Each Type in Cubic Yards.
Type Type Type
Amount in Cubic Yards Amount in Cubic Yards Amount in Cubic Yards
22. Surface Area in Acres of Wetlands or Other Waters Filled(see instructions)
Acres
or
Linear Feet
23. Description of Avoidance.. Minimization,and Compensation(see instructions)
ENG FORM 4345,MAY 2018 Page 3 of

24. Is Any Portion of the Work Already Complete? fYesio IF YES.DESCRBE THE COMPLETED WORK
25. Addresses of Adjoining Property Owners,Lessees.Etc.,Whose Property Adjoins the Waterbody in mom vun car be entered nem please ettaoh a supplemental W.
f S'�
a.Address- e7 �-A• Q �{1,, ,
Coy- /• State- �---- Zip- 2 2 i/‘ 1
b.Address- ,--//S , I- ' - r. CT.)
City- C/6 State- NC__ ZIP- W
c.Address-
City- State- Zp-
d.Address-
City- State- Zip-
e.Address-
City- State- Ztp-
26. List of Other Certificates or Approvals/Denieis received from other Federal,State,or Local Agencies for Work Described in This Application.
AGENCY TYPE APPROVAL' IDENTIFICATION DATE APPLIED DATE APPROVED DATE DENIED
NUMBER
'Would include but is not restricted to zoning,building,and flood plain permits
27. Application is hereby made for permit or permits to authorize the work described in this application. I certify that this information in this application is
complete and accurate. I further certify that I possess the authority to u e the work described herein or am acting as the duty autf hotted agent of the
applicant.
^�.. / L Jttic�
SIGNATURE OF APPLICANT D E SIGNATURE OF AGENT DATE
The ication must be signed by the person who desires to undertake the proposed activity(applicant)or it may be signed by a duly
authorized agent if the statement in block 11 has been fitted out and signed.
18 U.S.C.Section 1001 provides that Whoever, in any manner within the jurisdiction of any department or agency of the United States
knowingly and wilfully falsifies, conceals.or covers up any trick,scheme,or disguises a material fact or makes any false,fictitious or fraudulent
statements or representations or makes or uses any false writing or document knowing same to contain any false,fictitious or fraudulent
statements or entry. shall be fined not more than$10,000 or imprisoned riot more than free years or both.
ENG FORM 4345,MAY 2018 Page 3 of 3

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: J Fda t1'v►'? �Q..--�
Mailing Address: ) / 6 t,NaC,bCIL 7)R4 L�
AL)c164, Kj G 2-`76
Phone Number: 7/9- -76" 65d9
Email Address: J(9/&4jn%rQ) p1
a-
I certify that I have authorized CAAlbaly, GttrnrS'
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: /:7.
/ (
FGv4 ei u F _�'tie RA4S e,AJ
rs-t ,p
at my property located at 7/5 ,� �"� d/_' > ,
in rNraa 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 Jnformation:
Signature
vlL✓r/Y1,52.—
Pnnt-or Type Name
rtlf
Date
This certification is valid through / /

ADJACENT RIPARIAN PROPERTY OWNER ST MENT
I hereby certify that I own property adjacent to Qtir 4T --At t 4$e"Cti
/ ,'rs t (Na of Property Owner)
property located at �/ ,rj` 1//G �Sr art
(Address, Lot, Block, td, etj ,
on /Cr7Z.A1(/"r4 Qc � , in C)C4-1° ) Z_SI, r /3 r Y.l , N.C.
(Waterbody) (Clty/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
i .n.
iat I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTIONAND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
-/Arl-d O ci.51A-/ Try ��-074
; ion/
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
. (If you wish to waive the setback, you must Initial the appropnate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Si '4'fil i:d.i, &
lam re 7 S' i 'F=r,�uDGt�trDb
Print or Ty Name Prin q��T}�e me
-7/6 /4 Je-oele�/1il/F r ` To reeve "►Q ty,S
Mash Address M re
o<�Eh Z"'6r9 2 !y G g ___ir7a
C state otrito arch ^►^ c1
116
0 1(Q3q
TeJeph7 N 11 address Telepnl Nuker� f(.L_tees
Dale arr•
(Revised Aug. 2014)
'Valid for one caienda►year after signature"

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ANC , c�fr," -ft
I hereby certify that ( own property adjacent to r Jet 's
l` (Na of Property Owner)
property located at 1 5/1//4 s ST Z 7X.•r r
(Address, Lot, Block, lq .go d, etc. -,
on ,47t",A, re Q�� , in GcpN .LSc.E J , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
JHA 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)
A/1/ft/iL-4/✓;� % Pv/'✓,
WAIVER SECTION
i understand that a pier, dock, mooring pilings, boat ramp, 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.)
JHA I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Si azure / _j Signature* ( ' +
�,f 4� .cmin E� Tim Akins
Print or�TTy Name Print or Type Name
"7/6 cl1��(/<.&2/ 20000 Norman Colony Road
Mailin Address Mailing Address
( /e" .✓ ,,c l Y6'9" Cornelius, NC 28031
Crtj�S4�S i3 r� ._, t/ltllo5•f14;i4b4.1 City/State/Zip
`� � � �� 704-562-6869
Telepho Nu er/e ail address Telephone Number/email address
? / 2,4571) 09-21-2020
Dare ' Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature"

SANDBAG REMOVAL NOTICE
TO WHOM IT MAY CONCERN:
7-f
I, j17 -i/n/r)6�.-- , give permission to
to act as
my agent in my behalf in obtaining a CAMA General Permit to place
sandbags as a temporary erosion control structure in front of my
property at 4/`S _ '_s- o s L a_
v-i-rsi_
I, VA Gum�I L__- , have read the
specifications irf 5A NCAC 7H-0308 a 2 and understand that the
( �( �
sand bags may remain in place for up to years after the date of
permit approval. I understand that I will be responsible for removing
the sandbags within 30 days after that date or at any time that they are
determined by DCM staff or its agent to be unnecessary due to
relocation or removal of the structure. I will also be responsible for
removing any damaged sandbags during the period they are authorized
to be in place.
I also understand that the removal of the sandbags shall not be
required if at the specified date for removal they are determined by
DCM staff to be covered by dunes with vegetation sufficient to be
considered stable and natural.
AUTHORIZED SIGNATURE: 4_.
DATE: `�;/ r Z. 7�)

' CAMA/ ❑DREDGE i FILL N O ?7�1i�� A B C O
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue C 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 ISA NCAC .
` t j� ( LJRulesattached.
Applicant Name l '' Avv�� 0U�✓-.-✓ Project Location: County 1 dti.... s.('C-�--
Address tac Street t�Address/State Rpadf L t#(s) f f
City et IA State NL ZIP 2'�{r(I _/ S
Phone#(9( ) G (4E-Mail eltieh , j.to," Subdivision —
Authorized Agent 7... _r•...,a,J„ `S City OGC tart ((it- ate. & ZIP 2 h=1----
Affected C CW ❑EW 0 PTA DES ❑PTS Phone# ( ) River Basin L"' "--
AEC(s): EA 0 HHF 0 IH 0 USA ON/A Ad' Wtr.B 4^ L unkn,
ORW: yes n PNA yes ClosestlI Maj..Wtr.Body - --
Type of Project/Activity N t•• `•1 c\ 6 e.,Y,4 I e..1--e,.-� c S�'rt (r�,firt�l�{�
1 (Scale: ( 5 )
Pier(dock)length
Fixed Ptatform(s) ) X 3CG ea-con I^
MEN
Floating Platform(s) i •
Finger pier(s) /� .
Groin length f I -- --' , • , • 1I , I j ' .fs ��
ii - tct — -4-4- o " !/number 1.
Bulkhead/Riprap length t i ( - _L- --
4 c .
avg distance offshorei
max distance off •
Basin,channel
cubic yards I l , { . l
Boat ramp ���0 t I%II ��$1 n Q�Qi;ioo t �.
F plvw t►jnl�t_w}riy,�,�f.i,-,i,- rre �>/ 11
Boathouse/Boatkh
, IffilIKIAllitit A •
Beach Bulldozing ` 9 .0 4- ` hSiVIIlV
iiMi_i4t,1
•
6 Y '1 r .r f.
Other 0i0 K , _._N. g.
kMil I I I 6 mi.l
snoreine urge+______501 --ART-11"---; III= AI rNil
SAV: not sire yes t,a•1
Moratorium: nla 6 no -mow I s �T NMIMINIMIM
/Fc ' _ '- a• •
Ill
Photos. yes — I y , t -•
�\
Waiver Attached: yes n 1 t I i 1 _ - -- -
A building permit may be required/ by:�fke+Y-0 14A-6615 1 ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisd' )
Notes/Special Condi s t LIU (J Or_V___-ys A liai jt (y t AL 4 f Jsur,[Ysc.: , -sttt'e
t ‘\o." a SE , d l.- ,,. 440-5-13•1Ici
h.. C i4 if. '6n_0.1 .-
______,
. rb `I✓
or t Printed Name P 'G-` 1 J•'L
Plaass re octpliance statement on bac of permit e' Signature
Signature �UV W f ' 1 i U 2,al . V)
I( Z4 '�
Applksdo^F s) Check* Issuing a xpira.on
Date
Scanned with CamScanner

Chock
Dab Received Date Deposited Cheek From(Name) Name of Permit Holder Vendor 11/ natant Permit Number/Comments Receipt or Refund/Reallocated
e
Colnn1 Columnt Column3 Column,/ Column5 Column. Corumn7 Column8 Column9
'Minor Modification Fee#47-87,Kinder Morgan NC Ports,
11/4/2020 11/5/2020 Matthew Mooney Kinder Morgan for NC Potts Wells Fargo 230 $ 100.00 Wilmington NHCO _ KE rct.12409
11/3/2020 11/5/2020 Robert Allan same Coastal Federal Credit Union 8263 $ 200.00 GP#77840D PA rot.11554
11/3/2020 11/5/2020 EZ Docks Plus LLC Elwood Petchel BB&T 1140 $ 200.00 GP#77624D Ben rct.11723
11/3/2020 11/5/2020 Jerry Ennett Moll Bland Coastal Bank and Trust 3426 $ 200.00 GP#77668D JD rot.11764
11/3/2020 11l5/2020Andrew Barnes Susan Brady/Andrew Barnes Chase Bank _ 376 $ 200.00;GP#73585D JD rct.11657
11/3/2020 11/5/2020 Carolina Bluewater Construction,Inc. us Wang 'BB&T 23124 $ 600.00 GP#77683D BB rct.12430
11/3/2020. 11/5/2020 AMW Docks and Marine Construction LL Tram Watkins&Kelly Webb BB&T 6039 r$ 400.00 GP#77681D BB rct.12499
11/3/2020 11/5/2020 Grice Construction of Brunswick County In Brenda and Barry Hooks BB&T 14211 $ 400.00,GP#77684D BB rot.12431
11/3/2020 11/5/2020 B and B Marine Construction Jay Plummer Wells Fargo _ 1514 $ 400.00 GP#77688D BB rot.12433
11/3/2020 11/5/2020 PFL Construction LLC Robin Timmons Nacy Federal CU I 1927 $ 200.00 GP#77676D JD rot.11658
11/3/2020 11/5/2020 Clements Marine Construction Edgewater HOA FCB 5572 $ 200.00 GP#77891D KE rot.12412
11/3/2020, 11/5/2020 B and B Marine Construction Harold Fowler ;Wells Fargo 1515 $ 400.00 GP#77886D .BB rot.12434
—
11/3/2020' 11/5/2020
Timothy Powell James Jackson First Bank _ 9206 $ 200.00 GP#77868D_ BB rot.12495 _
11/3/2020 __11/5/2020 B and B Marine Construction Wiliam and Noreen Moody- Wells Fargo 1516 $ 400.00 GP#77887D BB rot.12435
11/3/2020 11/52020iSpencer and Carol Rogers ,Channel Haven Property Owners State Employees CU 6792 $ 100.00 I Minor Mod Fee.#141-90,Wilmington NHCO PA rct.11558