77739D - Wood

0 ❑CAMA / ❑1 DREDGE & FILL N° 77739 A B C -3:5'
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 C r- // / Ur O
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r7
J `IApplicant Name `�ci�� Project Location: County___ pules
Address G / r & /v C 9 S Street Address/State Road/Lot#(s) /,,
City / /J�b/k-) State� f'ZIP 2 L. "' _4
v( /' S 4/.
Phone# 9_ 6 7Q,# 'ZQZbbE-Mail Subdivision
Authorized Agent //A- City OG.- .. O/.,- ZIP 4 �--
Affected L CW DEW ,PTA IiES /PTS Phone# ( --) River Basin Gv • C)
AEC(s): HHF El i UBA WA Adj.Wtr. Body Ale CFfe— dap' an /unkn)
PWS: t C
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body /v
l
/ l '
Type of Project/Activity
(S e: / P_ 10/ )
Pier(dock)length / ,
Fixed Platform(s) / i I -
1.
Floating Platform(s) 4/ i/ - 1 } -- I ' —
( t it
Finger.pier(s)
Groin le h
i , i I
num r
i 1
Bulkhead/Riptap length
avg distance offshore 1 I
max distance offshore I ' YY1a'
lk- tip
Basin,channel �� r
i i i l � 1 �
1 i
cubic yards ' i Boat ramp ,J r 1
Boarhouse/Boatlift/ 7 722 _ 4_ ._.+..._._
a 1 I 1
i 1 i� — —a
ry
Beach Bulldozing y j�' t j i � r �,y�j }/'
Other W51i +t-4.-/ A1J7 ' I f t/t f 't"'r" 1
r 1
fi/D 0 r -
Shoreline Length I I
I 'tf {
SAV: not sure yes f / 6),e�
— _
Moratorium: n/a yes no i f j_ . --i
Photos: yes end 1
Waiver Attached: ens) o I1 �^
A building permit may be required by: ci /I C '1 . . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
91-c.(Ar. 4-7 (---
Agegt or Applicant.Printed,JVanle Permit Officer's Printed Name
` .)f j((/1/ / /' , J-Jf-.-
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, - ,.. /'r fr 'f.Y .1 i (/// -�_���`Y
at�ise **Please read compliance statement on back of permit'" Si re
1a15-1) I (6\° j ,z z t 5. ZI.
Application Fee(s) Check# Issuing ate Expiration Date i

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 (252-946-6481) or the
Wilmington Regional Office(910-796-72 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

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ADJACENT RIPARIAN PROPERTY OWNER STAT T
• '
I hereby certify that I own property adjacent to e e_ _s
1� �-- � ( e of Pro e�/,Qw�)
property located at R gT sti s ,0 y fw i rI r
address, ot, Bio , Road,etc
on 4 t 2 KKa o ex-. , in , N.C.
(Waterhody) (City/Town and/or nty)
The aplicant has described to me, as shown below, the development proposed at the above location.
ibild 1 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,Mit/
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.
(Pro erty Owner Informa " ) la nt Property Ovum, Information)
44,j.c._ 41.4 1C 0
sitriature Sign;m01,4 vo.e
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Print or Tye Name Ptint or Type Name ,
M 'ing Address / a7_5
D 7 M tin=tess rS d
Ci /State/Zip City t i r
tI9— '7 —goo2D 7i �?-10 , i
Telephone Number Telephone Number.
7—/q—a0Id 7,f q.--zes�0
Date Date
(Revised 6/18/2012)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: eg?ideL/t 6(.033,
Mailing Address: k / l e SO Sect
Vk� A75 9
Phone Number: 9)9— 2W — U D ozo
t� G� ,4_&
Email Address: edl'�e ,, © rn1 , (: - _
I certify that I have authorized ,
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
-%necessary for the following proposed development: i)0 c� -/
00C-k Vr—
at my property located at Mt -S 4 f,LLy .SA. ' ^ S/zil/Z1 ck ii/Z� 4 L
y
in 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:
"20
Signature
phi bac)ac
Print or Type Name
Title
7 I /, I ACAO
Date
This certification is valid through I I

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: (' fC (,O
Address of Property: / .- 5 4 ka er5- /, f2 A t
(Lot or Street#,,Streetfor Road,City&County)
faa--/(7,1-)Z-Zrtg
Agent's Name#: - Mailing Address: 07 VSC6 14 C---So ,522ee7l
Agent's phone#: 9 f 9-7`st 6-go 7o ,tL.'t a 1\ AL. cz'7S)
. 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.
(/(/1 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 a 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 ' cent Property Owner Information)
( f�
.7„,lioe
Signature Signature
tcWJt Ic (A)Pc' 0 A9I-`c k0l f�®DS • .
Print or Type Name Print or Type Name
lqg ne so 5 2I 07 i,& )1 0 s o
Mailing Address Mailing Address
EljULI91.V_ VI� �7-5g B &A, 'VC 2,7SOy
City/State/Zip City/State/Zip
1'1- 79'6- /O`6A--6 ���`3�q-- �o�f �
Telephone Number -Telephone Number
7-/mil " 02e Ac) `7- 1 i - 2-02o
Date Date

r' CERTIFIED MAIL • RETURN RECEIPT REQUESTED
•
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER N•TIFICATION/WAIVER FORM
dea
Name of Property Owner: (Aie,0 ,4
/'7'$ � 1 61.e t est r 1k flack 4, it f7 c
Address of Property: �� u r
(Lot or Street#, S reet or Road, City&County) /
Agent's Name#: &O )1 ..ttiC0cL Mailing Address: a Y1cSO
Agent's phone#: 161`7%' OZD 10 ,ap/itQ3v. At_ cZ.7s-Q
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
"proposing.they proposing.A description or drawing, with dimensions, must be provided with this letter.
1V9g*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.)
[/ r 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)
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Signature SignatIre
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Print or Type Name Print or Type Name L
WA tC dO Sc aLI - ,.
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Mailing Address Mailing Address
154 42(9.6i4- A-7-5-al ALC, cZ_Ty43
City/State/Zip City/State/Zip
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Telephone Number Telephone Number
Date Dat

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
fr
I hereby certify that I own property adjacent to gieti f C( A'd 's
property bilut&L �lh rzD N me o�roperty Owner)
located at � ���� 1'iN at'
(Address, Lot, BloAk, etc,.)...
on It eepe F HZ I 'Deg' `in r?n d,� L"%
, N:C.
(Waterbody) (City/Town and/or ► • i nty)
The applicant has described to me, as shown below, the development proposed at the above location
di9-14-r 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
the4,p,S1-t
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 Informati n (Adjacent Property Owner Information)
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Sig�atur� � ���D Sign ure
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Print or Type Name Print dr Type Name
Mailing�
Address Mdiling Addre s
AC- �"76��f s ue , xg�4 3
City/Sta ip2i.
Telephone Number Telephpne N ber
7-/9�- z gel 6r7/o20/72402D
Date Date
(Revised 6/18/2012)

• Chock
Date Renamed Date thpeekld Check From(Name) Name of Penult Holder Vendor 11/ amount Permit Number/Comments Receipt or Refund/Reallocated
Columnf Cdumn2 Coluumn3 Columna Columna Columna Column? Column!! Column9
__ 1/292021 Restoration Systems.LLC Howard Malpass Towne Bank __ 177330 $ 200.00:GP 977784D JD rot.13616 —
1/29/2021 i Restoration Systems.LLC Town of Topsail Beach Towne Bank 17329 $ 200.00 GP#77531D JD rot.13615
1/292021 Christopher Reid 1005 Ocean Boulevard LLC The Bank of New York Mellon 1038 $ 100.00 minor fee,1005 Ocean Boulevard,Topsail Beach, JD rct.13614 ._
1/29/2021 Eddie Wood _ same BB&T _l 1819 $ 200.00 GP#77739D _ 'JDrct.12383 __
1/29/2021 Shelby Lawrence James Lawrence Wells Fargo 6087 $ 200.00 GP077529D JD rcl.13613 _
1/27/2021 B and B Construction Money Order Mclendon Beach House LLC Wells Fargo 19-08.834.7331 $ 400.00.GP#77658D heap rot.13587 _ __
1/27/2021 Delta Dock and Boatlift Jason Johnson FCB 9015 S 200.00 iGP#73588D JD rot.12378
127/2021 Mantime Coastal Construction,LLC Kirk Fox CresCom Bank 3329 $ 200.00 GP#719000 .1mac rd.13588
1/27/2021 .B and B Construction Money Order Robert and Julianne Hurst Wells Fargo 19-086347338 S 400.00 GP#77851D tmac rct.13580 1
1/27/2021 Backwater Marine of NC LLC David Brady BB&T 1214 $ 200.00 GP#775710 BB rcl 13514
1/27/2021 Delta Dock and Boatlift John and Pamela Hultin FCB 9026 $ 200.00 GP#77738D JD rot 13811
127/2021 Sound Side Marine Construction LLC Guy&Ann Forrest FCB _ 103 $ 200.00 GP#77753D BB rot.13508
1272021 Steven Michael Greif same Piedmont Advantage CU 445 $ 200.00,GP#77762D .BB rc1.13512
1272021 Welbome White&Schmidt Dentistry Partnership Martin and Shannon White FCB 29232 S 200.00 GP#777600 BB rot.13511
1272021 J Banks Garnson Jr. Banks and Susan Garrison Wells Fargo _ 13700 $ 600.00 GP#77761D BB rot 13510
1272021. Gregory Gage Greg 8 Allta Gage Wells Fargo • 4262 $ 200.00 GP#77752D BB rot.13513
_ 1/27/20211 Holden Docks and Bulkheads Tracie Hams Rice CresCom Bank _ 3651 $ 400.00 GP#77723D BB rot 13507
1272021�. Holden Docks and Bulkheads Gracie and Daniel Hams CresCom Bank 3649 $ 400.00 GP#77727D BB rot.13504
1272021' Landon Funsten same Bank of America 1569 $ 200.00 GP#777510 BB rot 13509
1/27/2021 B and B Marine Construction Money Order Sand Dwellers II.UOA Wells Fargo 19 088347330 $ 400.00 GP 077750D __ BB rot 13508
1/27/2021. Bledsoe Enterprises Inc. Ocean Dunes HOA BB&T i 20023 S 400.00 OP#76181D PA rot 11577