77721D - Hill

0 CAMA / DREDGE & FILL N° 77721 A B C D
GENERAL PERMIT Previous permit#
> � yew ' 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 5A NCAC .46, .
Rules attached.
Applicant Name „Q‘ ,\I Project Location: County (--" ... ,c ;.
7 + /
Address ;� ( ��(1�,.�-k.n� �` . Street Address/State Road/Lot#(s) 57
City K a,..,-- ‘5+L e c•C Ifs State 'I ZIP Z `ito ( 4.-t c 0, 0. 0 --�)
(
Phone # ('-;� ) b S95.1 E-Mail Subdivision
Authorized Agent �.�.,,.e (7(.. ( � City ( ) I Si.z- Gce.,,k ZIP 4%16 cf
Affected Cicw EW K,PTA IDES C PTS Phone# ( __ ) River Basin (.,...142--
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body CGt A - ( (nat / unkn)
❑PWS: t
ORW: yes / no ' PNA y; no Closest Maj.Wtr. Body A-1 W UJ
Type of Project/Activity �T. Ai 0 wr. Pis., tl o
_ � s\\---- `i
; A o _ Cc.1.,,. c-t •. ._A\ pc,.-....a/ Z x 0 2- bo€.\-\%t r`1 c>.. Nv-kli. s 1 I..- of .�1-...„- (Scale: )J 1 S )
Pier(dock)length 1")' 'M
Fixed Platform(s) T f }
Floating Platform(s)
$ 4 (k.O -"V
1 i
Finger pier(s) Y — ----.-.-
t_ _-_
Groin length t .
number — . 9kA -
Bulkhead/Riprap length _" r i {
avg distance offshore i J ` -
max distance offshore _ r 1,�• 2
Basin,channel _ i , - --$ -, ����
j
cubic yards $I f �-- N j2
Boat ramp i f ..
.�rr
Boathous atll /2 7C 12 ' -- _.__...._.. ant Y• iL�u _... ... .�_ _...._... � ^._.�
`_ ; — v. L Lap QQA Li •
!� u c+
Beach Bulldozing a s 1 o t
Other ' y v., i " t , . ►io to 4�.� Lek c..J'',S I
Liv t
Shoreline Length _ ��,�^ S
SAV: not sure yes o K-4ry V16‘S[,"CI �: � �s`\ ��+� {
Moratorium: n/a yes 1 �.C�1�v.� I_. J_� Q1tbym.v,6 - j . c�1"'
Photos: yes 4, i '-----._.. i I — — -.i r
Waiver Attached: no I I i I f -
A building permit may be required by: OCQcr. \ca ec?)€ C -1'.• . E See note on back regarding River Basin rules.
( Note Local Planning JurisdictionL
Notes/Special Conditions J� �C +` l r
` ^+`\\ ,,,,0A .eKCJ“4 PXI S1; `_ P' -,\,1 A;-`^ �`
k j-7--, J\ /l LI,k,,,r LI•e.._
._ 1 4,-..c......,N.6.. --..4,ck,
Agent or t Printed Name it0 rin Name
Signatu Pled compliance statement on back of permit"'e Signature
god `` P 1 -ZlvinV UGa I/I 5/►, ! 2 !
IicadbnFees Check# IssuingDat Expiration Date
APP )

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 (252-946-648I) 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 252-946-6481
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

ADJACENT RIPARIAN PROPERTY OWNER STTEMENT
/X/-1
I hereby certify that I own property adjacent to e/ 's
J / (Name of Property Owner)
property located at --- A s c i mdna .:
l (Address, Lot, Block, Road, etc.
on Ai' me/t/ t'.Q,1a/ , in o.r/ w1s(-0,k ' 'IN.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to Ron.,
,��a�a ,//VV 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)
pkeew• �%_syd.
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.)
—,/,dj R ,v I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
97 /r'a,oA/,.S" orb
(Property Owner Information) (Adjacent Prope Owner Information)
Signature / Signature*
i/fz IL A; ,64k1 Az LJ /S0A_
Print or Type Name Print or Type Name
6"/ Rtm o461 I/O COJrinan. DR
Mailing Address Mailing Address
o.2 ' 4/ C, CP/1nc'J/ -SIMR,iq Mc. 3-,c;6i
City State/Zip Cityr tate '
. /. . . V4 . . .yy,. y347
Te hone Number!`email address Telephone Nu r il address
I v�'AZ%
!)ate //y�/ Mac"
(Revised Aug. 2014)
'Valid for one calendar year after signature'

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: hel/t
Mailing Address: _. / f�cfri')
�c_
Phone Number: 6 3 � 55.e7" 370
Email Address.:
I certify that I have authorized A , a l ice ,A 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: 1.2s4/fal"04
A/e t, 2 £09617/ ,
at my property located at $ Jg�'c�,�d rl� 6.7" 6..— 41.C- ,
in ekw,51.01cA' 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
//A
Print or Type Name
41?2,11'ei D/e PoRoF&ij
Title -
1 / °Yl .2,/
Date
This certification is valid through I d/ I 2/

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to /64 1-4, 's
(Name of Property Owner)
property located at <57 T"►c_.4 ni vn, / 6/.
/ n (Address, Lot, Block, Road, etc.)
on ,'VlJ 'n/ one Cexot� , in 07-8 N C. b u.,iSL.A (A , N.C.
(Waterbody) (City/Town and/or County) Cat A5
The applicant has described to me, as shown below, the development proposed at the above
location.
�).C--' 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)
Oka EAc.4_5
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.)
. _ _ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement. $. Ri 7/0nc1 671 02-13
(Property Owner formation) (Adjacent Property Owner Information)
- � (L6 can
Signa/ire attire* J4rnp s CI asscr�
,c YL ts /gccI , J J /77ana�iY/711041 LLC
Print or Type Name / Print or Type Name J
�7 RIrno'^ ��� GAa /3/ L e
Mailing Address Mailing Address)
City/State/gip City/State/Zip
Telephone Number/email address Telephone Number i email address
Owe / / Owe* /f e,7/�/
(Revised Aug. 2014)
'Valid for one calendar year after signature'

. Cheek
Date Racelad Date Deposited Chaclt From a(N rml Name of Parmil Holder Vendor 11/ amount Pamir Number/Comments Receipt or Refund/Reallocated
CwnMN Column2 Column, Column,' Colunm5 CdumM Catmint Column!! , CoAnn a
1/13/2021 Allied Marine Contractors LLC Richard Almond FCB 9594 $ 200.00 GP#77702D Tmac rct.11622
1/13/2021 William T Herring Tommy Herring FCB 16898 $ 200.00 GP#77807D _ Tmac rot.11624
1/13/2021 Allied Marine Contractors LLC Jonathan Woodworth FCB 9593 $ 200.00 GP#77813D Tmac rct.11621
1/13/2021 Allied Marine Contractors LLC Edward Falcone FCB 9595 $ 200.00 GP#77703D Tmac rct.11623
1/13/2021 Willie Clarence Richardson/Richardson Cc Kouba 'BB&T 7874 $ 400.00 GP#777130 BB rot.13644
1/13/2021 John Turner same BB&T 2158 $ 200.00 GP#77715D BB rot.13645
1/13/2021 David Once Money Order Keith Hill Western Union/Wells Fargo 19-210.0640E $ 200.00 GP#77721D BB rot.13642
1/13/2021 Craig Mergenthaler same Coastal Bank and Trust 1087 $ 200.00 GP#77524D _ JD rct.11748 _
1/13/2021 Harbor Marine Construction,Inc. Tommy Herring •Bank of America 1129 $ 200.00 GP#77523D JD rat 11747 _
__1/13/2021 Drew G.Todd Jr. Waters Edge at 016,LLC Woodforest National Bank 1017 $ 200.00 GP#77587D BB rct.13641
V13/2021 Debra Wilson Ignacio Marino LG FCU 2102 $ 200.00 GP#77561D .BB rct.12450
_1/13/2021 Ignacio Marino same USAA Federal Savings Bank 4033 $ 200.00 GP#775610 BB rct.12450
1/13/2021 John Andrew Tammaro II same Aquesta Bank 1579 $ 200,00 GP#775730 BB rct.13635
1/13/2021 McPherson Marine Services,LLC Brown Living Turst FCB 3761 $ 200.00 GP#77559D BB rct.12449