80114D - Ansley

0 .CAMA / DREDGE & FILL ,c I6/ `G 4- i4 80l 14 A B C
GENERAL PERMIT JQ " Previous permit#
�C New !Modification Li Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality / -)[/ / '7`�°CJ
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC V r f !/ •
r Rules attached.
/
Applicant Name V f C 4 r( t' r/V S�7 Project Location: County g-/**/Pt. d".
Address /404' ,fc... s /ft Z-00 Street Address/State Road/Lot#(s)
City //1 / /4•1State f ZIP 2i/1 // ri4-7 b--
Phone# �)7 75 ' ''3� Mail Subdivision
Authorized Agent /u / Q City_ ZIP
Affected E CW ..Ew PTA ❑ES ❑PTS Phone# ( ) River Basin W 'O '
AEC(s): OEA J HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body v7G / Ad .mil, an unkn
o Pws: � fl L U t/
ORW: yes / no PNA yes/ no Closest Maj.Wtr. Body / S ��
Type of Project/Activity / L / 7U L'3 C___
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number ' �.._...._� _ — ......�......_.
Bulkhead/Riprap length ■■■•, '� 11111111111111.1
avg distance offshore . �0■■.'■■■ ;uWii
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max distance offshore Emil"
Basin,channel I141fl1fl1"
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Shoreline Length 1111111 i�- HIHHIH
�. ._ .41 � �1 `, 1
SAV: not sure Lo ! {
1 .. HiJ
Moratorium: n/a es1
Photos: yes no • r 1
Waiver Attached: dip -- - I
A building permit may be required by: I See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction) , /, /,, /nAA.i.i,t
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Notes/Special Conditions `l C t G / ' Y/ e.- /44 co` '
it�V f -. a t yr cio r 0 esi r-es/Irr� oh
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Agent or Applicant Printed Name / PerrmitO)ficer's Printed Name
Signature **Please read compliance statement on back of permit** Si r
,D 5 5-Lc2 z -fc---. z / , -/s- 2
Application Fee(s) Check# Issuing Date I Expiration Date

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 I 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(9 I 0-796-7215)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/ 1-888-4RCOAST 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 9 I 0-796-72 I 5
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 STATEMENT
i •
I hereby certify that 1 own property adjacent to v l C'�
(Name of Property °r)
property located at . (0 " L ')(- �S &\ '
-.-fi (Address, Lot, Block, Road, eta.)
on f i i c. - C/l ee , in k O Gfe CA9 - , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
Ma-/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
�K�1
•
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.)
6`"'�I do wish to waive the 15' setback requirement.-
I do not wish to waive the 15' setback requirement
(Proppprty Own r inf rmation) (Adjacent Property Owner Information)
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s.g.a ure
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PrintS .A-T0(trio�
in or Type Name Print or T Name
‘ci •-) t-V‘ \--00pct k'10 fi Sceltk ktiopRc)
Mailing
g Address s �-- Mar g ddress
tin w t� £ _..- L `-�i ,�"'�c( '-i ► .113J )
City/State/Zip a2 g'! 1 City��p
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Telephon Nu ber Telephone urn r
2 t 17 f 2 i( 2.1 RFCFiVEP
Date
i Date
V\C.tcP tJ s'el a7'et wU}1 I d C.et-i (Revisiiiflbh04§f 1
DCM WILMINGTON, NC

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DCM WILMINGTON, NC
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PbLck
. ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �1 l 'C� —� NASAL /:'s
Napne of Property er)
c
property located at t 0 /4 (-D - S tk.. 1 -^CD O -C�.
(Address, Lot, Block, Road, etc.)
on � G �'� �LP� �� , in P-l+i D �2 C , N.C.
(Waterbody) (City/Town and/or County)
The app• nt 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)
- K,-,2
Ce_e_ pi-tkc__LeD r-4-e142.. \ .1/4-2L 1
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
(Property Own r Inf ration) (Adjacent Property Owner information)
\/ t S ,ate /4 /- ,- (
Signature
sZ\ c v- � N S �e ,4 4 rr 4. &L. 7 c,k
Print or Type Name , i \ t Print or Type Name
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Mailing Address i- --4.--- ri Mailing Address
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Telephon Nu ber Telephone Number
-,'/ 2- t Date
111J 2... 7- 1
DateHECEIVED
V CrK.4 JS`ey Z ctw&1}i IV Gatti (Revised_fl&fill a21
DCM WILMINGTON, NC

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Check
Dab R...teed Date Deposltad Chock From(Mama) Nam*or Pamtlt Holder Vendor 7tr amount Permit NumberlCommenta Receipt or Refund/Reallocated
Cabin/ Colurnn2 Cobmn3 _ Columro Column& Column& Colunn7 Column& Column9
_2/18/2021 Richard Penny Conatuction,LLC Wendy Mack Navy Federal CU 1567 $ 200.00 GP#775960 KE rctr.13674
2/1812021 John Dunkle Suzanne Dunkle Fulton Bank j 568 $ 200.00 GP#78820D Tmac rot 12912
2/18/2021 Gam Golob Jeff Lawyer Layafette FCU r 179 S 400.00 GP#77709D Tmac rct.12915__
2/18/2021 BarryGolob .._ same Layafette FCU ! 177 $ 400.00 GP#777100 _Tmac rot.12917
2/18/2021 Augustus Paul Davenport Mark Davenport BEAT 555 $_ 400.00 GP#77707D Tmac rot.12918 _
2/182021• 'Michael J Ouimet Loncille Litz Wells Fargo 2150 $ 400.00!GP#77708D tmac rct 12919
2/182021 Barry Golob Cathy Lovejoy Layafette FCU 178 $ 400.00 GP#777080 tmac rot 12916 __
.2/182021' Michael Ouimet same Wells Fargo _ 2149 $ 400.00.GP#777110 tmacr rct.12920 _
2/18/2021 B&B Marine Money Order BSB Resort Properties _ i Wells Fargo i17-9794116421$ 400.00'GP#776570 tmac rct.12913_ _
2/1812021 Fire Mechanical Scott McCaffrey Wells Fargo j 2074 $ 200.00 GP 8776390 mac rd.12911 __
2/18/2021 Michael Leone Kathleen and Michael Leone FCB _ i 5136.$ 200.00 GP#777710 PA rot.11687
2/18/2021 Roland C Lingle same _ Lumbee Guaranty Bank 507 $ 600.00 GP#777630 tmac rct.13596
2/182021 Carolus Building Company Alfred Stewart First Bank 1463 $ 200.00 GP#777670 JD rot.13552
2/18/2021 Richard Penny Construction,LLC Thomas Simpson NavnFCU 1565 $ 200.00 GP#777930 KE rct.13670
2/18/2021 Jill P Ansley same First National Bank . 5520 $ 200.00 GP#80114D JD rct.13563 _
2/18/2021 Pemtit Pals Riverview POA CresCom Bank 3735 $ 200.00 GP#77794D BB rct 13525 _
2/18/2021 McPherson Marine Services,LLC Tim Poirier FCB 3963 $ 200.00 GP#77796D BB rct 12964 _
2/18/2021 McPherson Marine Services,LLC Chadd Smith FCB 3962 $ 200.00 GP#777970 BB rct.12965
2/18/2021 - Jeffrey Skidmore same Peoples Bank 1018 $ 200.00 GP#77788D BB rct 13524 __
2/18/2021 7Towr of Wnghtsville Beach same FCB 118099 $ 400.00 GP#745920 PA rct 13675