77799D - Jordan

CAMA/ ❑DREDGE & FILL N° 77799 A B C
6:7
GENERAL PERMIT Previous permit#
>'-% 'ir.NQvV -Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality 1 I and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 61-
1200
1 ❑Rules attached.
Applicant Name ek t• a J��1\D 1 3 r .— Project Location: County \)('''^3-' '6k%
Address 12(-\O i L .:1(..,.....-,,.., VJ 1. Street Address/State Road/Lot#(s) g i\ ,... -k-o n
CityLcJ• . ^1�i State/3c- ZIP 2g53 S2 ) 1 •
Phone#(\to) 21t ?n'i E-Mail c c ('-)C` ° c Ic j" ,,I.c."`Subdivision
n
Authorized Agent ���^ ��r.,, L�••Le— City tJ��.., •� s,� '�¢�c k ZIP ?�`�(0y1
Affected ElCW 0EW PTA ❑ES ❑PTS Phone# ( ) River Basin ( U it t
❑OEA ❑HHF /❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body A'i 4( (nat ma /unkn)
❑PWS:
Closest Maj.Wtr. Body A\�-�\'`.)
ORW: yes / no PNA yes /�
Type of Project/Activity \v^ S6-\` ne v�.� 1r1\U ^c coo G1C- a. n L...,ca,--
v
(Scale: N '1 S )
Pier(dock)length t 1
1
Fixed Platform(s) ACA 1 1 i---t—
t
Floating Platform(s) (" K/(0Nii, <-....ef7,_ 1
I
TT 1
Fingerpier(s) I —..........._ 1 .�.__..._........_._._..�..• —.._.._._._.__. .
Groin length + I
` i
I ,
number —;_._...—.._.�.._.._ —.._ ; .T '.. --- r .... _ _ �_
r I
Bulkhead/Riprap length
avg distance offshore 1 I
1 ; I .
max distance offshore
1 �_. 1
i
Basin,channel I i -
I
I C
cubic yards
Boat ramp uj '
\ 1
f
Boathouse/Boatlift I--r- 1 r A- al .,_.. 1111�,��� �
I • ,«--r+rt 4 1, i I
.. , 7
Beach Bulldozing /� '+ "'ft. T I +
Other I MI6- I 1 I j i 1 PAC ,f f I
I
i
�,1Shoreline Length PN h(�,rt , in , d. ( v �1111
1 \ 11 ri Y rY •I
S U t ( 1U
SAV: not sure yes , --- -- - - �`
Moratorium: n/a yes —_. ,
Photos: yes
Waiver Attached: yes no 1 • I 1— 1 —
A building permit mayrequired by: ELLl2 `c`'t V $ C. r '" n See note on back regarding River Basin rules.
Note Local Planning
Notes/Special Conditions () VI n 1. e- � \ n oA eX(2.4.,L P`CY Sk")^, (1i r "•-c c ( t-'f.
L) -)Ct‘ d CA Q_ i- kcA ----S.-7) ,-_, , 1 ,...., '---\--- /,.,,k...
Agent or Applicant Pri NameQ Permi 's Prin' \(..) - ted Name 1
Signatu **Please read compliance statement on back f permit** Signature
l
Applicati Fee(s) Check# Issuing Dat 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 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(910-796-7215)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/ 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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property OwneLRequesting Permit: J0C2-474-1•4
Mailing Address:—_. i 2-4 o0 IDR-
tJg--tt� �S��� C. 2f3S' -
Phone Number: - 7 0 5 r -
Email Address: sc:,xrfe_v-J C 9 7)-1 C3 -
r
I certify that I have authorized --c-i<k,
.Agent!Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: ce`\ac,: rj r-r-Wv,)
at my propertylocated at , ^- 5"\- O L
in '`'`-`A`"€w ►a- County.
I furthermore certify that I am au-thorized 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:
— 1
Sign tur
C.- RLI L. , oko,0.4..)
Print or Type Name
Title
9 i 3G i 'z42. - -_
Date
This certification is valid through / v oe? C_L Pti9 'i78

CEl 'IF.IED MAIL. RETURN:RECEIPT REQUEST iD• :.
DIVISION OFPOA$TAL MANAGEMENT.
ADJACENT.RIPARIAN PROPERTY OWNER NOTIFiCATIONJWAIVER.FORM
Name of Pro a Owner P e' b9 • -•SC3�h -s
•
Address of Propert•y t Lrr 1 I�%'1 7•�.CQCI h
�SCe 1�2uc
(Lot or Street4;:Street or Road; City-B,County), •
Agent's NamefR • t'1C:F:. PLI.C.�Ivtj .. • .
Mailing Address 40�.1�1.�ctCh �-
Agent's phone ii C 1 0`5 C q•b9J ...
�ccc��H aCt
1•hereby certify that:i own �.rd a I dacent to the above:referencedproperty,.The individual�a I m for
this ermit ties described.to•me as shown on the:attached.drawing the development.they are p opos rig
if �tft3 G dui ;'*I. . `
• litsiwflosa.'•. i have objections to:t)iis proposal
t if you have objections to whit rs being proposed, you'Must note the Olv of Coastal
Management(0CM)fn writing•within 10`.days of receipt of:this note ogres .. •'' mailed to 127 Cardinal Drive Ext:, Wilmington,:NC, 28405-3845 0CM re:resen of also be
contactedat(910)796 7215 Mo•response Is considered the:same�as no bj ect/on else en
, r ',_
j dean
r : WAIVER SECTION
I understand that a pier,dock,mooring pilings, breakwater,boathouse,:lif,or groin must�:be setback to
minimum distance.of 15'from myrarea of riparian'access unless waived.by If.you
me.:( wish to.waive the-
\,,1<.
setback, you must initial the appropriate:blank:below:)
1•do•wish to`waive:the 15`setback requirement..
`rt setb`ac
(`Property Owner Information) - : . ..Adjacent Property Ownerin=• mallen)
.i.::::.*:-.....:.:.::::....-.:.::.....,:.:1.1....s......:31)(A:bc-1.. .-::6.,,,A.„;6:::.:::-::...-.:-.....- ..- •. - :.
signature.
Print:or Type Name
s
Prrnf or Type Name
Mailing Address . f :4
• Mailing Address
�� rrlc l rV . ZJr Y.t
Crty/State/Zrp
L ,hi L
2 ��
Telephone Number .
Telephone Number
Bate :.
�.44 �
Revised 6%18/2012

CERTIFIED MAID, • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: b c c-ckot n
Address of Property: l, W t Lrr - (:1 �r 0 CSZCt hI5� E Cic
(Lot or Street-,i Street or Road, City& County)
Agent's Name#:&r i(R OR'S'tru(,�ivy Mailing Address:Lk1(6l 2QC'f Dc-
Agent's phone#:\1D-5-1C -9oq$ r -1-61Q fit\ N( Z 9(gy
4
V) I hereby certify that I own property adjacent to the above referenced property. The individual applying for
x this permit has described to me as shown on the attached cjrawin, the development they are proposing.
C~ ' 'Y r t ,. .' t
CI
-_Ci ( 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 Div •,'n of Coastal
--f Management(DCM) In writing within 10 days of receipt of this notice. Cor -- . • should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represe , • 1 also be
• _ contacted at(910) 796-7215. No response Is considered the same as no objection joalithfrebeen
C notified by Certified Mail.
qr WAIVER SECTION
V1 I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift,or groin must be set back a
8 minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the
setback, you
uuJmust Initial the appropriate blank below.)
_ gL/'L I do wish to waive the 15'setback requirement.
--- I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adj cent Property Owner Information)
W3/n(16 i\isid Cg3tiA X - 415Ze
Signature Sign tore
Snt\ \DL1 S6CICk,i1 g2ja.r" Z . /40-0._,
Print or Type Name . Print or Type Name
Meiling Address Mailing Address
.auV-,("\bCt<1 \\IL 2 35LJ4I JC 764(o
City/StatelZip City/State/Zi
R`U- C5N — Qc5(e 9/?-8/ -)-
Telephone Number Telephone Number
00/ .
Date Da e
Revised 6/18/2012

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Z�ne1u �� ����� J , -

cheer
Date Received Date Deposited I Check From(Name) Name of Permit Holder Vendor IV .eOYnt Permit Number/Comments Receipt or Refund/Raelbcated
Column, Column) Column3 Columml Cahnne comma Column7 Column) Column9
2/22/2021 3/2/2021 Marc Simeon Alice Wilder PNC Bank _ 211 $ 100.00'minor fee.2110 Washington Acres.Hampstead PnCo JD rct.13585
_2/22/2021 _ 3/2/2021 Overbeck Marine Const./Daniel Shirley Chnstopher Scent SunTrust 5397 $ 200.00 GP 077595D KE rct.13673
_... ..
2l2212021 3/2/2021 Jennifer J Johnson Jason and Jennifer Johnson First National Bank _ 2623 $ 200.00 GP#77758D BB rct.12969 _
2/22f2021 3/2/2021 Anthony Can Cashier's Check Nick Sanf State Employees CU 101542 $ 200.00 GP#77800D Be, rct.12968
2/2272021 3/2/2021 Backwater Marine of NC LLC John and Heather Brown BB&T 1248 $ 200.00 GP#77592D BB rot.12970 _
2/22/2021 3/2/2021 Grace Construction of Brunswick County Inc Charles and Shelby Jordan BB&T 14446 $ 200.00 GP#77799D BB rote 12967
2/22/2 221,_ 3/2/2021 Rhonda McCall _ sama Bank of America 1084 $ 200.00 GP#77795D BB rct.12951 _
2/22/2 _ 3/2/2021 CMT3,LLC Carolyn Austin Bank of America L 3017 $ 200.00 GP#77780D BB rct 12972
2/22/2021 3/2/2021 Partriot Boat Lift and Dock Maintenance,LLC Allen and Jan Kelly Aquesta Bank _ -_ 1031 $ 200.00•GP 0801 13D _ JD rct.13566
2/22/2021 3/2/2021 CLTMC.Inc. John Lawson FCB I 1166 $ 200.00 GP#77640D _ Tmac rct 12914
2/22/2021, 3/2/2021,8&J Construction o1 NC.LLC __ Alma G Davis Trustee/Rhonda Hatch BB&T - ' 2316 $ 200.00 GP#75820D _ Tmac rot,13530
2/22/2021, 3/2/2021,Ann E.Cordell same PNC Bank ; 1513 $ 200.00 GP#748890 _ Tmac rot 12922
2/22/2021 3/2/2021.Island Contracting.Inc. David Durack Branch Banking and Trust 37555 $ 200.00 GP#778100 Tmac nd.12908
,2/22/2021 3/2/2021 Linda Kanoy same BB&T 10043 $ 200.00 GP#758280 Tmac mt.12921
2/22/2021- 3/2/2021,Southeastern Southeastem Coastal Construction Co.(1 of 2) Sean Desmond South State Bank i- 12083 $ _ 200.00 GP#775110 _ _- _ KE rct 12728
2/22/2021. 32/2021.Southeastem Coastal Construction Co.(2 of 2) Sean Desmond South State Bank ' 12100 $ 200.00 GP#775110 _ _ KE rot.12728
2/22/2021 3/2/2021.Lighthouse Marine Construction Inc. Adam Litton Coastal Bank and Trust 3640 $ 800.00 GP#801120 _ JD let.12388
2/22/2021 3/212021 Davey Resource Group Inc ' Jared Lippe!! United Bank 2192 $ 400.00 GP#775970 PA rct.11589