76498D - Jackson

0 CAMA/ ri DREDGE & FILL N9 76498 A B C OD
GENERAL PERMIT Previous permit#
>' La-New —Modification CComplete 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 SA NCAC 0 4H, /acC w r'z-
El Rules attached.
Applicant Name 10 i4 J(' 3 CL 17 ' Project Location: County /1
'(0✓/17,41-3.4r
Address 1E1 Card Pli1A6 Street Address/State Road/Lot#(s)
City Cifrt(vr/r P'aGL' State N( ZIP (54,2f -
Phone#( liu ) SI) hi 3 E-Mail niaCk_StY)1955eCA0tarn Subdivision
Authorized Agent r.,q,/ /tYb y kqe City ZIP
Affected 0 CW EW [ 'PTA ❑ES ❑PTS Phone# ( ---)-- //River Basin 04,i
AEC(s): ❑OEA ❑HHF ❑IH 0 UBA El WA Adj.Wtr. Body /'` i fY/1Yi? �,Plf(A Vfid /4 nat /unkn)
❑ PWS:
Closest Maj.Wtr. Body ;1 i^ D l/,-e—
ORW: yes /(no PNA yes / (I Type of Project/Activity ?lye se,f' * l nc-trz,69 Gr tbQ/./WI ptith A kl PX 517)6i ,Eir
(Scale: An )
Pier(dock)length
Fixed Platform(s) I i
Floating Platform(s)
Finger pier(s) I ---- ----
.._.. 1/41 V" .l ._._.._._...._..__ _
Groin length . i
i
number — K „......i: pr;j; Att-w,)r
Bulkhead/Riprap length
avg distance offsho - 1
I
�¢
max distance offsho - t QI 1 . !k'5 7 y� if� 4(
Basin,channel f • 4 ficat'1)� k r is
p4 ire--- }
cubic yards I } 9 51,c, t , ix+ —
Boat ramp ; 1 �� 41'%1
Boathous oatJi )bk') � Ok } _.—_ �— _____ _�
I ; i
} - -Beach Bulldozin ' ( I 1
j I "�YOther �7
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Wiwi{ ,X i f
i X 1
Shoreline Length_ 56 I i I + Ta >,-.
SAV: not sure yes ® y 1
4
Moratorium: n/a yes fi'}o I —`_ (,} /�610 �
Photos: yes 6 i _ j -- r'y,
Waiver Attached: ( no I 1 I 1
A building permit may be required by: —tirw,T% q( ( -irJ/l E.1C.,,,4 . ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) 1
Notes/Special Conditions /( VII S I Zyl? 1) 7y 1;Go/. CCi. ,4/ f-_-7,c,
pi.r7n'-I R'!?/1/6Y;Tzi'S g 1//tt i%r1 t iti . t-G 7. ) (1,-V11/7(c./i'f 7 /c,-,/ S/,?�
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Agent or Applicant Printed Name PermiittOf ticer's/Printed Name
Signature **Please read compliance statement on back of permit gnature
(,- C —�-
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Application Fee(s) Check# Issuing Date 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(910-796-72 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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• - AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION; .
'Name{,of Prope `Owner Requesting.Permit 3. /e,, c,c -" a , ' • _
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�'a certify,that•• ha e:authorized ., /
{. Agenti7:Gontractor` a
i s act on my`behalf,, fortlhe purpose•,of appl"ying for and obta►ningrall CAMA permnnits_,
necessary_for the'following proposed<development{ Are,W ,, . •• n
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This='�ettficatort is_'vaiidhrough_ LL : y

ADJACENT RIPARIAN PROPERTY OWNER STATE MENT
I hereby certify that.I own property adjacent to relreso, 4 Z n, ;s
4 (Name of Property Owner)
property located at qOq (yr
(Address, Lot, Block,Read,.etc.)
on •CA ece,ivl . in • C-6 i'o\ems, Y1 . , N.C.
(Waterbody) (City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection.to this proposal.
i
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)
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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 Owner Information) (Adjacent PropertyOwner ation
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Signature glatice
1erega I-1. Jackson e,#1 4`/
Pratt or Ty a Name - Print or Type Name
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Mailing..- gel g Caned re Mailing ddress
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City/State/Zip City/S e!I_ip
Telephone Number • Telephone Number
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(Revised 6/18/201 2)

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, , ADJAC T`.RIPAR!AN PROPERTY OWNER STATEMENT` _, .
I hereby certify that l own�property adjacent to= -,� �a , !''V '-s , , -
• (Name of.Property Owner} a,
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property located at.`°g0t1�f1CA
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• 4Naterbody) (Cityrrown and/or County},• Y `_
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' t - The applicant hastdescribed tome, as'shown elow,the development proposed at the above location a..
have no objection to this os - - ' ".
d. prop 81 ,.0 :•
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A,; . I have objections fo this proposal
', ' f �2 : DESCRIPTION• ANDIOR DRAWING.OF.PROPOSED.D,.� LOr.., ENT` ' . r
' ' .'. ,'(Individual proposing development must.f ll in descrlptron below or attach a site:drawingl
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i` X WAIVER SECTION. .', ,. �.
' ° , l understand that a"pier,dock, mooring pilings,.Vbreakwater,boathouse,lift,or groin must be set b•a te•a `2 -Yt ,
minimum distance of 15'from my area'"of riparian access unless;waived by me (If you wish to waaive -
• ^the setback, you must initial the appropriate blank below) t 1 ,,'. z., ' '
I:� I dorms"h to waive the 15`setback,requirement' fY - : ` v
P 1 da not wish`to waive the:1`5'setbackreywrement �
Y-`(Property Owner Information} �` (Adjacent Pro e f ati on 4 �
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that own property adjacent to 7 ,(eSo. 4 c)ac(S n is
1 (Name of Property Owner)
property located at i0� ��t74.if1Gvt
(Address, Lot, Block, Road�y,e_tc,)
on CA 06 eh , in t16kt~'ol Mah, Vi ,. , N.C.
(Waterbody) (City/Town and/or County)
The applicant 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 ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in'description below Or attach a site drawing)
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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 Owner Information) (Adjacent Property Owner Information
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Prirft or ape Name Prr or T/e Name
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Mailing Address Mailing A doss
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Telephone Number Telephone Number
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`�, (Revised 6/18/2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to TI1eSC. 41 3.--ack-Son
n (Name of Property Owner)
property located at CIOCi (i cdi
(Address, Lot, Block, Road,,etc.)
on 06'rh In Cln.rv\ 10e , N C
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location
1_ 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)
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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 Owner Information) (Adjacent Property Owner Information)
t etesci I--1 . Tcickso►� e. v
Pnrft or Type Name
Pn jor Type Name
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Mailing Address Mailing Address
City/State/Zip City/Stafe/Zip
. Caro/frig.6tach Ale d 8 vd8"
Telephone Number Telephone Number
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Dore 1/ /X.1 !)rite
`?' (Revised 6/18/2012)

Chock
Date Received Doty Deposited Chock From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Column Column2 Column3 Columnb Columed Column6 _C_olumn7 Columns Cdumn9
3)5/2021 3/9/2021 North End Builders NC LLC Nick Nicholson SunTrust 1038 $ 400.00 GP#76184D_.. PA rot.11593
3/5/2021, 3/9/2021 North End Builders NC LLC Pat Johnson SunTrust 1039 $ 400.00 GP#78183D TP rot.10319
3/52021. 3/9/2021 Lighthouse Marne Construction,Inc Chris Mewborn Coastal Bank and Trust _ 3656 $ 400.00 GP#88378D _ JD rot.12390
3/52021 i 319/2021 iRG Marine Contracting/Ronnie George Teresa Jackson Bank of Amenca _ 1062 $ 200.00 OP#784980 _ PA rct 11592
3/52021! 3/9/2021:Topsail Offshore.Inc. Forest Sound HOA Coastal Bank and Trust _ _ 1329 $ 400.00 GP#8633750 __ JD rot.12389
3/5520211 3/912021!Castle Home Builders Maria and Sal Miliara PNC 4805 $ 100.00 GP#801111)(1 of 2) JD rot 13568
3/5/2021,_ 3/9/2021'Castle Home Builders Maria and Sal Miliara PNC - --- 4797 $ 500.00 GP#80111D(2 of 2) _ - JD rot.13568 - - --
3/52021} 3/9/2 20 1 iJames C York same NAVY federal CU 8562 $ 200.00!GP t80109D JO rcl 13570
3/52021! 319/2021 i W Carl Bazemore same United Bank 1030 $ 200.00 GP#77600D BB rct 12927 _
3/520211 3/9/20211Land to Sea Construction,LLC Felice and Richard Brenner FCB 414 $ __ 200.00 GP#77897D KE rct.12731
3/512021, 3/9/2021 Gregory Holden __ Elsie Cume United Bank 5510 $ 200.00'GP#77783D_ 1BB rct.12929
3/52021 i 3/9/2021 Gregory Holden Milton Howard United Bank 5509 $ 200.00 GP#77785D BB rct.12930
3/5/2021' 3/912021 Gregory Holden Jeff and Catherine Tucker United Bank BB 5508 $ 800.00 GP#77784D rct.12928
_...
315l2021 3/9/2021 Gregory Holden _ Richaerd Mendenhall United Bank 5511 $ 400.00 GP#77788D BB rct.12931 __
3/5/2021 3/9/2021 McMullan Partners,LLC same First Bank 72357 $ 400.00 GP#77599D BB rot.12926 _
315/2021, 3/9/2021 Danny Ray Britt Jr. _ same Edward Jones _ _ 1714!$ 200.00 GP#80117D __ _ BB rct.12932 ___ __
3/5/2021, 3/9/2021 David Anthony same B8&T 2562 S 200.00 GP#75821D Tmac rd.13531
__
315/2021 3!912021 Clark Environmental Services,PC John Payne Select Bank and Trust i 6511 $ 200.00•GP#77705D 1 of Tmac rot.13532
3/5/2021 3/9/2021 Clark Environmental Services.PC John Payne _ Select Bank and Trust 6514 $ 400.00 GP#7770502 of 2_ Timm rot.13535
3/5/2021 3/9/2021 James R Bums Revocable Trust James Burris Welts Fargo _ 1132 $ 400.00 GP 1180131D KE rct.12730
3/9/2021 Dr Mona Faye Black same •Bank of America 9828 $ 848 00 NOV#21-03D)Permit$400/Penalty$400/Invest$48 OnCo _ JD rct.13572
3/9/2021 Custom Island Homes by Ken Kiser Scott Blankenship United Bank 1734 $ 432.00 NOV#21-10Db/Permit$200/Penally$200/Invest$32 BRCo TP rel.10320
Major fee,123&127 Island Bridge Way,Wilmington NHCO NO
3/920211 Logan Marine,LLC River Island HOA BB&T 7112 $ 250.00 split PA rd.11590
3/9/2021: S.Bailey Paul and Shen Bailey State Employees CU 1848 $ 400 00 GP#775410 BH rct.12701
3192021 - Chases Eames !same BB&T • 4993 $ 400.00 GP#775421) GBH rct.12702
3l92021' Peron Lange same Allegacy 1 2071 $ 200.00 GP#77543D !BH not 12703
3/9/2021 Steven R Smith same First National Bank 1447 $ 600.00 GP#71814D •Tmac rct.13534
3/9/2021 Permit Pals Todd Surratt CresCom Bank - 3496 $ 100.00 Minor fee.205 Caswell Beach Rd BrCo_ Tmac rct.13533 _
3/9/2021 Camden Pender LLC same FCB 1087 $ 200.00-GP#80110D JD rct.13509
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