66375D - Fofrest

lel . CAMA / .. DREDGE & FILL C' ,'` "r,N ,
GENERAL PERMIT Previous permit# .ter �jd4,5 •
�� __New Modification Complete Reissue Partial Reissue Date previous permit issued • 5'Z"!`
As authorized by the State of North Carolina, Department of Environment and Natural Resources r (�j L/
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC (� `r , /-
O Rubs Cached.
Applicant Name cy-e54- �w��/ip Prlo'ect Location: County c-4tI '/wi1�-
Addres i� f y0 44. �rwtti r Address/ tate R d/Lot#(s)
City f State i\IC ZIP1 '44 4 j out,, of 7"-6e.,-e c an n.,lt, i
Phone #(/O 50--- ZrCc" E-Mail ,
�K .Subdivision -)r c cb✓+-
•
Authorized Agent _ P City li.01, 5'-C ZIP ?r
Affected 4-4.-
❑Cw xEW J TA ❑ES ❑PTS Phone # ( -_ _}- - River Basin J.k•' '0 •
❑OEA HHF ❑IH ❑UBA ❑WA
AEC(s): Adj.Wtr. Body 7 U VW hi (nat./man /unkn)
❑ PWS:
ORW: yek / no PNA yes no i Closest Maj. Wtr. Body- CA-�- O t)A) P
Type of Project/Activity . h' D r'Yv� lM0\4 Pi 4- - r=4-tir�Ltc 4 •
i (Scale: �,. >U )
Pier(dock)length l
\ I I i \ `�Fixed Platforrn(s) \V\Floating Platfor ) 1IN
Finger pier(s)Groin length I number i
Bulkhead/Riprap length i — 1,0:,
��
avg distance offshore
max distance offshore( l ;
Basin,channel .41—ZS I
p .
..‹,..------,,,...,,, , ,
cubic yards �'t.- p PIOZ1t. „.
/]� ,���"W �/
_,,,<Thc. .---''
Boathouse!koz,tlift ' /0 P. A VA/ '.----..„. ,
Beach Bulldozing
Other N N prl 7,41 ,iliAtiali,
•
-
Shoreline Length �+ikt" Ott oe.. ,..
SAV: not sure yes 7iio �M 1 j
n ' I I /
I0N-'
Moratorium: n a yes no
Photos: yes o Il /�_
is
Waiver Attached: yes eo I '
A building permit may be required by: -P••'{/UI t W • ❑See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)Notes/Special Conditions Pr(4f�- '5;;?_/f`
'10 �l(Le_c4 g� o. 't /0�
Z .,64.4-- c-A4/A 0 ir-e-etc-4
D I oY� hb -J 0I Al _� Wk _
ri (r & d ), t---
Agent r Applicant Printed Name Icr itO iFer's Printed Name
/t 7'�_..-z ,%�
Signature **Please read compliance statement on back of permit** Si re
4-U(' s y-:.� f �-• ! --7 , 5-• 2-
Application Fee(s) I 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 (252-946-648 I) 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/ 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
1367 U.S. 17 South 127 Cardinal Drive Ext.
Elizabeth City, NC 27909 Wilmington, NC 28405-3845
252-264-3901 910-796-7215
Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Brunswick, New Hanover,
Dare, Gates, Pasquotank and Perquimans Onslow-South of New River Inlet-
Counties) and Pender Counties)
http://www.nccoastal management.net/
Revised 08/27/14

A
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f z ♦ ? - s =� /� , 4
FYI
4 �-.E11 Le p kr. L YF 'Ei �VlI t' Previous;permlt# wA , fl,,
Y ,�ve�r � f �Tplete � rtt..Reissue - tDate;�revious per�n�f�tssueiir � , �.
� _
Ass authnized fayF�tSt}ate� chroJep� rt"nt of t~n±i► nmentia)t�uelity !, 7 ,w
:and the coastal R r y3.Ctxniriis5lon lq ad area bi eij r N mental concern pursuant to�t5A N"CAC ; 0`?+t '" !7 "
at Aj5 ucant',etrme r � jact.Lo *fort:`County
fAtfdress+:'e0 tP 1 ' � Street Address/State'Road/iLot'#(s)
;City+" `'`' State J't 'Zip __ . `A . .
Pjtone ) • oi' 9. E.,Mail Subdly sign, '` .: �
Authorized • ( i. •b X1ltA p - e e
k Agent City ?"J ZIP
Affected.: [�CYY; mw- , PTA D€s, OPTS: ,Phone# (~-�- " .,, i, ..'Bas(- ' :C .k
AEC(s); ©Roos; -Adj.'Wtr.:Body f IN ,{rnat Neill) •
rOfW: ,yes:./ 'PNA Yes;! .Closest Maj.Wtr.Body , •., „ i . �- tl;Qr.):.,
r --
'Ijrpe:of Project/iAcfivity v t '. `,`� r 0 J '7:. i"2A,t °'-',=.''..,.':.,.'Fr .,L',,.' ,r'e ‘
g 0,4,1, - j,9 1-4 .� j—'i 7 /r I� �% (Scale: i ,f ''F"
i.
► ( )bch
_ ` ,fit
!Fl edPiad rn(a) - t.-. , f , r /i�tr' .3�--'!o -r 6 i. ea
i,•FloatingPlitfb ,(s)• '
Groin ie»gth l i 1 �^ *
nutttber i I {ri
0 oe."',.. .... ,
...EL
`:$ulkheadl Ri raplftigth e _„t_ ..i _ ismt P ' ,_If/ a . P
,avg distance ofrshoro 1 i $ __ L. ,,���
-.max. ,
..„•, , : ., distance o sh�ro , , . . +il:!>r ,+`
i •. ;cubic yards :,�4 ' IIPIiui
i.
� am amnia'
'
iT
nu
1
"Boar' mp. ' �
,.
44at101 BoaiRk.,,:m _ _
i
11 1_l, iel,r1fti_1,.i, -l p__'''i_,A.„O.,_,....,._,i:.s-._.__.1,. 11..1...
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, licash Bulhiozing: o .- .p,...... ---._.-.—.._,
-_..-.„-,-:._.4.-.,,_..'r.'.,!..._-.tVI-' '._,2....-,r•-.._-_41„-- 'LA_-,
,-.
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Qtiiar f 1 _i'4 j tF
,___ -1- -- , g i , _, ._....41,1,Aii_ 1 . .
`Shorellne Loch H r
' SAVt. nor:urea yes. j #. { T !*M► ! i .
t ;:{ . ` ._ �"_. ' t * 4,f
'`
Moratorium: p/a.' :yes 1 1-_ 1 '�t
Rhatos: Yes C.:o'` i0 -
Walvor.Atta=hcdf yes. Stair I ,: r +1,
i , j . .,
'A.building.permit may be requlred,by; a .�Sea riote.on back regardingr.ltN4r,Basin rules +« '
(Note local'PianntngtJurisdlction)
Notes/Special Conditions , 1-- ,,r') - •' r f C 'G 1 t..
im / + _''!' � I{F!_ * l -_ .t -/ - 7 4 [ate a, I d` f
}
ant or Ap lcan tintoc1 Marne i� - - ._ R itOitic�s Pdrtted.Nama -
atum, "Pleasereadcompliancestatementonbackofpermit"* Stgna
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t.�: •otIcat casfaJ ,......,...+ _ - .._....... - AratinstDxte- ',-ze—L 1Zli.—, �LHIL>4t14{1�3tli _ _

3/4/LUL'1 LUL'I W UL_GU'I b'I b.1P9
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: freVes4 $a iJ grvvecumn,t♦S
Meiling Address: Pa .Aox (i^/2
ps4Th � .� Ne Zgf-y3
Phone Number: 9/6 2C Z -214
Email Address: koct 9 :/•Gc�w�
i certify that I have authorized 1 ()I ?
Agent/Contractor
to act:on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at r r^G'S
P--eio, G —, County.
a ^ 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
�r ,rove.,, , C
Print'or Type Name
Title
Date. ._
a ,
•
certifi cation is v: dihro _
Ill
h4knc•//moil nnnnin nnm/moil/i,/l Nnnhifl4rach/CAAfrnv.0 u l cmrlflAIC ,nrPr!`(1r n sDfnvfllv �A'7nrninrknr=l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
f hereby certify that I own property adjacent to {Name of Property ner
L--
�l t/ — //)) ,,II /4 ,� ter' •
property located al 3 7 M ;vu.'[ S -�-' �'
��11 '' (Address, Lot, Block, Road., etc.) • N.C.
on M 'ko 4- (C 'tf/(,t/ , in l�-t(�,;i�t) i',,d /�-0+?G'�a-/' ,
(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 AND/OR DRAWING OF PROPOSED DEVELOPMENT
- (Individual proposing development must fill in description below or attach a site drawing)
re-dp, Cbc-e-a- • a a a ci e4li-P44,-; ce.
ol
•
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.
(Pro erty Owner Information) (Ad'acant Property Owner Information)
.4‹-ali
Sihn4tur92 r , ,5'i Anu urea
Am raAow •..-- �
Print or Type Name Print or Type Nam1B
iglQ Auc C.12 191 HotAigrd S iar. t•
Mailing Address Mailing Ad Tess NC
Ab.wprl-pftx me Zi�ftJ3 , ,,,,, S
City/State2ip City/State/Zip
Telep an Number relephon Number
1e Date
!Revised 6/i&2Of2)
Scanned by TapScanner

i
,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT .
hereby. reify that I own property adjacent to . _._L l�res 5a0 , s
} (Name of Property Owner)propertyti uated at ) �"v. f1/lai ,°[- c L. -f "tif)e-5. /en=if `
(Address, Lot, BI ck, Ro d, etc.) n
on __ �t(,i%.//:' `1 .:.� /'�+'1��-/' , N.C.
(Waterbody) (CIty7Town 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 AND/OR DRAWING OF PROPOSED DEVELOPMENT
- , (Individual proposing development must fill in description below or attach a site drawing)
•
•
•
WAIVERSECTION
' ,I s•understandthat 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_mewaive(If you wish to `
the setback you must initial the appropriate blank below.)- . •
do-wish to waive the 15'`setback requirement.
' •:=l•do not wishto waive-the 15' setback requirement. ; -
(-Property Owner Info ation) = . Y(Adjacent,Property Owner Information), , Y
1g ° Signature , #` : J\) m2 P .• Vign tu/e .,{(/- ''. _.
fib :'Print orType Name •e " .. t Prnt'or Type7Name
•
, Marlin A ldros / Mailing ress
4 o ,
Ci /Sta e/Zip. e
4
�_ rty/Stare/Zrp
9/ G
Telephone Number ' A.,. Telephone Number'V
s 3,`3 aaaZ 1 4: 3/3 /`2
Date;' ire ' `d ?'§� �,a- 4 x-a, - A r a � 7 r - -ea, a,�.,
,�� ! i� � � � "Date >
� -tea � ;' �- �` `� a'r g 3 � "�'
'7ge ._ �# V � : > ,(Revsedis/1.a/2o12)g '
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�.�;` ..- �, � -s --sty " 3i '' {M 3 ..,% �` .. z �
14- _ ,�., - " �',£'. s �... svr $ t' ,� r tf a i slkt4a ., :.:7 `�'" 4 , m �,:a�
'� �. ;� -;' � � ¢CIS,.-; i_- s f°F�Tr � z',. -�s 4 x a ;�$
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`u3, A i ,4 5 � ' R f �` .'.c 4� 11 3` } 4.F.1 . x 7 'r4 -;r , 4';s .7!1 , .g"
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Y ..'g i A Gib 1*&.f'JI, "; .- y.. No. 74263 ^b'x'$� i . k t 1
"s- En R►L ,4P RMI Preulous,pemnR# A h
x�
4 ' •e t 11 1 PI� AICtt! ti i ai ti i'Reissue Date previous per?ntlt i5tted '
,kaboorYxed by t t4 N rt i it ,Departn O nt of Environmental'QualIty _ - /
}and the CoastalRes r 4s Corti ission)n,ati'irea of environmental concern,pursuant:to�ISA NCAC , m' .
s _ Ruts ried-
' Applicattt:Nanie_ . - t _, O I�A •f"i Off' r- o,ect Location: County _. f .
x PAt(tlres' , , •I. treet Address!State'Ro•ad!Lot#s -
:Gty:' .: 'eY '-' i 'State PC 'ZIP' 3 ` t r+3 f .r
'Rhone —)- -71>9 'E-Plail Subdiv slop se.e `:'r -, 4l1u
f
utharizederar : j -r City ' + e(frt ZIP
. bat •°• ,91,EW rAPTA.. ' cgs. .Pr1s. on Phe# - -�-�.-:.- ;___ ;RiverBasinV 4 t.1,
Attested, oueA-' HHF 01la," o(IBA -EIWA A .
ARC(s); •
©`rws Adj.'Wtr,Body i, (nat-r /unkn)
ORW: yes,/ ? PNA yes/ aosest Mal.Wtr.Body' 1 '�' fir .- '-�tl
Ajo
'ijrpe of Project!Activity l - ,1,1 PJA 1 1 T `9 /A)
X 141M 'V 1 k (scare:
c ' 'Pier( t )length _ !
Fixed Pla m(s). j.. .1 - i, �' _4 i 4 i r
' �`�FloatingPlatt� (a).� -I
Grotn.loiigt6 -d -4_ � NMI, tojp, " -
twmber # L l t• : _.
6iiiliiteadl Riprap length # -__-_- ,- -- i - 1—'—',"---„ x
a ',i av distance offshore �. _ _ _ .
t
= max distance. sh�re.
r
i cubic yards_ I
• L
Boat ramp. I _.�... , ply*-4,- ' -I_ _ _-. 1
ra
goathou Smart i __ 1 - - #-`
bi ar
BeachBulldoxing. _ „, ., .
t
Other �) 1 •• •
r
I
t
I i,
'-'' '' ri--1 1 ifigpo :,..--,-
� • 1.1111 j L 'IV
. Shoreline'Length• 14 t r _ — 1 j i '!'
Ay: not sure. yes - -1 i__-1 -- _`-��1 .--` ®_- : "a er► — ,.�+ "'� -s i f.
l Moratorium: of ( I 1 I I 1 1- - w 1'. .� i" .,A
C ' photos: o _ -*_1 _-_ C .- 2c- I' ' 'r i ''-, j +
�t °WalverAtached; yes « �I ,_ `_ 1 . . sus.-4..,.,.. . �' s,� l ,
i ''A buildingpermitmay be required by; (..r" '' _.- 0 Seat-out-on back regarding River Basin rtil 's>..
3 :
Note Local Piannln$Jurlsdlction) A ,r—• _ J'Notes/Special Conditions .-C .rl A„�' d ` _` G- :1 l
IF 5
I. 1 -—14 7 r4- `: -7 4, 1. ` "
. hig.L. jtis.'` Aeat orAPp l r. r#ttted Name -- fiker's Printed.tNiame •
Si hire—, e*PIeasoreadcampliancestatementonbackofpermft"t' Sign re' T
, - fie ' ' _ ..70 .--/41 _ AP ., 411,-
'8iatticathariftelsi Chrefctk _ 'l«tdn,DDte --. AA/. -..r• .-i a

Check
Date Reclined Date Deposited Check From Na _ Name or Permit Heider Vendor Cheek number amount Permit Numbr/Camm.nta Receipt or Refund/Rwllocated
Corumnt Column2 Column3 Column) Cohenna Cokrmna Column? Column!! Cokrnrne
3/5/2021 3/9/2021,Nod End Builders NC LLC Nick Nicholson SunTrust 1038 $ 400.00 GP 0761840 ;PA rd.11593
3/5/2021 3/9/2021'North End Builders NC LLC Pat Johnson SunTrust 1039i$ 400.00 GP#76183D 'TP rct 10319 _
3l5J2021
3/5/2021r 3/9/2021 Lighthouse
Lighthouse Marine Construction.Inc Chris Mewborn Coastal Bank and Trust 3656 $ 400.00 GP#66376D JD rot 12390
3/52021' 3/9/2021 RG Marine Contracting/Ronnie George Teresa Jackson Bank of America 1_ 1062 $ 200.00 GP#76498D _ PA rd.11592
Topsail Offshore,Inc. Forest Sound HOA Coastal Bank and Trust l 1329 $ 400.00 GP#86375D _ JD rot.12389 _ _
3/52021- 3/9/2021 Castle Home Builders Mana and Sal Miliara PNC 4805 $ 100.00 GP#80111D(1 of 2) _ JD rd.13588 _
3/5/2021; 3/9/2021 Castle Home Builders Maria and Sal Miliara PNC 4797 $ 500.00 GP#801110(2 of 2) _._IJD mt 13568 _ _
3/5(2021: 3/9/2021 James C York same NAVY federal CU 8562 $ 200.00 GP 1180109D JD rd.13570
3/5/2021 3/9/2021 W Cad Bazemore same United Bank _ 1030 $ 200.00 GP 0776000 BB rct.12927
3/5/2021 3/9/2021 Land to Sea Construction,LLC Felice and Richard Brenner FCB _ __ _ __ 414 $ 200.00 GP 077897D KE rot.12731
3/5/2021 3/9/2021 Gregory Holden Elsie Cume United Bank 5510,$ 200.00 GP#777830 BB rat.12929
3552021 3/9/2021.Gregory Holden Milton Howard -United Bank 5509 $ 200.00 GP#777850 8B rd.12930
-3/52021 3/9/2021 Gregory Holden Jeff and Cathenne Tucker 'United Bank 5508 $ 600.00 GP#777840 B8 rd.12928
3/5/2021 3/9/2021 Gregory Holden Richaerd Mendenhall United Bank 5511 $ 400.00 GP#77786D BB rot.12931
3/5/2021 3/9/2021 McMullan Partner,LLC _ same First Bank 72357 $ 400.00 GP#77599D 8B rot.12926 _
3/52021 3/9/2021 Danny Ray Britt Jr. same Edward Jones 1714 $ 200.00 GP#80117D 8B rct.12932
3/5/2021 3/9/2021 David Anthony same BB&T 2562 $ 200.00 GP#75821 D Tmac rot.13531
3)5/2021 3/9/2021 Clark Environmental Services.PC John Payne Select Bank and Trust 6511 $ 200.00,GP#77705D 1 of 2 _ Tmac rat.13532
3/5/2021 3/912021 Clark Environmental Services.PC John Payne Select Bank and Trust 6514 $ 400.00 GP#77705D 2 of 2 Tmac rat.13535
_
3/5/2021 319/2021 James R Bun-is Revocable Trust James Burris Wells Fargo 1132 $ 400.00 GP#80131 D KE rct.12730
3/9/2021 Dr.Mona Faye Black same Bank of Amerca 9828;$_-548.00 NOV#21-030/Permit$400/Penalty$4001 Invest S48 OnCo J0 rct 13572 -
3/9/2021. Custom Island Homes by Ken Kiser Scott Blankenship United Bank 1734 $ 432.00 NOV#21-10Db/Permit$200/Penalty$200 1 Invest$32 BRCo 'TP rct.10320 _
Major fee,123&127 Island Bridge Way,Wilmington NHCO NO
3/9/2021 Logan Marine.LLC River Island HOA BUT 7112 $ 250.00 split _ PA rct 11590
3/9/2021 S.Bailey Paul and Shen Bailey State Employees CU _1846 $ 400.00 GP#77541 D OH rd.12701
3192021 _ Charles Eames same BB&T 4993'5 400.00 GP#775420 BH net.12702
3/9/20211- _ Aaron Lanoe same Allegacy 2071 $ 200.00 OP#77543D _ IOH Yet12703
3/9/2021' Steven R Smith same First National Bank 1447 $ 60000 GP#71814D lTmacrd,.13534
3/9/2021 _ Permit Pals Todd Surran CresCom Bank 3496 $ 100.00 Minor fee.205 Caswell Beach Rd.BrCo Tmac rd.13533
352021 Carden Pander LLC same FCB 1087 $ 200.00 GP#80110D JD rct,13569