80174D - Autry

0 CAMA / DREDGE & FILL N° 80174 A BCD
GENERAL PERMIT Previous permit#
)G New Modification ❑Complete Reissue L Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality 1
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC C .
rEl Rules attached.
_Applicant Name 1�\A- t-- i �( Project Location: County '-Fv',t( i'
Address - \<;.,C X �C�'S Street Address/State Road/Lot#(s) I.Ic <''. FI\IA
City •� 1. �.--t'ac State NC ZIP 2 1. I-/y C
Phone# (_' _) '''-`1 - -%'C'`lS E-mail - Subdivision
Authorized Agent . 4--c_ r'�hit:t-ke:\''\ City t i l `;,CCA( l\- ZIP "I L{5
cw p EW ®-PTA ❑ES ❑PTS Phone# ( ) River Basin J I,k Cr" k
Affected OEA 0 HHF 0 IH 0 UBA 0 N/A
AEC(s): Adj.Wtr. Body 11 r- i.: S (I.G,i,L (nat /unkn)
PWS: l
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body /-IT L&
Type of Project/Activity 'Inns-
(Scale: ( 2 C. )
Pier(dock)length
i -.fi:i Iry F: . . F-
Fixed Platform(s) CIi I 11 i'),l") i
Floating Platform(s) I '` CK.� \w�4 ----I'?; 1 1 r r N `/i
Finger pier(s) 1ClNK u cX i . . - ? 1,0i.1 '•1 I '
Groin length or. �v, l -_.._.._ I , A�.
number
Bulkhead/Rlprap length I I 6 }
avg distance offshore ,
max distance offshore + i 1
Basin,channel I �� r� I1 l i
!ylfT�y_.L,mac—(N,. , I i - - - -
cubic yards �..4:)/( -r(( ; 1
Boat ramp
I
Boathouse Boatli —
i j
Beach Bulldozing ; III
Other i'!I ..u)( -
a
i
I
i
•
Shoreline Length _ 6e{yLlQ✓\ I
SAV: not sure yes no , _ i - {
Moratorium: n/a yes no !li • 1 1 oi✓ C C.v E. '1, .
Photos: yes no L t- .- J . 1, is
Waiver Attached: yes no
A building permit may be required by: I C-) x I 1 `' r'C l.A ' . I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) .
Notes/Special Conditions /\C��: Or tit\C.C4-(.. r't`\ ) , r 'Imo' '`-'st� (4 r°V-
`-.I .
X. ,Y?`(‘,4 1`) -Pc t.l—
ent r Applicant P ted Name Permit Officer's Printed Name
Signature **Please read compliance statement on back of permit** Signature 1
` , L(:. ' 5t --'2)1I `2 \ -I/ S'Z 1
Application Fee(s) Check# Issuing Date Expiration Date

I
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(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

JCAMA
Ri*® 'FtLL N° 1 - A B - CENERAL PERMIT - - . Previous permit# 3itto
q
New CiModification C.Complete Reissue, -.•.:Partial+Reissue Date.previous permit issued }'221-3
As authorized by the State of North Carolina,•Department of Environmental Quality " - '
and the Coastal Resources.Contiriission in an area of environmental concern pursuant to ISA NCAC
- . - , r-:Rule
'[''� ,f - n s aetazhtd.
Applicant Name____ '-'►V -,, !T`�5v r`� ` Project Location: County_ 'PericK.Q,
Address j ? . " c? ...v. __ ,, Street Address/State Road!Lot.#(s) )2D fot1 , • ,
City 1[ ai State ZfPqq5 - _-_
Phone;#(60.)6-6- `1.c ;E-Mail _..___ :Subdivision - . " " M,--- ,._ ____ -,.._.
AutharizedAgent o'jle Wo�►ti� 4 City �_ l Z1P �{ , . .�G
Affected ccw `pw:- '. A' .1-ES C.PTS . Phone# (___-__)_`— _��`_.-___..- River Basin_ Oct
k.
:wOEA t-UHHF f2";IH - [IUBA Cl NA t /�
AECW: ' Adj.Wtr.Body`•._`ZA.Aks_:(, +_1n Oat e/unkn)
r Pws: ,,,, tt
ORW:' �yes/f . .PNA• yes- - - Closest Maj.Wtr.Body *,,J_,_>: _
' 7Ype°af larojectl.Activity {fit' + c (-1 d2co4+<tidk 1ttY1 Sj C7Y-\
`Q*.--- -\-i °) 171 O (Scale: ! n 2d )
Pier(dock)lengthe.-.: A.foKs .__-
ed Piadorn,(s) �(��� 1�i 'j > -
Flb.'rrg-Platforms) __ •ft'.�?I�_f131�- tioy.. -'', o • j y( ;
Fie pier(s)- .,,"__,_.— _µ t ir'�� t?d�t f'j 3 . ': 21 '1 :
Groin t gth _ " CY
o Bulkhead/' e ,length, ___— i .,1,.a _ , -
avg dista offshore i r. - _
inns distan e offshore / i r ' -
Basm channel. �.(.�, G SS4�- - ,
S -
ye.
cubic yarch._ - — • l 6 /1�r e$' r f
Boat ramp T _.-.. i • i ! rt 3
Boathouse/Bead:St_ .u
t N j
Beach Buikfozing _ _` P j 1
Other, l_,- -t tik,)f_.tv\,_ i. - "` _ - -- - - _- . .
.
Shoreline Length 'r' __,3a� - 6 /tka� - - �(�p '(}: `
SAY;- no sure yes - t ,., ! ��1
Moratorium:
rJa yes _ 1 Zio e_Ara+r iol lr3 .
•
Photos: yes '\'V
' .' L- - t,, . •
Walver attached:.
1.
A building permit may required by n j0.� C Ye re, , - See note on back-regarding River Basin rules.
(Note Local Planning jurisdictioti�)r ry A - y
Notes/Special Conditions r��tx. ( t k
� etnc��c gipp. 1� r�1xr��i�,t� roc _
j
A; _
g at- r Applicant P'ite N ,e PermitOti cer's Pr Hied Name
$61, NJ 44t,.._'1.-
.
Signa ire t''Please read compliance statement on back of permit s Signature
_ ..____x ,,._.._ - _ _„,,... _ Tt 38 m - .-_-1[5(4). - ` "'�w i 51z i_
Application Fee(s) Chick// Issuing Date - Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION + ,BAR 1 0 2021
Name of Property Owner Requesting Permit: Jane Autry
Mailing Address: PO Box 3585
Topsail Beach NC 28445
Phone Number: 9 1 0.545.7095
Email Address: janeautry©Charterflet
I certify that I have authorized Hal Fogleman ,
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Repairing floating dock
at my property located at 1210 Carolina Blvd Topsail Beach NC 28445 ,
in Pender 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:
CLZ-61.11-1
Signature
Jane Autry
Print or Type Name
Owner
Title
02 /28 /2021
Date RECEIVED
MAR 1 0
This certification is valid through I I 3 ( / 2 i DCM WILMINGTCp

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to an Rtrr 's
(Name of Property 04vner)
property located at I a 1 0 0 { I >�0,1 81 . To S a I l ul°Q..0 11, I Y C
(Lot, Block,Road, etc.)
on Be.., n1\4.3 n\ Lnirie., \ ' in TOl Sa t.l eeh `Pe Nder , N.C.
(Waterbody) (Town and/or Co nty)
Applicant's phone#: [phone] AS Address: 0 {30 X d
To psai I 6.Q.ChNC 018'44,
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (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.)
1 do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
-Pl• to% 3.5EJ
Mailing Address Signature
To sQ,i , teo.e.\\, NC a841� A�ber�c� E. Eirer-
e
City/State/Zip Print or Type Name
Qi I0. 546 1016 qn-ssc?- 1530
Telephone Number Telephone Number
Signature Date Date
DCM WILMINGTGN. NC

17,07.
• ,: %3 •
. .
. .
_ .
• • r• ". "C..1:2'
. _ . . . ...........
• . _

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHO USE)
I hereby certify that I own property adjacent to -TQ�,� t' Ru-Trs
y
(Name of Property O+tvner)'
property located at I a l 0 V p,,t^ 0 I I NG._ 81 . TO S Ou i t �eA.C. /1) +'
(Lot,Block,Road, etc.) I
on BI ,,t.1\4S C, IlA.N1/ ', , in TO4SQvt -13 leet,e,h Ye,Ndtr N.C.
(Waterbody) 1 (Town and/or Co nty)
Applicant's phone#: I 1„Mailing Address: 0 130 ' c� d
�Q psai I 1, N C aX445
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet(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 not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
4). O. 130)( 3c5Ec5
Mailing Address Signature
7o sa; 1 teo.AI N C a8414 ,j�eXi� ui , 74-�
City/State/Zip Print or Type Name
( 10. 646 . 1 Oq ?17f Fay- 2r
Telephone Number Telephone Number
(5—/ —d ) /
Signature Date Date
DCM WILMINGTC k,

( 2 1 2 Oty--akka. ) 210 �a.,r .o e carp<<
�aG�oC �pr/t�u� Jie %vi ry 4/6 8. 9� r
27i /t.Ver? Actin Ve.,, PO 80x 3586 Or-,38 ele.y'ela ,Q
/6a.noke Vt4 .21-tovi op,,o-WacA_ Ii'10111;cvm t46
C o2S /`'t 2/O 0
/5 r
Q 0
• Molexdipmew
"e-r
Ex( 75•7_
RECEIVED
MAR 11 0 2021
DCM WILMINGTON, NC

Check
Data Received Date Deposited Check From(Name) Name of Permit abider Vendor Check number amount Permit Number/Comm/ants Receipt or Refund/Reallocated
Columnr Column? Column, Column4 Column& Column& Column? Column& Column9 •
3/16/2021 Southern NC Marine LLC(1 0 2) William and Tonya Roberson First Bank 1390'.$ 200.00 GP#80103D JD rct.13573
3/16/2021 Southern NC Marine LLC(2 of2) William and Tonya Roberson First Bank 13861—200.00 GP 080103D JD rct.13573
3/16/2021 Steve Woodard same PNC Bank 2572I$ 200.00 GP#76187D PA rct.11591 _ -_
3/16/2021 John J Strobel(1 of 2) same BB&T ___--1622 $ 200.00 GP$80186D BB rct.12944 _
3/16/2021 John J Strobel(2 of 2) same BB&T 1626 $ 200.00 GP#80186D BB rct.12944
3/16/2021 Kenneth Billings - same SunTrust 1144 $ 200.00 GP#801880 BB rct.12710 _
3/16/2021 Thomas J Rumsey same USAA Federal Savings Bank 7001 $ 200.00 GP#80122D - •BB rct.12950 _
3/16/2021. Torn and Holly Rumsey same United Bank 153 $ 400.00 GP#80122D BB rct.12937_
3/16/2021• Backwater Marine of NC C LLC Tony and Stephanie Hill iBB&T 1264 $ 400.00 GP#80185D BB rot,12943
3/16/2021, Ted Hudler _ same BB&T 10915 $ 200.00 GP#80118D BB rct.12940
3/16/2021 GAce Construction of Brunswick County In Alvin and Annette Odom BB&T 14496 $ 400.00 GP#80125D BB rct.12945
3/16/2021 'Once Construction of Brunswick County In Walter and Jennifer Fielding BB&T 14497 $ 200.00 GP#80130D BB rct.12946
3/16/2021 Grice Construction of Brunswick County In Edward and Patricia Murray BB&T 14498 $ 200.00 GP#77562D BB rot.12947
3/16/2021 •Kenneth Gregory K and Louise Gregory Coastal Credit Union 3655 $ 200,00 GP#80187D BB rot.12948
3/16/2021 Basil Kushner Basil and Melissa Kushner NAVY Federal CU i 829 $ 400.00 GP#80192D BB rct.12949
3/16/2021 Grace Construction of Brunswick County In Town of Sunset Beach .BB&T I 14499 $ 400.00 GP#80132D BB rct.12976
3/16/2021 •Grice Construction of Brunswick County In Donna Doudican .BB&T 14502 $ 400.00 GP#80127D BB rct.12977
3/16/2021 Structural Concrete 8 Millworks.Inc. Darry Hargrove Southern Bank 41602 i$ 600.00 •GP#77550D 'BH rct.12714
3/16/2021 Allied Marine Contractors LLC Allen J Warren FCB 9937.$ 200.00 GP#801750 BH ret.12713
3/16/2021 Allied Marine Contractors LLC Jane Autry FCB 9938.$ 200.00 GP#80174D `BH ret.12712
3/16/2021 Charles Duckworth Money Order Chris and Mary Batten Wells Fargo 17-76805361 $ 200.00 GP#801240 IBB rat.12941