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80297D - Riley
CAMA / l y DREDGE & FILL 9 80297 A B C D GENERAL PERMIT Previous permit# )"..---' New Modification Complete Reissue Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality /{"J�: /7 l,.l • and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / (J /� ❑Rule g attached. Applicant Name 0 �G �' ' `l Project Location: County ��,Tij �.,Q� - Address 5� J ` m_doO Street Address/State Road/ Lot #(s) " ,---- City r� i S 9 - State/ " —ZIP T)'t(LL3 lit-/ e._. Phone#0 9 rb "37 ('4 E-Mail _ Subdivision I Authorized Agent /V/ 013— - City ZIP Affected ❑CW yV f A LIES ❑PTS Phone # ( -�"' River Basin I' .0 ❑OEA 7❑HHF ❑IH ❑UBA ❑N/A AK �(s): Adj. Wtr. Body NNW (nat' unkn) IIPWS: -/ PNA yes / no) Closest Maj.Wtr. Body /44/ /- ' 'LI 1' ORW: yes yi Type of Project/Activity V0 CI a J l h e u 1 l/ (Scale: /(1. 1C ) 4- Pier(dock)length Fixed Platform(s)__ I Floating Platform(s) i • j t �� Finger pier^(s) 'erre; / _A_ ; 1 Groin length (/� number`. �.._-_.__ Bulkhead/Riprap length — — _.. ....!..._... .. _ ! ....i avg distance offshoreII j 1. I j max distance offshor Basin,channel cubic yards r 1 II 1 I Boat ramp / Ns, I e y . 7-0 �+ jb1 Boatho�z/Boatlift' f � X/2 , --. _._ _. i... ,�/'—...._.._— --.__.._......._..._.I"� I 1 Beach Bulldozing , f ' — Other `-���`— I i i • Shoreline Length , I t A . `kt .1, D / SAV: not sure yes .. 1 Moratorium: n/a yes Qo # 1. irjr Photos: yes „en . . . . t- 1 r„--- f t - ___•__ . ...sr) 1.- . Waiver Attached: es no ey'' A building permit may be required bye N„(u", C Y' -7•._ • I I See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions Applicant Pr Age C '� _I DA-0.____ ____. Pe orinted Name cer's Printed Name Signature "Please read compliance statement on back of permit** Signat 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 (252-946-6481) 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/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (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: 910-395-3964 Fax: 252-264-3723 (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 AlIlk AICAMA/ _;DREDGE & FILL t� 1 80297 A B C D ENERAL PERMIT Previous permit# >'-=' •,.New `-IModification riComplete Reissue -i Partial Reissue Date previous permit issued As-. horized by the State of North Carolina,Department of Environmental Quality �(+�� / and the Coastaf s Commissio in an area of environmental concern pursuant to I 5A NCAC (/ 2-Cep C ule flatbed, Applicant Na �a �� Project Location: County___— � _. _ Address_ dr ss Pe' 0e/041, ,..... Street Address/State Road/Lot#(s) City _ 4 State/ 'C P 7 Phone#7i0 4 "4''E_Mail. Subdivision _ Subdivision Authorized Agent A.,/iir- City ZIP Affected Li CW LIES OPTS Phone# .a (-- - ^... River Basin._--.._.!. AEC s : D OEA L HNF O IH Ell UBA ❑N/A ( ) El Pws: Adj,Wtr. Body_Al1Witi _.('• unl 1I) Closest Maj.Wtr. Body --/ 4!_ 0!.2 / ORW: yes / on) PNA - 40> ` - — . Type of Project/Activity (/� (l 0ag Pier dock)length _ . . (Scale: �/�� ) i Fixed 'Iallorm(s) • i I •Floatin_ •latform(s) _ _ __ _ Finger pie s) • i Ili, / Ai . f1Groin length ; �_ f • i number • I I • . ii Bulkhead/Riprap I- : h avg distance offs' e _ • ; max distance offsho ./- • • • ' • • Basin,channel , cubic yards_- ..--__._. i . • . � i • Boat ramp_ � ITO. Boathoiiiiipll 1 Zititid . . Beach Bulldozing ' I . . i . E Other — --— • `f i I i r . . . • : k . : -• ---n !l r` �V Y/� — { Shoreline Length_ — SAV: not sure yes 9. t 1 (f/.i Moratorium: n/a yes o , ..t— TKO /�f Photos: yes I ` t 5. �a I 'Tt."r Waiver Attached: no •-xcg/ ir366- • •" A building permit may be required byi �, —:See note on back regardidg River Basin rules. (Note Local Planning Jurisdiction) 77 Notes/Special Conditions i _ — ' _....-... Ag or Applicant 'flied Name• Pe 4 ,cer's Printed Name Signature " ease read compliances• on back of permit"" Si $3 l Application Fee(s) Check# Issuing Date • - Expiration Date 0 CAMA / DREDGE & FILL N° 80297 ABCD GENERAL PERMIT Previous permit # )C New Modification Complete Reissue Partial Reissue Date previous permit issued .. As authorized by the State of North Carolina, Department of Environmental Quality d7 74 / 7 / / i and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC � ❑Rules attached. Applicant Name f f' �( / l� 6 `� Project Location: County �,.1A r/n ( • Address 5� --A') G 'C / (. �-fe . Street Address/State Road/ Lot #(s) City / /4l i r -e State /IL ZIP 7.�' /PI Phone#('7//�/tom I`4 E-Mail Subdivision Authorized Agent /)/ f/- City ZIP Affected ❑CW EW [ ,PTA LIES ❑PTS Phone# ( -) 'r- - River Basin f/' 'U O ❑OEA HHF IH ❑UBA ❑N/A A (nat' 1�1�lunkn AEC(s):: Adj. Wtr. Body ��`V / ❑ PWS: P ORW: yes / no PNA yes / no, Closest Maj.Wtr. Body ��E`' �/ 'I �� Type of Project/Activity , Pier(dock)length 4 (Scale: "J7 ) Fixed Platform(s) _ ' i i Floating Platform(s) i I j �- Finger piers) ( F......._—._ __ 1r' _ — .._..------.— 4—+-I— Groin length., i ( I I i j number -.._ _._._ . ..... ...._.— 1 Bulkhead/Riprap length » * f avg distance offshore _ l t C I { i max distance offshore 1 1 I Basin,channel \ I I I , I I r •• � cubic yards 1 ' Boat ramp _ / i I ' &�'I 1-0' , -Eit4 1 J Boathouse/Boatlift) 1 Z.- ,V ---rr2 ---- - ---�i..�.r .- r �� i Beach Bulldozing ' It- I I , t , 11 Other ��-.._� i i I W III ` jI j' �% V 1 Shoreline Length i X • 1 1_ li_t4t/ e ti.... SAV: not sure yes (to —. Moratorium: n/a yes no �� Photos: yes •_-- I _ --1 rxxftP— Waiver Attached: yes n✓'• /..". , 1 --- !., A building permit may be required by: i,,t4etr 7 t-1--- E See note on back regardirg River Basin rules. ( Note Local Planning Jurisdiction) Notes/Special Conditions i 21 j clA it r i k t. ' i) 6 L '----. Agent or Applicant Printed Name • Pe ' O cer's Printed Name Signature **Please read compliance statement on back of permit** Si ,..„.-740),...4_, 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 (252-946-648 I) or the Wilmington Regional Office(9 I 0-796-72 1 5)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: 252-247-3330 Fax: 252-948-0478 (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 252-264-390 I Fax: 910-395-3964 Fax: 252-264-3723 (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 Prbpei (s-F peon 5 tki\A - `P 1312-0150.50 �o Li WA IA014 y 6fldtK7wA - Am • I2' -t ,Zi 0 Fr -� N, O r( )) 0 n J W L w�d CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner PCL "` Saivtp t _ Address of Property: 35—` Y19 v.)oesj L^- 44,41154J, NC 2< y3 (Lot or Street#,Street or Road, City&County) Agent's Name#: Mailing Address: Agent's phone#: I hereby certify that I own property adjacent to the above referenced property. The individual applyin. for this permit has described to me as shown on the attached drawing_the development they ar- roposing.A description or drawing,with dimensions, must be provided with this letter. 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 Division of Coastal Management(DCM)in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext_,, Wilmington,NC, 28405 3845 DCM representatives can also be contacted at(910) 796-7215. No response is considered the same as no objection if you have been notified by Certified Mail: • 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 wi waive he 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) V61-111,":111--) Signari r Si ature 2 II //a 5��p l4- Print or Type Name Print or Type Name 35-1 togwooJ LA 35-7 Ooq food L&i.t . Mailing Address Mailing Address (--la r skeJ 1 N` J /c. 2-2r Y Y3 City/State/Zip City/State/Zip ti to It) 17 Ii ( �I'r Y � S - 5 —I o P R . Tele hone Nu ber Telephone Number 3 ) a >/zo2 I 3 } 28 Lae I Dare Date t Revised 6/18/2012 PROPERTY OWNER STATEMENT ADJACENT RIPARIANT I hereby certify that l own property adjacent to J °',,-tt- ` ./ ,s a e of Property Owne property located at .351 as Y w°O '� P (Address, Lot, gl Road, tp.) on , in l0-1/0d • —, N.C. (Waterbody) (City/Town and/or County) TF pplica t 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) Pe,Al1-4". e 44 A kw /I t-- .x. o. -1--. P; ` be,,,.-1-- N.F.4.- , 1 tee,,�t ‹e...e... V':..,.:.at.t% C (a` 4LJt 1 • WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a mp)etba9)( -mum distance of 15' from my area of riparian access unless waived by me. (If you..wi�b_to.waive _p you must initial the appropriate blank below.) '' t + . I do wish to waive the 15 setback requirement.. I do not wish to waive the 15' setback requirement. . ., .- (Property Owner Information) (Adjace t Property Owner Information) /14A-1(5 sgrQtT� Signature n ,�a vex ti 21 Va-M 5ep...".p IL Print or Type Name Print or T...y Name } ,357 0 a y woo 1 �I _ �1 001 woo) 4,01 Mailing Address Mailing Address - City/State/Zip City/State2ip . «10)C IC, - -VT i 7 (qlD] q'(3 �.I""�O,y Telephone N mber Telephone Numb r 2 3 �26'1- I - 3 I S 1 Z d 2 l Date Date (Revised 6/18/2012) AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: 3c1 Doctw oo c a.,,,p S .a,1 l c. 2g t6 3 Phone Number: (°\ Email Address: )r1 I,V SdU^`���an4�5 ` ( I certify that I have authorized 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 Sri 0 oc to air,c w.. PS4 , in PtAc 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: Sign ure J1 . (2_ Print or Type Name bwm e./ Title 3 I Z6 z Date RECEIVED MAR 31 202.1 This certification is valid through I I DCNI WILMINIGT'ONI, NC Mir CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Fc-"" SAP t 35—l 0�`t�ooJ t-" l] f �C 2S�1 3 Address of Property: / (Lot or Street#, Street or Road, City&County) Agent's Name#: Mailing Address: Agent's phone#: I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are roposing.A description or drawing, with dimensions, must be provided with this letter. 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 Division of Coastal Management(DCM)in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response is considered the same as no objection if you have been notified by Certified Mail: ' 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 he setback, you must initial the appropriate blank below.) RECEIVED I do wish to waive the 15' setback requirement. • MAR 31 2021 I do not wish to waive the 15' setback requirement. �`^p^ WILMINGTON, NC (Property Owner Information) (Adjacent Property Owner Information) Vattlaitt-J Signa At Si ature J erkc L I2 /Da,/v-t S p / Print or Type Name Print or Type Name YP /� J / 3 r' ool wood LA 3s7 Ool k OOd Mailing Address Mailing Address (.�a,A,f s. 1 A/C 2Pr.3 /'.„,.-7Ds4.4 -A/c, z -Y Y3 City/State/Zip City/State/Zip C`�L9 to lti l -I t e ( 'l D) Y ti o s> Telephone Nu ber Telephone Number .3 ) 2� 2GZ I 33 2$ Za 2( Date Date Revised 6/18/2012 111 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 0 l 's a e of Property Owne property located at 3 5-1 Oe y �©•(� (. p (Address, Lot, lock, Road, etr.) on , in 1i/OS d , N.C. (Waterbody) (City/Town and/or County) The applica t 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) pe, �: 16 rift` r mf-4 ° �q Ptt.".st. cx,' a. r- t 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 yo ish o ve the setbac you must initial the appropriate blank below.) a„ 1 I do wish to waive the 15' setback requirement. MAR 3 1 2021 I do not wish to waive the 15' setback requirement. DCM WILMINGTON, NC (Property Owner Information) (Adjace t Property Owner Information) Signati/e Signaturen . d-vim ti 2 Pa.,n c..^.jo ( Print or Type Name Print or Ty e Name a ) Mailing Address Mailing Address t-leA,"Ap s 1, 4- z8Pi) P0- ,9s ._d A/c- 2leV V3 City/State/Zip City/State ip • c t o)C rc — Z� 17 ',D) q(3 -- (cloy Telephone N mber Telephone Nunfb r 3 7 $" 2O2 I ��ZS Za21 Date Date (Revised 6/18/2012) 0 y CAMA/ ❑DREDGE & FILL No 80297 A B C D ENERAL PERMIT - Previous permit# Y71 New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As-. horized by the State of North Carolina, Department of Environmental Quality /Z/1�1 and the Coastal Resources Commissio in an area of environmental concern pursuant to I 5A NCAC riffs �GGJJ g,. e ttached. Applicant Name 0 44 �/ Project Location: County �. � , Address s ,�m� woo Street Address/State Road/Lot#(s) City 4 ( '� State fr'c- iP 21'y yi .:4,1401 __ Phone# `-t-11) 444÷E-Mail Subdivision Authorized Agent N/ City ZIP Affected (❑CW A ❑eS ❑PTS Phone# ( �)� River Basinhi°10 • AEC(s): El ❑HHF ❑IH ❑UBA El Adj.Wtr. Body AI WA/ unkn) PWS: ORW: yes / PNA Closest Maj.Wtr. Body_AV � CI ' 20€., , ,/{L'> Type of Project/Activity V,V (f //oa yZl (Scale: / ` ) Pier dock)length a, i Fixed'latform(s) III 1 Il 1 Floatin: 'latform(s) j ! j lI __ /� _ ( I �Li� ' Finger pie s ! ! I _I_ ! e�� • "i , Groin length ! IIIIIe i ( �' i ; number '' .f. Bulkhead/Riprap le .' —�ry , •._ h ■� O_. • ,.. ! avg distance offsR:'.e ! ! S I ! ! j max distance offsho Basin,channel ' ! I 1 ! 1 cubic yards 11111 ! I lAi Boat ramp , ( 17 / Boatho :oatlift • I — — — I j— ! ! I I , 1 ! ll 1_±=E Beach Bulldozing i , -! _ Other \...j... I I ! I I ! I i NMI 1 Shoreline Length N/? f/ ! j 1_ _ / SAV: not sure yes i ! —i . , Moratorium: n/a yes �.o ^! 1 k+�'P,• H I Photos: yes .°5..i -- — �._.._. I _....-- _I 1 Waiver Attached: no =o A building permit may be required by er ' ( . I I See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) 7 ^ Notes/Special Conditions T„. i e.I�.1.1-Iv ri-71,.. Nt--0-,. Ag or Applicant Printed Name Per �cer's Printed Name Signature **Please bead compliance statement on back of permit Si:'. e 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: n Tar-Pamlico River Basin Buffer Rules n Other: I _ 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-888-4RCOAS-T 252-946-648 I- - Fax: 252-247-3330 Fax: 252-948-0478 (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 252-264-390 I Fax: 9 I 0-395-3964 Fax: 252-264-3723 (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 Check Date Received Date Deposited Check From(Name) Name of Permit Holder number Vendor Cheek numb amount Permit Number/Comment. Receipt or Refund/Reallocated Columnt Cokmm2 Column3 Columne I Column. Column. Column Column. Column9 _ 4/13/2021 Avalon Oaks same Paragon Bank 1026 $ 200.00 GP/80173D BH mt.12709 4/13/2021 Jonathan M Riley same First Bank 113 $ 200.00 GP#80297D QH ret.13474