80254D - Murray

0 CAMA / DREDGE & FILL No 80254 A BCD
GENIRAL PERMIT Previous permit #
' '
_Neer Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality O 7 1 f /zo o .
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC �f .
I/� ❑Ruleshed.
Applicant Name /�Y k v i Y/ Project Location: County K` �4-
Address ,- 3.0 O4 /7(/`-1 S t/ ;./ C Street Address/ State Road/Lot#(s)
City' TL F 1.-1- w6tate NUZIP 2'4-247 66, N (nv / 6/r1 /c 4A--)
Phone #(/(0)h1 '( , ' E-Mail Subdivision
Authorized Agent _ Al A City ) c. i'` F 77 ZIP 24 T J
Affected ❑CW WVV. A ❑ES ❑PTS Phone # ( . River Basin 0
� � ❑OEA HHF ■IH ❑UBA ❑wA Adj. !�1.', man /unkn)
AEC s : Ad . Wtr. Body �7 ti'C �� Ada
ORW: yes no PNA yes / no• Closest Maj.Wtr. Body /A Gl`
Type of Project/Activity G i/ Cie e- ' tA •
r + X r ; (Scale: Or�,/�' )
Pier(dock)length (0
Fixed Platform(s)
r 1 I
Floating Platform(s) I/ /• i %
1 i i Finger pier(s)_ ell< ,/�
i' 1
Groin length i � '/I
number y..._. _.- / I_ /
Bulkhead/Riprap length
p r 0,4...44i 6 '(/
avg distance offshore f ' 1
max distance offshore t, 0 L 4, / i I
Basin,channel r , Z•5
' .41‘111.
�!i
/� j
__, ! w-.....riP.— —
cubic yards v., 1�I
- L v
Boat ramp 0�. i I
Boathouse/Boatlift I
z.
tml
. .. .
Beach Bulldozing 't (i
Other I i
Shoreline Length 1 n j , El
, i
[ ,A •
SAV: not sure yes
1 1 __
Moratorium: n/a yes 29 7 1 1 _l
I
V
Photos: yes 1 i
Waiver Attached: �.pp'
A building permit may be required by: c v r F-- C[ T E See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/Special Conditions
-eiV f k Ur✓ 7„,, )kit
Agent or Applicant Printed Name Permit 1 icer. Printed Name
Si ature *"`Please read compliance statement on back of permit"'"' Signatur
.-- /10” Y -M .z . //9 .Z1
Application Fee(s) Check# Issuing Date Expiration Date

4
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: [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

.
0 its cAMA/ D DREDGE & FILL 4 A B C¢
ENERAL PERMIT Previous permit#
ew OModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As auth rized by the State of North Carolina,Department of Environmental Quality
and the Coastal Reso rces Commission in an area of environmental concern pursuant to ISA NCAC 67
-�;:les ched.
lic Ada • yllt P r Project Location: County
App' aqt"" me
Address ` itR4AS V' /✓• • Street��Add/dress/Ste Road/Lot#(s)
---------jt----
City
to/SLIP 4 �+'Y� '�( I ®/�1 � ------
City
Subdivisio
Phone (a)` t" s �/E-Mail�s
l" iD+� City ZIP_"
Authorized Agent
TA p ES ©PTS Phone# (
River Basin ` li
Affected" DDew �!�''� 4 �"
❑OEA �i HHF "= IH UBA Cl wlA , Adj.Wtr.Body / main'unkn
AEC(s)s D Pws:
,_ Closest Maj.�Wtr. Body----
ORW: yes no PNA ( / no_
•
Type of Project/Activity; l�A1� arii..-.•Q/,rl
0 / (Scale: i/�� `
Pier(dactt)length , .
i 1 j i � f , ,_,.-_,. � jr. INIE
Fixed Platform(s) � i } I � w: .'
# � i l
Floating Platfortn(s) ; i I I
Finger piers) E A // 1 xr- ' °y 1 i _� i �. -.—
L
Groin length ,, t ; • i , I 1 ,
number 1 (, l i i 1_ ; . t _ f - i e j—t �
imin
%
. Bulkhead/Rip .plength z° t �� ," �iir i
i t-
cubityards avg divan a offshore ° l l V v =—T —. ...
° ruax dime -offshore >,° �mil.f,• . �€ 1 'Q„ ,
Basin,channel _ • —1 , , . ; i 7
,:. ' , °,:1's f i itL'� , ##
-
Boat
ramp ; j" 1 l I i I a
TT /
$oathouse/Boattift '"` 1 -,- , itiir_ -
,. �. 1
a�
Beach Bulldozing aim" ! - � ( a
Other } I t ��
o =
•
1
Miesso —
s J t•
1 1
r .s...., i ,...
..............._
---r--- a' is
Shoreline Length_ �� f I icy
r , 1-, I 1.4AziLaiwi atzaml,
5AV not sure yes a 3 si ."
Moratoidum: n/a yes,E31 � int _..._t�.�?_ - --
Photos;;•-0 ° yes=". �. .=E �, E.- �.., .: . T1 , i_ .. -
waNerA�ttached:
A build g:permit may be required by: V iii
Q See noto:oti back regarding River Basin rules
(Note Local Planning Jurisdlction) "
Notes/Special Conditions
v
AsCJ --''�
Agent orApplicanti d Name .e Permit y—,„°Printed Name
S atur+ Please readcomplancestatementonbackofper it"' Slgnatu___...,7„ ,
-�
ApplicMlbnFee(s) _ G eck 6 IssuingDato Expiration Date

Locality Permit Number
Ocean Hazard " _ Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
• (For official use only)
GENERAL INFORMATION
LAND"OWNER-MAILING ADDRESS
•
Name V i= if V RifiNcir
Address TOO (�� , R is S 1/i'i=kJ.) CS
City State iq Zip 2 ayZ°I Phone 0 tD - L13I' p e
Email S+ev e WM U r rao `/<L,tM,u-A , C 0 M
AUTHORIZED AGENT
Name l � / p
Address rr
City State Zip Phone
Email
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
266 A+k4ts Po,,, - "Rd
ML. 2-9 s
DESCRIPTION OF PROJECT: (List all,proposed construction and land disturbance.)
T; r ( I2 ') ., I�a.wlp , 'Dock_ C i2 X(v )
SIZE OF LOT/PARCEL: O(A (5 square feet critiq7614 acres
PROPOSED USE:Residential (Single-family 0 Multi-family ) Commercial/Industrial Other 0
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: r square feet(includes
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but
excluding non-load-bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,etc. that are within the applicable AEC.Attach your calculations with the project drawing.)
RECEIVED
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources(DEH1:lrg)?9 2021
YES NO X
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: nrKlisVgtOffdOCITON, NC

' OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile HomePark Approval,Highway Connection,and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP: •
I,the undersigned,an applicant for a CAMA minor development permit,being either the owner-of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as:(check one)
17
an owner or record title,Title is vested in name of 5TE TEt ) i &Pc'
see Deed Book t i(p page 13 in the Vcittler County Registry of Deeds.
an owner by virtue of inheritance.Applicant is an heir to the estate of •
;probate was in County
if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(I) re/me-apt 1O rri c )v 17o A�+1 ,,,
(2) Cie I ?6A-` 25Z ?i'6A-sot• (?awl— -kci S+..f� C,-L 2-8 qq
(3) •
(4)
ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu--
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
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.
This the 15 day of ,20 Z(
se„, l u ra t .JL
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA per i ' ation
This application includes:general information(this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for$100.00 made payable to the locality,and
any information as may be provided orally by the applicant. The details of the application as described by then ouurteb are
incorporated without reference in any permit which may be issued.Deviation from these details will constitute a violation of
any permit.Any person developing in an AEC withoui permit is subject to civil, criminal and administrative action.
ANK I d 2021
DCM WILMINGTON, NC

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Iv 1 i . D M WILMINGTON, NC
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORING PILINGSMOAWFT/BOAT,HO(JSE)
I hereby certify that I own property adjacerit to -i-t--zuaw MlitolkY ss
(14nrne•of Property Owner)
1-)
property located at L.G.6 7'.5-rp Ws(vi (PotAA- KcA
(Lot,Block;Road,etc.)
on )J ATCO '8A13
,in ()R.r (i rY ,N.C.
(Waterbody) (Town:and/or County)
Applicant's phone II: go-161-6658 Mailing Address: Ei RDS
CMr LIF 11 4 ME NC 2E10?
He has described to me,as shown below,the.development he is proposing at that location,and,' _
have no objections to his proposal.I understand that a pierGooringpilings/boatlift I boathouse
must beset back iminimum distance of fifteen feet(151'from my area ofripariaii access unless -
waived by me,. (If you wish to waive the Setback,you must initial the appropriate blank
below.)
cyoI do not wi§h to waive
I dia wish to waive that setback requirement. -----7--------
DlSCR1 PTION AND/612 blaWilCit OF PeR.OPOSIilb DEVELOPMENTi •
(
(To be filled in by tndividualr s
popoing evelopmen0
..... d . ..: .. ... . .. . .
)\rfl-rk.c.G-e-0
RECEIVED
APR 1 9 2021
DCM WILMINGTON, NC
— - (Information for Property Owner Applying (Riparian Property Owner InfOrmation)
for Permit)
56o U B p as V i ow Cr fe.-.....,,...____ ,,'''/..:..,1_ /91-cilvo<
Mailing Address Signature
CMC1. 14 MitUE NE81127 / /i/) -t-4 A /40 rr/ ro frt
City/State/Zip Print or Type Name
'TO-431 -6656 3
Telephone Number Telephone NW-fiber
-- SlAw---- --. 3-'-41-:- L-
Signature Date Date

. US MAIL . . , .
C ERTIF_TEU MAIL—RETURif RECEIPT REOUESTED -
DIVISION OF COASTAL MA.NAGEl ENT
AD,IAC:E'NT RIPARIAN PROPERTY OWNER STATEMENT
Narne of Property Owners D -c.-d►s-N IA v `A.Ki — --
Address of Property: '64 pClti N Sevt 'Po t 1t► T.D , 5r.:2F Cc-rt.? lie
(Lot or Street 4,Street or Road,City.&Count•)
Applicant's phone# ct(b-li3t- 6 65s Mailing Address: 5-6 b 2( R i r2 D.S V;am.; Cr
( A-sru )4A-YPE - :NC 1su z`l
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit
_�Alas-ciesc :beri:te me as-show: ,�;<CRe ath,ain:v sir iwii g=the-dam: opmert they-are proposing.-A description offira ijiw; - -----
with dirriei sions,.must be provided with this letter.
0----> lr2LAA 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 Est..
Wilmington,NC 28405-3845, DCMV1 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 uude stand that n'pier,dock,mooring pilings,breakwater,boathouse,or lift 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 th e
approptiate blank below'.)
,//,-1 _I do wish to waive the 15' set back requirement,
I do not wish to waive the 15'set back requirement.
(Proper wner Information)l.,
(Riparian Property Owner'reformation)
Signature Signature -
S - vtT. ki2it A ti25. .2. ,Jo ('G`,c3/1..
Print:or Type Nam. e Print or Type Name
So .13 i a s Vt: Cr c27 ?sA fot4 r
Mailing Address Mailing Address
e c LI— 14- i vU I C: 2 yZq S /' G o2 y -
City/State/Zip City I State/Zip
Telephone Number ?.Ib-43 I� 6 SSA Tslepiione Number.�3( �P >17 9-3
Date 5.2 l • Z I Date — r' tiz i
RECEIVED
127 Cardinal Drive Ext,,Wilmington,:North Carolina 28405-3845
Phone: [phone]\FAX: [phone]\Internet: wm.nccoastalmanagement.riet
An Equal Opportunity 1 Affirmative Action Employer—50%Recycled110%Post Consumer Paper APR 20 21
DCM WILIMINGTON, ANC

• .--RAD4EU-ItER--
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER0100.R.ING PILINGS/BOATURTMOATHOUSE)
hereby certify that I bwn prbp.erty acljacent to1/1.iitacA
(Name of Property Or)
property located at 2 C2 G? A -1)61"-i RC:k
(Lot,Block,Road,CC.)
On I.A)clers in S
,N.C.
(Waterbo ) (Town and/or County)
r,
Alplicant's phone#: CIO 4131-6656) Mailing Address:. _56611 .r011-3
tk- kr_ XrC Z-86/Z7
_ He has described to me,as shown below,the development he is proposing at that location, and,
have no objections to Ins pthpoiit,Taderstandiliafa:Pier/trioorinpiliriks I boallift/-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 •
gto da wish-to waive that setback requirement.
DESCRIPTION AND/Ok i)P.A*1*= OF PROPOSED DEVELOPMENT: . ••
(To be filled in by.individual proposing development)
- - -(infol-mation-fcit-Property-OwrApplying (lZiparian Property Owner InfOrm
for*Permit)
tic,„ ct v.Aki
Mailing Address Sigriztur
CA- I 1- C- Zc i9
5 c ciTtc 4
M, Ofv/Gse_' _Po
City/State/Zip Print or Type Name
9,10 Lai-66 SS
Telephone i tuber Telephone Number
32/ '2 1-1(71/4
Signature Date RIV.IVED
APR 1 9 2021
DCM WILMINGTON, NC

US MAIL . . . . . . ., ... . ... .
CERTIFIED MAIL-RETURN RECEIPT'REQUESTED -
DIVISION Or GOAS'T` .L.MANAGEMENT
•
• ADJACENT RIP_ AY PROPERTY OWNER STATEMENT-. . .
Name of rOperty Owner: S-t-F,teR '"\ v^-Rih-( _ -
Address of Property: - 266 '" -TV._I N Soiv ?o i ivT .R D r SP*it e t;
(Lot or Street ii,Street or.Road,City&.County)
Applicant's phone#: ?(b•-1i31•(e65. IvlailingAddress: - c '1 .3= R-Ds View Cfi
['A_571. /4-A'iJE NC 2&41z 1
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit
__-_ has described to mesas shove on_the attach.ndJ.+rswing:-the development they are_proposin -_Adescriptior afslrawin.E�___�--
with'ditriensioris,must be provided with this.letter.
fl,..—
� 4.0..P.4 I have no objections-to this proposal. I have objections to this proposal.
If you Diane 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-E>_t.
Wilmington,NC 28405-3845. D..CM representatives can also be contacted at(9I0)190-7215. No response is
considered the.sante as no ob#eetion if you have been notified bv.Certified Mail.
WAIVER SECTION
I understand,that a,pier,.dock,mooring pilings,breakwater,boathouse,or'lift 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
appro) '~tte blank below.)
7 I do wish to waive the 15' set back requirement. .
I do not wish to waive.the 15'set back requirement.
(Proper- wrier Information) (Ri aria Proper ner tnforma
Sig
nature
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Print or"Type Name Print or Type Name
5001 1Z i tt.D.S :LW C:I . ® V 1\1 15"--
Mailing Address 'Mailing Address
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City/State/Zip City I State f Zi I
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Telephone Number 91 0- �3 I p Pr' b Telephone Number 7( ( ✓
Date ' , 2 1- .2 I Date .
127 Cardinal Drive Ext.,Wilmington,North Carolina 28405-3845
Phone: [phone] FAX: [phone]I Internet: www.w.nccoastalmanagernent.net APR 19 L021
An.Eavat Opportunity%Affirmative Action Employer-50%Recycled 1.10%Post Consumer Paper
DCM WILMINGTON, NC

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COMPLETE;THIS SECTION ON DELIVERY
SENDER:.COMPLETE THIS SECTION . ,' .. .
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IIII Complete items 1,2;and'3.
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• Print your name anol address on the reverse Cl Agent
• so that we can return the card to you. ..t .4.4rid 7--zi •ddressee
B7eceitred by q:26ted Name) C. D a.of Delivery •
• Attach this card to the back of the mailpiece,
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• or on the front if space permitsA(/cA4. O
1. Article Addressed to: D. Is delivery address different from item 1? isi Yes
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III miliElliiilll 11 I 11111 1111 III %Certified Mail® Delivery
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i L.,eisurea Mail Restricted Delivery Restricted Delivery_ _ __ ___- -- --- I (over$500)
' 7020 -3160_0002 _20
Pb Form 3811,July 2015 ligh,17530-02-000-9053 Domestic Return Receipt
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SEINILYER: COMPLETE THIS SECTION . ''COMPLETE THIS SECTION ON DELIVERY
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111 Complete items 1,2,and 3. A. Signature
•11 Print your name and address on the reverse x7e___ 0 Agent
so that we can return the card to you. .----- 0 Addressee
91 Attach this card to the back of the mailpiece,' B. Received by(Printed Name), C. Date of Delivery •
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or on the front if space permits '
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1. Article Addressed to: ----,...
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D. Is delivery address different from item 1 0 Ye.
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If YES,enter delivery address below: 0 No fin. /Norf.
eirt kte. _ . •)
. Olo 4+1c' 1)
• - - u
S P ci, 2egit
' 3. Service Type
0 Priority Mail Express®0 Adult Signature
Ci Adult Signature Restricted Delivery OCI RReigglIsstteerreded MMaaillnRestricted
7.Certified Mall® Delivery -
9590 9402 6005 0069 9559 64 0 Certified Mall Restricted Delivery 0 Retum Receipt for
• • -. • Delivery. Merchandise
70 -I Delivery Restricted Delivery-CI SignatareVonfirmationm 20 3160 0002 2097 6258 an 0 Signature Confirmation •" . -- Li 11151.11E9 mall Restricted Delivery i Restrict,PS Form 3811 2.^ (over$500) ed Relivery,-July 1v PSN 7530-02-000-9053 -,_, ----'1., 7:Domestic Retum Receipt
•
RECEIVED
APR 1 9 2021
• IDCM WILMINGTON, NC

., 4,*„:,..i.o.:_tiositivivz,, afiviii", z•
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. 141041, .
• . • • _ ,
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CtRTIFIED-KML-.MTURNRECEIPLUE . ,
-— . .. . ...
' .DIVISION OF'COSTAL VAN-AGPVIOT: _
AIMAtENT'RIVARIOPitoPEVY OWNW:.$1',Alti‘ifIENT
N4roo offtopOtty:Owi : 11 El*
Address O-f Property 26 ioet-ors1 '—a' Sc-it --e::1----,,-F•q--.1':
ttc, •
. ,
4
..„_. .,..__pOittitnetvivoliel! W4317 44,-)-V 'M ailing Addiess: -'•-----=------- -°''-7-7:-------t--AI*.if ' 2'11r — --'1. H-- ' '
. .
,e.
. i7440i40YrdiillimillOi;0Kiiiiti4 to 04!-IiitioV6-0'"‘-i47:47.: r"e'rillelii444i4""4 . 474*-1 "!
... — hes,*6titleo tti,tne-es.stlo*.1 4;:41:t,pr,,-*;:qmwmg:thd,d-cycipppienr;:thOtire-0coposingi A 4Pk:riPtto jukfltra NP:10,
with dfinciisiso§,•-rriiistii-dbiovidectwitivitiii:tettm . .
. . • . .
-'7>:'' 4.)4/4‘ . Ibtive:lice objections to this proposal ilia;ie objections to this proposal.,
If you you have objections to wkatis being proposed,you:n potity9*,D_! tsion of •Coastal,Mat4enett(OC_K,
)
, .,,.,, -,-Drive-,.: .:
iii-writii)tivi.'thin Wday*O.:00iO4 iwnotio. Corte,s044pocctimb!i#Ailidr71i21:5C: air I 1 1.0 otirt.
Wilmington,NO8465480 DCW:retiiiientetNese-hp also ho.e0toefecl at MIDs19 -,.-_. , . 0 MP._ _.._ .
:Consideredthesame.as,no obikiiiiter you have boep:notif10131,-Certified-Mail-_
... -. .. , . .. , .
WAIVER SECTION'
- ' be a miliiiriuraidittitilda,Of
I understand that dock,mooring iiiiiilgs.ti0014-..*:§010*#4. 13ft must .set, back .:. ..„ ---
15!:from my area of tiriatiattleoptvoless:wa(vect by me (If you wish to.vvtheti1.0-s4bacit,you thOstinitiAtto-
approolifolitaiikWbio:
. . . • -'-'''-'''.
_ : eefri, idd Vviitittf waive-the I. ,!vt.back requirement. - - -
V•
,.,., . .
' ''
. I do notiwfsh,t0AvaiVethe<-15';abut;aviTeropa
(1690ei: Oe-1414thil#004
(Ritiariait Prolleityi0itner Itufotzolioa)
_.. :
..I\-.._ - -- - -,,------- -4-,' ./A•70.,- -Aiii--1,,,,.. .. ,, . . ,
. .
------3sitio.. ,. - Signature
, i)St 14\ al*
asti
-Z
-- -- - - • - . . .. -,,
.
pfidor Type,Ngme Print Name
,i - -
GOY 13i g DS VCC44 cr 9V .,,i4A3x :s. Rote...- g/- .•, ,
ail re
, _ .... ...,.
City/State/ZipC)741".,.. :
. _. - ...
PAYI:Statel ZiP
Telophone Number ?16-.443!744:5', i g -,) ''
Telephone L‘, --‘r7
Da*. ,5-21,• Z.,t Date
t2/Cagilemtbsive ext,,.Wiiming!oe,.Ncelh Carolina-28405.3845
Phone: [phone] WAjt 910-39.6,3964:1-Internel wtWcn00004taknonagementnet
,ip EgoaloppoOlai(v.VAffimatti!o:ActlatoriplOor-5öwReoicto4A**Post Consumer Paper.
_.

• •
. 4EtwER,,.
.. .. • ..„,. .
•
ADJACENT wrotAst PROPERTY OWNER STATEMENT
(FbitA:PIER4100.00-nitivelse:elitNirLIFT/BOAM0110)
'therbY-certiftthat I owitOtCPrtY adjaceatO _Si's- WEN_ Ku:WY is
• (Ikligike•pf POp6rty_OWnell • . .
, 6-1
property located at :4(a 0 . INTY-figort P:s5t4 tt."01
(Lot,;Bleeki ROad,.etc.)
•
on Art. Vt1 Atag, 13n ,agc:
, .
(Waterhody '- -ffown and/0 0)11;4).
1 :_,
Applicant's phone!!' qib7:q,31. : 458. Mailing Address t- - 5766q: igi 1
i2j)s: gi:041
CAsiar# 441'0E' AC..2.$401
He haadeseribed to.mei ap,sliewn below;the development he4:prepoSiagg,thatiooation,andil•
have no objections to his propOsili-1'.uridetatand:tliat a pier/mooring pilings:/..botit lift/boathouse
must be set back a:rOiliimiti:distInce:of 4fteenica(1:51:ftm toy area of itiOari7dotess:unlesa.
waived by me. (If you wish to Wake,the-setback;you must initial:the-appropriakhlank
beim)
. ,
I"de not.wish:to waive
_ .
,14/- Iwish to waive - _ -a
-.A\., -•,-- , .do ,thaysetbck requnument.
„opr, . : . _ .
oi",,
(
tor
. pr,scRfrnoiTANDJOitimik**6 pii:fticilitisti)Dtv-toitriorri- — '.
. .
, „.•:- (To be- filled iiiiiiiiii0calproposikt ekvelopment).! .. . . ,.. ...
ik fkL8L;EA,.
-..........,............._.,..:.,....4.:........-___...........:.........,...........:.....„............,.........,_____.......:...,...,.......__________.,
(Information for Property Owner Applying, (Riparian Property Owner Information)
for Permit)
5,15ti Baas i4
Maillig,Address- , Sigoatgit'
.66n-C-, . AMIE Xce.81/27 A'AzI -.44 44: "tart 7 rioA
C
eityittitelZip Print Of Type Name
16--431-6658'
Telephone Number Telephone N umber.
'ill( 1-/'
Signature Date Date
,

- - - - -
, ..
. 1:1S. MA114.
. ,.
•
- CERTIFIED:NAIL,--.-•RETURNItECEIPT.REOIJESTED. -'
.,__. ._ .. ... .. ... . . .
PIV$1.0.0-91!'::COA04:0ANA4Nit$17: . .
ADIA'COtligARIANIP:OARTY OWNER STATEMENT
. .. . r“, • - .
- .
.galtle.,of Property Owner
Oviitner.:
Address.OfProperty: , _ 2'q-0- ,1*TYH,(1:4-4: : _7P0..,t114t". .:R1) •s„- -0,0s.,,,t7...f . , ,. ._.• ,,
(Lo:or$0ee.,t1;•Sirget•or li.pa4,:c*.;$;:Cotti41
Applicam)41tertek CtP.'ti.:3.b4::4,s0; . . ,MEtilingAddttsk ‘a 04, . 1::‘RS4, •-••14Pt`i Cf::
Covs.Ito. ItAto4t. 0'e-• z.,, .m?
. .. _ , . _.. ...,. __. . ._ .: .l . .
.. .. . . . ,... .. . ..., ,. . - .. _ _ . . -. - ... „. . • . -
"1*W*.eeti OA a t' -'c;,1,74 j*.Operty:e4jaeetif,tn.die'abOe--rerelenee4 piopert. . The,liiilliiii14(apt014fOrg4s!petrilt"
has de4cribedlo•me.wsiteM on the'ettaehethfrawing t6e,iiti.relbtinient:they;fee'proposing'; kastideiwotitra sjittg_„,
ii4ith.ditnensions,.must be ortivided.4ifji this letter.
-- , •- •-- • - •"
et,?, -,,114.014: I ifave.-0?obleptioot to this proposal . , t have otijoctio-4,to this proposal
_ ._-•-•
Ifyciiiboe Oloqtong.fiywhni-Winint.propost4,1...pu must notify the Division of Coastal Management(D014).•
in writing 10Ataysi.rof;'.0ceiptinfthineiice Correspondence should be mailed to I.27 0401.101 tliY#:fixt;.
WilMip.gmlliiN.0:Vi405,--3.'64 .. liCM:reOrefientatiiiis,can,also be centacted.at(910):19642M No response'is.
ottsideied,theltamer.'as,:ttb-ohiedieklf.4ron have been notified by Ceditied-Me it., . ..
.... ... .. . . , . .. , . ..
WAV.WWTION. -
I understand 1bat kokr,,c0pie,mgorin&Pilings;breAwMet•beatbquAei,Rrlift:mu,st be*tbackastinhnuntdistmIce4.
1:5?-fivn-foAzqa.of riparian aceep.eniew•walyed by-Me, (if you;wiskio,waive t4eOtbacjcat,•.p.:pkgsf initial the
. appre i •' te blatilc below)
. . . . .
Aceitc -.. I.do wish to wat"c the IS''set back requirement..
' -l, ' : _ • Lao;Ilett*itil to Waive til6;151 et-back.requirement
(recipe': ` ' ivnerIntertriaiien)
(R.ti iia Proper . - ner
_ . . . . . .
Signatu .• .-' -'• Signatbre
- II. • -A.,,,' - ' '
.. .
FA 17:tit.v _ikM: _
..„. ..,
Print or Tylie,Name '' ' PrtutorTypellaMe
Si.6,04 StitOS• V-.;••04 Ci _ - 421 t' l
Mailint.Milreig' . Mai hfigAddrest.
‘ i. „‘„,.
1-;•
a tbi!'S.T4t- 14.Att.o.„ - N,L 289Z-1, . 0.ikkum104 .fk.' tRilea.V. . •,
,., . . . : . . .. .. .
:.. . .. __. _ . . .
cit9ftstate'tZio _ City/SWe i Zin):: I
ai. LA-›.1 r' i c 9'
Telephone Number -I. [0.7' -4 oirtiii.Ili ,o Number [0' 549- . 7 Uti 1'5:
Telephone '_ .-..-'. .: .' ::
.!
Date 1.1. Date 1474
, . - .. . . ..
121".dardinilDritie ett,Wiltolopg,,Moilh.Carollna 2845.415'
PhOne:'.9.104964i10-,FAX: 9111;395-3964 t-lhleMet..0Ankttcitalmanagemednet
An Ec41411000npaitegArritaiive AOPtiEOpttlyet-50%Rete.b14%UM Post COLiumes Paper:-
.

• urtRin_n' t IVFR
ADJACENT RIP01AN ' tOPE T' 'OW IERSTAT)sMENT:
lT olt ii PIER%06.1ti 4FC PII..iVds'lifttAT? .�'k'?'l�O�10;0 ,
40)
I�hereby certify°that_Y own propertyadjaEentfd •.
• • (Name:- . of Property Cher}• • .
ro erl loca C�fr P4.�,k : K Ida .►�4 i
p_.p y Ot tedat�-
(Loft73loc)c;Road _ett�c)
` rN C�
(Waterbotf )_ (Town,and/or.County)
8 _ . 50oc1: a.ro tteui C
APpticancs Phone _cl qtd �-3--- 6,-. Mai mg.Atldresss-
((v.Fk ik (u c, auzq
He lies described bAiie;ag-showitl Blow:the•developrrieitt 12e:-is:proposing at that location, nd;1 _
have.no:objections to his•proposal;l unde standUtiiat a_pierlmoorrig-pilings I boatlift/bsoathousi
must be set back a minimum dista ce"of fifteen feet(1:5')-from n y;area of riparian access unless
waived by.-mc Cif you wish tie-waive the•setback,you must initial th e.appropriate°blank
beIow.).
.: I:db riafwiish to.vuaive-
I'iio wish to waive that:setback regwtcment. _
• ,DTSCRIPITON:AND/OR',Og4WiN (01,*(0$ 1�-iitArttiaViVIE tri'
(Ta be filled in by�lndivldualproposing developnt en) .
p:,,..i.i.„2.4.,..k
. ._ _ :: . ... .. .: - - . :-.- _. - : ,....-- ,,. .-,,..
(Information for Property Owner Applying" (lRiparian•Pr perty Owner Inform tied' - _
for Permit).
53,yt R e
tf
_ . -
Marlin -Address' . _ .. Signatur
F K _At ?6,- ' -
:City/StatclZip - • 'Print�or Type�Name
to' ----(e--3.:' 740 Z
Telephone "her
Telephone'Niiinber-
f(4vi
Signature Date. Date

•
' — •
SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVER't
COVOtelbarns1; - • ' • 'Afilnatir*
_ ._
oc-FitO Y.0*Titetiatindtio.dem tovritroe (.7.4.10-4
SO that A-stacart 03414#44*ft°you.
AtthOttlits-ciddiouteladkitltb*milltigotei B.R!*010d:11`YR44200***" C. of peuvj
or on the front II space perntlts. r ,.
••-• , .
1.".Okla Aiickette;Ittii :CX,10;1*.efteddit-s4 di7igetAtcli,Ran 1,
40,11e. .
All' - .0iYISSOnter CkAgtitiCAM*4410Ve •at40
774, *I* 1?04.
et, 4'1 2:e44.5
• .
00.,i100,61,tkii..,,p. •
11111111111E111111111111111111111111itill . EfFteglp*ditar!. 5
'AikaSignitrilliatiictid beitity. CI Registered MO FfOtl •
WM: .1:10uvpry-
959(194026005406995,5044, .aCciMaOWuiyReturivRecalpt
. r• - •" Otgia 000,Y,
' _ - - 4D.direeP rl,N'gneg#01"*Illanal''''
tie II31600002 2017, .138.54. Si 0.41grafitileirOiagan.
- RestrIcted Demty
PS Form
81.1;:JE4*-4110'F4170(!*400cittr: ' '
- •. . - - - -
SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
a
C04,100 Jterns mita; •
PA* and'40-41fISS,otritio iwerse , _
sti that we critk:ret -th.e • .
AtOkdh this-cald1000 back of*wog:110*e. !'*-Ate:p
orAtt ffie front ifstiat.cfpormits. _ Vt;, ,
_
Ec. crePdy isOrp*Oleitilitsmitt .yetk
- , g Wimp
m;enter delivery 101-1Nin
13•4-44'. • ss
Segal . •
3. soive, I:IVO:11410
Add%situ",
1111111:11111111111111111113111111111111 'PA0.1:sk-aboRrsosb..60
OtOrtifloa megfiedriqed Oliver/ 0 9040'wing%
9$94,940 -,..6005.0069 9559'71'; 7-merchiroo
wive Bo:ow periay rksiona*.ookroofr,
. .
'pi 002 t1977' 6241- IA -- so%--40.contrnoxt-
ae,., roam MipisirkAiiiDow Rintiktid,Odkor
DOmaisktfiet0 Reoilpt
for m73811 jU41-20 15-PS14. 7t$4162.006•9053., , •
_

•
I:ocaht'.
. . ; PennitNuneber;
• .Ocean:Hazard Estuarine Shoreline, , ORW Shoreline - Public_Tiust Shorelines - ,:.Other--,
- (For ofcial erseonly)
GBNERAL:INFORMATIQN
LAND OWNER MAILING'_ADDRESS'
Name_ Strktt - - ' s'R R•.I ' `
Address . 3`t,l(Otf J ,iZ0 ._ _ _- _ ..- -v _ _ _
City rA I1 . Ei-ks(t - State .L Zip '°I Phone --;PE VO." Z,�' g ' ;.
r land'_ - �=i"e.`tc=V 0 1 utra j WLaa :.c Ow1 -
AUTHORtZED;AGENT'
al& 1 `•t•
Address:. -- ..- .. ___
. State, _ • Zip __ -Phone;
City - _ . _ . _ - ._
•
•
Email':.- �. ., _.__..- _ _ _- _ _ . _ --= . __ —
r
LOCATION'OF PROJECT:(Address,street name and/or directions to site,name..of the adjacent,waterl ody)
2 QQ_
1.
DESCRIPTION OF PROJECT•(List all:propsed construction-and land disturbance); _ ,
4 _. ... �:i/` ( ')
_ _ ,- o 0J_ .F oc ...- ( (s f 6$ ., _ . .. _ -_
SIZE.OF LOTIPARCEL: :8 Gait_•,65: square feet, acres
PROPOSED v4p.,...44iitentiOlt& tSifigte4andlyk Multi-family El) Comrimeretal/Cndustnal Q Other Q;
COMPLETE`EITHER(l)OR(2);BELOW:(Contact your,-`Loot?-gemit Officer if you are not sure w141 ABC applies
• to.yourpropei4):
(I) OCEAN HAZARD AECs TOTAL FLOOR REAOF PROPOSED STRUCTURE: -t" square feet(includes.
air conditioned;Irving space,.parking;eleyated above ground level;non.conditioned'space elevated aboveground-level.but
z` excluding non-load-beanng attic space).
1 (2) COASTAL SHORELINE AECS:SIZE OF BUILDING FOOTPRINTAND=OTHER IMPERVIOUS OR BUILT
(1PON.SURFACES square feet(includes.1hwarea ofthe:foundationofall buildings,driveways,covered.decks,:
concrete:or-masonry patios;eta .that_are-within the applicable AEC.Attach:your calculations,witlirthe project drawing)
,
STATE STORM WATER MANAGEMENT'PERMIT:Is the project located in,an area subject to a State
Stormwater Management;Permit issued by the NC.Division of Energy,Mineral and Land Resources(DEMLR)?=
YES_ 'NO _ ,
If yes,,list the:total built zpon area/impervious surface allowed for kink lot.er parcel; r . equate:feet;
F
I

• •
•
0111S:R:PEPHISVAYAP:;:.11iF*UPRERCrit:eatOtit*Y410;11111101.**Yr.t040ifei***Otheffialt die'PA
• _
minor developznentpemut,including,but not limited to Drinking Water Well,Septic Tank(or other sanitary waste
treatmetittyiteni)-tiiitdint,teetricaki.:011inibing,,,geating and Air Conditioning,
FiA
Certification,SO4))4*S144.00 CitintioL:Sigidl*IS4*-'41***14444)bil0'.1tio*-TOkkAlif084kfilittii*:0500,(ion,:anit
oiliew.dhodtwithiyouttocall'ennit-04ertfigoore4iitonriatfork.
STATEMENTIWOWNERSIOPe:
Itihti,undersignekait applicant for it:C:At4iii.Mintirtlevelopmpn(permii;being either owner ritinvpetty jiyott AEC or:3
person authonzed to act as an agent for purposes of applying ibr a CAMA minor development OdiMiti;certikthattlid,Peittin:
11,0,04.1412,0dovAct on thit application has a significant interest in the real property described therein This interest can be
ttan owner or record title,Title is vested in name of 517ttitt4
see Deed Book
-0(0-A _.•_ __ County Of!.0440-4.
, .
;411:ciiitierti8tfttite.of inheritance4 Appficaritii-a*heittlithi,Sta*Or - --
,probate was in County
„... if other lotemst,„§14..as.wri(te.w.contiqcorlegsei,explaiirbelovorusettgp.argqsheoplkatfackt.qttikappli4ti0;.
10..TIFICAT1011;pFAVACE.N T-411!ARIANIRPPERTVOWNERSi_
t,_tigtiteitilote_.cett*tititthef011bviing goson*ote,ownert0-propertios-adyistning,thig-ipropertylt affirm*41 haw;given„
APTAfg,iNOTI_COtO.'0ach of**OriFtriiiiii'm intent:v*016p this property and-:(0'OPOVfeit it,tAmAptrniit.
001.0); (Ack.k..041,
_ PA . .001.0t$7_
(z)_.,:c64,1„ . _ .25t, /44E.s.s _ _ 2g,44g
— • . _ _
_ .
..-AOK:NOwpF,,,DogItiENT&
1;.-ii*und_epign04.,#cf.cngwiddepli)4th,eloitkovnierkkaware-.440t theofeoestittidevele#004*016004fofan area which
iiiarke:SgscOtible:..tto erosion.and/or,floodinw'Igkno_wiedgp,that the Local Permit Officerhas explained to'me,ttio;ortidw
takhaidict pritiblenisassoi005011ftliii-10..liitkexplanatiortvat accompanied by recommendations concerning stabihza.
tionandflidproflflg techniques:
I filciher.moroipdrtifkihat t.arp:autkiri*d tograflt,and do.iktiptgOtit4tetti*.iti!i to Di*.410-.of COalstallytonolgOnOit,gat,
the LocalPermit Officer andteiragents to enter on theiforernefltioned lands in connection with eluatmginformation
reikted
,
This the day of._„.
•
,
r*Oinvrier Or person autbozjzedto act shiiher agent:Tor ppn1006 offilitiviCA148.-pe
This application Includes gener4tinform0100,(041600);, 1100k01010tEe.,d0serifiedeittlie" ack"OfEkig'aPPlicd#014the
ownership statement,the OceanHazard4EC.:1.41.0110e Where moeFewxa chgc1c-Ar$40400.;igtgki)0.046kr04,he'lo*gifiA,ond
00,Ehliriikitioeae:niay-lieptoielegl orally to. theapplicant Thedetails ofthe:opplitationAtliescrfb9d*Mese,goureg;:oke
Incorporated wilkoul reference in apypermIE:1010h may be issued.Pelit0100front_theie:404illoill0eithillitte4ilalatiOatif
apypOrmit.ApypersowdevelOpingfn anAEC3vilhoalpermitksubfedi(O'cil-44‘01m.hpaland`OWOM.V.tivgfictlOik.

Check
Date Received Dery Deposited Check From(Name) Name of Permit Nobler Vendor Check number amount Permit Number/Comments Receipt or Refund/Reelmeeted
-
Columns Column2 Column] Column/ Cokrmn5 Columml Column? Columns Columns
4/27/2021 Andrew Grady Gordon I Grady Gordon First National Baml 1015 $ 200.00 GP#799100 TP rct.12801.
4l2712021 .Chad Tracy same Wells Fargo 105 $ 200.00 'GP#799470 8B rct.13107
4/27/2021 1658 North Howe Street,Inc. Jhn and Beverly McCloskey 1BB&T 1586'j$ 200.00 ,GP#802290 Tmac rct.13541
4/27/2021 Steven L.Cobb 1 Steven&Robin Cobb IFirst Citizens Bank 1533 j$ 200.00 GP#799090 PA rct.12762
4/27/2021 JW Harrison Mechanical Inc. !James and Karen Harrison IBB&T • 5748,$ 200.00 ,GP#802610 PA rct.12764
•
4/27/2021 Town of Oak Island j same BB&T 83802'$ 200.00 GP#799540 PA rct.12759
4/27/2021 Coastal Marine Piers Bulkheads LLC (Ricky Hancock Wells Fargo 23815,$ 200.00 •GP#802380 BH rct.12879
4/27/2021 AMW Docks and Marine Construction LLCiPhillip and Cythia Price ]BB&T 6202 $ 200.00 GP#799040 jBB rct.13108
4/27/2021 Bruce Marek,P.E. Bald Head Island Ltd. •Wells Fargo 2105 $ 200.00 GP#801440 Tmac rct.13543
4/27/2021 McPherson Marne Services,LLC 'Robert Frankenfield First Citizens Bank 4042 $ 200.00 ,GP#802280 ITmac rct.13004
4/27/2021 CLTMC,Inc. 1Kerry and Kristin Blanchard First Citizens Bank • 1184,$ 200.00 GP#802620 iPA rct.12761
4/27/2021 CLTMC,Inc. I Denise&Kirk Kloeppel First Citizens Bank • 1181 $ 600.00 GP#802640 PA rct.15757
4/27/2021 Duke Real Estate Inc. I Gerald and Cathy Duke Wells Fargo •
4836 $ 600.00 ,GP#80257D IPA rct.12760
4/27/2021 I jSea Dog Marine Construction,LLC 1Sae Mist Campground First Bank •
1287,$ 200.00 GP#60274D IBB rct.13104
4/27/2021 Steven William Murray jsame PNC Bank •
1073 $ 200.00 GP#80254D JD rct.13409
•
4/27/2021! (Bob Drach same Fidelity Investments 1328,$ 200.00 GP#802390 iBH rct.12878
4/27/2021' Coastal Marine Piers Bulkheads LLC Singleton&Sebrell Coupland Etal.Wells Fargo •
23785 $ 200.00 GP#76166D IPA rct.11599
4/27/2021' 'Grice Construction Davis&Susan Thomas BB&T 14500 $ 200.00 GP#80129D 'BB rct.12994