79981D - Keaney

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\ ` \
GRAPHIC SCALE \ RIPARIAN LIMIT, TYP.
20 0 10 20 40 80 \ \ \\ \ 15' RIPARIAN OFFSET
MNI=11111 ` ` ` ` LIMIT, TYP
( ' • ET ) \ \
inch = 20 ft \ \ \\
\ \ \ PROPOSED BOAT LIFT
\ \ \
\ \ EX. PIER' \ \
1CN \
\ \
EX. FLOATER 8X30' ` \ \'r\
\ \ VP \
\ \
\ \ \\ \
\ \ \
\ \ \\ \
\\._USACOE SETBACK LIMIT' \ \
\
EX BULKHEAD'
G-NERAL NOTES: `1
1. PARCEL LINES ARE APPROXIMATE AND ARE NOT NP-.. a
BASED ON PHYSICAL SURVEY DATA. 10
2. WIDTH OF WATERBODY FROM EDGE OF COASTAL WETLANDS ,-340'+/-. SITE PLAN (PAGE 1 OF 1)
4. FINAL LENTH OF PIER TO BE DETERMINED AFTER LV
SURVEY AND COORDINATION WITH CAMA.
MR.MICHAEL KEANEY
107 SOUTH SHORE DRIVE IV A���
HOLDEN BEACH, 1C 28462
2rzv2o2o 910 B76 6U

•
DocuSign Envelope ID:9FC0D2F7-4DB2-4E0C-854G2849D40D248F
CERTIFIED MAIL-RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWA1VER FORM -
Name of Property O Michael&Julia Keaney
Address of Property. 107 South Shore Drive, Holden Beach, NC 28462
.
(Lot or Street#,Street or Road,City&County)
Agent's Name#.Sea.Dog Marine Mailing Add ress107.SW 9th Street
Agent's phone [phone] . 'Oak Island, NC 28465
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 proposing..A descripfion or drawing,with dimensions,must be provided with this letter.
✓ I have no objections to Ibis proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notrfythe DiWsion of Coastal Management
(DCM) in writing within 10 days of receipt of this notice- Contact information for DCM offices is
amilabieat. orby a.4RCOAS"i:
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, boat ramp,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 appropriate blank.below.)
AV I do wish to waive the 15'setback�.. requirement.
I do not wish to waive:the 15'setback requirement
(RraPelly.avner lnfonmation) (Riparian Pro erty Owner Information)
M.iat,s a kluit,t1.
Signature f tire
Micheal Keaney
..: _.._.. ........_ ......_. Margaritavilte E..l.0
Print or TypeiIame Print or Type Name
107 South Shore Drive 2183 James B White Highway N
Mailing Address Mailing Address
Holden Beach, NC 28462 Whiteville,NC 28472
City/State/Zip City/State/Zip
[e-mail] �y p
Telephone Number/Email Addr�ess Telephone Number/ ilAddress
2/23/2021 laC --
Date bita
Date
( Aug.2014)

. , DowSign Envelope ID:9FCOD2F7-4DB2-4E0C-854C-2849D40D248F
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT. ;
I hereby certify that I own property adjacent to. Michael &Julia Keaney ,
. . s
(Name of Property Owner)
property located at 107 South Shore Drive
on 1CW (Address, Lot,.Block,:Road,etc.)
, in Holden Beach;.Brunswick County ' , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location:/
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
•
WAIVER SECTION
I understand that a pier, dock; mooring pilings, boat ramp, 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 eat SQL der Information) (Adjace roperty 0 er formation)
►SignaturC 4FszEoacz...
•
Signature
Michael Keeney . Rtnwp R Paul Parker
Print or Type Name Print or Type Name
1 n7 Snuth Shnrp flrivp 3328 Winterbell Drive
. .Mailing Address Mailing Address
Holden Beach, NC 28462 Burlington, NC 27215
City/State/Zip City/State/Zip
mpkeanev(a�aol.com pe4.1@Pett4A190 ascn .dke_
T 1 umber/email address 'Telephone Number/email address
Date td'
Datee /
*valid for one calendar year after signature* (Revised Aug. 2014)

DocuSign,Envelope ID:9FC0D2F7-4DB2-4E0C-854C-2849D40D248F
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Michael Keaney
Mailing Address:
107 South Shore Drive
Holden Beach, NC 28462
9104448690
Phone Number:
Email Address: [e-mail]
I certify that I have authorized Sea Dog Marine Construction, LLC
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: boat lift
at my property located at 107 South Shore Drive, Holden Beach
in Brunswick 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:
rittiD.cusgnw by
14OCFFFAF92Ff1W112
Signature
Michael Keaney
Print or Type Name
Owner
Title
2/23/2021
I I
Date
This certification is valid through I I

Cheek
Date Received Data Deposited Check From(Name) Name of Permit Holder Vendor Cheek number amount Permit Number/Comments Receipt or Refund/Reallocated
Cohrmn7 Column2 Cokrmn3 ColumM Columns Column, Column7 Columns Column➢
_5/12/2021 William Wallen Mollie and Bill Wallen State Employees CU 3711 $ 200.00 GP#80165D TP rd.10324
5/12/2021 Michael Keeney same Bank of America 2175 $ 200.00 GP#79981D PA rct.12774
—5/12/2021 SAJA LLC Sam and Jayvee Wood Wells Fargo 7476 $ 200.00 GP#79933D PA rct.12776_
5/12/2021 SAJA LLC Sam and Jayvee Wood Wells Fargo 7477 $ 200.00 GP#79982D PA rct.12775 _
5/12/2021 Gregory Holden Richard Whittfield ,United Bank 5577 $ 600.00 GP#79984D PA rd.12777
5/12/2021 McPherson Marine Services,LLC Ray Martin First Citizens Bank 4159 i$__200.00 GP#75823D Tmac rct.13006 _
5/12/2021 Dr.John A Azzato same First Citizens Bank 10910 $ 200.00 GP#80303D Tmac rct.12888
5/12/2021 McPherson Marine Services,LLC Margaret Wright Wills First Citizens Bank 4158 $ 400 00 GP#801380 Tmac rct.13007
5/12f2021 Logan Marine,LLC Thomas W.Himmel BB&T 7419 $ 400.00 GP#79979D KE rct.13436
5/12/2021 I B and B Marine Construction Greg Sloan Wells Fargo 1734 $ 400.00 IGP#79913D JD rd.13418