79926D - Clark

toECAMA/ '❑DREDGE & FILL No 79926 A B C
GENERAL PERMIT Previous permit#
ONew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 61 7f/. /oZ ot7
❑Rules attached.
Applicant Name 4h'7/h'tl C/a%/ Project Location: County /J`L/jszi./,(
Address !,., 15h/6i ,Kr...f Street Address/State Road/Lot#(s)
City Ord( 7mrk-(' State /1/C ZIP ,*Q(S SGvVv vri.-
Phone#( ) E-Mail Subdivision
Authorized Agent_ceo Ppy /f 2a`,'r...0, City -- ZIP ---
Affected ❑CW STEW le PTA ❑ES ❑PTS Phone# ( —) River Basin Gbh'i/sr —
❑OEA E HHF ❑IH ❑URA ❑N/A
AEC(s): PWS. Adj.Wtr. Body Dow,S ( (nat / i6-0)/unk
ORW: yes / no PNA 0/ no • Closest Maj.Wtr. Body /Zi''> fl t•rr,I'G;y ' t'« `C
Type of Project/Activity Pro 1Y:C.,,v, ib .iVISi'J( 77 f-- d/C)i-Fi4-- a y)G7 -4r / 67,,L7S€T,,4-/y i- 7
peel l(�y/r/ q j ii`7i 4a.y4.. , - r'' �.5 (Scale: A4 S
Pier(dock)length.. +
Fixed Platform(s) x v A Ai.u1,r+'+ V 1• '
Floating Platform(s) YID 45.
Finger pier(s) E• i l
Groin length `, 1 I
number _,_._ — .......—...._ ;....._— _
Bulkhead/Riprap : h _.* r _..
—_
-
®avg distance o ore I' Ff Sr
max distance of- ore 4'AeL ?`a Basin,channel Oki 4C
�� ,....t
I a 1 _I
cubic yards ( * P 1 ' Jr,- . }
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Boat ramp I ` `/�
' - .� I.- 42 i -Ilia _ — '
Boathouse/Boatlift • j
littr4—ini ' 77P—L '• .7-- .
ii ,7r. ii4_'1;_7 V- .
�� �,,
i V- j,
Beach Bulldozing „ "�� _ — __ �i:7 LL
Other < l � P f ~// i
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rvcr �✓ 1� •
Shoreline Length fjQ r•
(4s-a p` y/ ''St, kt (4' 'tci i •
SAV: not sure yes �Sd -• , -._- _ =•S'S:T' — }
Moratorium: n/a yes f.... r y_._ I F#GI
Photos: yes �9 l iic ci✓ �i�............ ..
Ip
t a S c, �....!--t t_ ._ r4 I � .... '
Waiver Attached: yes gsli ' > > 1
A building permit may be required by: IC)'i*( ill /-ift, . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 4t f125 07114 1(i i 1 C/() lailiiffRi-s/ -, f( oyyi 74 ?Kr.0
/'S t �4/J sa/�o✓ ? !i c✓ //r kY S�- Lc fnt 7e A- , l-¢+'r c p,',>} r't.-1 ri f f Z K f �ci 4 'i1/_
+ket C7L1 6/44 ,f„,, _,
Agent or Applicant nt Permit Officer's Print Name
Signature **Please read compliance statement on back of permit** Signature

•
(Th ' CAMA/ DREDGE & FILL
ii
GENERAL PERMIT
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New Modifi, on Complete Rocsue Pa'
Pi t.N.. .tis permit
DM('pi es,101IS permit SSlii`._1
is aa,"Cu.zec1 by the Sole of North C.vol ut Droa,-..m.,,,t Qtr IL!,
ano t,e Cauca!Rvsou,,:es t.',,,,,,,,,s ,.,,,a,,as e),,i,n,,,.,,,lie,,,,.. ., ,.. .su t'....) I S A ls,k_A,- i ,.. ','.: i....:(-
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Applicant Name ( .p . ti- t ,',i ,L
Protect docation County , , .., i
Aodress ':i ';t i• -...-
St i cet AcIdtess State Road Lot #1 s.
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State l ZIP '• i.
..ii I. .% ‘..Phone s( i
E-Mail
Siihdivision —
Authorized
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City _
ZIP ---
CIA' .(EW -"PTA E 5 PT5
Affected
Phone # i — --- Rive, Basin ... .. a
OEA NNE IN USA NA
A ECI s
VS1
PWS
Ad! tr Body D:-t , t ORYk' • .
PNA t2,t; no Closest Mat Wtr BodY
Type of Protect Activity .), i.' 1.-/4..... ' I
' ''..1 r i._,_,5 _ /,•„_ILELL. _ ,:f! _, _
(Seale: t^ i )
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Boar'amp
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Boathouse Boathit
4 tA4.1 v; .I 1 "' — • _....l.. ,..••
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"/Fellf)1, v'if
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Other itelfer iC. ft-c ro c 4. /*1
SAV not sure yes &
..,
....
Moratorium n a yes 411:ii
t 1.•
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Photos yet do
0.5 g.vcw. tAt Sig,
Waiver Attached yes el
regar
A building permit may be required by"kaf ilW IV See note On back ding Rises Basin rules e?tr 4?"
(Note Local Planning Junsdictionti‘,., 7 .
i /
Notes/Special Conditions ta 4Ltis% Lill a, (_ 7 "-14"6 11 ---s4,---,_ i---, / ,4-.-,, --'i
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14.-,t-tettoi_,I ,,,, ., /..---'15 ie_i-V , c.A AaV711,7e..,,c1:_e_2•41 i`t tv pie? 7±._.rig_f_y_IL f_c. !!
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Permit Officer s Print I Name
Agent or Applicant Printed Name
acea ‘ Ibte.lit"-'
S
Signature ••Please read compliance statement on back of permitSignature
••
4 ili) 5i/t 4
0. . Issuing Date Expiration Date
ApplicationYeetsr

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72 /CLARK CYn: .. AND
'V
c" / ERWIN k4/NAH I
121 SW 6Tr1 S` //
/
—MCP OF RANK
6'X4C P L k /
EDENS & AUTRY INC
%�" 123 SW 6TH ST
/
/ /~ ',
NLW LINE / 20'
/ / 20'
RIPARIAN LIMIT, TYP.- / / ,� 24*
i WATER BODY LIMIT 456/ y, /
15' RIPARIAN OFFSET J ' /
LIMIT, TYP
15'x16' PIER HEAD /
\ W/ KYACK LAUNCH
BENCH SEATING / COASTAL WETLANDS LINE\ ';
0.0' ® NLW \
2.8' (60' FROM TOP 1.2' ® NLW
OF BANK) © NLW
1)o
SITE PLAN (PAGE 1 OF 1)
N
® MRS.CLARK AND ERWIN
\ 121 SW 6TH STREET C N 10
OAK ISALND,NC 28465
4/4/2021 910.876.08S2

. .
Decusgn Enyelope ID:0AE86872-9806-4845-925E-99BA1 D1 DCD28
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property OwnerCynthia Clark & Hannah Erwin
Address of Property: 121 SW 6th Street, Oak Island, NC; Brunswick County
(Lot or Street#, Street or Road, City & County)
Agent's Name#:Sea Dog Marine Mailing Address 107 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 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. Contact information for DCM offices is
available at httt;//www.nccoastalmanagement.net/web/cm/staff-listing or by calling 1-888-4RCOAS T.
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.)
c
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Progr pwjer Information) (Riparian Property Owner Information)
•-u��pru y
(11/4(.1A , fir
8 180CA29CB.€B Signature
Signature
Cynthia Clark Edens & Autry Inc
Print or Type Name Print or Type Name
121 SW 6th Street 7480 Old Maxton Road
Mailing Address Mailing Address
Oak Island, NC 28465 Red Springs, NC 28377
City/State/Zip City/State/Zip
[e-mail] flarggliff
/1Nc'AVTRy 4AAPT
Telephone Number/Email Address Telephone Number/E ail Ad RGdress ee-M
2/23/2021
IIMIONIIIIINIMEIM
Date Date
(Revised Aug. 2014)

•
'DocuSign Envelope ID:0AE86672-9806-4845-9256-99BA1D1DCD28
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Cynthia Clark & Hannah Erwin
Address of Property: 121 SW 6th Street, Oak Island, NC; Brunswick County
(Lot or Street#, Street or Road, City& County)
Agent's Name#. Sea Dog Marine Mailing Address: 107 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 oposing. k..de '`talon or drawing,with dimensions,mustbe 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. Contact information for DCM offices is
available athttp://www.nccoastalmanagement.net/web/cm/staff-listinq or by calling 1-888-4RCOAST.
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
je—QxuSlgned by: PPiCfLi)
16 tit4io CL
Signa 44.468,4180CA29C8468 Signature
Cynthia Clark Bart Milburn & Marta Dash
Pont or Type Name Print or Type Name
121 SW 6th Street 124 SW 7th Street
Mailing Address Mailing Address
Oak Island, NC 28465 Oak Island, NC 28465
City/State/Zip City/State/Zip
[e-mail] 1111111 t Ce1n
Telephone Number/Email Address Telephone Number/Email Address
2/23/2021
Date Date
(Revised Aug. 2014)

Chock
Dab Received Data Deposited Cheek From(Name) Name or Permit Holder Vendor Chock number amount Permit Numbar/Comments Receipt or Refund/Reallocated
Column) Column2 Cdumn3 Colonne Cdumn6 Columne Column? Column8 Colunrn9
5/20/2021' Lighthouse Marine Construction William Uzzell Coastal Bank and Trust 3759 $ 200.00 GP#80170D JD rct.14139
Lighthouse Marine Constructiopn Marilyn Thomas Coastal Bank and Trust 3765 $ 200.00 GP#73593D JD red.14138
5/20/2021 )Backwater Marine Construction Scott Garmon BB&T 1304 $ 200.00 GP#79986D PA rct.12782
5/20/2021 CLTMC,Inc. Brenda Bowling First Citizens Bank 1186 $ 400.00,GP#80294D PA rct.12781
5/20/2021 Cynthia G.Clark same Coastal Credit Union 4346 $ 200.00 GP#79926D PA rct.12779
5/20/2021 Ralph D Evans •Dean and Judith Evans BB&T 1214 $ 200.00 GP#799950 PA rct 12778
5/20/2021 Jerry Mills Construction I Grace Summersett First Bank 3094 $ 400.00 GP#799960 BB rct.14932
5/20/2021 Warren White Jr. Warren and Gayle White Piedmont Advantage CU 6773 $ 200.00 GP#80104D BB rct.14931
5/20/2021} .Grice Construction John,Cynthia Jones BB&T 14600 $ 200.00 GP#80208D BB rct.13123
5/20/2021 Backwater Marine of NC LLC James,Elizabeth Gibson BB&T 1306 $ 200.00 GP#79952D •BB rct.14930
5/20/2021 Jogh Debell Jr John,Pamela Debell BB&T 8762 $ 200.00 GP#80102D BB rct.14929 _
5/20/2021 Logan Marine,LLC Keith Batten BB&T 7378'$ 200.00 GP#80101D BB rct.14928
5/20/2021 Waterbridge Contractors Sports Endeavors Investments,LL South State Bank 6190 $ 400.00 GP#799530 BB rct.14926
5/20/2021 Patrick Antinori Mary Grumpier First Citizens Bank 1099'$ 600.00 GP#777450 JD rct.14076