80208D - Jones

J1CAMA / ❑DREDGE & FILL N° 80208 A B C C
GENERAL 'PERMIT Previous permit# J
>� New ❑Modification 'Complete Reissue ❑Partial Reissue Date previous permit issued
As aut orizd 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 /2 C'_
I El Rules attached.
Applicant Name 6 t s L -, � , r, �� - .5 Project Location: County CT-A j_ , t k
1.
Address Li—I-
(o 3 ! ku-,--.(' ---, /-•• AN (2- 8- Street Address/State Road/Lot#(s) 11 0 i
City CD' ^^ State ( ZIP 2 "]Z 53
Phone# I <_ Z I(-I U .\-( ( J )AA c., j, c ^. Subdivision
( l � (PO I11 E-Mail ) J�
Authorized Agent `-�J c (1 Gr i C_k_ City F (S/� /3e-. c f. ZIP 2 ?`1 \o y
Affected ❑CW A EW $ PTA ❑ES ❑PTS Phone# ( ) River Basin ` 5
AEC(s): ❑OEA ❑HHF ❑IH 0 UBA 0 WA Adj.Wtr. Body ( ,^ ( (nank
❑ PWS:
ORW: yes / PNA yes / Closest Maj.Wtr. Body ( W
Type of Project/Activity \ L.. \u, -. - c :�(i r� i 2 �v/ ( L
(Scale: 7 S )
Pier(dock)length 6
f
Fixed Platform(s) P' X 1 2 i i i 1 I i
Floating Platform(s) r,
L. r(2 e--"'N
I
Finger pier(s) ! ,` I
Groin length jji�
number
Bulkhead/Riprap length 1 — _..._!__._.._._ }
avg distance offshore L(t A ` 2' I
max distance offshore
Basin,channel I E It • 9 i
cubic yards I i 1 $ ~�+ VS ( {
Boat ramp j
Boathous- III' y f 5 ff r ' ._
t: rY
I
Beach Bulldozing ` I (. _ CO 1
{
Other ( f 14-4 •S f , A id
Shoreline Length So C f
SAV: not sure yes ( no f 1�\`1♦� O✓12 S t/1 c`
Moratorium. n/a yes n I 1
C-
Photos: �i f —� I 1
Waiver Attached: ye ,no
A building permit may be required by:_ O 62,./•n (S(C 6 e G C in . U See note on back regarding River Basin rules.
(Note Local Planning Jurisdictio 11 l
Notes/Special Conditions —Mack.^ C�c ,1 i tr'\, n ‘} -t K.(�[-a- e 1( ck i, e r-'• Y�:.� (;r i C,
n 1� 1�f a r \\
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Agent or Applicant Printed Name PermitO rinted Name
Sigma **Please read compliance statement on back of permit** Signature

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 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)

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: A r ►L �d Nis
Mailing Address: y7 G 3 -Tit#atps ON rn sI/
6-tra- k NV C. .7 7 a-53
Phone Number: 1/y' It 91'
Email Address: J i vH a I Q 91'n R-d 'C 44
I certify that I have authorized G r 1 C,Pi 0-6-n ST A te,c.#/CY'-'
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 3 V a-e_ cS4. C/ 16
in D p
✓k //$ h/7k 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:
Signature
r o ti�S
Print or Type Name
4,wn �✓`
Title
I z l ?-
Date
This certification is valid through I I

ENDER: CC11PLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
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• Print your name and address on the reverse
so that we can return the card to you. ❑Addresse
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or on the front if space permits. ?---) j�#C. Date of Deliver
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
�n`1, V 1-N If YES,enter delivery address below: El No
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Certified Mail® Delivery
Return Receipt for
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❑Collect on Delivery
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2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery 0 Signature ConfirmationT
Aail 0 Signature Confirmation
7 017 0660 0000 7486 9126 Aoail Restricted Delivery Restricted Delivery
PS Form 3811.July 2015 PSN 7530-02-000-9053 Domestic Return Receip

RJ USPS TRACKING#
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First-Class Mail
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( III I I )80 Postage&Fees Paid
USPS
, i Z L Permit No.G-10
9590 9402 5492 9249 3656 11
United States •Sender:Please print your name,address,and ZIP+4°in this box•
Postal Service
GRICE CONSTRUCTION
6618 BEACH DR. , SW
OCEAN ISLE BEACH, NC 28469

I. . 'osta ervice
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Postage cc
$lI,..I_r
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eriniea mail service proviaes the Tonowmg oenenis:
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A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
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A record of delivery(including the recipient's retail associate.
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fora specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
nportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Maile,First-Class Package Servicev, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whict
Certified Mail service is not available for requires the signee to beat least 21 years of ag
international mail. and provides delivery to the addressee specifiec
Insurance coverage is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear
certain Priority Mail items. LISPS postmark.If you would like a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy retum receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: J a\C1 J C)n e5
Address of Property: `mil \c o ( c o -1 LQ (3.1-QCt CIO
(Lot or Street#, Street or Road, City& County)
•
Agent's Name#.GT ict IA*klcki Mailing Address:4)Ity_ 1 tc-h `
Agent's phone#: \\D rb1�'qU k5 ' :,1n �2 t( & Zwym
I hereby certify that I own property ddjacent to the above referenced property. The individual applying for
this .:rmit has described to me as shown on the attached •rawin. the development they are proposing.
a „ I, I have objections to this proposal.
= if •ou have objections to what is being proposed, you must notify the Div .,.n of Coastal
.'' Management(DCM) in writing within 10 days of receipt of this notice. Cor -: • • should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM repress - also be
contacted at(910) 796-7215. No response Is considered the same as no objection pethilyikbeen
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 the
setba k, you must Initial the appropriate blank below.)
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjace •ro .rty O . ,.r Infor on)
1/4)0.10&.! OfAi;C- (r•-agr110111111.7
Signature Signal e
Print or Type Name Print o'r Type Name
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Mailing Address Mailing Address
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City/State/Zip "City/State/Zip
7TV9V/V,0
Telephone Number elephone Number
Dale Date
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U.S. Postal Service`"
CERTIFIED MAIL° RECEIPT
1 Domestic Mail Only
1
For delivery information,visit our website at www.usps.com
3 L03591.19C
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Extra Services&Fees(check box,add fee an ate)
] ❑Return Receipt(hardcopy) $
] ❑Return Receipt(electronic) $ $I I,111 I Postmark
] ❑Certified Mail Restricted Delivery $ $IJ j 1l j Here
] ❑Adutt Signature Required $ $I 1•1) 1
❑Adult Signature Restricted Delivery$
Postage
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..eruneu maii service provfaes the following benefits:
r A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
I A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Cerrtified Mail reQeiptto the
I A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service— -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
important Reminders: -Adult signature service,which requires the
I You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whirl
I Certified Mail service is not available for requires the signee to be at least 21 years of ag
international mail. and provides delivery to the addressee specifier
Insurance coverage is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
I For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.
ARflf Anal OMR MAI/arca,DON 7510119-rttH1AOd7

•ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items �2,and 3. Jr-•nat -
■ Print your name'and address on the reverse rr-4)- / , j/ ❑Agent
so that we can return the card to you. .i . .. �� . B Addresse
• Attach this card to the back of the mail piece, �'./_ i e:by�r• in' : . Date of Deliver
mint
or on the front if space permits. d ? ` _ • M."- Li 2
1. Article Addressed to: 7 r Is de we addres different from item 1? CI es
ON e Cr\ ``1�,- ` If YES,enter delivery address below: [allo
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❑Adult Signature Restricted Delivery 0 Registered Mail Restrict
9590 9402 5492 9249 3656 28 -5 edified Mail® Delivery
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0 Collect on Delivery Merchandise
2. Article Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery D Signature Confirmation.'
1— — •ed Mail 0 Signature Confirmation
7 017 0660 0000 7486 J C Jr 3 3 •ed Mail Restricted Delivery Restricted Delivery
.$500)
PS Fnrm 3811_July 201 f PRN man-n2-nnn-9nsa Domestic Return Receio

USPS TRACKING#
■ + C :� 2-80 First-Class Mail
MIN 11
I ` Postage&Fees Paid
I r� I I 4 L USPS
Permit No.G-10
9590 9402 5492 9249 3656 28
United States •Sender:Please print your name,address,and ZIP+4®in this box•
Postal Service
GRICE CONSTRUCTION
6618 BEACH DR. , SW
OCEAN ISLE BEACH, NC 28469
lII�1'l�tilll"'�I1��,1l�11,,,,t,III'�t7�1�'llt'ill�'lltlll!'�'1"

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: JO h n 1 C y VL�a, .loots
Address of Property: 314 gtry_paXe St-, Oce4o .Lie. _aeac-1 JV G 28'+b 9
(Lot or Street#, Street or Road, City&County)
Agent's Name#: N,S),e Mailing Address:
Agent's phone#: V )'-t—
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 dimension ust be provided with this letter.
1 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 the setback, you must initial the appropriate blank below.)
I do wish to waive the 15',setback requirement.
ems.. I✓ do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Signa ure Signatur
Jokr F JoheS r- l i- ! -G gi7z-
Print or Type Name Print or e Name
34 Dare Si-. 5 d},��.f/y- - 4//E-
Mailing Address Mailing A dress
OC& to . sIa geaell" NG 20461 D S L 97
City/State/Zip City/State ip
(Z./— 3 c 5---- y- '027:5
Telep one Number Tefeph e Number
Date l/ l42_,0-2_,I
Date
Revised 6/18/2012

•
•
Check
Date Received Date Deposited Check From(Name) Name of Pem,h Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Columns Column2 Column.) Column4 Column! Column6 Column? Column8 Column!
5/20/2021 Lighthouse Marine Construction William Uzzell Coastal Bank and Trust 3759 $ 200.00 GP#80170D JD mt.14139
5/20/2021 Lighthouse Marine Constructiopn Marilyn Thomas Coastal Bank and Trust 3765 $ 200.00 GP#73593D JD rct.14138
5/20/2021 Backwater Marine Construction Scott Garmon BB&T 1304 $ 200.00 GP 879986D 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#79995D PA rct.12778
5/20/2021 Jerry Mills Construction Grace Summersett First Bank 3094 $ 400.00 GP#79996D _ 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 i 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 rd.14929
5/20/2021 'Lo�q Marine,LLC Keith Batten BB&T 7378 $ 200.00 GP#801010 BB rd.14928
5/20/2021 Waterbndge Contractors Sports Endeavors Investments,LL South State Bank 6190 $ 400.00 GP#79953D BB rct.14926
5/20/2021 I I Patrick Antinori Mary Grumpier First Citizens Bank 1099 $ 600.00 GP#77745D JD rd.14076