80121D - Guirintano

CAMA / 11 DREDGE & FILL0
No 80121 A B C
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
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 0 711, JRd U .
❑Rules attached.
Applicant Name geff40 2.if Sa-r7 61ar//)*(1p Project Location: County 5/14751✓ C I
Address 17'4 S a tic' )4'14I '!tl Street Address/State Road/Lot#(s)
City )1 Aclt{/4 k(CI✓State tiC ZIP,?ctf�
Phone# (61O) 554 /QA:2 E-Mail rep/141'S'(Cm--"(( .a9 -'Subdivision
Authorized Agent C P6, C,LC City -- ZIP'""
Affected ❑CW ❑EW ®'PTA ES ❑PTS Phone# (�)---- //�� River Basin G.(4 1... r
AEC(s): OEA ❑HHF ❑IH ❑USA ❑WA Adj.Wtr. Body rAfgat (nat ►ar /unlu
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body Q/��
Type of Project/Activity /J;/ ft, ,,, idl,l ( /I e( clew " TGr�f�
(Scale: ,A its )
Pier(dock)length eXi 5 it'.,
1 l
Fixed Platform(s) I
r�
Floating Platform(s) ek' -in l 1
Finger pier(s)
Groin length
number — —._ __ . .. f
Bulkhead/Riprap length _L _; _
avg distance offshore _ I
max distance offshore
Basin,channel --
cubic yards I 1
Boat ramp / / f 1 I
�..._.._... ..._ ' ......_ — eLT�' --. ..
Boathouse/:Bo"a`tl' j : 'S.J }'.. f r✓ -- 641—
E
,,„_
: :
, ,
Beach Bulldozing lit,
] ._i. i Tre (V 1 I— -
Other A
� �4.� I ��
1: 1
-c1 kori
Shoreline Length �. f r i
SAV: not sure yes po —1_... 1 YX i , 1 —. { f { .'„.„.-,
4
TV rt
Moratorium: n/a yes _91tith A//l'lo - -e4m0
Photos: es vrd � ._�?K._ � 441 _ ..
1111
Waiver Attached:)(+ es no .' •/,
A building permit may be required by: 1 , !� , i7 dr / . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) o®
Notes/Special Conditions /emu 4Vc7 f 7, /1CC., - Y /,-(T`1 1 i'c),' ///,
( y67, h .
� ' 37° /1.40cC.f/
Agent or Applicant Printed Name 461e11.—a � Fi/(4
Permit Officer's . ed.Nam
Signature **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(910-796-7215)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 252-946-648 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)

K(CAMA/ iL DREDGE & FILL :V° 8 O 1 2 1 A B C
GENERAL PERMIT Previous permit#
MNew LIModification ❑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 I SA NCAC 0 hi, )gW v
❑Rules attached.
Applicant Name 1 f Oa 2,T1.5077Gfjf if)j i f- Project Location: County 8'ion,„; C_i-
Address 114 Sviol rela'14'/ � /` Street Address/State Road/Lot#(s)
City /a ` State /V C ZIP 29`+U 2 --------
Phone#(610) 3'S4 to el EE-Mail ( lQ PSF tOu4L_Ctr'-[subdivision _____------
Authorized Agent CPC, !.4., City ZIP'
Affected D CW ❑EW INPTA N1 ES CJ PTS Phone# (_., River Basin�N1 �
AEC(s): OEA ❑HHF Li IH ❑UBA Cl N/A Adj.Wtr. Body 624'L(,c.C�/�� --- (nat unkn)
O PWS:
ORW: yes CB PNA yes /� Closest Maj.Wtr.Body QL��
Type of Project/Activity thfacit, he di /17 e- { de 6 4 ) - GiC%*
(Scale: S )
•
Pier(dock)length em.540,
Fixed Platform(s)_ ; li ) , i I 1 !
Floating Platform(s)a 'j ' } {-___-
Finger pier(s) f I ' --
Groin length —__Y- { I i
- I i i i -- f -'-
number — I4 t � I-
'
'Bulkhead/Riprap length -^ ( ; - t i '
'
1 E
avg distance offshore -- f i F � t It }max distance offshore I I
1--} -i H
Binchannel 1 _ --� -- i . I
cubic yards { 1
t
j
Boat ramp [ - / - c all4,e 1/,„,„, -_ ,
Boathousiiiii )21r1,� �% %` • . _,
i . , . i ;
. . ,-
Beach Bulldozing N7 J , i
Other y fr , Ski ' i T
1 1!
i
161 I I �!
6 sec(
Shoreline Length t!Y ,
---r' -+ems '�--• ! j 1.
P9 I t i ' H i i
SAV: not sure yes � r. 1 i , �
1� ! ,, � I ' f a i
Moratorium: n/a yes 0 , Y w o17i1'-ai rt(.st0 ! SpaK . /
Photos: yes gy 1 K�
Waiver Attached:X 1 € no
A building permit may be required by: -'~'t"` /6 /12 leolam/ Li See note on back regarding River Basin rules.
(Note Local Planning jurisdiction)� / C7
Notes/Special Conditions �� ®
,C 4Y�'� i t N- O, /, � r�' /Lrr- a
irr
y74-vh,,,,
if'
5 7 'vie c cal
Ben Brink (CPja, LLC.) gthGtAilco
Agent or AppllcanPrinted Name Permit Officer's c t N
Signature **Please read compliance statement on back of permit** Signature
_0°--V _111-3_ _bltel r _ _ _ LO.//k ?/

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit Regina and Jason Guirintano
174 Sand Dollar
Mailing Address:
Holden Beach,NC 28462
610-554-1042
Phone Number:
[e-mail]/[e-mail]
Email Address:
CPG, LLC
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: add boat lift to existing docking facility
r e located at 174 Sand Dollar
at my property
in Brunswick County.
l 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:
40090
1m'on g.int no(jun 9.200111:41 ED71 aegma99+.9ae Jmn P+�m fin 9.202111:JT FUT)
Signature
Jason Giurintano/Regina Giurintano
Print or Type Name
Property Owner
Title
6 7 2021
Date
6 7 2022
This certification is valid through I I

IIlnl l VII II11II III lIIIINIH l hII g351s P0? 6 4 ' «
runewlek County, NC Raylstar of Dsade pays 2 of 4
WHEREAS, the owner wishes to consolidate these two parcels of land into a single
parcel of land for all governmental purposes relating to zoning, taxation, special
assessments and issuance of improvement permits by governmental authorities;
NOW, THEREFORE, upon execution and recordation of this INSTRUMENT OF
COMBINATION,the aforementioned parcels of land are hereby combined into a single
parcel for all governmental purposes relating to zoning,taxation,special assessments and
issuance of improvement permits by governmental authorities and shall hereafter be
described as follows:
BEING all of Lots 222 and 223 of Heritage Harbor, at Holden Beach,
Brunswick County,North Carolina,as surveyed October 1,1968,by Harold Willis,
which map is recorded in the Office of the Register of Deeds of Brunswick County,
in Map Book 9 at Page 87, to which map reference is hereby made for greater
certainty of description.
There is excepted and reserved from the above described property an easement and
right-of-way five feet in width adjacent to the streets and roads on which the above
described property abuts, for the purpose of widening the roads as shown on the
above referenced map,and for doing the usual road work on these roads and streets.
This right-of-way easement to be perpetual and be binding on the parties of the
second part,their heirs and assigns.
IN WITNESS WHEREOF, this limited special purpose instrument for the
purposes specified above and is not a conveyance of ownership in any way; the makes
have hereunto set their hand and seal,the day and year first above written for the purpose
expressed.
/1i C a M EAL)
MICHELE ABBATEM CO
t�l U, (SEAL)
te OS GIURINTANO
(SEAL)
. r G ON GIURINTANO
2

Sand Dollar Drive A
Town of Holden Beach
Springsteed
Parcel 231NAoo2 14
PROPERTY r
LINE 1/4 SAND DOLLAR
•
Existing Bulkhead n
4'x 5'
Shoreline: -188'Total
Waterbody Width: -73'via
aerial imagery
Ramp '`
EXISTING
STRUCTURES
12' X12'
PROPOSED
L4FT BOAT LIFT UP
Slip#2 8X34FT FLOATING DOCK
—28FT
Slip i CANAL -Not to exceed pier headline
- Docking facility less than i oo'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I awn property adjacent to l Gi+nntam ,a
(Name of Property Owner)
property located at 174Sand Dollar L-Z71i115
Mamm.&Carnal (Address, Lot, Block,Road,etc.)
on , in Flaldcn Rescfi Brunswick , 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 fill in description below or attach a site drawing)
See attached drawing of boat lift.
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.
�aaraar_, 8=otiu
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Signahi a Signature' erode Morn-ham a Mahlon Ord
Print or Type Name Print or Tl'Pe Name iamb
M&i'iq Ad°reae Wing Address 110 Rothschild Street
City/Stata/ip City/State21P Holden Beach NC 28462
Telephone Number/ema+J addrees Telephone Number/ernal4 addnsas
Dare oars• 06/10/2021
(Rerraad Aug 2014)
'Valid for one calendar/ear after signature'

1.
_• i'ia `�.r-' i '`'''S` E F rid'F I Ajt,C F I L f 's'1`5, A. .`�,-
Otik �'THE COMMONWEALTH OF MASSACHUSETTS ,
•(.► Division of-Environtri Law Enforcement " 4 i,
TITLE NUMBER ISSIIE DATE '"" MANUFACTURER ill
IV 284423 07-12-2001 SILVERTON v•
J YEAR TYPE SERIAL NUMBER 1
* 2001 CABIN CRUISER STNAD156L001 4
`.a ..
USE COLOR HULL MA'ERIA. LENGTH
PLEASURE WHITE FIBERGLASS 33'0' r
CEPT NUURER STAT.(TITLE) OWNERSHIP
, ACTIVE CO-OWNER 1 .
Taooi
K �.
_Y NAME&ADDRESS OF OWNERS) /It
EUSSA B.CLEWS THOMAS B.HICKEY JR 4
25 GLENOAK DR 25 GLENOAK DR Ag,
4\* WAYLAND,MA 01778 WAYLAND.MA 01778 4�
,0lr . •
t 11:(
(,► RELEASE OF LIENS 4ti
Syr (FIRST LIEN)INTEREST IN THE DESCRIBED VEHICLE IS re
FIRST LIEN HOLDER HERESY RELEASED Pt
4
!y
..'3f; -.. ... NAME RELEASED ` 'L
4► AUTHORIZED SIGNATURE 4 N.
.'s SECOND LIEN HOLDER a"
t (SECOND LIEN,INTEREST IN THE DESCRIBEDVEHICLE IS j
ib
HEREBY RELEASED
ION
DATE .
NAME RELEASED► .
AUTHORIZED SIGMA TURE 7
THE DIRECTOR OF THE DIVISION OF LAW ENFORCEMENT HERESY CERTIFIES THAT AN
APPLICATION FOR A CERTIFICATION OF TITLE FOR THE MOTORBOAT I ATV DESCRIBED HAS
Ir,.''.-._>'4 BEEN DULY FILED, PURSUANT TO THE PROVISIONS OF THE LAWS OF THE COMMON- Olt
.• WEALTH OF MASSACHUSETTS.AND BASED ON THE STATEMENTS OF THE APPLICANT AND i,
' O' k(• THE RECORDS ON FILE WITH THIS AGENCY,THE APPLICANT NAMED IS THE OWNER(S)OF
SAID MOTORBOAT/ATV
S / i
'x „ THE DIRECTOR OF THE DIVISION OF LAW ENFORCEMENT FURTHER CERTIFIES THAT THE \
MOTORBOAT I ATV IS SUBJECT TO ANY SECURITY INTEREST SHOWN HEREINVb
DIRECTOR RICHARD A MURRAY i

II' II11111111111II1111N1Iu11111 B351s P 784 0'
Brunswick County, NC RegisIIr of Dads paps 2 of 4
WHEREAS, the owner wishes to consolidate these two parcels of land into a single
parcel of land for all governmental purposes relating to zoning, taxation, special
assessments and issuance of improvement permits by governmental authorities;
NOW, THEREFORE, upon execution and recordation of this INSTRUMENT OF
COMBINATION,the aforementioned parcels of land are hereby combined into a single
parcel for all governmental purposes relating to zoning,taxation,special assessments and
issuance of improvement permits by governmental authorities and shall hereafter be
described as follows:
BEING all of Lots 222 and 223 of Heritage Harbor, at Holden Beach,
Brunswick County,North Carolina,as surveyed October 1, 1968,by Harold Willis,
which map is recorded in the Office of the Register of Deeds of Brunswick County,
in Map Book 9 at Page 87, to which map reference is hereby made for greater
certainty of description.
There is excepted and reserved from the above described property an easement and
right-of-way five feet in width adjacent to the streets and roads on which the above
described property abuts, for the purpose of widening the roads as shown on the
above referenced map,and for doing the usual road work on these roads and streets.
This right-of-way easement to be perpetual and be binding on the parties of the
second part,their heirs and assigns.
IN WITNESS WHEREOF, this limited special purpose instrument for the
purposes specified above and is not a conveyance of ownership in any way; the makes
have hereunto set their hand and seal,the day and year first above written for the purpose
expressed.
at'etrnCtitta EAL)
MICHELE ABBATEM CO
G l u.}/ (SEAL)
>'•� OS GIURINTANO
`\pYA,gp o` (SEAL)
It;i a C, ON GIURINTANO u9 `
2

Springsteed_APO
Final Audit Report 2021-06-10
Created: 2021-06-10
By: Ben Brink(bens coastalpermitguy.com)
Status: Signed
Transaction ID: CBJCHBCAABAAM95JPgZBIAjWG16_aGOWTAr7IP8MWhhy
"Springsteed_APO" History
,n Document created by Ben Brink([e-mail])
2021-06-10-3:27:42 PM GMT-IP address:174.81.113.38
E, Document emailed to john K Springsteed([e-mail])for signature
2021-06-10-3:28:40 PM GMT
Email viewed by john K Springsteed([e-mail])
2021-06-10-7:07:17 PM GMT-IP address:69.147.92.147
4 Document e-signed by john K Springsteed([e-mail])
Signature Date:2021-06-10-7:10:44 PM GMT-Time Source:server-IP address:172.72.2139.143
Agreement completed.
2021-06-10-7:10:44 PM GMT

174 Sand Dollar_Holden Beach APO
Final Audit Report 2021-06-10
Created: 2021-06-09
By. Ben Brick(benOmastalpermdquy.corn)
Status- Signed
Transachcn{D- CBJCHBCAABAAZQ-79NEMAdezgtea-7a7161YstaZgiLp
"174 Sand Dollar_Holden Beach APO" History
Doc znerlt aid by Ben Bmk - )
2021-06-09-10:4658 PM GMT-IP 174311.11330
Document ernaiied to Rhonda Wooten-Town of Hoiden Beach(r woote1hbtownhail_corn)for lure
2021-0609-10-.4832 PM GMT
Email viewed by Rhonda Woolen-Town of Holden Beach(tvrootettaihbtolwnhali_com)
2021-06-10-0:5258 AM GMT-IP address 7035.18541
• Downward e-signed by Rhonda Wooten-Town of Holden Beach( corn)
sq aiwe Dais:2021-06-10-224:05 PM GMT-Time Salter server-P address_68198-181.68
O Agreement completed.
2021-06-10-2:24:05 PM GMT

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to won Gs'"aono 's
(Name of Property Owner)
property located at '''said Dollar L-122/213
Canal (Address,Lot,Block,Road,etc_)
Manmadeon ,in Holden Bead//Brunswick ,N.C.
(Wateerbody) (City/Town and/or County)
The applicant has described to me. as shown below, the development proposed at the above
IocMon.
have no abjection to this proposal.
I have oblectlons to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must 1W!in description below or attach a site drawing)
See attached drawing of boat lift.
WAIVER SECTION
I understand that a pier,dock, mooring pilings,boat ramp, breakwater, boathouse,Mt,or grout
must be set back a minimum distance of 15'from my area of ripaian access unless waived by
me.(If you wish to waive the setback,you must initial the appropriate friar*below)
jaiui ram`
^ I do wish to waive the 15'setback requirement
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Ad acent yyPro{p�errty Owner Information)
w* eol!/L C� /l�rQl4G1
_ w air;mas �..Rs� �iudam.
Signature Jason and Regina Giuritano Signature' John K.Springsteed
Pnrt or Type Name i 74 Sand Dollar Print or Type Name 5000 Park Place
Matting Address Holden Beach,NC 28462 Mating Addrees Charlotte,NC 28209
98o-jib-16{i CdjdSLp [e-mail]
Telephone Nrm6ertarasiaddrtas Telephone Number t emit address
Au' 6/8/2021 ice' 6/10/20211
(Revised Aug.2014)
'Valid for one calendar year after signature*

Chock
rod Date Deposited , Check From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Column) Cdumn3 Column) Column5 Columns Cdumn7 Columns Columna
!021 Allied Marine Contractors LLC Todd Surratt First Citizens Bank 10184 $ 200.00 GP#80108D PA rct.12826
!021 Scott J Prestage same Wells Fargo 2620 $ 200.00 GP#80136D PA rct.14331
!021 Land to Sea Construction,LLC Michael Cosenza First Citizens Bank 483 $ 400.00 GP#801810 IKE rct.12859
!021 Sea Dog Marine Construction,LLC Lucky Enough Oak Island LLC First Bank 111 $ 200.00 GP#80167D PA rct.12831
!021 Permit Pals Richard Green CresCom Bank 3718 $ 200.00 GP#801050 PA rct.12830
!021 Backwater Marine of NC LLC Michael Bryant BBBT 1322 $ 200.00 GP#60113D PA rct.12829
!021 Backwater Marine of NC LLC John Lank BUT 1323 $ 200.00 GP#801140 IPA rct.12828
!021 Backwater Marine of NC LLC Donald Swink BUT 1324 $ 400.00 GP#80115D PA rct.12827.
!021 Permit Pals Aaron Moffat CresCom Bank 3524 $ 200.00 GP#801120 PA rct.12787
!021 Allied Marine Contractors LLC Betty Happ First Citizens Bank 10187 $ 200.00 gp#80111d PA rct.12833
!021 Allied Marine Contractors LLC Demar 8 Monni Hammonds First Citizens Bank 10186 $ 400.00 GP#80110D PA rct.12832
!021 Allied Marine Contractors LLC Travis Gannon First Citizens Bank 10185 $ 200.00 GP#80109D PA rct.12834
!021 Grice Construction Hampton and Judy Cobb BBBT 14669 $ 200.00 GP#80124D BB rct.14053
!021 Orice Construction David and Rebecca Entedine BUT 14670 $ 200.00 GP#80125D BB rct.14054
!021 Rhonda McCall Leslie and Tischa Bailey Bank of America 1121 $ 200.00 GP#80181 D BB rct.14051
!021 Eileen Hennessey same Security Savings Bank 2396 $ 200.00 GP#80313D BH rct.14102
!021 Southern NC Marine LLC Robert Brooks First Bank 1442 $ 200.00 GP#79915D JD rct.14337
!021 Regina Giurinlano same Branch Banking and Trust 1673 $ 200.00 GP#801210 PA rct.12835