80282D - Bouchard

41,-)CCAMA / DREDGE & FILL N9 80282 A B C %f D
GENERAL PERMIT Previous permit #
):—New ❑Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �(( --77
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �CZ . I L—
❑Rules attached.
Applicant Name (,.� • c�� uC�� _ Project Location: County 1A '�_
Address (41011 CA.D j ctl( n Street Address/State Road/Lot#(s) 755 'Pc:track.
City ACATtY\ State15- ZIP ii(
Phone # (i) (13(-c6(q E-Mail Subdivision Authorized Agent 1C`c, IY� City (c�K n
—\ i eQ c\ ZIP ZeLiZ
Affected ❑CW TOW PTA ❑ES ❑PTs Phone# ( ) River Basin
AEC(s): ❑OEA C HHF IH ❑UBA El N/A Adj.Wtr. Body `i (nat 69/unkr
❑PWS:
ORW: yes / >ro PNA yes /� Closest Maj.Wtr. Body ��w�
{
Type of Project/Activity W [ ` - C�(�C.t�1`t'�-(
-
_DO )
/
(Scale: 1 a
Pier(dock)length��pp '""' (.-_�)l (J� Q
Fixed Platforms))7YJ' /tO��6r "�`/ L"�'' t 1 �" �� E-cCr_
— i I
g O �lczll - f
Floatin Platforms n _
t— I N `7'
Fi er pier(s)
Groff ength t 111 1
nu ber vit .�Q 1�
rap — 1 ( — r' C1�4., _.._
, -T i l
avg dista a offshore
max distant offshoreL.-:,.....tL_ 1
Basin,channel
cubic yards ...
i
Boat ramp j i 1 g j ! I
Boathou = I i j
..x, .
o ff` v v ((
Beach Bulldozing - ,� V� 1 t I
Other 0001 Lo+d (
t0 d
Ii
/�MM i
Shoreline Length �1 (QV I
SAY: not sure yes ® { / H�
Moratorium: n/a yes '-5 Y (� —' I I
1
Photos: yes �3 5 ��`-(``ice- f {
Waiver Attached: yes no I I I j
A building permit may be required by: ((7l�'1 �SM
°� ��4h See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)( �_ l j
Notes/Special Conditions '\JO� •f0 EE 91-11l� r teuza I 1IL , 0-t .io
evv.)cc tw 4 15 ' r;A)o c,6..... -k-bttc
Agent or App icon Printed N PermitOfficer's Printed N.
IS ` i �• 1 Dili 1
Signature "Please read compliance statement on back of permit** Signature - r

0❑CAMA / .I DREDGE & FILL N° 80282 A B C tiD
GENERAL PERMIT Previous permit#
)C ` New —Modification El 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 -
ElRules attached.
Applicant Name 6:: �` )30, c,c-c` Project Location: County t\,x,.. .. +3co.,-,.0--/'
Address -((o k (..A..)11 j=t-c\ct<- L 1 - Street Address/State Road/Lot#(s) Z 35 }7c-r,a ck N
City A...;‹4 i r\ State TS ZIP 78 4- (
Phone# ( 'I`r; ) 133-jam- c(`k E-Mail Subdivision
Authorized Agent «`c." V' i,-\ City ( G“ '2('r``-\ \ f'Gc\'\ ZIP 2e-tU
ZiS
Affected ❑CW S IOTA PTA ❑ES ❑PTS Phone# ( ) River Basin C El
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body �k•A k�I'c �a� (nat Hia '/unkr
❑ PWS:
ORW: yes / no PNA yes / Closest Maj.Wtr. Body L��)
Type of Project/Activity w C%X L'l'r\ti '}UC\`: )`"-
(Scale: I j=3o )
Pier(dock)length to 'O/ . //,^ /Fixed Platforms w /1‘y W tovegA i I
FloatingPlatform(s) FVSZN �tr; 1
j �:
Figker pier(s) f , -.._
Groin ength + - i
�; .
nu ber .._.
Bulkhead/ rap length — j — z.._.._..�_._. — �:i - —.--.---._— .__ 1
' ! �
Ica
avg dista e offshore -� A' �‘
max distanc ffshore �`\
Basin,channel
j
cubic yards
I j I
Boat ramp _. MI ' t
Boathouse/Boatlift -3),[3 1 -F--.__.__ _..
IC�
Beach Bulldozing 4 Sb( j
Other Co iYe,r1i -W1KWN f 1
l'U I i V 1 1Z,pilv\tp IC 1 !
Shoreline Length "+I '0 � � ( 1
Y 1
SAV: not sure yes /f� 1
Moratorium: n/a yes e� iit.. 1. ..--_ ..-._. ��`�,- t --- -- 1_
Photos: yes 7 E. '
Waiver Attached: yes no 1
A building permit may be required by: if c '"- l C L k . ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) L l- _ (' ` /
Notes/Special Conditions 7b eK-CQQGk ' "i- irr " '�7(`C kCaCk i i 0--k 7-c
6-,_) �_,Ef2,
(ioJ2
_
Agent
v-,J- _,,,,,,_ 4-\si i L
or App icant Printed N PermkOffice�sed N nryq �a `
Signature **Please read compliance statement on back of permit*-* Signature

1 it
ei,‘XCAIVIA ,,/ Li DREDGE & FILL NQ 80282 A B C f�/''1
GENERAL PERMIT Previous permit# ��/
)'--�''New CiModification ❑Complete Reissue LiPartial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality , r (�
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC t1 •
``� o C Rules attached.
C <,l
Applicant Name . uG `C Project Location: County :. vn.i•l
Address (410( i, .D41 ct.f. (,t) 1 Street Address/State Road/Lot#(s) Z?5'' c.Trktki-4,e,
City _ ^ ►`M1-7\ State 1'/- ZIP j(
Phone# ( i ) c(3 t---�j(-1-_E-Mail Subdivision
Authorized Agent tC`7� i� City_ ( -� d1 �i� y.C� ziP 2-€�ZB
Affected ❑cw ¶ 1CPTA DES OPTS Phone# ( ) A� River Basin C..- --'.,
AEC(s): OEA iHHF IH D URA ❑WA Adj.Wtr. Body '_l' t ^_O. (nat /unkn)
G PWS.
ORW: yes / PNA yes PC)
Maj.Wtr. Body ► TT�-)�
Type of Project/Activity . --Cc t 1 -'�
tr /
(Scale: 'l =t'(.._ )
Pier(dock)length "--- ( A _
Fixed Piatform(s)543;t YIG�(a 1� I — -- t. -1- (4Y'i i� �LafZ t s j, i .
- I 1-, ;--- �i• • ---- i i-- �. j__t .�.
Floating Platform(s) t81zZk ! !
Fi er pier(s) t-i()( 1 f i t t -f i— i j
-_} :
Groff ength i t i 1- 1
j
Bulkhead/ ' rap length j�� , , i I A..•�� n— t---Z'—1--i---
avg dista a offshore 1 , { 1 ---`..__ 4..-1_1-. 1 r._ ' .a i i ' _1 1
_ 1
} r
max distant ffshore # I [ l i IP i # .
Basin,channel .- .. ` 1._ _ ;� _ -�__ i. __ j
i4 i
cubic yards i I • j
} a
Boat ram t i ....rt. (.__ .
Boathous-taro 1 J�� t 1 I -r--;__ a--, _i _ _ I { _._.
1F-
Beach Bulldozing n 1 ` 1
��ey� r -- _i .. t t i — 1
Otherco yrea,,itiku,h`i ±HI-LH
. .- i i I �.. M �t1.' xi ._ __ 1—i __, jt } _
Shoreline Length_-.U.- % ! �,,ti,
SAV: not sure yes e ""'� _ 1
7
„S j— r 'r 1 4
Moratorium: r f -1----1
t r .-..a. .!_
V l
rda yes � -f-- 4 t
Photos: V- ,
Waiver Attached: yes i--_ I -__. i r ( I . ____ ._ l ( t _ I
i
'-- t
A building permit may be required by: (Oti-2` - 'g (1i r 'vt; C... _k . j See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) // p���t� ��-p ��-- -- nn j
Notes/Special Conditions + '/0 f�}� 6,..-r t l'�� --pre( Y l I Y i t '7 c)
eAAC-CCiEG,- 1i ri'? i O."- �e,.:k'kp kC -
•
!� d( Kam- ��-
---
Agent or Applic rime
PermitOfficer sprinted =
t '''.. ... .4 4/171 ...E1)
Signature�y� P�cn'o ad c lance statement on back of permit** Signature

ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Completerint your
items 1 2,and 3. A Sig re(C'�
• Print your name and address on the reverse X (L-y_ 7v("'— 0 Agent
so that we can return the card to you. 0 Address
■ Attach this card to the back of the mailpiece, B. Received by ted Name) C. Date oaf-/Deliver,
or on the front if space permits. Cu C- / —dr—ZI
1. Article Addressed to: D. Is delivery ad �� m 1? 0 Yes
`) v4 C. /Ltyn L,; If YES,enter a every a clressrbcow: ❑No
.�x�--Q A I -yid ? APR 9 8 2(121
c1yyy A1a,1L 1 • 1
j,riG Yi NG c� 3S DCM WILMINGTON, NC
3. ServiceType 0 Priority Mail Express®
II1'II' IIIII'IIIIIIIIIIIIIIIIHIIII'II'IIII ❑Adult Signature ❑Registered MaiITM
❑Adult Signature Restricted Delivery 0 Registered Mail Restrict
Gl.efirtified Mail® Delivery
9590 9402 6418 0303 3480 95 0 Certified Mail Restricted Delivery 0 Signature Confirmation*
0 Collect on Delivery ❑Signature Confirmation
2. Atticle Number(Transfer from SerViria Ian fl collect on Delivery Restricted Delivery Restricted Delivery
7018 3090 0001 9062 0301 ;tired Mail
>ured Mail Restricted Delivery
over$500)
DS Form 3811.July 2020 PSN 7530-02-000-9053 Domestic Return Receiol

.ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3. A. fignature
• Print your name and address on the reverse X l CI Agent
so that we can return the card to you. �(' 0 Addresse
IN Attach this card to the back of the mailpiece, B• ved by - t:-, ,-me) C. Date of Deliver
or on the front if space permits. Lt iiLL o CAA- -
1. Article Addressed to: D. Is delivery add- different from item 1? ❑Yes
V ` t 4 rod eN `it/477-I If YES,enter d ErN o v: ❑ No
q k 1(/h,tr'i_s C owsfi "4 < •• APR 2 8 2021
570 Ai- /o'(// 4 i -
/v 6 3 Y33y DCM WILMINGTON, NC
1��h,, ,
3. Service Type 0 Priority Mail Express®
111111111111111111
IIIIIlIIIIII'IIII III I I I I I I I II I I I I I II(1 Iistered Mail."
rt Signature Restricted Delivery 0 Dult Signature 0 elivery
Registered Mail Restrict
-9590 9402 6418 0303 3472 03 0 Certified Mail Restricted Delivery 0 Signature Confirmation*
0 Collect on Delivery 0 Signature Confirmation
2. Article Number(Transfer from service Labe° 0 Collect on Delivery Restricted Delivery Restricted Delivery
❑Insured Mail
70.19 1640 0001 7 419 8325 Incur s Mail Restricted Delivery
DC e.,.....'2A1 i 1..I.,DMA oOM-7cn11 nn.nnn_nncn n.......�at..os.....o..,...:..�

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
f
Date ;? .2-1
Name of Property Owner Applying for Permit:
`. /qoAciztied
Mailing Address:
4'/O/ & - we4' 1/0194-1
141,ts4;114 trit. 178131
31
I certify that I have authorized(agent) f/' /7 ; f 't to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) A'',44,1 rilt)4 /4.9 Auk iifd •/ " 9
f Q
at(my property located at) 7 3 s' ,,r f 44,' v{. �}r1 e
RECEIVED
APR 2 8 ?0?1
This certification is valid thru (date) /2/ "(fig/
DCM WILMINGTON, M
dO/lr .
.1411411/1 - 1007-//C -/
Prop 0 .ner Signature Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
/� p;n
Name of Property Owner: ( r .f' sf:�s'�' ►_-!'
/f 3 4,--1)4/)„../Address of Property: c /i'..•'r"Y f 1`
(Lot or Street#,Street or Road,City&County)
Agent's Name#: ��/';g2 rift . Mailing Address: Pa. /"SOX ,.
q/U V 7/o2 o3c1 �`, I;-�F.r:': _>..1 At
Agent's phone#:
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 p posing.A description or drawing,with dimensions, must 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_ Contact information for DCM offices is
available at httpi/www.nccoastalmanagement.net/web/cm/staff-listing 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.) RECEIVED
I do wish to waive the 15'setback requirement APR 2 8 2021
I do not wish to waive the 15'setback requirement. DCM WILMINGTON, NC
(Pro•* O, (Ri ' n Property Owner Information)
ature Signature
e`.--g: gourila/vd c 61e, _ Li
Print or Type Name Print or Type Name
1!1 D1 VidAffarer Wei S o ,-- '7 6
Addr
ess
ress
Mailing Address MailingG
ALtv g 1 '?f l3 l ���P,� i.�
City/State/Zip City/State/Zip
9i9. 9319c/ 9
Telephone Number/Email Address Telephone Number/Email Address
o? /s z/ 9/2
Date Dare
] (Revised Aug. 2014)
• M_ ar%AA

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Check
Date Received Date Deposited Check from(Name) Nama of Permit Holder Vendor Cheek number amount Permit NumbenCommente Receipt or RefundlReellocated
Columnf Calumet Colunn3 Column./ Column5 Column! Column7 Columns Co/umn9
_ 6/3/2021 Gary Stanton Ange Bank Check Brent Elmers First Bank 30273079 $ 400.00 GP#80133D JD rot.14328
6/3/2021 Pippin Marine Construction LLC -------- CJ Bouchard Wells Fargo 5800 $ 200.00 GP#802820 ,BH rd.12890
6/3/2021 Pippin Marine Construction LLC Gine Poole Wells Fargo 5801 $ 400.00 GP#80309D 'BH rot.12889
6/3/2021 Archie McGiA JBJB Propteriea LLC First Citizens Bank 8961 $ 200.00 GP#80168D �KE rt.13449
6/3/2021 Michael Ann Williamson same _ Truliant Federal CU 1487 $ 400.00 GP#80129D BB rct 14934
6/3/2021 Grice Construction Redfern Scott LLC BB&T 14671 $ 400.00_GP#80123D 'BBrct.14941 - — -
6/32021 Grice Construction John and Linda Morgan BB&T 14667 $ 200.00'GP#80128D BB rat 14940
6/3/2021_ Grice Construction 419 6th St SB LLC B 14668 $ 400.00 GP#79997D BB rct.14939
8/3/2021- BM AMW Docks and Marine James McLeod BB&T 6243 $ 200.00,GP#79999D BB rct.14938
6/32021_ Carolina Bluewater Construction,Inc. Craig Miller BB&T 23458 $ 200.00 GP#80172D BB rot.14944
6/312021 F 8 S Marine Mike Desmond First Bank 1021 $ 200.00 GP#80183D •KE rot.12851
e