80168D - JBJB

0 'CAMA / DREDGE & FILL N9 80168 A B C
GENERAL PERMIT Previous permit# to SZ 9
)C New V Modification Complete Reissue ❑Partial Reissue Date previous permit issued 1 I t I z O zo
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 N . oo°
❑Rules attached.
Applicant Name .1;3'G evorc v4 t.S <<L L/AVcAeve IMt Project Location: County Ni¢,t,., !4i k- V'/-Cw
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Address P. 0 • GJNII U fr S C1 w+Street Address/State Road/Lot#(s)
City1N VOSH-F)Vk\\i! CCG (Jr State ZIP a is0 `} S Vto'( iT✓lV'€
Phone#(' l0) (0I Z CSny 1' E-Mail Subdivision rk,,v bi' S\C ►—cS`
Authorized Agent MGv kL JolnvY an Cityi\iV,t11n+ VI iQ ZIP a itk K0
Affected ❑CW rxEW ❑PTA ❑ES ❑PTS Phone# ( ) River Basin Wk'ke Ua 14
AEC(s): ❑OEA IIHHF ElIH ElUBA ❑WA Adj.Wtr. Body '',M o+S
❑PWS. ��h(�^'Q nat /man funk
Closest Maj.Wtr. Body�-\V ..Gt^v'1 k Q S tSU^G'
ORW: yes /�noj PNA yes / no' 1
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Type of Project/Activity #Iv,5 4 10A-F l vq:, &Lk. ,
1 J i
(Scale: . LJ J
Pier(dock)length _
Fixed Platform(s) := . '.■21 w
Floating Platform(s)3 2.•s V 11y I� _ ■■ ki OM
Finger pier(s) 2 x ■■ i ' ■-ti ev eriallUi
Groin length N� _'/I tirNMI /I"
number — } -
Bulkhead/Riprap len
avg distance offshore ' lrM II�I,��, i —.IMI —■ !
max distance offshore / g•7 ua�, �� mi� —N—
Basin,channel M��— NE es,.. ; I
•■Uummi U i`lil W1NMI___
/ I 11111111•1=1111111111111110111N►it NM11011 MIMI
cubic yards ■■_ ■ RIZ ■�NUi
Boat ramp �'7 M�— �- ____
Boathouse/Boatlift ..._._..e........._ x i OR WirAl 1 IOWA Lye• t
L
t M —. E
Miiii t� C'7 C o
Beach Bulldozing ' ° ; - MY ��MI
1�/ l���,�� ' ' �li - — a ►
Other In�gi�a�����i���t�9gn, 0 • �M E� ���Y
■■— IMMIil NN, ! 1 11111111.1.11111ME_� I ME
Shoreline Length / 11w—MEM. ! U
SAV: not sure yes no 111111111111111■ IIIIIIIIIIIIIII• _ - - . { I 17.4+�'
Moratorium: ID yes no —
Photos: no :IY , � A 111 UV.......P v — i a . .
Waiver Attached: I no � % may ► 'n .V.
A building permit may be required by: 4\n.,- TOW.-- u} V t C1t 1 c Vt 1 t 1 (11 U See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) 1 o.�
Notes/Special Conditions A l l F4 • 2 00 0 -4— loud ) S - e 1 ((�T P c((I�a I Y e toi+5,e) - 1 j-3•
rl e e IU l�oevA--�- -1'I oa-fi v� dor_le__ S 1,k I I 1/70 - �xLe i cl -4-I� �1 v l s Vl 11 e (� ‘) (4-1
_ID e V hecct I1 v4 •
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Agent or Applicant Printed Name nn Permit icer' Rrinted Name
Signature Please read compliance statement on back of permit** Signature � '

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�tr s ss=9ED MAIL • RETURN RECEIPT REQUESTED
ts;la DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: *--7—(3J
Address of Property: ` - R- - `� ( �-x V ale �.
(Lot or Street#, Street or Road,City&County) C. O
Agent's Name#: AA 41L Jd pr1 MailingAddress: Po B �Sr
Agent's phone#: q 1(9 L� . 1 - a q 3 ( 2- K s� c tt c ��°'
. 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 de•3cription or drawing, with dimensions, must be provided with this letter.
ifik 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 theDivision of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Exit,
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 bank below.)
I do wish to waive the 15' setback requirement.
•
I do not wish to waive the 15' setback requirement.
(Prope ., Owner information) (Adjacent Property Owner Information)
414' rnadifie,ttirr ti
Signature Signatuti
Tr -i 13��at,. L C , r `' a A iUlAN44iscvekT F +4A1�etiv1/4
Print or Type Name Print or Type Name
d3054 (p
Mailing Address Mailing Address
City/State/Zip City/Stateiip
L 6 - 1�9C/ 7�c l
Telephone Number Telephone Nirmber
T 0- ZW 2 • 3 7? ,RECEIVED
Date Date 5l -Wz 1 MAY 2 7 Z 0/+
Revised 6/18/2012

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that own property adjacent to At l4( ij -''c 's
(Name of Property Owner)
property located at Li `�1/ PR.
/- '(Address, Lot, Block,Road, etc.)
on t lt'k lhAito`c ( . in leer/nkv.11,7 Noll 4/C- ''4s`rc`�C,, 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 dbWopment must fill in doscription 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 ripanan access unless waived by
me (It 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) (Ad' cent Property Owner Information)
itv(r,)____ .,r 0/4:71 . .,
Signature' t�' /3 S - ti'i��(.-t »e. 4%,- .
Prurt or Type Name Print Of Type Name
f C E©x 6 4 " �'.Gt I1'=.
Matting Address_ Mailing 4s
ll p'
City/Sta etLp N C Z 1. 'Y 0 CityP t/ f`iya `moo t
Telephone Number 1 email address Telep N t email address
9 i 6 - (et 12--o Y4 fr S '..3r+ 2 t
(Revised Aug 2014)
"Vakrd for one calendar year after signature"

•
❑APPROVED NO EXCEPTION TAKEN
❑APPROVED AS NOTED
❑ REVISE AN RESUBMIT
❑ REJECTED
0 SUBMIT SPECIFIED ITEM
1-"F
41 ' H By Date
6' 28'-1 0 ' 6' h— LEGEND
Fl CORNER BUMPER
' A
DOCK TENDERING
11 n r�� ( -GMAT
�... ___� I I � 12'HDG CLEATS
12'TIMBER PILE GUIDES
' 32'
'll — la (44 `) = 2�1Xt4 ' 1`►y A 14 I I 1
,
0 38'-1 "
\ - ( 1U =D-fi3t
q - 3J Li WALER CUT DOWN TO WALER CUT DOWN TO
V
` ( 1 - RECEIVE FAN DECKING RECEIVE FAN DECKING 1
t 6'
I I f n 1 1
8'
6' --
PILE RETAINER LOCATIONS AND QUANTITIES SHOWN FOR ESTIMATING PURPOSES ONLY.
-� 6 F
1 � BELLINGHAM MARINE HAS NOT PERFORMED ANY PILE DESIGN ENGINEERING SERVICES.
IY BELLINGHAM MARINE RECOMMENDS RETAINING A PROFESSIONAL ENGINEER TO PROVIDE
�� LI l� 1 /l ANCHOR PILE DESIGN SERVICES PRIOR TO CONSTRUCTION.
Cn./I` V TIMBER DIVISION PROJECT NUMBER: SCALE NIB
Ilingham 8373 ARCHIE McGIRT DOCK
set a BAR110)21 G$BLw.
EtELLINGIrAM CASTLE HAVNE.NC 26129 MARINE0 L MM' U61BBO.06TB DRAM BY: B.R.
TEL [phone]BB5 o ENGINEER•FAK:ptNB 2lo.eBv WRIGHTSVILLE BEACH,NORTH CAROLINA DATE: M.NB0.M21
NA triev THE WORLD'S MOST SSION MOM
AM MAR ES INC H 0 PROJECT MANAGER:ATO W�.
COMPREHENSIVE NCFDS'+C1N0XNJd CHECKED BY: DOCK LAYOUT
REVISIONS MARINA BUILDER MINE iNw SHEET NO.: 1 OF 4

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit i ui
Mailing Address. l�t*
y U- b
Phone Number: C - s
Email Address:
I certify that I have authorized G'N tit •r _--�
Agent i Cortr -tor
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 t- >h cA< Do_
in County
I furthermore certify that I am authorized to grant, and do ,n tact 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:
it jr 2i�'t
Signature
() re‘'
Print or Type Name
Title
r I =- , I r-o z.{
Date
this certification is valid through

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vander Chock number amount Permit Number/Comments Receipt or Refund/Reallocated
Columnt Column2 Column3 Column4 Column6 Columns Column? Columns Column9
6/3/2021 Gary Stanton Anqe Bank Check Brent Elmers First Bank I 30273079 $ 400.00 GP#80133D JD rct.14328
8/3/2021 Pippin Manne 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 McGirt JBJB Propteries LLC _ First Citizens Bank 8961$ 200.00 GP#80168D KE rd.13449
6/3/2021 Michael Ann Williamson I same Truliant Federal CU 1487 $ 400.00 GP#80129D BB rvt 14934
6/3/2021: Once Construction_ -- - Redfern Scott LLC r BBBT 14671 $ 400.00 GP#80123D BB rct 14941
6/3/2021 Grice Construction John and Linda Morgan BB&T 14687 $ 200.00 GP#80128D BB ret 14940
6/3/2021 Grice Construction 419 6th St SB LLC BB&T 14668 $ 400.00 GP#799970 BB rd.14939
6/3/2021 AMW Docks and Marine James McLeod BB&T - - -- 8243 $ 200.00 GP#79999D BB rat.14938
6/3/2021 — __ Carolina Bluewater CConstruction Inc. Craig Miller BB&T 23458 $ 200.00 GP#80172D BB rat.14944
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6/3/2021 - ,F 6 S Marine Mike Desmond First Bank 1021 $ 200.00 GP#80183D KE rat 12861