79997D - 419 (Four One Nine)

OCAMA / ' DREDGE & FILL 1�10 '�999'7
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GENERAL PERMIT Previous permit# (1(!Bs0 C
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued elf 2; J24
As authorized by the State of North Carolina,Department of Environmental Quality ( �O
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC14 `
❑Rules attached.
Applicant Name 1L�y �a ... Sg 1..L C / V\b t(o(A. j-1 Nrli..JL Project Location: County t 'A.s I,L....
Address .Qt J S(�l0(,f S q. 9 Street Address/State Road/Lot#(s) ilf q �k� )4
City 0 VtU�I AC- v State 1J 4-- ZIP 2 202_
Phone#l°fit) St v'�^'r7 01Z Email IA QF,a 1qi�, (21.4,i.,I•'o Subdivision (�
Authorized Agent C` "z -, l(D' i c-C._ J J City S� S t v (LA" ZIP Z t((o g
Affected ❑CW ❑EW ❑PTA /ES ❑PTS Phone# ( ) River Basin L,,,•,_`,,, ,--
AEC(s): ❑OEA El ❑IH El UBA CI N/A Adj.Wtr. Body ^4
❑ PWS: (n /unkn'
ORW: yes /.no,_..) PNA yesage Closest Maj.Wtr. Body n`t S C J t k.
Type of Project/Activity l nA S4i-A c L n c..� In,0( /c‘•... \ , , -,,-. .L Pa.,,I- c S
FY:i s!l et I,.r \` (Scale: N T S )
Pier(dock)length ___
■■■■■■■
FixeFloating'Platform(s)Platform(s)
II!!IIII lull.. . ' HHHHHHHI
Finger pier(s) �•■■■■■ IrSIIIIIMPAII • �iM�MM■■■Groin length 'llII0IHhi.ii!illllull
numberc ■■■Bulkhead/Riprap length cO ■ilioipriEipppuii
■■ lull
avg distance offshore
e '� ��„�
Basin,channel . 10 _
cubic yards ■■■■■■■■ ugit r ■■■■m■■m ' I ■■■■■■■■tinui
Boat rampHI '`
.111111111
Boathouse/Boatlift Iliallil! i___ 1 �111
II ■■II -1--1111111111111
g �/■■■■�■■ ■ ■ :fii■■■�
Beach Bulldozing �fI(j (P t
OtherIII c.f t
I '
I
G,
Shoreline Length
not sure yes ,�' I
SAV: 11111
� --
, ,_ ;
111111
Moratorium: n/a yes
■Y
Photos: yes ,d?� 1 _-....-- rt I ...__ ■■ ■ 1 C
Waiver Attached: no
I
A building permit may a required by: J A.S< 1 e 4 C . . U See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction ` r
Notes/Special Conditions t� ,�1\( c. L \\ n J C 11 Cc Si-4 Lps t-(l c., S
jj
Agent or Applicant Printed Name PermitOffiC�ltS n ed Name
WC -. 1. 1 \ ( k- 40 12/
Signate *•*Please read compliance statement on back of permit** Signature , j

• AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
419 Sixth Street SB LLC
Mailing Address: 615 S College St FL9
Charlotte, NC 28202
Phone Number: 617-510-9072
Email Address:
[e-mail]
I certify that I have authorized Grice Construction
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Replacement of existing canal bulk head
at my property located at 419 Sixth St Sunset Beach NC
in Brunswick 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
Malcolm Hargrave
Print or Type Name
Owner
Title
4/19/2021
, ,
Date
The completion of the project.
This certification is valid through / /

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SENDER: COMPLETE THIS SECTION
m
■ Complett37#ems 1,2,and 3.
I Print your name and address on the reverse '3''
so that we can return the card to you. ig—FErdressee
■ Attach this card to the back of the mailpiece, B. Received by(Pri fed Name) C. Date of Delivery
or on the front if space permits. r 'y"- Ch? -1_ 3 .
1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes
6m e 1�-h er If YES,enter delivery address below:
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\3133 Pore c 1 r'`c.:p
C\(\m{ c-li e W 23`632
I I I I I III 111111 I I II I I I I II I II I I 3. Service Type 0 Priority Mail Express®
0 Adult Signature 0 Registered MaiIT"
0 Adult Signature Restricted Delivery ❑Registered Mail Restricted
9590 9402 5492 9249 3656 42 ertified Mall® Delivery
❑Certified Mail Restricted Delivery o0 Return Receipt for
0 Collect on Delivery Merchandise
o nh Rio Ali imhar?rancfar from carvir a label) 0 Collect on Delivery Restricted Delivery 0 Signature Confirmations
7 017 0660 0000 7486 9119 ie i Restrict `•.elive ry Signature Confirmation
)) e Restricted Delivery
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return r:nnrr,+

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:4\C‘ Silo Si ('ee -G Cif k- Lm�\wA l r
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Address of Property: `l\SV-V\ S ` N- x�n. � e*c.1C�
(Lot or Street#, Street or Road, City& County) -
Agent's Name#:GT 1CR' a.I*uC.1 iv(1 Mailing Address:6)M I tC\\
Agent's phone#:(A\D 5T't•(1095 eek,), 1s2 i( \ N( 2 9(9q
I hereby certify that I own property ddjacent to the above referenced property. The individual applying for
this •zrmit has described to me as shown on the attached •rawin• the development they are proposing.
I have objections to this proposal.
if you 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) 798-7215. No response Is considered the same as no objection jieftle.been
notified by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
P 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.)
i1�✓ tag,: _ =+-
`'' I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjacent Prope Owner I rmation)
a r C3 ) 0 ,Q. &9
Signature Signature
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Print or Type Name j Print or Type Name
( AS , C6\1,-qe % -Fi _13/33 i)d Hi- (De.
Mailing Address I r Mailing Address
C` r1� ��� 2S�ZOZ - 3 eHE$7f,ec//"LL V} 23132_ "
City/State/Zip City/State/Zip
U1 - 5$b 9c lZ i64- 739• 904 3 ,
Telephone Number Telephone Number ;
.y.
Date Da a ,
Revised 6/1 2

U.S. Postal arms
CERTIFIED MAIL® RECEIPT
Domestic Mail Only
3
.1. For delivery information,visit our website at www.usps.com
choompir7 1 J s
) Certified Mail Fee • ••-•
0470
_ $
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Extra Services&Fees(check box,add fee§!rfprFlyrre)
3 0 Return Receipt(hardcopy)
3 0 Return Receipt(electronic) $ Postmark
3 [JCoddled Mall Restricted Delivery $ i Here
] ET Adult Signature Required $
0 Adult Signature Restricted Delivery$
3 Postage
3 $ 03/19/2021
3 Total Postage and Fees
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3. A. Sig /
• Print your name and address on the reverse X / ID Agent
so that we can return the card to you. ❑Addressee
• Attach this card to the back of the mailpiece, B. Received by -rinted Name) C. Date of Deliver,
or on the front if space permits. `) 7.-s' '
1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes
` ^ si—a C If YES,enter delivery address below: 1N0
l�V,lm-`q Z 'ice, \ P\ c
Chci.r\c,1:\k \\k(- ?f Z77
I I I I'I III II I II I ' I I I I I I II III 3. Service Type❑Adult Signature 0 Priority Mail Express®
0 Registered MaiP
❑Adult Signature Restricted Delivery 0 Registered Mail Restricts
9590 9402 5492 9249 3656 35 JR:Certified Mail® Delivery
0 Certified Mail Restricted Delivery 64iLReturn Receipt for
0 Collect on Delivery Merchandise
2. Article Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery 0 Signature Confirmations'
n"^cured Mail ❑Signature Confirmation
7017 0660 0000 7486 9102 ur$Mail Restricted Delivery Restricted Delivery
PS Form 381 1_July 2015 PM 7530-02-000-9053 Doxrestic Return Receipt

•
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Properly Owner Lk\Ck SM SiMe T-S1 '- - (_,\G,\ciA m ro\te)
Address of Property: `\\CA 5t` t 5n � 3QQ& _ _ _ •1
(Lot or Street#, Street or Road, City & County)f -tom_ t�
Agent's Name#:G i a RSArU.( yi c1 Mailing A�ddress:CDtD'i� 1 ►Ch 1�C
Agent's phone#:\\D 5"1G-gtJg5 An I3 Q (k,tc_\(1 N( Z`69rsG
I hereby certify that I own property adjacent 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.
• i have na bh(ti2 tit oposat, I have objections to this proposal.
if you have objections to what is being proposed, you must notify the DivisOn of Coastal
Management(DCM) in writing within 10 days of receipt of this notice. Correspefceshould be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representtr 4dan also be
• contacted at(910) 796-7215. No response is considered the same as no objection 1,161 been
notified by Certified Mall.
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 du wish to waive the lb' setback requirement.
do not wish to waive the 15' setback requirement.
(Property Owner InformaCC13t"l's
ion) Ad cent Pr rty Owner Information)
.9. �laLl R1vC_t
.Signature .Signature
IAN, 5ixHhsV i-L-L Pi to f
Print or Type Name Print or Type Name
Mailing Address Mailing Address
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City/State/zip Ci y/State/Zip
Telephone Number Telephone Number
Date Date
Revised 6/18/2012

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Check
Date Received Data Deposited Cheek From(Name) Name of Permit Holder Vendor Cheek number amount Permit Number/Commenb Receipt or Rahnd/RN#aelted
Columnt Cdumn2 Column3 Cdumn4 Cokumn6 Column. Column7 Columns Columns
6/3/2021 Gary Stanton Ange Bank Check Brent Elmer. First Bank 30273079 $ 400.00 GP#80133D JD rd.14328
6/3/2021 Pippin Marine Construction LLC CJ Bouchard Wells Fargo 5800 $ 200.00 GP#802820 BH Mt 12890
6/3/2021 Pippin Marne Construction LLC Gine Poole Wells Fargo 5801 $ 400.00'GP#80309D BH rd.12889
6/3/2021 Archie McGirt JBJB Propteries LLC First Citizens Bank 8961 $ 200.00 GP#80168D _ KE rat.13449
6/3/2021 Michael Ann Williamson same Truliant Federal CU 1487 $ 400.00 GP#80129D BB rd.14934
6/3/2021 Grice Construction Redfem Scott LLC BEST 14671 $ 400.00 GP#80123D BB rot.14941
13/32021 Grice Construction John and Linda Morgan BB&T 14667 $ 200.00 GP#801280 BB rd.14940
6/3/2021 Grice Construction 419 6th St SB LLC BB&T 14668 $ 400.00 GP#79997D BB Id.14939
8/3/2021 AMW Dodd and Marine James McLeod BEAT 6243 $ 200.00 GP#799990 8B rd.14938
6/3/2021 Carolina Bluewater Construction,Inc. Craig Miller BBBT 23458 $ 200.00 GP#80172D BB rcL 14944
64/132021 F&S Marine Mike Desmond First Bank 1021 S 200.00 GP#801830 KE Id.12851