79999D - McLeod

0 2 CAMA/ Ll DREDGE & FILL N° 79999 A B `63,
GENERAL PERMIT Previous permit#
�� MNew ❑Modification ❑Complete Reissue El 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 C) -(-'( 1 2 0 0
❑Rules attached.
Applicant Name "a.yl S I'k `Leos- Project Location: County I J(-- S ( 'c
Address 1 (0 A r j ,ntj tC.
^ r../- -, Street Address/State Road/Lot#(s) 141 69 fJ.
City L c - I,-u"N State N(__ ZIP 7 ?f 3 jy‘ cd t e Vi ,
Phone# ( li0) 11 10L/2E-Mail JCI ry t L. ad SC@i-'`"',1., Subdivision
ff ``
Authorized Agent - (c ft. W t 4 City S J,n s e t• do 4 c (il ZIP "Z Y`/(o 8
Affected
•�CW A ❑ES CI PTS Phone# ( ) River Basin - -��--✓
�� �W
AEC s : ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body _-c
O ❑ PWS: � C�c j (n�map�/unki
ORW: yes / � PNA yes / Closest Maj.Wtr. Body + lc 5 —
Type of Project/Activity ' n ._. r e--,
�,�. c Cv' '^
± S �Jf (Scale: 1( 7 S )
Pier(dock)length II x +
Fixed Platform(s) �1� Ill , ' /'� • ,
Floating Platform(s) gx 2O !� j �„/ r� G 4
Finger pier(s) v I 0 ` II ._._.�. I
Groin length .
number �A�yn(�y L.._._L¢ , .. ...... .. ....... . . = r- II _ -
Bulkhead/Itiprap length
avg distance offshore - j ` --. .
max distance offshore { -}
1
Basin,channel a i 1
cubic yards 1
Boat ramp { I 1
Boathouse//2'7X i 3 _� _ -..... -
Beach Bulldozing I -- /f
Other -�--.�, �, { �' : ^,
ti r
0/�Shoreline Length So• i G
I
SAV: not sure yes n __. Sa -. ' -__._. CL G J.lbe��•I
Moratorium: n/a yestil ! F-,._--
Photos: ✓ T... _..
Waiver Attached: yes no
A building permit may a rAquired by: 2), S t C f c c k . 1 I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction \\
Notes/Special Conditions -lc-- c A A .\S r,‘+ r'f,C.s.,te e j,S C L.c, I . '`4.--
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cant Tinted Name Permit° 's Printed Name
e'' _ 1.,___ 1-<,_ .L., 4/49-1121
Sienature **Please read compliance statement on back of permit** Signature I

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CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: - -nnc s '-5,4 oc-I
Address of Property: 4O 9 ,,resz-.-C-i 5L1ILE r
(Lot or Street#, Street or Road,City&County)
Agent's Name#:cA`6Q-44) � Rio-6- Mailing Address: /7a� /
ee_ `Z--emu/
Agent's phone #: .Z; - -o 6-Y _C'J)3 ,J c o.?fs' 67
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 dimensions, must be provided with this Letter.
�ivil;AL
0, iE-- FOCI have no objections to this proposal. I have objections to this proposal.
r
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 http://www.nccoastalmana_gement.net/web/cm/staff-fisting or by caning 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
1 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.)
ak L
?'AP%se, " ( K_ I do wish to waive the 15' setback requirement.
0,Ni~ / N
-------`7 I do not wish to waive the 15' setback requirement.
(P ner Inform ion (Ri rian roperty4,11gformation)
, . 7:ow
jk2t) PI- -41)
11 b- (.27),ize, <___.-
Signature ignatur,
y tL rirsP L l`i (1..4)KjSSAC
Print or Type Name Print or Typ Name
%M� ON r
Mailing Address Mfg Address j,
u�6�•`�--orJ N
7is-. /% r1.4-1,k AA ZL'%r,
City/State/Zip City/Sta eiZip
7C Z 5? (7u 1 -j
Telephone Number/Email Address Telepho a Number/Email Address
-Y- 021 S /6/fr.t)l I
Date Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner. �1 S .- l Go
d
Address of Property: ig O ! A)0' t"'1. h wz .6 r •
� (Lot or Street It.Street or Reed,City&County)
Agent's Name#:l! liticeo5 t Mailing Address: kip H 4ec-ckrii-.S4J
Agent's phone#: / el-06c p - 7Y 4 G r F
I hereby certify that I own property adjacent to the above referenced property. The individual
o
ng for this permit has described to me as shown on the attached drawing the development
are proposing.Aslescrig(ign or draw] g.with _must be mended with this lettpr.
I have no objections to this proposal. I have objections to this proposal. Z
Z,.h AC 1f you have objections to what is being proposed you must notify the Division of Coastal Management
oft
(DCM) in rftfna wttlMn 10 days of r ceipt of this node.. Con act Mlforrastion for'DCM on►kes Is
avai�ebAa new
nib?!/lrww w by 1.S8&4RCOAST.
No response is considered the same as no ob(ection I you have been notified by Certified Malt.
WAIVER SECTION
----, t understand that a pier, dock,mooring pilings, boat ramp, breakwater,boathouse, or lift must
-L4u0":g-be set back a minimum distance of 15'from my area of riparian access unless waived by me. (tf
ato. you to waive the setback,you must Inlet the appropriate blank below.)
FLL
'- Z r,-- - I do wish to waive the 15'setback requirement
I do not wish to waive the 15'setback requirement.
(P . . . Information) ( parlor Property Conver Information)
_ �
--/44--4°---- A*11.-
r:• re SignatsinC -----
S At�)ec v4c C,v J;�(Xtivl
Print or Type Name Print or Type Name
9 Ait lr-j 1e.-1 S r . 12--`ic 64fi¢14N r1(7)6G- u
Mailing Address Meiling Address
•
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Telephone Number/Email Address Telephone Niuntber 1 Ema7 Address
Date Date 1 1
(Revised Aug.2014)

DocuSign Envelope ID:5883AD02-13CEA-4598-92CC-8ACC1308AA54
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
,165 fif-clAh)
Mailing Address: 7t i4p` I A/4 71-V LR._
Algol rJ / A/c- 7-8 ;;S'
Phone Number: //1)
Email Address: VI) m S 6mA,` • c 6'
I certify that I have authorized WCS A i
Ag t/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: k'r Dc
at my property located at } gel c Az.' D •
} �'in '5vJ: 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:
oowsbnee by:
�-JJ4
Signature
). /11e c'1
Print or Type Name
c(A/O
Title
Date
This certification is valid through lZ / 3 f I ZJ

Cheek
Date R.calwd Data Doomhad Check From(Noma) Nam.of Permit Holder Vander Chet*number amount Pam*NumbMComm.nb Receipt or Refund/Reallocated
Columnl Column2 Coumn3 Column4 Colamna Column. Cakann7 Columns Columns
__ 6/3/2021' _ Gary Stanton Ange Bank Check _ Brent Elmers First Bank 30273079 $ 400.00 GP#80133D JD rct.14326
6/3/2021 Pippin Marine Construction LLC CJ Bouchard Wells Fargo 5800 $ 200.00 GP11180282D BH rot.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#80188D KE rot.13449
6/3/2021 Michael Ann Williamson same TruliaM Federal CU 1487 $ 400.00 GP#80129D BB rct 14934
6/3/2021 ,Grice Construction Redfern Scott LLC BBAT 14671 $ 400.00.GP#60123D BB rot 14941
6/3/2021 •Grice Construction John and Linda Morgan BEAT 14667 $ _ 200.00.GP#801280 BB rot.14940
6/3/2021 Grice Construction 4196th St SB LLC BEAT 14668 $ 400.00 GP#79997D BB rct.14939
6/3/2021 AMW Docks and Marine James McLeod BB 6243 $ 200.00 GP#79999D BB rot.14938
6/3/2021 Carolina Bluewater Construction,Inc . CT Craig Miller BEAT 23458 $ 200.00 GP#801720 BB rct.14944
6/3/2021 F&S Marine Mike Desmond •First Bank 1021 $ 200.00 GP#80183D KE mt.12851