80269D - Ward

e '-_ CAMA / DREDGE & FILL N° 80269 A B C a
GENERAL PERMIT Previous permit# ,, ,(p'3
�� _!Nev,' -Modification Complete Reissue ❑Partial Reissue Date previous permit issued Siy/0
As autl rized by the State of North Carolina,Department of Environmental Quality ��/ /1��
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
;� Rules attached.
Applicant Name-- A c,, ' 1�.e. �{.a Wr - Project Location: County (.-
El Rules
w, IC_
Address / GV5 S,./4 s ///e. cc n r. Street Address/State Road/Lot#(s) —7 2 /t(,,-1,'L,c
City J� Su., State NI( ZIP 7 3-U3(q �L
Phone# Ocfy)(9 2. Co Y a E-Mail M>'w 4• C 2 - ,^'+e 1,t,,,subdivision
Authorized Agent Lick - a (1, ". (-fa_ City 0r..ew, . 6/-c. dica (7 ZIP 2"y(o, 9
Affected : °CW AEW TA DES ❑PTS Phone# ( ) //1� River Basin L....- +--
AEC(s): ❑OEA ❑HHF ❑IN ❑UBA ❑N/A Adj.Wtr. Body C.G( ^' ( na unI
❑ PWS:
ORW: yes /? PNA yes �� Closest Maj.Wtr. Body ����
Type of Project/Activity /4 c--c clQ Jic, fzr,, 1/, - ' -z_ rUiM -,(, t..,e A ) 1, f
(Scale: N S
Pier(dock)length v(��((Li
Fixed Platform(s) I - �
%, � �( _,- I
Floating Platform(s) Ng f(, ( Ai �i
Finger pier(s)
Groin length 9.:..rf triz . ( '
number _ 1 i l.. ......._ .-
1 • •
Bulkhead/Riprap length r 1 F
avg distance offshore g .... i ' \ \1
max distance offshore
Basin,channel ' I
• C
cubic yards I j J
c‘C/''
Boat ramp
Boathouse/Boatlift 1`( k i 41 — — ....._... -- . - ..._ ._..._.�._.....__,........._............... .i. �_._...........�_.__... f j:.. ---.-+.
vJ L ii.b Xf ���i
} i i
Beach Bulldozing W i 1, L J�
Other / 1 5. I. r
.>/ !
Shoreline Length �U /,( ^ 1�,�„f
(�(A.6
SAV: not sure yes C
Moratorium: n/a es ri-1 '[
N
- I 1 1-- ! . , ,
Photos: yes 0 _...-1._._' ._ '
WI Waiver Attached: ye�r�no \_ 1
A building permit may b required by: Wt." \ 1. 13(GC 'f\ ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) . �` \
Notes/Special Conditions\, I -''D i .,r<-" ,Th.Q„�. Sl , n (%'�•c'.\L C tZ 'p r ,,..., Lk,\• : ' '
NO .,> `.., r � , >' % es...it_
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Agent or Applicant Prin Name Permit N e /
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J�Y\`.^' / U iu,1 \ Vim- et'2g21
Signature.*'*Please read compliance statement on back of permit"" Signatory i

AtaiENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: kMa, j
Wo\rck
Mailing Address: '9-c VkA<Pi rz S
C c.e& �1 (3 .«C,, ) L 2
Phone Number: - p _ g _ 5--��
Email Address: v'A ( vim c s (.6
144
I certify that I have authorized Gri co ( `3 2_(_, 4M
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA pern
necessary for the following proposed development: tc\S b 1;-
at my property located at —12 Au cAc�
in County.
I furthermore certify that I am authorized to grant, and do in fact grant perm,
Division of Coastal Management staff, the Local Permit Officer and their agents
on the aforementioned lands in connection with evaluating information relatec
permit application.
Property Owner Information:
A1-41-(-te,„j 6dct (
Signature
I
Print or Type Name
77tle

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MA AGEMENT
ADJACENT RIPARIAN PROPWRTY (OWNER N TIFICATION/WAIVER FORM
�
•
Name of Property Owner: C\(14 h W Q
Address of Property: IZ mQriNoe S V n 3_76.e2104.61
(Lot or Street 0, $trdet or Ro d, City 8.County)
Agent's Name 0:GT itk Cli: h3 Lk.C.\-1�() Mailing Address:lptD it 32Qc,.\1 "
Agent's phone 0: `‘\0-5—lci-c1V15 aQcoltr161Q 4c \ k 2til(ig
I hereby certify that I own prdnerty litlJaoent to the above referenced property. The Individual applying for
lhls has described to me as shown on the attached the development they are proposing,
__ __ I have objections to this propose{.
If you have **potions to what Is being proposed, you must notify the • ,. ., of Coastal
Management(DCM) In writing within 10 days of receipt of this notice, Co • „b should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405.3845. DCM . abo be
contacted at MO) 70S-7218. No response Is considered the same es no objection "� ' Aeon
notified by Certified Mall.
WAIVER SECTION
I understand that a pier,dock,mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15'from my,area of riparian access unless waived by me, (If you wish to waive the
sett , ou Mutt Initial the appropriate blank below.)
,4401.0aiireasmiimarni"._
."7` - .i do not wish to waive the 15'setback requirement.
ram+
(Property Owner Information) (Adjacent Property ner in
lk e_il'A ' 4�
Signature 8tifignature
' } h Jar Jed-c,•.e A ; /iJ.l4/ -,
Print or Type Name Prin dr Type Name
\ 0$ 31a6 ?\ctc 'fir 70 Ai0,1rd-& St:
Meiling Address Mailing Address
Vcc.tlt‘is` ^ Nc. 2430.01433 pt.Z.6. Xc. i g ri,
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telephone Number Tel hone Number
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Date -Date
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ENDER: COMPLETE THIS SECTION
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• Complete items 1,2,and 3.
• Print your name and address on the reverse N Agent
so that we can return the card to you. fit.!Y 141 1 ❑Addressee
R v b P' to N C.
• Attach this card to the back of the mailpiece, B. y(/ pat Delivery
or on the front if space permits. ��ive t-I. Article Addressed to: D. I ry address diffe nt from item 1? ti Yes
If YES,enter delivery address below: 0 No
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I I I I II III 0 Adult Sult Signature ce Type 0 Priority Mail Express®
❑Registered MaiIT^
0 Adult Signature Restricted Delivery 0 Registered Mail Restricted
9590 9402 5492 9249 3667 55 B' 8rtitled Mail® Delivery
❑Certified Mail Restricted Delivery 111:0Retum Receipt for
❑Collect on Delivery Merchandise
2. Article Number(Transfer from service label)
0 Collect on Delivery Restricted Delivery Signature ConfirmationTe
:d Mail ❑Signature Confirmation
7017 0660 0000 7486 8792 xi Mail Restricted Delivery Restricted Delivery
--.$500)
PS Firm:IR11_.lulu 2015 PSN 7ssn-n2-nnn-9n53 r)nmoctir Rai,...,n___•_.

CI;RTIF( DMAIL_•RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPI RTY (OWNER NOTIFICATIONNVAIVER FORM
Name of Property Owner:- C\nel+1 h w Ct rd
Address of Property: I Z 1 \O n f be E - V CS/..CA.''� T6,e 6461
(Lot or Street#, Street or Road, City&County) -
Agent's Name#:GT 1tt Ce ‘'RSATIXC.A-1 Mailing Address:61D M 1. ic-Y1 Dr
Agent's phone#: ;\D-51G-Olbg5 (nIG1Q lakY461 1`14 21S%(sq
"'+ I hereby certify that I own prdperty 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.
0
; _ —7-
j #tbl ' to'this proposal, .___.___ I have objections to this proposal.
t If you have objections to what Is being proposed, you must notify the ' 1. of Coastal
Management(DCM) In writing within 10 days of receipt of this notice. Co should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405.3845. DCM rep also be
�,,. contacted at(010)7ti8-7215. No response Is considered the same as no objection' �` � Men
notified by Certified Mall. ,
4' 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 whh to waive the
setback, you Dligajand the appropriate blank below.)
Aresommigiladmisideme111~1,1140011.1,111111111Niv'v.-s
..---i I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjacent Property Owner Info n)
WOMCkin ry Cck5etik j
F ,
Signature S nature l
Print or Type Name Print or Type Name
n2v46 akci,5 \\c 'Or 1k AI/F PP-Imo`
MaltingAddress Ma ling 9
165` ^ 1\C. 246034 ict33 Oi erk
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Telephone Number Telephone Number
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Revisbd' O12

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ENDER: COMPLETE THIS SECTIO1 cTION ON DELIVERY
■ Complete items 1;2-,and 3. atute
• Print your name and address on the re X l—f" \ 0 Agent
so that we can return the card to you. 0 Addressee
• Attach this card to the back of the mailpiece, �ec•ived by(Printed Name) C. D: e.f Deli ery
or on the front if space permits. 11 " .. • 2
1. Article Addressed to: B. IS elivery address di'erent from item 1? • Yes
3.4k•P`",\ \ t\1-k-n If YES,enter delivery address below: 0 No
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C)cQuvY\ -b- 1�e��� ��[L
I 'I I I III 111111
IIIII I 111111
( I II I I 3. Service Type PriorityEl Mail Express®
0 Adult Signature ❑Registered MaiITM
0 Adult Signature Restricted Delivery ❑Registered Mail Restricted
- fied Mail® Delivery
9590 9402 5492 9249 3667 79 o Certified d Mall Restricted Delivery IbRetu n Receipt for
0 Collect on Delivery Merchandise
❑Collect on Delivery Restricted Delivery Signature ConfirmationnM
o artirla Ni imher(Transfer from service label) n Inel marl Mal 0 Signature Confirmation
7 017 0660 0000 7486 8785 ail
l RestrictedDelivery RestrictedDelivery
PS Form 3811.July 2015 PSN 7530-02-000-9053 Domestic Return Receipt

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Check .
Cat.RacNvad Deb Deposited Check From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Commenta Receipt or Refund/Reallocated
Column/ Coumn2 Column3 Cokunn4 Cowmn5 Columns Column? Columns Column9
5/272021 Christopher Morrison Const. Chris and Stacie Morrison First National Bank 1607 $ 600.00 GP#80106D PA rct.12783
5/27/2021 Tyler B Cook same _- Fidelity Bank 3110 $ 600.00 GP#80107D PA rot.12785
5272021 C Guy Sorrell Jr. same Bank of America 5060 $ 200.00 GP#80152D PA rot 12784
5/27/2021__ Duncan Marine Contractors,Inc. Vance Neal Branch Banking and Trust 8381 $ 400.00 GP#80131D KE rel.13444
5/27/2021 James 0 Burch ,same PNC Bank 846 $ 200.00 GP#79965D BH rel.12896
5/27/2021 ,Christina Grifaldo Jamie Grifaldo Coastal Bank and Trust 1094 $ 200.00 GP#79920D JD rd.14145 _
5/27/2021 Adam Tawes same BB&T 7273 $ 200.00 GP#79921D JD rot.14146
5/27/2021 Boat List Specialist LLC Rick and Dana Benner BB&T _ 2000 $ 200.00 GP#799870 PA rm.12780
5/27/2021 Joey R Floyd PA same First Citizens Bank 2131 $ 200.00 GP#79919D JD rel.14144
5/27/2021 F 8 S Marine Contractors Inc. Dave Anna First Bank 1020 $ 200.00 GP#79991D KE rot.13445
527/2021 HS construction LLC __ MattHon BB
&T Merritt B&T 2612 $ 200.00 GP#71772D BB rel.14935
5272021 Once Construction Matthew and Rebecca Ward BB&T 14566 $ 200.00 GP#80269D BB rat.12999
5/27/2021 Custom Design Marine,Inc. Jack Rector First Federal i 1381 $ 200.00 GP#799480 BB rel.14933