79920D - Grifaldo

41 C CAMA/ ❑DREDGE & FILL N° 79920 A B C ( 15'.
GENERAL PERMIT Previous permit# -
>< :New ❑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 6 7/-' . /Z-0 d
Rules Ched.
Applicant Name ��� I �% �� ��� i>C) Project Location: County ��
Addr s 5?b/ - /ii,Jti 7n A-/C-- Street Address/State Road/Lot#(s)
City j)4 CILSoN Vi L(c/ state' z1P'YC9-e' /0 / U- f N/) /4-1/-
Phone 4/0 �� -- N-7 tr E-Mail Subdivision
Authorized Agent fs/44-- City r 14 ZIP 71443
Affected ❑CW W ,P Cl PTA ❑ES ❑PTS Phone# ( ) River Basin •U
D OEA ❑HHF ❑IH ❑URA ❑N/A ��R ,
AEC(s): Adj.Wtr. Body C J/ratan /unkn)
❑ PWS: ` ` -i
ORW: yes /, no: PNA yes / - Closest Maj.Wtr. Body J , v t' � 5-Uv'l
/ 1
Type of Project/Activity / -c �!�-(.e `i /1 --'7 7' )4 tt. 7 6S
UA15 ' ' ' u. : 4 c 1 ) /, r
rt / (Scale: / c )
Pier(dock)length b V/f
Fixed Platform(s) 1" 130/ ! ' l
Floating Platform(s) I i
Finger pier(s), 1 1 _ ___ — iiIV I
:
Groin length : ' i i I
,number , —,—
i ——
Bulkhead/Ripr length `` �— 1 f i
avg distance offshore
max distance offshore
Basin,channel j I ( -/ // 4L\i0a
cubic yards i I I I 1/ �/6 /r # 1
Boat ramp /_
{ I i �
Boathouse/Boatlift __i. _ _......_............._......t 1 --- --..-._........_...............
ito
Beach Bulldozing ; - I i I.(,L •
Other ( - 1/
Shoreline Length t/ 66 i 1 i / �
1 y/ /
SAV: not sure yes t
-._...
4 1/14- .
Moratorium: n/a yes no I 1 i 1 I
Photos: yes f�S
Waiver Attached: 'y _ _ ( 1 I 7
Vf
A building permit may be required by: `' "�`"/ -7 `� . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) J
Notes/Special Conditions
jAilAAA-1"
&?i' 4 (c/cr' 512612,1
7tor Applicant Printed Name Permit Officer's Printed Name
/ qJ2- 12i
Signature **Please read compliance statement on back of permit 1 , Signitufe

.4 CAMA / DREDGE & FILL 9 79910 A B C--"n
E N E RAL PERMIT Previous permit#
ew Modification ' 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 15A NCAC a 7/1 */ a
Z©V
Rules at hed.
Applicant Name a V1&I iF �Fik`PO Project Location: County �•'�/��
Q� .may�� -- - -
Addre `,/��/dfv ;414/ //RTC! y Street Address/State Ro /Lot#(s)
City/��T`7/�Q/✓I/(LtE Stat �ZIP`4 10 t ( �/£ b 4,4 Aix
Phone 0 S.jr r YE-Mail _ _ Subdivision yr
Authorized Agent r/A— Cityfl. ZIP `O g5_-
_ cw „,.., A ES PTS Phone# ( "ver Basin a/•0
Affected oEA HHF ❑IH UBA N/A
AEC(s): Adj.Wtr. Body 4i 5 ill
,(® /=O A ,_/unkn)
PWS:
Closest Maj.Wtr. Body-. ... _
ORW: yes ` PNA yes y�
Type of Project/Activity r (/L e e°14 l� 74�l
�i�•ii' : �'� t,
(Scale: / Q2,0 )
Pier(dock)length �� ~
Fixed Platfor (s) 1 r'
Floating Plat rm(s) i
Finger pier(s • i i'
Groin length
number v-+....---T ./t- /v ...--..„.1
Bulkhead/Ripr length
avg distanc offshore
max distanc offshore � �r o t
r,
Basin,channel / 1
III
cubic yards _•r� • y 61)41.64 /f'Y X/
Boat ramp i
'fle•q f
Boathouse/Boatldt Il tvlrid • ` _.-•
v /V/ i ��
'I
fi
Beach Bulldozing C �►
Other /
Shoreane Length V4- �� 7
SAV: not sure yes iiip
/ ^/l`/,
Moratorium: n/a yes n• fff"'��� /
Photos: yes ig, 11/11��
Waiver Attached:
r53)1P"
�� I"�
A building permit may be required by: 77 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
1, t
AMMfC4r." t
Age t r Applicant Pi r .� e , P; % er's Print Name
Si nre **PI: •-read om a I':nee statement on back of permit*' Sig

I
704 Paluho1 Ave 7D : PPkj Aie 70 $ fo/qhc! Ave
P1d4 f a v)e.‘ Ja v.i i e. 6r; 4ido *-ev,en Murray
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ro
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tN 4N ii- g low .,
- Qep IQce
E et,ck w1+L pIxed
I. e dot , (sawve 4 f9Ylik) N .
NNA
HY
M �ed� ) banneI seibacK
U.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to `/a 'ie 6„-, 4W 's
(Name of Property Owner)
property located at 706 io land i4ve
�(Address, Lot, Block, Road, etc.)
on kVO4--e“ 6a`� , in 5� CI)/ , N.C.
(Waterb'bdy) (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 development must fill in description below or attach a site drawing)
Sege a 1-4-aci-ecP dl wtnir
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 etback, 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) (Adjace tProperty Owner Information)
1--"2"-------
'ignat ur Signature
far n1 e 6-i 4/46 Ida Taw es
Print or Type Name Print or Type Name
SD/ Fawn MO/ 7°Y ,eo/Qnc/ AIL/- -
Mailing Address Mailing Address
TGcksoh v,'//e NC 2 YO s.„1 C,I-y NC ZF4/1/5-
City/State/Zip City/State/Zip
9yo--Sgl -1/79(/ y/O- 232 -05-09
Telephone Number Telephone Number
filly 4-4_ Z6Z/
Date Dale
(Revised 6/18/2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L.}arivp ✓ r 4l/Gr/0 's
(Name of Property Owner)
property located at 706 , 0/"/I/ /4C�-
(Address, Lot, Block, Road,,etc.)
on , in 5' (-7Z C;-fy , N.C.
(Waterbody) (City/Town and/or County)
The applican s 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 development must fill in description below or attach a site drawing)
drv--ocuc.),
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 setba , 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 I formation) (Adjacent Property Owner Information)
Si ature Si na ure
a f/ c ejr/k/d° kv� � t�riu
Print or Type Name Print or Type Name
C)/ cakin //-4 r l .5004 {rd s U,-r;,- CI
Mailer Address Maili Address
acirson ',//P /UC 7351c +it - o\�,�
Ci y/State/Zip City/State/Zip
S/o-5-2S — `f 77-( 110 - ti 3 l - �(
Telephone Number Telephone Number
/nay- /7 zI Ie Z \
Date Date
(Revised 6/18/2012)

Check
Dab Received Date Deposited Check From(8p•/ Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Rotund/Reallocated
Column) Column2 Column? Column) Columns Columns Column7 Columns Column!?
527/2021 Christopher Morrison Const. Chris and Stacie Morrison JFirst National Bank 1607 $ 600.00',GP#80106D PA rct.12783
5/27/2021 Tyler B Cook same Fidelity Bank 3110 $ 600.00 GP#801070 PA rel.12785
5/27/2021_ C Guy Sorrell Jr. same _ _ Bank of America 5060 $ 200.00 GP#80152D PA rat 12784
_ 5/27/2021 'Duncan Marine Contractors,Inc. Vance Neal Branch Banking and Trust 8381 $ 400.00 GP#801310 KE rd.13444
5/27/2021 - James 0 Burch same PNC Bank _ 846 $ 200.00 GP#799650 BH rd.12896
_5/27/2021 Christina Grifaldo Jamie Grifaldo Coastal Bank and Trust 1094•$ 200.00 GP#79920D JD rat 14145
5/27/2021 Adam Tawes same BBBT 7273 $ _ 200.00 GP#799210 _JD rd.14146
527/2021 Boat List Specialist LLC Rick and Dana Benner BEAT 2000 $ 200.00 GP#79987D i PA rd.12780
5/27/2021 Joey R Floyd PA same First Citizens Bank 2131,$ 200.00 IGP#79919D _ JD rct.14144
5/27/2021 F 8 S Manna Contractors Inc. Dave Anna First Bank 1020 $ 200.00 GP#799910 KE rct.13445
5/27/2021 145 Construction,LLC Matt 8 Memd Hon BB&T 2612 $ 200.00 GP#71772D BB rd.14935
5/27/2021 Griot Construction Matthew and Rebecca Ward_ BB&T - -- _ 14566 $ _ 200.00 GP#80269D _ BB rct.12999
5/27/2021 Custom Design Manne,Inc. (Jack Rector First Federal I 1381-$ 200.00 GP#79948D BB rct.14933 -_