80312D - Green

05,CAMA / `r DREDGE & FILL N° 80312
GENERAL PERMIT Previous permit# A B C
�� *New ❑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 (J 'r µ , I (0C)
❑Rules a ched.
�Applicant Name ;if 11q-� ( e.r v. Project Location: County D'3(j ) t� r
Address (((G (-3r'cr cAkAsJ - cikrIAA.'r Street Address/State Road/Lot#(s)"�IC( 6. 1)f.
City -Ilrloa(, State 6 ZIP 27-O-(3
Phone#(3 6,1 --4O't( E-Mail Subdivision
Authorized Agent City r :krji1vy? ctd& ZIP 2ce42-tJ
Affected fl CW E EW ❑PTA litcEs CreTS Phone# ( ) River Basin CCF
AEC(s): OEA HHF ❑IH illUBA ❑WA Adj.Wtr. Body ( g ,,pp�f- ` � (nat /unki
PWS: � 1"" �• �"�� /)
Closest Maj.Wtr. Body
ORW: yes /goi PNA yes / I L
Type of Project/Activity �S-i� LAP k VOL:L -Irl12_CiCk
(Scale: 1 s!= 10
/ )
Pier dock)length
Fixed P rm(s) i ' I
Floating Platfo s) j
f
Finger pier(s) ;
Groin length
number __. +4 I E�C — i- —
��YY
Bulkhe Riprap length I'7�y —_...—_._<* --44 Lv� .....�__..._._ .......{ i I
I
avg distance offshore i < � 4 `: I ; / `� '
Ii ,
max distance offshore 6t
in,channel
R- '
cubi ds J
Boat ramp III I
j
j
Boathouse/Boatlift , -- - — — /�/i-mt./ 4. /i
I // I
Beach Bulldozing i
Other Ilf�kiVICL7� 1�� ± 1 ,'•
." '
411' ?`ZOI i I �
� ` a►'
Shoreline Length+/- J( / At- 4*.
I /
SAV: not sure yes �nZI At- —._.4_ . ..G�
i ,
Moratorium: n/a yes ©o —._.___.—._.—_....-._._.._...._I__. i I
y �__ - I __ i i
Photos: es no —____._. i
Waiver Attached:, es no • 1 `� � .
A building permit may be required by it,..)...„ C4'`�fY�C1 `-
vv `��G'!(;Y\ I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) �{ ir i
Notes/Special Conditions ! \ -'►'tf,1Y\- d6 ' - 1 :1p s C�SJ O�"i'1k ,
Ow _tip lexA4 f\ ' L c 0 )y( U) 4IL. t .
ent or Applicant Print N Permit Offi r p 'nted N e
elp ‘/\; M—t\
ig`at re Please read compliance stateme n back of permit "* Signature / f

0 ,.CAMA/ ❑DREDGE & FILL N9 80312 A B C C
GENERAL PERMIT Previous permit#
>� 57New ❑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 F`1 I (
/ ❑Rules attached.
Applicant Name k))((1,A IAA l l q-e'Q,►\ Project Location: County ' K;c L_v; \cwe(-
Address (I((p (-5,-eg4,N\AAave e\ A, ,v... a Street Address/State Road/Lot#(s)--q IC{ (c\,.\:.LQ T('.
7
City i ✓v‘rnc L,L State NY-- ZIP 2 f c
Phone#(7,g4:) ',7 --: 0c ( E-Mail Subdivision c�
Authorized Agent City %,a c k c v \ iCAL\\ ZIP 2�'9 ZE
Affected ❑CW ❑EW ❑PTA Tp [ES PTS Phone# ( ) River Basin (....C. -.
AEC(s): OEA HHF ID IH El UBA ID WA Adj.Wtr. Body " '(yr c('1 f- FM (nat /rJSan/unki
❑ PWS:
Closest Maj.Wtr. Body As-Ls-Du...)ORW: yes / no PNA yes / no
Type of Project/Activity y i - ( `e 0.0
(Scale: 1
Ir= le/
)
Pierfdock)length
Fixed Pfatform(s) J
Floating Platfo s) i C (af k4 .)71 �
Finger pier(s) T
1 , I
1 i. i_ i_. _ ,,.4pt%.X.F L
Groin length
number - _ -.—. _
/
Bulkhead/Riprap length 0'v �y . -._.. � � �+ i F...... {.._ — ..._. � ....._.1.-.- � �.T— -- � —�—
avg distance offshore ' N . \< NI -4 I IlY
max distance offshore
asin,channel �� `�'
cubic rds1 / 1. 1 - V / f
Boat ramp ' f /�I Aj i
Boathouse/Boatlift i 1 .-._. __ t i i
f / { , t
Beach Bulldozing 1 Other '?--tuf�cc� 44 reck l� i f Vittf) I
1 : ,
, . / a A , , ,
iiv
/ i , { -P')e"1
Shoreline Length "- C. )cQ
l 17 -2 ., ii.4 SAV: not sure yes my i ^ _ .—i
�I '
i ;
Moratorium: n/a yes ED �1 fI- 1...
Photos: yes 'n� i
Waiver Attached: es nog `
A building permit may be required by h _C"b i./ 0(k 1 !See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) '
Notes/Special Conditions !'' P+ `� e6 6C7'.5-6...c (G«�'S le; GIu af- PO
0344 _hoc 'x -)0[6. -(u.}..S cc ---,t.jl .
or /liCant Printed cName Perm
- .� r`y. 1--ccAl-t-ent
AP_
y P \ , it Offs inted NTT ..Op
ignature **Please read compliance statement on back of permit** Signature
1 f

t ,b .,! 0 cA.LrlEVS A-Wk W#L`/AN' .54-1&I A trgtElv
334-41o9 -1 Oct 1
b
Q (LOCATION MAI'
` ( NOT SCALE)
h o v,.
(� LT 12A BLK 14A �� �'
M B. 3 PG. 67 4' A" .
J� � w
o� 2
LT 11A BLK 14A
g
� M.B. 3 PG. 67
N 14'16'27" E
8.41 /
P PIER
/
VEW ei-H t-V14 2 /
14%
is . Plet FLAG A1 S
�©�-i '8t10•F METALFT
IPE STATION
/ N 09'26'45` E /BUU(HEAD 9?Sl. / 0
13 �O I (G 1-:7 42.63 HIGH LT 20A BLK 12A P.K. SET $y�14
LINE M H 3 AC. 67 24ti/• ? 14.
s.
�E-14 At N , I T8�• 3
�V ' / METER C w 8,� 4 ry/11
eir NoI ..IP.K. SET _irrEOSTING
HOUSE
LT 19A BLK 12A
LEGEND M.B. 3 PG. 67
L S —IRON SET
NOTES
1. AREA COMPUTED BY COORDINATE METHOD
2. ALL &STANCES ARE HORIZONTAL
3. FOR REFERENCE SEE AS NOTED
4, LOT SUBJECT TO A 10'UTILITY EASEMENT
ALONG THE RIGHT OF WAY OF ALL STREETS.
719 CANAL DR.
jl(NA BEACH, N.C.
THIS PLAT REPREs 1jy5 AN ACTUAL SURVEY THAT MEETS OR EXCEEDS '�"Pl" '�9
INC REQUIREMENTS or A CLASS 8 SURVEY IN ACCORDANCE µ6TH THE Q 4 �s
STANDARDS OF PRACTICE FOR LAND SURVEYING IN NORTH CAROUNA. BEgt
COPYRIGHT O HANOVER OESlCN SERNL'E P.A.. ALL RIGHTS RESERVED, * Tg REPRODUCTION OR USE OF THE CONTENTS OF THIS DOCUMENT OR ADDITIONS Zd L�� Q,OR D�ELEITONS TO THIS DOCUMENT, IN WHOLE 0R PART, INTHOUT THE BRITT W 0•7
CGWSENT OF 1NE LAND SURVEY&R IS PROFd81TED. `'''•�•".. 8U ONLY COPIES FROM THE ORIGINAL OF THIS DOCUMENT, MARKED µ1IN AN • -
ORIGINAL SIGNATURE AND ORIGINAL sEAL of THE SURVEYOR ::sGA'WA 1 t��
CONSIDERED TO 8E VALID AND TRUE COPIES '� BE °•al.st7lii•�
30' 15' 01{ (v/I 30•
711S MAP IS NOT FOR RECORDATION 1
r MAP FOR
1 SCALE W FEET
GRANT A. LATTNER 1
INCH ` 30 FEET
LOT 20A BLOCK 12A HANOVER DESIGN SERVICES. P.A.
CAROUNA BEACH LAND SURVEYORS ENGINEERS &LAND PLANNERS
NEW HANOVER COUNTY
NORTH CAROUNA 319 WALNUT STREET
YALIdINGTO N.C. 28401 u
SURVEYED DATE: DECEMBER 6, 2005 PHONE: (910)
(9tD)343-8002 ITJy`J^
REFERENCE: DEED BOOK 3187 PG 405 \ FAX [phone]
JOB } 11465 Sµ71

it4v.41A IZS,At.pr-fivvy WJ t-f fil,
CERTIFIED MAIL • RETURN RECEIPT REQUESTED !1 C4n G
C,4�U�lr4 �i wC
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:WIUALA al i- '(L4 Lk "EAI
Address of Property: 1 tq MM4L. V?.• CA.(2g-DIVA BEAcei PVC ZigyetZ13
(Lot or Street#, Street or Road, City&County)
Agent's Name#: Mailing Address:
Agent's phone#:
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 p posing. A description or drawing, with dimensions, must be provided with this letter.
A 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 the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
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 blank below.)
fl co I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Inform tion) (Adjacent Property Owner Information)
1MA- AVSA1---Q _C;,____- ...e...-2 .„&___S.. .._
Signature Signature
W t ik4(4 k.C24,EN •i tyCdS arty A o i L oN_ A PA
Print or Type Name Print or Type Nate
6 f cio C eeEivi4pAN 6z. i5 41+ Pc...ck,\,,-D Po,P
Mailing Address Mailing Address
City/State/Zip City/State/Zi I
3M - t6-r-70a1 110 5 l 2- 9 09
Telephone Number Telephone Number
Si4112-0Z f 5 Ji .- Ji,, I
Da Date
Revised 6/18/2012

,i. s Ph(oNy
CERTIFIED MAIL • RETURN RECEIPT REQUESTED -
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: WOE L1-IAI4 6j{pitif c- teg&/l/
Address of Property: ` I 1 CANAL 0 . C >Q QDLxA •eie'Ac.1.1 tt 7.442.0
(Lot or Street#, Street or Road, City&County)
Agent's Name#: Mailing Address:
Agent's phone#:
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.
ME,tf 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 the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
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 blank below.)
/t4G/tn- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property wner Information (Adjacent Property Owner Information)
ittiO ./q /171
Signature 1)4. f 5 , Signature
(l,I)FI t L�BEN / IQsJqVfk7
Print or Type Name Print or Type Name (
1 k; ILEEAY ''AN av, ll Z/ Ai, i,exkk_ f2,-.(kaid
Mailing Address Mailing Address
z-1C43 ( L2I
City/State/Zip City/State/Zip
3310-467-` 01 l 9I o-thy z,78
Telephone Number Telephone Number
S41-1 /2Q I s , a/
Date Date
Revised 6/18/2012

•
Mr. Miles Murphy
Senior Planner
1121 North Lake Park Blvd.
Carolina Beach, N.C. 28428
Subject: Request for new bulkhead at 719 Canal Dr., Carolina Beach 28428
Dear Mr. Murphy,
William and Sheyla Green, as property owners of the subject location, are requesting your affirmative
response to the Adjacent Property Notification Form required by the Division of Coastal Management.
Please see the sketch showing the alignment (in red) of the proposed bulkhead addition. The Corps of
Engineers and CAMA have visited the site and have determined that there is an allowable space to not
violate the 404 Wetlands regulations.
We would appreciate your review and response in favor of this request.
With our best regards,
V V
9411
William and Sheyla Green

Jurisdictional Determination Request
US Army Corps
of Engineers
Wilmington Distnd
This form is intended for use by anyone requesting a jurisdictional determination(JD)from the
U.S. Army Corps of Engineers,Wilmington District(Corps). Please include all supporting
information, as described within each category,with your request. You may submit your request
via mail, electronic mail,or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www.saw.usace.army.mil/Missions/RegulatoryPermitProgram/Contact/CountyLocator.aspx,
by calling 910-251-4633,or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE&CHARLOTTE REGULATORY WASHINGTON REGULATORY FIELD OFFICE
FIELD OFFICES US Army Corps of Engineers
US Army Corps of Engineers 2407 West Fifth Street
151 Patton Avenue,Room 208 Washington,North Carolina 27889
Asheville,North Carolina 28801-5006 General Number:[phone]
General Number:[phone] Fax Number:[phone]
Fax Number:[phone]
WILMINGTON REGULATORY FIELD OFFICE
RALEIGH REGULATORY FIELD OFFICE US Army Corps of Engineers
US Army Corps of Engineers 69 Darlington Avenue
3331 Heritage Trade Drive,Suite 105 Wilmington,North Carolina 28403
Wake Forest,North Carolina 27587 General Number:910-251-4633
General Number.[phone] Fax Number:[phone]
Fax Number:[phone]
INSTRUCTIONS:
All requestors must complete Parts A,B,C,D,E,F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency,please note the specific submittal requirements in Part H.
NOTE ON PART D—PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination,which may include inspection of the property when
necessary. This form must be signed by the current property owner(s)or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D-NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation(NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service,prior to starting work.
Version:May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: 719 Canal Dr.
City, State: Carolina Beach, NC
County: Hanover
Parcel Index Number(s) (PIN):
B. REQUESTOR INFORMATION
Name: William Green
Mailing Address: 1116 Greenhaven Farm Dr.
Pinnacle, NC 27043
Telephone Number: 336-467-7091
Electronic Mail Address: [e-mail]
Select one:
ElI am the current property owner.
❑ I am an Authorized Agent or Environmental Consultant'
nInterested Buyer or Under Contract to Purchase
Other,please explain.
C. PROPERTY OWNER INFORMATION2
Name: William Green
Mailing Address: 1116 Greenhaven Farm Dr.
Pinnacle, NC 27043
Telephone Number: 336-467-7091
Electronic Mail Address: [e-mail]
I Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request(copy of Deed,County GIS/Parcel/Tax Record).
Version:May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3,4
By signing below,I authorize representatives of the Wilmington District,U.S.Army Corps of
Engineers(Corps)to enter upon the property herein described for the purpose of conducting on-
site investigations,if necessary,and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I,the
undersigned, am either a duly authorized owner of record of the property identified herein,or
acting as the duly authorized agent of the owner of record of the property.
William Green
Print Name
Capacity: n Owner ❑Authorized Agents
4/26/2021
Date
William Green
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps,and the JD would be used to avoid and minimise
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
11 I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
0 I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
EA Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
9
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
I believe that the site may be comprised entirely of dry land.
Other:This request is to identify the 404 wetland boundaries relative to a bulkhead
3 For NCDOT requests following the current NCDOT/USACE protocols,skip to Part E.
4 If there are multiple parcels owned by different parties,please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version:May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION(JD)TYPE (Select One)
ElI am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination(PJD)provides an indication that there may
be`waters of the United States"or"navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting,all
waters and wetlands on the property will be treated as if they are jurisdictional"waters of
the United States". PJDs cannot be appealed(33 C.F.R. 331.2);however,a PJD is
"preliminary"in the sense that an approved JD can be requested at any time. PJDs do
not expire.
DI am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination(MD)is a determination that
jurisdictional"waters of the United States"or"navigable waters of the United
States"are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act.Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable(33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner,permit applicant, or other"affected
party"(33 C.F.R.331.2)who receives an AJD may rely upon the MD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
❑ I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
nMap of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
nSize of Property or Review Area acres.
nThe property boundary(or review area boundary)is clearly physically marked on the site.
Version:May 2017 Page 4

Jurisdictional Determination Request
ElCompleted appropriate Jurisdictional Determination form
• PJDs,please complete a Preliminary Jurisdictional Determination Form'and include the
Aquatic Resource Table
• AJDs,please complete an Approved Jurisdictional Determination Forms
n Vicinity Map
Aerial Photograph
USGS Topographic Map
n Soil Survey Map
Other Maps,as appropriate(e.g.National Wetland Inventory Map,Proposed Site
Plan,previous delineation maps,LIDAR maps,FEMA floodplain maps)
• Landscape Photos(if taken)
nNCWAM and/or NCWAM Assessment Forms and Rating Sheets
nNC Division of Water Resources Stream Identification Forms
Other Assessment Forms
7 www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/JD/RGL 08-02 App A Prelim JD Form fillable.pdf
8 Please see http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Jurisdiction/
Principal Purpose:The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses:This information may be shared with the Department of Justice and other federal,state,and local
government agencies,and the public,and may be made available as part of a public notice as required by federal
law.Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination(AJD),which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure:Submission of requested information is voluntary;however,if information is not provided,the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version:May 2017 Page 6

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
Project Coordinates(Decimal Degrees): Latitude:
Longitude:
A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
• North Arrow
• Graphical Scale
• Boundary of Review Area
• Date
• Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Wetland Waters of the US,404
wetlands,etc. Please include the acreage of these features.
• Jurisdictional non-wetland features(i.e.tidal/navigable waters,tributaries,
impoundments) should be labeled as Non-Wetland Waters of the US, stream,tributary,
open water,relatively permanent water,pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters,waters that lack a significant nexus to navigable waters,or non-
jurisdictional upland features should be identified as Non-Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional(i.e.
"Isolated", "No Significant Nexus", or"Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
• Wetland and non-wetland features should not be identified as Jurisdictional,404,
Waters of the United States,or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States,Potential Non-wetland Waters of
the United States,wetland, stream,open water,etc. Please include the acreage and
linear length of these features as appropriate.
nCompleted Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled"Survey Standards for Jurisdictional Determinations"to ensure that the
supplied map meets the necessary mapping standards.http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Jurisdiction/
Version:May 2017 Page 5

U.S. ARMY CORPS OF ENGINEERS
REGULATORY PROGRAM
APPROVED JURISDICTIONAL DETERMINATION FORM (INTERIM)
NAVIGABLE WATERS PROTECTION RULE
Adjacent wetlands ((a)(4)waters):
(a)(4) Name (a)(4) Size (a)(4) Criteria Rationale for(a)(4) Determination
Coastal 0.02 acre(s) (a)(4) Wetland Wetlands adjacent to tidal waters.
Wetlands abuts an (a)(1)-
(a)(3) water.
D. Excluded Waters or Features
Excluded waters ( b)(1)— (b)(12)):4
Exclusion Name Exclusion Size Exclusions Rationale for Exclusion Determination
N/A. N/A. N/A. N/A. N/A.
III. SUPPORTING INFORMATION
A. Select/enter all resources that were used to aid in this determination and attach data/maps to this
document and/or references/citations in the administrative record, as appropriate.
❑ Information submitted by, or on behalf of, the applicant/consultant: Title(s) and date(s)
This information Select. sufficient for purposes of this AJD.
Rationale: N/A or describe rationale for insufficiency (including partial insufficiency).
I1 Data sheets prepared by the Corps: Field notes 4/28/2021
E Photographs: Other: On site photos 4/28/2021
►'� Corps site visit(s) conducted on: 4/28/2021
❑ Previous Jurisdictional Determinations (AJDs or PJDs): ORM Number(s) and date(s).
❑ Antecedent Precipitation Tool: provide detailed discussion in Section 111.B.
❑ USDA NRCS Soil Survey: Title(s) and/or date(s).
❑ USFWS NWI maps: Title(s) and/or date(s).
❑ USGS topographic maps: Title(s) and/or date(s).
Other data sources used to aid in this determination:
Data Source (select) Name and/or date and other relevant information
USGS Sources N/A.
USDA Sources N/A.
NOAA Sources N/A.
USAGE Sources N/A.
State/Local/Tribal Sources N/A.
Other Sources N/A.
B. Typical year assessment(s): N/A
C. Additional comments to support AJD: N/A
Some excluded waters,such as(b)(2)and(b)(4),may not be specifically identified on the AJD form unless a requestor specifically asks a Corps district to do so.
Corps districts may,in case-by-case instances,choose to identify some or all of these waters within the review area.
5 Because of the broad nature of the(b)(1)exclusion and in an effort to collect data on specific types of waters that would be covered by the(b)(1)exclusion,four sub-
categories of(b)(1)exclusions were administratively created for the purposes of the AJD Form.These four sub-categories are not new exclusions,but are simply
administrative distinctions and remain(b)(1)exclusions as defined by the NWPR.

U.S. ARMY CORPS OF ENGINEERS
REGULATORY PROGRAM
APPROVED JURISDICTIONAL DETERMINATION FORM (INTERIM)
NAVIGABLE WATERS PROTECTION RULE
I. ADMINISTRATIVE INFORMATION
Completion Date of Approved Jurisdictional Determination (AJD): 04/28/2021
ORM Number: SAW-2021-00888
Associated JDs: N/A
Review Area Location': State/Territory: NC City: Carolina Beach County/Parish/Borough: New Hanover
Center Coordinates of Review Area: Latitude 34.0435 Longitude -77.8896
II. FINDINGS
A. Summary: Check all that apply. At least one box from the following list MUST be selected. Complete the
corresponding sections/tables and summarize data sources.
❑ The review area is comprised entirely of dry land (i.e., there are no waters or water features, including
wetlands, of any kind in the entire review area). Rationale: N/A or describe rationale.
Z There are "navigable waters of the United States" within Rivers and Harbors Act jurisdiction within the
review area (complete table in Section II.B).
® There are "waters of the United States" within Clean Water Act jurisdiction within the review area
(complete appropriate tables in Section II.C).
El There are waters or water features excluded from Clean Water Act jurisdiction within the review area
(complete table in Section II.D).
B. Rivers and Harbors Act of 1899 Section 10 (§ 10)2
§ 10 Name § 10 Size § 10 Criteria Rationale for§ 10 Determination
Carolina Bch 50 linear RHA Tidal water Tidal waters
Basin feet is subject to the
ebb and flow of
the tide
C. Clean Water Act Section 404
Territorial Seas and Traditional Navigable Waters ((a)(1)waters):3
(a)(1) Name (a)(1) Size (a)(1) Criteria Rationale for (a)(1) Determination
N/A. N/A. N/A. N/A. N/A.
Tributaries ((a (2)waters):
(a)(2) Name (a)(2) Size (a)(2) Criteria Rationale for (a)(2) Determination
N/A. N/A. N/A. N/A. N/A.
Lakes and ponds, and impoundments of jurisdictional waters ((a)(3) waters):
(a)(3) Name (a)(3) Size (a)(3) Criteria Rationale for (a)(3) Determination
N/A. N/A. N/A. N/A. N/A.
Map(s)/figure(s)are attached to the AJD provided to the rcquestor.
2 If the navigable water is not subject to the ebb and flow of the tide or included on the District's list of Rivers and Harbors Act Section 10 navigable waters list,do
NOT use this document to make the determination.The District must continue to follow the procedure outlined in 33 CFR part 329.14 to make a Rivers and Harbors
Act Section 10 navigability determination.
3 A stand-alone TNW determination is completed independently of a request for an AJD.A stand-alone TNW determination is conducted for a specific segment of river
or stream or other type of waterbody,such as a lake,where upstream or downstream limits or lake borders are established.A stand-alone TNW determination should be
completed following applicable guidance and should NOT be documented on the AJD Form.

•
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish,you may request an approved JD(which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II-REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION:The appeal is limited to a review of the administrative record,the Corps memorandum for the
record of the appeal conference or meeting,and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However,you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the If you only have questions regarding the appeal process you may
appeal process you may contact: also contact:
District Engineer,Wilmington Regulatory Division Mr. Phillip Shannin,Administrative Appeal Review Officer
Attn:Brad Shaver CESAD-PDO
Wilmington Regulatory Office U.S.Army Corps of Engineers,South Atlantic Division
U.S Army Corps of Engineers 60 Forsyth Street,Room 10M15
69 Darlington Avenue Atlanta,Georgia 30303-8801
Wilmington,North Carolina 28403 Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel,and any government
consultants,to conduct investigations of the project site during the course of the appeal process. You will be provided a 15-day
notice of any site investigation,and will have the opportunity to participate in all site investi ations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer,Wilmington Regulatory Division,Attn:Brad Shaver,69 Darlington Avenue,Wilmington,North Carolina
28403
For Permit denials,Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer,Commander,U.S.Army Engineer Division,South Atlantic,Attn:Mr.Phillip Shannin,Administrative
Appeal Officer,CESAD-PDO,60 Forsyth Street,Room 10M15,Atlanta,Georgia 30303-8801
Phone:[phone]

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: William Green File Number:SAW-2021-00888 Date: 04/28/2021
Attached is: See Section below
El INITIAL PROFFERED PERMIT(Standard Permit or Letter of permission) A
• PROFFERED PERMIT(Standard Permit or Letter of permission) B
LI PERMIT DENIAL C
® APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTI N5I:The following identifies your n is and"o ons regarding an adnun •4 : ire appeal i the above decision.
Additional information may be found at or http://www.usace.army.mil/Missions/CivilWorks/RegulatoryProgramandPermits.aspx
or the Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit,you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission(LOP),you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety,and waive all
rights to appeal the permit,including its terms and conditions,and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit(Standard or LOP)because of certain terms and conditions therein,you may request
that the permit be modified accordingly.You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice,or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter,the district engineer will evaluate your
objections and may:(a)modify the permit to address all of your concerns,(b)modify the permit to address some of your
objections,or(c)not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections,the district engineer will send you a proffered permit for your reconsideration,as indicated in
Section B below.
B: PROFFERED PERMIT:You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit,you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission(LOP),you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety,and waive all
rights to appeal the permit,including its terms and conditions,and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit(Standard or LOP)because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice,means that you accept the approved JD in its entirety,and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD,you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

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SAW-2021-00888
In order for an RFA to be accepted by the Corps,the Corps must determine that it is complete,that it meets the criteria for appeal
under 33 CFR part 331.5,and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form,it must be received at the above address by 06/27/2021.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
Digitally signed by Brad Shaver
E Date:2021.04.28 15:53:48
Corps Regulatory Official: 04'00'
Date of JD: 04/28/2021 Expiration Date of JD: 04/27/2026
he Wilmington District is committed to providing the highest level of support to the public.To help us ensure we continue
to do so,please complete the Customer Satisfaction Survey located at-
https://regulatory.ops.usace.army.mil/customer-service-survey/
Copy furnished(electronic):
NC DCM attn: Tara MacPherson

SAW 2021-00888
❑The waters,including wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below onDATE.Unless there is a change in the law or our published regulations,this
determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ There are no waters of the U.S.,to include wetlands,present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act(33 USC 1344). Unless there is a change in the law or our published
regulations,this determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act(CAMA).
You should contact the Division of Coastal Management in Morehead City,NC,at(252)808-2808 to determine their
requirements.
Placement of dredged or fill material within waters of the US,including wetlands,without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act(33 USC§ 1311). Placement of dredged or fill material,construction or
placement of structures,or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act(33 USC§401 and/or 403).If you have any questions
regarding this determination and/or the Corps regulatory program,please contact Brad Shaver at 910-251-4611 or
brad.e.shaver(a usace.armv.mil.
C. Basis For Determination: Basis For Determination: See the approved jurisdictional determination
form dated 04/28/2021.
D. Remarks: The site was flagged on 4/28/2021 by Brad Shaver at which time four flags were hung on
shrubs waterward of the existing bulkhead. See attached field sketch.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps'Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants,or anticipate participation in USDA programs,you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service,prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B.
above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination,you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process(NAP)fact sheet and request for appeal(RFA)form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Phillip Shannin,Review Officer
60 Forsyth Street SW,Room 10M15
Atlanta,Georgia 30303-8801

SAW-2021-00888
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id.SAW-2021-00888 County:New Hanover U.S.G.S.Quad:NC-Carolina Beach
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Requestor: William Green
Address: 1116 Greenhaven Farm Drive
Pinnacle,NC 27043
E-mail: farmer7272(a aol.com
Size(acres) 0.183 Nearest Town Carolina Beach
Nearest Waterway Carolina Beach Basin River Basin Onslow Bay
USGS HUC 03030005 Coordinates Latitude:34.0435
Longitude:-77.8896
Location description:The project is located at 719 Canal Drive in Carolina Beach.
Indicate Which of the Following Apply:
A. Preliminary Determination
❑ There appear to be waters,including wetlands on the above described project area/property,that may be subject to Section 404
of the Clean Water Act(CWA)(33 USC§ 1344)and/or Section 10 of the Rivers and Harbors Act(RHA)(33 USC§403).The
waters,including wetlands have been delineated,and the delineation has been verified by the Corps to be sufficiently accurate
and reliable.The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE.Therefore
this preliminary jurisdiction determination may be used in the permit evaluation process,including determining compensatory
mitigation.For purposes of computation of impacts,compensatory mitigation requirements,and other resource protection
measures,a permit decision made on the basis of a preliminary JD will treat all waters and wetlands that would be affected in any
way by the permitted activity on the site as if they are jurisdictional waters of the U.S.This preliminary determination is not an
appealable action under the Regulatory Program Administrative Appeal Process(Reference 33 CFR Part 331).However,you may
request an approved JD,which is an appealable action,by contacting the Corps district for further instruction.
❑ There appear to be waters,including wetlands on the above described project area/property,that may be subject to Section 404
of the Clean Water Act(CWA)(33 USC§ 1344)and/or Section 10 of the Rivers and Harbors Act(RHA)(33 USC§403).
However,since the waters,including wetlands have not been properly delineated,this preliminary jurisdiction determination
may not be used in the permit evaluation process. Without a verified wetland delineation,this preliminary determination is
merely an effective presumption of CWAJRHA jurisdiction over all of the waters,including wetlands at the project area,which
is not sufficiently accurate and reliable to support an enforceable permit decision.We recommend that you have the waters,
including wetlands on your project area/property delineated.As the Corps may not be able to accomplish this wetland
delineation in a timely manner,you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act(RHA)(33 USC§403)and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in law or our published regulations,this determination may be relied upon for
a period not to exceed five years from the date of this notification.
® There are waters,including wetlandson the above described project area/property subject to the permit requirements of Section
404 of the Clean Water Act(CWA)(33 USC§ 1344). Unless there is a change in the law or our published regulations,this
determination may be relied upon for a period not to exceed five years from the date of this notification.
El We recommend you have the waters,including wetlands on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner,you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.
►��The waters,including wetlands on your project area/property have been delineated and the delineation has been verified by
the Corps.The approximate boundaries of these waters are shown on the enclosed delineation map dated 4/28/2021.We strongly
suggest you have this delineation surveyed. Upon completion,this survey should be reviewed and verified by the Corps. Once
verified,this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which,provided

Check
Date Received Date DefiedI d Check From(Name) Nance of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
CWam1 Column2 Column3 Column4 Column6 Column6 Cok.nn7 Columns Column9
7/112021 Sea Dog Marine Construction,LLC EAJ Futures First Bank 1381 : 200.00 GP#80162D PA rt.12841
7/11/2021 Logan Marine,LLC David Highsmith BB&T 7452 $ 200.00 GP#801450 JD rct.14902
7/112021 J Long Custom Homes LLC Jason Long North State Bank 2570 $ 200.00.GP#79971D BH rot 14109
Try12021 Patriot Boat Lift and Dock MainL LLC Wendy Ashe Aquesta Bank 1127 $ 500.00 GP#80143D JD rct.14350
7/112021 Amy T Faulkner Chris and Amy Faulkner BB&T 1755 $ 200.00 GP#80185D BB rct.14065
7/11/2021 Donald Barefoot i Charlie Chowning BB&T 6009 $ 200.00 GP#80183D BB rut.14066
7/11/2021 Backwater Marine of NC 11Richard8.Mindy Jones BB&T 1354 $ 200.00 GP#80154D BB rct.14057
7/11/2021 William H Green [same First Citizens Bank 1049 $ 400.00 GP#80312D BH rct_14101