80142D - Kennedy

0 4 CAMA / DREDGE & FILL °. 80142 A B C ' D
GENERAL PERMIT Previous permit #
>e ;New Modification ❑Complete Reissue I]Partial Reissue Date previous permit issued
As aut =tired by the State of North Carolina,Department of Environmental Quality / 2-0 cp
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC Q
Rul attached
Applicant Name Project Location: County _-_
Addres ,_ !it-I, Ali Street Address/State RRoaa Lot#(s)
City Q t Statec'_ ZI pa�//� /e.3
k c/!^-4 H//t7734-/,LY •
Phone# 3 _Mail Subdivision r
Authorized Agent /11P se'-'-7/2/ li City �/�/ /��^t"'��'"" ZIP 2j44c
Affected CW / W 'ETA r PTS Phone# ( ) l Riv r B�a�siin�f W PO I
AEC(s): oEA HHF /❑fH UBA WA Adj.Wtr. Body_/ A�f tinC , hs !"'~ /unkn)
Pws: d�� �
ORW: yes PNA yes Closest Maj.Wtr. Body __._ .
I r
Type of Project/Activity t•57 4/ D / -
r �7�--
(Scale: N/.c )
Pier(dock)length kr,__ /
Fixed Platform(s) / f ' I
Floating Platform(s) R 411
v I CV 11 ( 1W — T '- t'
1/_
Finger ier(s)
iI " 5 -.-
Groin I h j ' I11 i t i •
�._ tt��
nu er ■sue. "�Tj I i '�
r
Bulkhead/Ri length ___I-__t -".11 1111 ■ •.
K L t I i I . 4 t.- I i t ZaA-42--
avg distan offshore r r. j i
i i {
max distance shore ( ( 1
1 ,
, I t -o 2' 4 f I :
Basin,channel I -- 1 } i r j i , s
r- RIM , 1 T 1
cubic yards _ 1 I t f ) 4 4 f i { } l
•
Boaz ramp �— f 1 i R } i _eiti" '
t
t .. Y i
T R I
Boa �� t "r f j --
,
' : i t ++ i t 1 1 j- ` ` i l j
Beach Bulldozing I t
Other j
j ;
—+ r 1 i j
Ti i : i � 1
l
Shoreline Length� � � .�-'� ` /
SAV: not sure yes no • -ter' E- -
Moratorium: rya yes r I i f
i
Photos: yes �,''h , 1 Ih�1P/
Waiver Attached: yes 1 ' ILA 7b •i "_-_ .____------- "
A building permit may be required by: ir,, 1, ► .,,�1 t J See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
I Ag t); J;: : -'
Ap• "cant ,i •�a e �_ P s Prin:0,
Name
/I 1
read c mpl -statement on'. of it" i. . ,�
�A0 —M--21 /b— 71-V

0 J CAMA/ ❑DREDGE & FILL No 80142 A B C (D.
GENERAL PERMIT Previous permit#
��-% 4New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issuedr -,
As authorized by the State of North Carolina, Department of Environmental Quality / 7_n O
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
❑Rul attached.
Applicant Name ~2(��( Project Location: County 42t
Addres / • .. Ut I- (-i t - Street Address/State Road/Lot#(s) n
City a Statef( ZIP2-7 '/3 / O S' cL-' �I tin r ' ,IvD' .
Phone#("2-y 5"" !_Mail Subdivision
Authorized Agent !" • /4.1-. (L- City 7p cu/ ,4 t4 ZIP ?�
❑CW ED EW p PTA ❑ OPTS Phone# ( ) I Rio r Basin hi ►O .
Affected
AEC s : ❑oEA ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body �/11 '' �
MI
ORW: yes / no PNA yes Closest Maj.Wtr. Body G`""t%/
Type of Project/Activity /,4A S'�6f/,/ (.fd i el, ..._ 74;if ^//7
•
r
f .J (Scale: Weer- )
Pier(dock)length1' 1
Fixed Platform(s) / �r6 / i gi
2vs<Floating Platform(s) �JC 2 r, v Aar," it ' .! ay
Finger pier(s)
Groin length j
1 '
number __,__ -:4WH
i —
MI
Bulkhead/Riap length — i l 1 —
Z)40,,A
avg distance offshoremax distance offshore � ; p I �
Basin,channel
\ j I C�l 4!
� j
cubic yards
Boat ramp r
_' * 1
Boathou /7 � _ —r —_.. — — I
Beach Bulldozing i M_ ; 1
Other \. 1 I
i 1 f i t
Shoreline Length I 7
,/ i \
SAV: not sure yes el +� fr . ; l __.1 7� �\
Moratorium: n/a yes / n I
n -...
Photos: yes p,
Waiver Attached: yes 'no
1
A building permit may be required by: Al\NA d -- AA . ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
r d , ' 12,60-4--
Ag t rAp licant 'nt Same Permit'offic 's Printed Name
i **Please read compliance statement on back of r�nit** Si re

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Diana Kennedy
Mailing Address: 2713 Full Circle
Raleigh NC 27613
Phone Number: (248) 320 - 9070
Email Address: [e-mail]
I certify that I have authorized Southern NC Marine
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Pier Demolition and rebuild
at my property located at 1038 Channel Blvd
in Pender 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
Diana L. Kennedy
Print or Type Name
Homeowner
Title
06 / 16 / 2021
Date
This certification is valid through 09 / 30 / 2021

1040 Channel Blvd
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Diana Kennedy 's
property located et 1 f13R Channel 81vd TopsailBeachp28445 nerd
on Topsail Sound (Address,Lot,Word('Roar )
p , In Topsai1 b4each , N C.
(Waterbody) (City/Town and/or County)
The applicant// has described to me, as shown below, the development proposed at the above location
2-L 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)
SEE ATTACHED DRAWING
WAQ/ER 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 do wish to waive the 15'setback requirement
I do not wish to waive the 15 setback requirement
(Property Owner Information) (Adjacent Property Owner Information)
t S tte
g ' Si ure
Diana Kennedy _no S Lee
Pia
o r N PrintorT Name
273 Full Qircle t Peach Orchard Road
mamglr 1 fgh NC 27613Mailing FA rass
//91 48} 320 9070 City/State/Zip G1! NC 7S2a _
Telephone Number L• (O Z I;
6/16/2021 -Telephone Number
Date
Date
(Revised 6/f 82012)

1034 Carolina Blvd
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Diana KPnnedv
property located at 103 Channel Blvd _(Name or Topsail PBeac'hO O )4
8_ 5
(Address, Lot, lock Ro etc.)
on Topsail Sound in I opSaii beach , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
J y `S 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)
SEE ATTACHED DRAWING
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 do wish to waive the 15'setback requirement.
TR,6 I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Adjacent Pro ertt3 Owner Information)
Signature • •
Diana Kennedy ,!��aacy BP LLC
Print or T N m -'Print r Type Nam
113 Full Circle 1y3 Lafoy Dr
Mailing Address Maili Address
a�elgh NC 27613 laytnn Nr,_27527
City/Slat i City/State/Zip
�8) 320- 9070 (9t0 391- 2223
Telephone Number Telephony N be/
Dale
(Revised 6/18/2012)

Ch.k
Data Received Data Deposited Chock From(Nana) _ Noma or Prmk Holder Vendor Check number amount Permit Number/Commoner Receipt or RdundRoolloc.ed
Column,' Column2 Column3 Column4 Column5 Columnd Colulnn7 Colima Column➢
7/2/2021 AWM Docks&Marine Ronal and Loretta Elliott BB&T 6028 $ 200.00 GP#79951 D 8B rct.14060
7/2/2021 Doris Hatley same Pinnacle 3589 $ 200.00 GP#80192D BB rct.14056
7/2/2021 Southern NC Marine LLC Diana Kennedy First Bank 1447 $ 200.00 GP#80142D JD rct.14348
7/2/2021 Riverbrook LLC First St James Inc. __ Wells Fargo 1255 $ 400.00 GP#80119D PA rct.12839
7/2/2021 Barbara West same Fidelity Bank 3765.$ 200.00 GP#80138D JD rct.14340