74823D - Smith (2)

(L Ct n-c 7-Ki-7O i -//5 -LUG/ - J4A1
� 'CAMA / DREDGE & FILL No. 74823 A B C
GEN L PERMIT Previous permit#
>C Ijt1 w ' odificationn� \\❑Complete eissue • Reissue Date previous permit issued
As authorized by he to of t5rty. l-olinaa, ,art n Environmental Quality u---1.4 , +ZOO
and the Coastal Resources Corn issio ' an area Of ironmental concern pursuant to 15A NCAC lJ
gales attached.
0
Applicant Name Or / Project Location: County r'(A)Z 1 I r )(Street Address/State Rpa /Lot#(s)
City State ZIP � II es) I (D >t
Phone#'f Io)Z f fQ E-Mail Subdivision_ /1I
Authorized Agent I dl/1.11.AJnC.2 Cr City si7 � /1( ZIP F0-1'1
Affected ❑CW (1Ca4W `�TA ❑ES ❑PTS Phone# ( Ri er Basin` V4 0
AEC(s): �� HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body t 4 U i >C (nat /man /unki
J PWS: /
ORW: yes ( no `: PNA yes Closest Maj.Wtr. Body ci n r Si 14/C-1-^--
_LcType of Project/Activity Q i (4
! I (Scale: ' ifs 7/ )
Pier(dock)length 1� 61 P
Fixed Platform(s) III )(le
i4
Floatin Platform(s) i —._— f
Finger 'er(s) t{/_
Groin len h { _
number ,z'1.... - 'C- 1�' At _
Bulkhead/Rii'ap length �` ' }
avg distan e offshore - } ,
max distan -offshore ' S [ _
Basin,channel 61 1l'i 7��.
1 _ ,
�f
cubic yards � ,
. ' Ai 4/
Boat ramp � � H ,,,, , 1 i (
Boatho Ia. ' i
' � I
• •
Beach Bulldozing / -
i
Other
fi ,trii
l A }
/ t l
Shoreline Length 7 AJ
51s / —___—__I-
- _
—
Moratorium: n/a yes
Photos: es
Waiver Attached: y l.�� `7 , _
, ,
A building permit may be required by: l . ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
._rri1A1fLA
Ag t or lic t Printed Nameei, Pe it i nn d ame
Sin ure * Please read compliance .410.. ent on back of er 't ` Si n
g P i- P 8

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
'I hereby certify that I own property adjacent to g e( 57.4,- I41 s
(Name of Property Owner)
property located at GO-7 I Io`f' j 5 f
(Address, Lot, Block, Road, etc.)
on C`' �-, I , in 549-3-1 , N.C.
a���y) (City/Town and/or County))T t 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)
`)g"
7-
,i /
c ok9$r BQ
A, 1
19- -V\
-X -Cc'
s
cl y
WAIVER SECTION
I understa • at a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
min.,- 0-- d.. - ce of 15' from my area of riparian access unless waived by me. (If you wish to waive
t►- --tb- - •u must initial the appropriate blank below.)
._ __ _ do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requiremenit-_-- > -
(Property Owner I/•rmation) (A scent Property er Inform 'on)
iteD
a-. ,
�-- Cis
( arure i e
/a"11 In .0,.., r:01;‹,6P C g? ---4--
Print or Type Name P nt orfype Nam
Mailing Addres MJJMdss
kjOrS‘tiA) _IV City/ te/Zip ci fat !Li .
?0 31 40 ( ),5 .0 - /9__ 9
Telephone Number Tel
^^�� eph ne Nu ber
Date S t ' d°1 ) S//0 /02 i
Date
(Revised 6/18/2012)

i
1. hereby certify that I own property adjacent to /fi (Name of Property OW11100
Property located at (Address, Lot, Bl7k, Road etc.) N C
e't �n rY o m `�i C cRown and/or County)
on (WaterbodY)
The applicant has described to me, as shown below, the development proposed at the above location.
t4143 I have no objection to this proposal.
I have objections to this proposal.
----
DESCRIPTION AND/OR DRAWING OPROPOSED on below oELO has a drawing)
NT
(Individual proposing development must fill —. _ ,
(ply 19 <--- :'' ' --..7 I
1.
T
I 3
y
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set b
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
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.
_
(Pr. •.: rty Owner informs , on)
(Adjacent Property Owner Information)
tio
tibaue-s4h4A4621
S;�' ` e
.._ /- 4 ; . � Signature
o G l A) • Y1agr<tA Allele rA.li n e n
Print or T eName
Print or Tye Name
d / 1 1 OS Pr, �ce pia ve
Mail ng Address ' Ma/'l'ng Address
/ t d e39it5►�1 snv� Itt N� 2 ' ><s S
City/State/Zip
City/Slate/Zip fd 3.1.7 2S2 -75q- fr'I 5 f
Telephone Nu ber
Tele hone Number
is e, A /_ . 1 1-, 1 1 ii ills. 2,5. 2 n ? 1

.
AGENT AUTHORIZATIIN FOR CA'-A PEROT APPLICATI.N
Name of Property Owner Requesting Permit: act 1 /rj ,'/1‘
Mailing Address: 6 61 "2/ 41'1 41
Sr • (sly ec- agqs"
Phone Number: 9to a9& 33,
Email Address: I S C 07/nad
I certify that I have authorized tit cJ k1 S( 11-4a�yi (
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:C 61/1'7420
.
k
at my property located at &O 4
'',.
in e9 R.` rrll 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.
Propert ner information:
Sign ure
Do/ N. �i►► '��
Print or Type Name
Title
6 / 03 l a daq
Date
This certification is valid through / I

Chock
Date Rewired Date Dopeshod Chock From(Nem.) Name of Parma Holder Vendor Chock number amount Permit Number/Comment Recalpt or Rafund/Raanocated
Colonel Column2 Column) ColwnM _ Column5 _ Column6 Colter 7 Column: ColumnY
7/1/2021 Richard Brackin Jr same BB&T 2256 $200.00 GP#79989D TP rct.14877
7/1/2021 Lighthouse Marine Const. Joel Smith Coastal Bank and Trust _ 3816 $200.00 GP#74823D JD rct.14081

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J hG I, ! ° . c51Y1 1L--� 's
(Name of Property Owner)
property located at (0C)1 1 ,
(Address, Lot, Block Rod, etc.)on l2 '�
( CA) , in u{ i- r� slo�� ) , N.C.
(Waterbody) (City/Town d/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)
--11)34a-1 ) ,Q- 21aj d'1 .-13. •
fry
' _,ron ° v Po 'Q
d r�
1/
--Nomai0 ,,
,L__si i
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.
" ''d• --------
I do not wish to waive the 15' setback requirement.
(Pro rty Owner Informatio (Adjacent Prope Owner Information)
Si a re S. re
SY1`_)1-N a r�� r r'
Pri j t�rl ype Name Pri ��p�Name �/
�ncl,pJ� ,5L , Cf .,.<
Mail g Address WilingAd ess
L�'e�n ,,..-)i T 1�a3� /�i 1, N 8�65
city/tip/zipnn // �j
)0rvl(0-- �al0 City/State iparya �0"
Telephone Number r a��I Telephone Number
Date J 7—i- ° a i
Date
(Revised 6/18/2012)

AGENT AUTHO 9ZATI.N FOR C•,rs':A PERMIT APPLICATISN
•
Name of Property Owner Requesting Permit: (96/ Al 1,'/L)
Mailing Address: j Q ( ./ti
Gt�� N(- OFW5
Phone Number: 97o a gip
Email Address: r h J el) L iv y►a:(' GQa,
certify that I have authorized e s h I`Ad i,c (oNel, ,
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:.
at my property located at
in Cilvdk 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
_ ature
D /V • S ,./
Print or Type Name
Otiinatr
Title
9 I S
Date
This certification is valid through I I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
• I hereby certify that I own property adjacent to t)0.1 N. ;---\\--1 's
��� (Name of Property Owner)
property located at (.0 0-1 (Address, Lot, Block, Road, etc.)
on ' ( 1 , in rt I 19) , N.C.
(Waterbody) (Ci c�
wn and/or County)
The I l applicant has described to me, as shown below, the development proposed at the above location.
SI 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)
Zn iI 2 d3c r_ - Itr--F-s
VI
fr,cv,i; —...
,v, l� i6 1a' r
0 0
1
e)
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.)
tfiLt3 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(P o•erty Owner Inform- on) (Adjacent Property Owner Information
/ r) .�� tfli_an
• ature I Sign ture
•� Ihart hnne,(Brannan
Print or Type Name Print or T Name
_ 10 P pI� t-.. /O Pri`no L. Axe__
Mailing Address Ma'.ng AddressWOASO Li I\I.C, Gg*, )s ('-re env;cle, Nr. 0 70 r
Ci State/Zi City/St /Zi �/�
t110-Q9'(0- 33(o ---)s81_ 8'75
Telephone Number Telephone Number
Q ?-05 Qoa.lat a0.21
Date Date'
(Revised 6/18/2012)