80141D - Gaddy

OFCAMA / DREDGE & FILL N° 80141 A B C
GENERAL PERMIT Previous permit#
>' 4New ❑Modification ❑'Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized 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 0) 4 ,
Pp C """ c `4. 1 County
Rules ttached.
Applicant Name l 1M I C _f(,}� Project Location: Coun - �
Address- r K! v C to ,,,d, .� �0O Street Address/State Road/Lot#(s)City
h�u Statel'��) zip2 I \ I pt�p b/I�li(( (2od.Phone
#�I n 14''9 E-Mail Subdivisio U I a
Authorized Agent N A' City I ZIP 443
Affected ❑CW M:EW IPTA ❑ES ❑PTS Phone# ( `-)-- River Basin IA/,0.
AEC(s): III ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body A i vv w at man /unl
❑PWS:
ORW: yes / no PNA yes no Closest Maj.Wtr. Body -76� SO v
Type of Project/Activity 4-4 jt1L ‘Aa.L ,,.1,0 ,4<___- •
`. (Scale: )TS
Pier(dock)lengt
Fixed Platform(s) �L F
Floating Platform(s) 6 )( I i i !, i _ I
Finger pier(s) I
! Y— I
Groin length ;
number _ -......_r.. ; t i
ST1146
Bulkhead/Riprap length —.— .____.._..—_--
_
I
avg distance offshore I 1 i J
max distance offshore '
Basin,channel I
j I
1 E : 1 ' " E ,--friy6c4A to qii) i 1
cubic yards I
, .. j
Boat ramp
Boathouse/Boatlift }.........w ;. ,..... _.. ---. 1_...._....;...._.._ _._..._......._.._.__�___—..__......._�.—+._ _
._-- _.._.._..__......---. _.........-.._....-.-. _. _......_.-._....... I --....__...._._..-- -......
Beach Bulldozing ----- �_'.._._._ - I {
' I
Other
Shoreline Length �/"'y �/"
1 f lfilr
!
SAV: not sure yes a f `1' .
Moratorium: n/a yes ___ , __ -- L
Photos: yes4111/ PrP
Waiver Attached: dip no y .64.1 .
i�
A buildingpermit maybe required b : .64.1 .
q y �lWlt I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
bf'/I,' V i S 6—kriClir cl'\ klit--- (.0•2.4.2.1
Age or Applicant Printed Name Permit fficer's Printe e
1 **Please read compliance statement on back of permit** Si a r
1�1 /1 1 7 ^ '7 I I, 4 ^ i I

• •,UCAMA/ UDREDGE & FILL
N° 80141 A B C D'
GENERAL PERMIT Previous permit#
)G 1New ]Modification Li Complete Reissue UPartial 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
r Rules attached.
Applicant Name • . ' , _ Project Location: County _r
Address __ :' _• _ _ Street Address/State Road/Lot#(s)_
City T_ ' , _ _State i ZIP • _ r • '
Phone# ',_
(, ) E-Mail--- _ ___- Subdivision
Authorized Agent _ __ City _ ZIP -
Affected El CW ri EW I}PTA I]ES U PTS Phone# ( )__ River Basin._
s ']OEA fl HHF 0 IH fl UBA 0 N/A
AEC : Adj.Wtr.
0 PWS: Body _ kr at/man /unkn)
ORW: yes I. no ' PNA yes / no Closest Maj.Wtr Body
Type of Project/Activity ,
. (Scale: )
Pier(dock)length_ __
Fixed Platform(s) i I .; - '' •
Floating Platform(s) ___ __ 1
Finger pier(s)
Groin length
number _
Bulkhead/Riprap length_ —_ '+• I ii I i i
avg distance offshore _ I :, .j•t
max distance offshore_ 1 I 1 • 1
'
Basin,channel I • '
_ it 1, ','• t 1,4 1
cubic yards _ I, 1i
I; , h' • I .,r1 I
Boat ramp , },
Boathouse/Boatlift ! ( } i ' I
Beach Bulldozing — - • I ; I 1
Other
t !
1
I Shoreline Length i I _
i
i I/,
SAV: not sure yes no j
Moratorium n/a yes no 1 ' '/ ' i i 1 1 ''ri j
k.Photos: yes no ' '. +i i ! [ ' ',i
Waiver Attached: yes no -. - —• - t - . - ---
A building permit may be required by: [ 1 See note on back regarding River Basin rules.
(Note Local Planning jurisdiction)
Notes/Special Conditions
--Agent or Applicant P' ed Name_— PermitOfricer's Printed Name --
Signature * Please read compliance statement of permit** Signature
AnnlcatInn reek) Check# Issuing Date
_ Expiration Date

AGENLA_t1TNORIZATION FOR /\MA PERMIT/1PPLI�TIOJI
Nnmo of Property Owner Requesting Permit: CifPrs CAM) Lik /i CQl ( X 121/
Mailing Address: IS'I '<too alic N6
HAAisstfAA, aac 8'fYL
Phone Number:
Email Address: '. 04t
I certify that I have authorized1L K
Agent/Conrrador
to act on my behalf,for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: �kTF�t//? LFAKii4 o1= att-s m
fuomiA143 tcrrft,''tz► �,' FRt�_ t(n
1
at my property located at rf4NG%JANplr4S
in ptNio C.POVWCounty.
! furthermore certify that ! 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:
Si)C-061) Gatri kikt4111 "Vi
nature
K hied K��dht;k � t
� f
Print or Type Na ei
x KY/1 .
Tinto
lo1 ( l 2'1
Dote
This certification is valid Through

AJ?JACffit Ir Frr,\ri PRUf[ir1Y ra;frEr >rArrMi NT
'hereby cerl'fy Iha1 I corn rr1rn'y ar;Jacent'o...__.--C.11Pr.. .(2,.41)::'r
O'orrr•;hMPrprJ a' _.Jr!1,,• , (flame of Prnpnrty Owner)
(Addrn"e,I.ol,illnr.k i►,ad, ;t� --------- — .
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terlio<t f�Vvi',�_.(cLrv%Y .rl
_, t,r'r t` y) (CI'yiTriwn anther Co.mj—
ty
' The apn c�nf Ms��!s rr
r. . , n� ^ &rd t0 me as ncervn below,the dnvn!nprrert proposed at the above I,cali;n
•
I have no objec!ion to!It's proposal.
I hall Cb;ec:jc15 tr,th!s rr•.;•csat.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual Proposing dovefopmonr must IIII rbc ggtiplion.balow oLattach a sllo drawing)
1
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��,�l WAIVER SECTION
.� j\-' : understand That a pier, dock;mooring ptt:ags,broakwater,boathouse,Pft, or groin must be set cask a
J''r:i./ min'n um d.'slan:e cf 15' from my aroa cf r:parlen access unless waived by me. (I(ycu w!sh to waive
r•r/u :we se:baci�:,u must Initial!ha appropriate blark below.)
.1 I co v.ish to traivo the 15'setback rc ut q repent.•
I do not wish to waive the 15'setback requirement.
/trrrroporty Oanor Inform:10 i) r (Adjacent Property Owner Inrormatloni
l ( �� 1
.,l}, �.T', � 1. Sf� iIrd
�.. p�� �� �,ti �irnti+h grtn�C he�,' �v C�bi
�?ip52 j}7'21.'amo P cr T}F9 s^.�y ,�"�
1521 I( 1-r�C1 x' c� c��►n gnntti L1 rC11t�1 t'1'0 Y
_j�eA ~sf�v 1VG `I 1� ' � -A Address
j-"' �j G� nrl,r�►-n, NC.2_1n6
rs,si,"/..,zs.
Tp.e bend 1' s` 1 To.epl.one Mvnyet
fir Del.
(Rdvrsdd d/I$4012)

bJ LTAT� (Air
U--�21fl 0 / Ert STA7EMc II
I hereby certify that I own property adjacent to
+Rrs G.+f,Pr' 's
l)'Oj;e(1)'located a; u (}tame of Property Owner)
on J •
on Lot, Block;Road,etc.)
In PE' cou✓r`l .N.G.
�1-A)ler (Walorbody) (City/Town andlor County)
oj:,, The applicant has described to me, as shown below,the development proposed at the above locallon.
1 4110
X
_. I have no objection to Ihla proposal,
I
—�_ I have objeotlone to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must 111111E seripr bolopvpLet'tech a sire drawing)
;6,,1 . ghuu
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a
iPb • watvER S1= I0 `
/ " I understand that a plo.r,ldock, tnoorlrg pii ngs,breakwater, bOathodse,lift, or min must be set back a
doU minrmum distance of 16 from my area of riparian•access unless waived by me. (If you-wish to waive
1' the setback; you must Inklal the appropriate blank below)
I do wish to walye the,16'setback requlreoen.(:.
tg' I do not Web to waive the.15'setbackrequirerrtgnt,
�/(Proporiy Ovular Inrormetlo,) $ y (Ad tart Propert O vner Information)
str4h5
/�`�� Slgnnture
_j_yld.6,,,,#,, ,,
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Pr�',yr jYp,a'o/',b0 Q A P><nl or ippa Name
1� ' Address t 5?l�1 Ukt G��cttn �w�(
SS Ms I/ p Addnas i l.\G 234i3
� P, . 3g —. g13 >z)arY,le mra_ (a3o- 1B24
)(ralephone ttm,b_oc2„. rolephone Number
/C LLz1i i1 .
Dale Dan
(Revised 6/11/3012)

Check
Date Received Date Deoos/ted Check From(Name) Name of Permit Holder Vendor Cheek number amount Permit Number/Comments Receipt or Refund/Reallocated
Column) Column2 Column3 Column) Columns Columns Calumn7 Columns Column
7/14/2021 Charles Poindexter same Walls Fargo 1372 $ 200.00'GP#80221D BH rot.14112
7/14/2021 North End Builders NC LLC (Scott and Teresa Browning SunTrust 1010 $ 400.00 GP#80214D BH rot,14110
7/14/2021 Joseph Jacobus [same Wells Fargo 2949 $ 200.00 GP#802170 •KE rct.12873
7/14/2021 Arjean by the Sound Ext HOA same First Citizens Bank 1014_$ 200.00 GP#80219D KE rct.12874
7/14/2021 Village of Balh Head Island same PNC Bank 87238 $ 100.00 minor fee,328 S Bald Head Wynd(Lot 1319),BHI BrCo iRM rat.15501
7/14/2021 J.S.Mitchell.Inc. Clarice Willoughby_ Bank of America 1094 $ 200.00 GP#803060 'BH rct.14108
7/14/2021 Christopher Gaddy same Suntust 16472 $ 200.00 GP#80141D JD rat 14346
7/14/2021 Karen K.Sanders same UBS Financial Services 1097 $ 100.00 minor fee.,405 N Anderson,Topsail Beach PnCo JD rct 14904
i NOV#21-140,Lot 19-8N N King Fisher Ln,Hamp/Pnco
7/14/2021 Tim Lewis Money Order Germain Nadaud BOFK,NA R2099721883( $ 448.00 152004200/$48 IJD rat 14905