80219D - Arjean

0 ❑CAMA / ❑DREDGE & FILL No 80219 A B C D
GENERAL PERMIT Previouspermit#
��-- LiNew ❑Modification El 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 ISA NCAC 1 H • 1100
( El Rules attached.
ICY
Applicant Name Ale ,9`. -kk. SW11r.e tkuA- Project Location: County(iQi J 1 0 0V w'
Address '0 Go ( 411•Sf ` Street Address/State Road/Lot#(s)
City IN 1\W\10 kAk1w\ Stated V ZIP t4O l0 1 0\ co ‘,, QG V\ '1n V-Q-
Phone#( 3 U I'U—SA) 40 E-mail Subdivision
Authorized Agent � S LA-Crr'' Nci yt.yyk,E4--1- LA_L 15`°''''''�" ( Cityv\11\VVn1�� V(i/ ZIP vZ \
Affected ❑CW III ❑PTA ICES ❑PTS Ou Phone# ( ) River Basin` ^‘ C) `(
❑OEA ❑HHF ❑IH /❑UBA ❑N/A
AEC(s): Adj.Wtr. Body a c '- C-VL�-le.,_ nat)/man /unk
❑ PWS:
ORW: yes / :no PNA yes / no Closest Maj.Wtr. Body A\V\/� ( AA,8 C(Li S dU^cS
S. (And a+^-
Type of Project/Activity lh Scrn\\ CI\ y.\7 ti cs. V Q V e.TYY`u--4- I c C .1/vt,✓09 o- C oc. t W 0.4
_.'._ c.vici`v`.3 19e 'VY1 • (Scale: 1 : 30 ' )
Pier(dock)length /
Fixed Platform(s) / PA CI E e * ' 0 i
Floating Platform(s) ` ' r�y 1 0 6
Finger pier(s) {[— .(2—EC -•
— V/ ._._:..__ ;
Groin length 'k,14 1 V.
number 1 ........_.. .... _...T._ -I -..... a ........_... .. ;. .__ - `
t ti
Bulkhead/�Ripra4lengtht-1033I 1 �y _ -- ..,..�. }�� t J ! __
avg distance offshore C� ! s + 1 1fL__' ;--
max distance offshore J 1 ;j
Basin,channel �'•��• ` , '�
� v 1iefi___ i 77 S
1 i
i
cubic yards Ni.. I '�� .0
4 r-
Boat ramp i 1 41 t / / 1
Boathouse/Boatlift.: 1 i L - - ----
t-
Beach Bulldozing ,,.,r, WA
' ltjli4 ' 1 1 , ,
Other { 6�t I `�
1/- 401 1A1n(,1nA"tiCt ,-(- WI I T'Y 10,1V1 ‘44 3(f1MC5
-14u tat Y; bbt S-}r,-,.1 tic . 1i i . . S
Ai
Shoreline Length*/-H.3
rx I
SAV: not sure yes 1 _
Moratorium: n/a yes no f� i
Photos: no U tt4... 1 �.. - f __
lam! �� ..... _ ...__ -_
Waiver Attached: a no
T.X-110+ 14-tAC(A�
A building permit may be required by: ) _) t1/10V-W Cv• . I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions •-t 0 �n'(,} . j 1 u V a v-e \0 C..(� S-i G"t i A f P ck t\i'i' v 0 Cr ' S tA>� L
r o Cock S-1-t;.' ..r oA la A. - \1 c Lk V W1 L eC . l f
Gx s; 1 Sr-% :4-h 3A VI nkc-- 1'VA•2,(
Agent or Applicant Printed Name Permit Officer's Printed Name
, ;: .?; �' �f4-1 ) W 0 A ) Y1u L..( - 11.114-21
Signature **Please read compliance statement on back of permit** Signature

i .
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: i ? ) J �i ` - i '7Ct eA y ,( -(0)t
Mailing Address. 63 Off, hriaan
tivtlirrilOi
Phone Number:
Email Address: t:xrv'o V ►)c ra.1 1.( rvv
I certify that I have authorized (R3) I-Ott OA PitiW0'\
Aft Li-CAgent!C or g.0/ 1,1
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Pr; 11 1 "C SoLYICd
ti\kehl()OVI. HOP
at my property located at 11Ain NUN NLN NG,Y1 Mil/County
t 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 Pri 411,1 1 1).Je](!, lb� t `t"t V 11
ri�OO> Ok �I
Print or Type Name
VII1/441/4"f 13a1 d i4C CAUki",) i'62tek,
Title
a� / 0 i 2.oZ4
Date
This certification is valid through 0 1 t O LP i' -02-2--

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT L ,,1
I hereby certify that I own property adjacent to 1A t' 0/1 b+4 Title_ ) is ei\"T�U1Stvi s�
ll� /� (Narhe of Property Owner)
Property located at llf I !-1 Y"j t Pvi V
on C( {,4 s �,(('.e.''C... (Address, Lot, Block, Road,in 1(ti1�M r 71.) w Hal Dv eV N C
1
(Waterbody) (Chownd/or County)
The applicantpp has descnbed to me. as shown below, the developrrent proposed at the above location.
t/ 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)
WAIVER SECTION
understand that a pier, dock. mooring pilings breakwater boathouse lift, or groin must oe set back a
Tinrmum distance of 15 from my area of npanan access unless waived by me ,lf you wish to waive
the setback.� � you must initial the appropriate blank below
ba
v 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirem r;t.
(Property Owner Information) (Adja e Property Owner Information)
. ca:ur kt 5�=w10i bt Sith4Orl Si t e
.ffirculdelq\Ck.),14b"A
c ettA“1-- viA-ClarJ E‘I'l Aelet4 ]
•'rtorTypeName r _71*T,oe ..
to0a AlYcx.r‘ v(4._. 577.5 Y.-e•c%/F-P �1%)
Veiling Address Mailing Address
V\1ikiln v� (.(. ,,Z 4t I vitiAt{w(o-rovi NC '-'8`{a°[
2:i YState, r �irf Sta eiZp
here ';o a ,umber Teiepnc e r L
_:a� Date
Ra i,seo 3,•"'3/2012}

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i At- t ICA
i Hereby certify that I own property adjacent to Antf.6/1 ',"4-1'441 C.- )0J114 tx-fv t (3!Dv] '§
oroperty !ocated at LA? (k) -)t.0-11 (Name of'toperty Owner)
\ PVIVQ1/4--
YOVT 1 S Laa-- Address. Lot, Block, Road.etc.)
or
Ir. ,(s.1 ilvn'Nelc\iovA'tit yv vit.-4-0aq)/ N :
(Waterbody) (Cjyriovit and/or Countyk
The applicant as described to me as shown below, the developrreit proposed at trie above 'ocation
t/7 ! nave no objection to this proposal
nave objections to :71S oroposai.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
i Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
..-::e-7_,:aPc tat a z,e- .2.,--..:. — ning pilings breakwater boars:I...se .f- .:r g,:.- ----_s! ce se: :ac. 3
distance of 15 Fro— —, area of riparian access •Jniess ii.,aed z)
"7-.--: se:za:ok you must initia. t-e. appropriate blank pecw
I oc Nisi-, to W3Pie tre 15 setback requirer,ent
do not Nish to waive the '5' setback re.cuirement
,P oroperty Owner Inf rmation) (Adjacent Property Owner .,r-rformation,
- -
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Chock
rod Dote D000sited Chock From AMC) Name of Permit Holder Vendor Chock numb., amount Permit Number/Comments Recelot or Refundntoollocatad
I Coumn2 Column Column/ Columns Columns Column7 Columns Column9
2021 Charles Poindexter same Wells Fargo 1372.$ 200.00 GP N802211D BH rct 14112
2021 North End Builders NC LLC Scott and Teresa Browning SunTrust 1010 $ 400.00 GP#802140 BH rot 14110
2021 Joseph Jacobus same Wells Fargo 2949 $ 200.00 GP#802170 KE rd.12873
2021. Arjean y the Sound Ext HOA same First Citizens Bank_ 1014.$ 200.00 GP#802190 KE rat 12874
2021 Village of Balh Head Island same PNC Bank 67238_$ 100.00 minor fee.328 S Bald Head Wynd(Lit 1319),MIB&Co RM rat 15501
2021 J.S.Mitchell,Inc. Clarice Willoughby Bank of America 1094 $ 200.00 GP#803060 BH rct 14108
2021 Christopher Gaddy same Suntrust 16472 $ 200.00 GP#801410 JO rct 14345
2021 Karen K.Sanders same UBS Financial Services 1097 $ 100.00 minor fee.,405 N Anderson,Topsail Beach PnCo JD rct 14904
NOV#21-14D,Lot 19-8N N King Fisher Ln,HamplPnco
2021 Tim Lewis Money Order Germain Nadaud BOFK,NA R20997218831 $ 448.00 $2001$2001$48 JD rot 14905