80225D - Hines

XCAMA/ ❑DREDGE & FILL ,r4 80225 A B C
GENERAL PERMIT Previous permit#
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 0 7y. / )
't El Rules attached.
Applicant Name S�,ef 6 1h'nes Project Location: County An d
Address (gs E1; evil Street Address/SSttateRoad/Lot#(s)
City f-�► W€.i;ki& (I� Statej/t ZIP No4I .� 3 R44 fAtlevt e k , Ila . sE
Phone#(Jr 45 g '7 �' E-Mail 5L 11C Vite94t`j. Subdivision kV"Ail 7 yet/ 7,4D 1
Authorized Agent CPC, [�� t City &kat ZIP g4/,,A�
� � ❑CW YEW II .PTA ❑ES ❑PTS Phone# ( ) �! River Basin�f1N"-
ect
AEC(s): ❑OEA ❑HHF ❑IH CI URA CI WA /,^Adj.Wtr. Body l/ Aulman /unk
❑PWS: S 7F(..j
ORW: yes / rt� PNA /e Closest Maj.Wtr. Body �iiQ�
Type of Project/Activity /COJ4705 it r' 1l- . ie✓ iv: p/ 1 /r7n1 / Tl e
ka ya 5.4f'G'lC,.,/7 (Scale: AZ )
Pier(dock)length .j/X&AO i — i
Fixed Platform(s) ir)r it"4'16 -`-j----�-
Floating Platform ) I
Finger pier(s) r.
Groin length ' •
number 1 ,
Bulkhead/Riprap len_. ..
_ fir
avg distance offs •re
max distance offs • - 1 f
Basin,channel '(--
► i j
I A
cubic yards
i
Boat ramp ►
Boathouse/Boatlift 1,iti
Beach Bulldozing i',/ ',.
Other,5tejts'I
- i
S/ , —r
Shoreline Length 'r 7 l
SAV: not sure yes hb I
I
Moratorium: n/a yes
Photos: yes 1fo -—s---I
Waiver Attached: yes Qd
A building permit may be required by: / 4shAcy•cervn fly See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) �/� ,,r
Notes/ pecial onditions Lfit t' ii S d 7/4 /07-60 iZ 14-ki.i p Y�� iv
'77Z &?ei se?5 a/e agt elQl'.?Pr` M' Th 3 .4-1,/
Ben Brink (CPG/LLC) Fatra i►.i (CO -1•2G-2(
Agent or Applicant Printed Name Perm' Officer' 'nted Name
‘3103 11 '29.2-
Signature "Please read compliance statement on back of permit" Signature
n Firhoo nos it c,-7..,- .SE. Mc /n h II j in J D(

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Sheila Hines
185 Eli Run
Mailing Address:
Fayetteville,GA 30214
Phone Number: 678-438-7729
sunnydelight©bel lsouth_net
Email Address:
I certify that I have authorized CPG, LLC
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 _install pier to kayak stepdown
at my property located at 3249 Mullet Creek Place SE
Brunswick
in 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:
Sba-\•.
S eila Hires Julf 6,202111.-05 EDT;
Signature
Sheila Hines
Print or Type Name
Property Owner
Title
7 6 2021
Date
7 6 2022
This certification is valid through I i

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ' eIIa l l'"``
3149 Mullet Creek Pace SF.L-57 (Name of Property Owner)
property located at
(Address. Lot. Block Road.etc.)
on iIv(Mullet Cred1 ,in [w,it is•,Rrun,vri,k N C
(Waterbody) (City/Town and/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 till in description below or attach a site drawing)
See attached drawing of docking facility.
WAIVER SECTION
I understand that a pier. dock, mooring pilings. boat ramp. breakwater. boathouse. lift. or groin
must be set back a minimum distance of 15'from my area of npanan access unless waived by
me (If you wish to waive the setback,you must initial the appropnate blank below )
I do wish to waive the 15'setback requirement.
fif:tire
I do not wish to waive the 15'setback requirement
(Property Owner Information) (Adjacent Property Owner Information)
Signature Sheila!lines Si_nature` David Brennan or Marx!lanky
Print or Type Name Pant or Type Name
3:44 Mullet Leek Place S}_ 3251 Mulkt Creek Place SE
Mailing Addreolivia,NC 28422 Mailing Address Bolivia.NC 28421
City/State/Zip sunnydelghttbellsouth net City/State/bp 910-987-9297
mikescoastaihomes@gmail com
Telephone Number/email address Telephone Number/email address
Dare 7/6/2021 Dare' 7/12/2021
(Revised Aug. 2014)
'Valid for one calendar year after signature'

Brennan_APOForm
Final Audit Report 2021-07-12
Created: 2021-07-09
By: Ben Brink( .com)
Status: Signed
Transaction ID: CBJCHBCAABAAVag4pkJPRWWn4lwXk2ZvHyRf6U7mvWl
"Brennan_APOForm" History
n Document created by Ben Brink([e-mail])
2021-07-09-1:11:20 PM GMT-IP address:174.81.113.38
E+ Document emailed to Michael Brennan([e-mail])for signature
2021-07-09-1:12:06 PM GMT
n Email viewed by Michael Brennan([e-mail])
2021-07-09-4:20:00 PM GMT-IP address:174.247.11210
43 Document e-signed by Michael Brennan([e-mail])
Signature Date:2021-07-12-10:34:18 PM GMT-Time Source:server-IP address:67.209.10.218
O Agreement completed.
2021-07-12-10:34:18 PM GMT

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Sheila Hines ,s
(Name of Property Owner)
property located at 3249 Mullet Creek Place SF:I.-57
L«kwuud Fall IMu1letCreek) (Address, Lot, Block, Road,etc.)
on > ,in Bolntc►i Brunswick , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location-
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 of docking facility.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lilt, 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)
sr..1k. „ors*
�.. v,.„......._. Set([4rutrn;.u111,M1:11:15 LOT,
Signature Sheila Evans Signature* Serge or Ashlee Kruczko
Print or Type Name 3249 Mullet Creek PI,SF Print or Type Name
2001 ValleYstone Dr.
Mailing Address Bolivia,NC 28422 Mailing Address C,a NC:
rY•+ 7519
Cdy/StatelLp sunnydelighl©belisouth.net C`ty/State/Zrp [e-mail]
Telephone Number/email address Telephone Number/email address
Date 7/6/2021 Dates 07/10/21
(Revised Aug. 2014)
'Valid for one calendar year after signature'

Kruczko_APOForm
Final Audit Report 2021-07-11
Created: 2021-07-09
By: Ben Brink([e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAA6dNIKDFOcEkknyr1JSehdJYyvBp-Cjko
"Kruczko_APOFormtt History
,t Document created by Ben Brink([e-mail])
2021-07-09-1:06:20 PM GMT-IP address:174.81.113.38
P. Document emailed to Serge Kruczko([e-mail])for signature
2021-07-09-1:07:05 PM GMT
t Email viewed by Serge Kruczko([e-mail])
2021-07-11-1:48:45 AM GMT-IP address:66.249.88.60
by Document e-signed by Serge Kruczko([e-mail])
Signature Date:2021-07-11-1:55:53 AM GMT-Time Source:server-IP address:174.247.19.217
O Agreement completed.
2021-07-11-1:55:53 AM GMT

Jill 11N111 IIIIl 111111 Hi HI U11111111 64145 P1380 19
Brunswick County. NC Register of 7e4d pale
e 1 of S
Brenda M. Clemons Register of Deeds
91-16-2019 13:4B:35.900 Brunswick County, NC
NC REVENUE STAR: $160.011 ("6'5163)
6
VIP
gc10:1: tr.s.tr_11_!1_1 ,1;//� O •T . 1i 4-
Ck IMO', Cash$- —eftsid _ _Cash$ _ Financa_ --
4anions of document are illegible due to condition—
of original.
a Document contains seals veroSed by oriq r a
instrument that cannot be reotodemtd or rnnieci
This Instrument is prepared by Zachary T.Clouser a North Carolina licensed attorney. Delinquent taxes,If any,
will be paid by the closing attorney to the County Tax Collector upon disbursement of closing proceeds. The
Preparer has made NO record search or examination as to the property herein described,unless the same is shown
by his written and signed certificate.
Mail/Box to:Wortman Law Firm
Brief Description:L-57 STA-1 RIVER FUN PL K/256
Revenue Stamps:$160.00 Parcel ID:217MA057
NORTH CAROLINA
GENERAL WARRANTY DEED
BRUNSWICK COUNTY
THIS DEED made and entered into this i I day of 311Nur '.i , 2019 by and
between JOSEPH HOLOWIENKO and wife, KATHY HOLOWIENKO, whose mailing address is: 154 A
Heritage Vilalge, Southbury,CT 06488, hereinafter called"Grantor,"and,TANAS BALL HINES and wife,
SHEILA L HINES, hereinafter called "Grantee," whose mailing address is: 131 Loam Drive,McDonough,
GA 30252.
The designation Grantor and Grantee as used herein shall include said parties,their heirs,successors,and
assigns,and shall include the singular,plural,masculine,feminine,or neuter as required by context.
WIT NESSETH:
That the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee
simple, all that certain lot or parcel of land situated in Brunswick County, North Carolina, and more
particularly described as follows:
SEE EXHIBIT"A"
The property herein described was conveyed to Grantor by deed recorded in Book 4061 at Page 36 and
Map Book K at Page 256,of the Brunswick County Registry.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto
belonging to the Grantee in fee simple.

1111111111111111111111111111111111 B4145 P1381 6'P
Brunswick County, NC Register of e')esds page 2 of 5
And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the
right to convey the same in fee simple; that title is marketable and free and clear of all encumbrances,
and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever
except for the exceptions hereinafter stated,if any,other than the following exceptions:
a. County and/or Municipal Zoning Ordinances,Rules and Regulations.
b. Restrictive Covenants,Easements and Rights of way of record.
c. Ad valorem taxes for the year 2018 and thereafter.
If initialed,the property includes the primary residence of at least one of the Grantors.
IN WITNESS WHEREOF,the Grantor has hereunto set his hands and seals, the day and year first above
written.
PLEASE SEE ATTACHED SIGNATURE PAGE

'811111,!11jUhiL11111II/111111I 84145 P I� �,
Br�54tCk L'p �j 1381 9
unty, NC Register of Ijveds c ier 3 e{366 o
ge
(SEAL)
EP HOLOWIENKO
' (SEAL)
KA Y HOL WIENKO
STATE OF e.o,,,,tit... /-
COUNTY OF iV e , 14u-e--
`, ft �"� L a Notary Public for /UCH„ i,-,� County,
State of (.64n4,ckt , do hereby certify that JOSEPH HOLOWIENKO
and KATHY HOLOWIENKO,personally appeared before me this day acknowledging to me that they signed
the foregoing Instrument for the purpose stated therein and in the capacity indicated.
Witness my hand and official seal,this the t/1 _day of J a ti4,s-y ,2019.
(SEAL)
Notary Pub' CRAIG A.PAIGE
Notary Public,State of Connecticut
Commission Expires Nov.30,20i 9
My commission expires: 11 i. v/24'i 7
/; 's, x.tl{'
=v x1)TAler.
A ' e:
•sA !`
.,,; .e .�_..

IIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIII 84145 P1383/:on5-36'
Brunswick County, NC Register of rends page 4 of 5
PROf
EXHIBIT A
BEING AU.of Lot 57,Section 1, River Run Plantation(formerly Pier 66 Subdivision);the
subdivision plat for Lot 1-175,Section 1,appears of record in Map Cabinet K, Page 256,
Brunswick County Registry.
There is EXCEPTED from this conveyance the mineral rights which have been retained
by Weyerhaeuser Real Estate Company as appears In Book 424, Page 79, Brunswick
County Registry.
This conveyance is made SUBJECT to the consolidated Master Declaration and
Development Plan as appears in Deed Book 687, Page 885, Brunswick County Registry
and all subsequent amendments thereto Including Restriction appearing in Deed Book
728, Page 702, said covenants and restrictions as identified, are included herein to the
same effect and with the same legal force as if they were repeated fully in this
instrument and said covenants and restrictions shall be deemed appurtenant to the lot
and shall run with the lot in all future conveyances.

1111111111111111111111111111111 B4145 P1384t ors B'PRO
BrunswIck County, NC epdster of Deeds page 5 of 5
I.Bon,L Berber certify that this plot awe drown under my LOCATION we
supervision from an a:tuol surrey roade under my supervision de. daer:lptlm,recorded In Book ,Poe* 438.'etc.)(other) ed
sea 2tw NIA.4040
references that t.bounds/es oat surrey.d are clearly Indicated r Amen from information fount me noted hereon; that the ratio of
. pn 4vien as oeauloled I.t:MO.i M Bnt
el e Net .ee Mw+r ,o
cordons ow,G.S.85 47-30 ea emended.SFlbttsa my original aerobe*, pC
lik
• •' lens.number and seal BIM 11th day of January. 2019. rair me• Surveys IJoenee Number 1.-3027 R b
a1/1
Bi00tp11r 01l
ttttt11111HU//N"� SCALE
.'Q•oass" .2%
' r/4 9 __ Lockwood Polly River �� NOR teL HIGH WATER U NE
Coves Bearing Distance
��f�q �E. - L1 E.
N 5874l6
1k 4 --L7 U N 53-59 41 E 23•
.�97/p�'y,� P �� - l2 L4 N 5JS9 39"E - 11.83' i
'.,• L.
tar-„,, ��__` .4,-,. L5 N�59'0`E 1 .
10.0
c.
(L5'
N10.
4 THIS MAP MAY NOT BE A CERTIF D SUR VEY
AND HAS NOT BEEN REVIEWED A LOCAL
GOVERNMENT AGENCY FOR E
WITH ANY APPLICABLE LAND
REGULATIONS AND HAS NOT REVIEWED
FOR COMPLIANCE WITH
75 AEc REQUIREMENTS FOR RI,/fS.
•
•
LOT 56 c - LOT 56
N.
Curve I - 12.351.7 S_F.±
f rCl i TO NORMAL /
�I Reifies
HIGH WATFIt UNE v
1 70.00' 10,277.0 S.F. Al
.e 4
Delta 11 10,277.0 S.F.t
NO 4.24'55` = TO 30' �.
•
Chord BUFFER UNE
5.39'
Chord Boor.
S 4748'21"W µl4A��
0C t SFORA
Ne9.
y �70OJ
— -- - —— 'fir
•
'o pie —
R 1 80.'
Metes Reuses 1\7\2019 for noes Mange
\t Normal (html..Located Ape, 2018 `�M�
Elates:Revived t\11\2019 for FIRM Nap chows
and to odd ono to 30'Buffer line
LEGEND: Boundary Survey Of .
•- - Fond ken or Ism pipe Lev 57 - PNr 66 - Station 1 - firer Rum Plantation
-o-- Sot 1\2'Rem .
roved
t Comp Omer(Ty(TypNoted)' " "°) Sheila Hines & Tams Hines
-.- ca.qut..neimL
REFERENCE:
Deed Boot, 3943.Pape 438 Lockwood Fey Toone* snea:ek 01aey..S.C.
Nap cosmn K Pay. 256 40 0 40 80 120,
•
NOTES risi••i�— •a'
inn
•
1.Arse By caare;nata, GRAPHIC SCALE - FEET •
2.Erna Flood Mop identifies parrot scar t•-40'
s twsy In Fk.n Zoe AE13, Conrnenay A Z!M
Pone3 2036 K.8\28\t8. Berry L. Barber,P1S Iles1�t` '
•
3.Tee Pavel No.,21710,057 PO lot 02
4.Normal KO Water Una by Brunswick County CM O) 645-43333 4 .. •

Photo Taken:7.7.2021 Low Tide 12:30pm @ 0.3'
Measurements are approximate and NTS
N
Lockwoods Folly River
Estimated Channel(visual observation at Low Tide)
Width of Water body:6.25'
25'
4'x 16'Stepdown Kayak ?'
Mullet Creek(Secondary)♦ 6,
8'x 16'Fixed Platform
(Minimized/Avoided Coastal
Wetland Shaded Impact)
4'x"'120'Pier
River Run Plantation POA
—P/L
• —P/L
3251 Mullet Creek Place SE(Brennan) '75'Shoreline
/ 3249 Nyjllet Creek Place SE(Hines)
*owmn I
3247 Mullet Creek Place SE(Kruczko)
)

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vander Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Cdumn1 Column! Column3 Cdumo4 Colimnb Columns Cdumn7 Columns Cdumn9
7/30/2021 D&0 Construction,LLC Douglas Sholar First Citizens Bank 2387 $ 200.00'GP#80148D JD rct.14084
- 7/30/2021 _ Pippin Manse Construction LLC Roben Newcomb Wells Fargo Bank 5863 $ 200.00 GP#80215D KE rd.15727_
7/30/2021 Allied Manne Contractors LLC Earle Koontz First Citizens Bank 10320 $ 200.00'GP#802000 PA rd.12791_
7/30/2021 Allied Manne Contractors LLC Joe Wintsch First Citizens Bank i 10321 $ 200.00 GP#80207D PA rd.12790
7/30/2021 Sheila Hines same Wells Fargo Bank � 16553965 $ 200.00 GP i'80225D PA rat 12792
8/2/2021 Brian Coughlan same Truist 1903 $ 200.00 GP#79938D BH rct.14116
8/2/2021 Logan Manne,LLC T Scott Barbour BB&T 7580 $ 600.00 GP#80246D JD rd.14910
8/2/2021 Logan Manna,LLC Sean Simpson BB&T 7560 $ 200.00'GP#80249D JO rd.14911
82/2021 Logan Manne,LLC Sean Simpson BB&T 7547 $ 400.00 GP#802490 JD rct.14911
8/2/2021 Michelle L Bray Andrew Bray Wells Fargo 9385 $ 200.00 GP#801510 JD rct.14909
W 8/2/2021 Joseph Jones ,SERE,LLC NAVY Federal CU 1000 $ 200.00 GP#801470 rJD rct.14083
_- 8/2/2021, Sound Side Manne Construction LLC Robert Haubenrelser&Jenny Zuhde First Citizens Bank 122 $ 200.00 GP#80189D BB rct.15601
8/2/2021 Logan Manne,LLC Ropier Hendrix IBB&T 7548 $ 200.00 GP#80191D BB rct.15605
8/272021 1 AM W Docks&Marine David&Rebecca Graham I BB&T 6317 S 400.00 GP#801560 TBB rot.15606