80283D - Rumbold

CAMA / —DREDGE & FILL No 80283
0 A It C
GENERAL PERMIT Previous permit# —11 S4(p
>' f4ew ❑Modification Complete Reissue III Partial Reissue Date previous permit issued 'I- 11 -2UZ(
As authorized by the State of North rolina,Department of Environmental Quality //��
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 0 l �C)
1 ❑Rules attached.
Applicant Name V/�i C tC l, Ijc\ 7ILotdvi G ``c"'"'.'Project Location: County ,�A) c.�•
Address '' 5 D 2 O ✓'s6 c),, SW c,� Street Address/State Road/Lot#(s)
City Stater(C. ZIP Z a R P 2 SAJA
Phone# ( CO) qQ Li S 5 3 Mail I'v�"h ok G � ;0, �'•A Subdivision
Authorized Agent �,t r z,,.L- c,e u LL( City ZIP
Affected A Cw ,EW >rPTA ❑ES ❑PTS Phone# ( ) ar River Basin I .r•k2-�-✓
❑OEA ❑HHF ❑IH ❑USA ❑N/A �,L
AEC(s): Adj.Wtr. Body Sh cAo k v<./ �.. an /unk
❑ PWS:
ORW: yes / no, PNA �/ no Closest Maj.Wtr. Body S{�r, I<�(Z-` i�N
Type of Project/Activity Q.e___Vj,,,` + mac k•..•1 tZ c,k. i,, S c..-, c.,,, f.„� 5 S
;�� ,�, , t-1, \-\Jii( <<.-,Ue. c.,G.5 ` (Scale: 3 I S )
Pier(dock)length f./soil'
16; f , ' 1
Fixed Platform(s) x/(0 1 < ? r (Au-i-
Floating Platform(s) \ ` 1 �/ `1
•4
Finger pier(s) + �1� ` I" I f �....._ _.._.__ .
Groin length 1 WI { '
i i
number
Bulkhead/Riprap length - .� -I1
avg distance offshore
I i IV f ° {
max distance offshore i I 2 j
Basin,channel ± _ ` . II _ f I
cubic yards W (E
Boat ramp t"t I U ( - I
Boathous Boatli r Xf Z — --_._ ..__-. _. .. ._.___ 7# i v il/ .. -, `�
I,
--tom .1.._...._�......._. _... � ----- I
Beach Bulldozing I �^ i� M i
Other " 1"- t
i '0 ;p
4"-:::41 .....,.......a......—i
Shoreline Length I l0 S, f L- } i I i
SAY: not sure yes AZ , �N U ��fr
r1_
Moratorium: n/a yes oftri —
Photos: yesvit.titir ' � , I
Waiver Attached: yes n b+ t� • I i
r�,v�T -
A building permit may be required by: e,,,Sw,GL (w,.. . I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions ( L oc.(csl (I(, L.,k 3 t k,. ,t� ! - Ste.,.� , ) G S X.(t-c a 1 1*be'. c. I Jc,f c, ti1 �- IN t'.--G.. t r et,4--!n St La 1 c� t, t A ,.. 1..
( tI , 7f1J < J /'
OSV'elk. 1 It ! pre r.. S. .t /- . Cu'-ekthtin
r
Agent or Applicant Printed Name Permi icer' Printed Name
_ \__ - - k _ 12'Z'-I•.21
Signa�t re **Please read compliance statement on back of permit** Signature
i .iL-.-2,. _., Cl." ,. - - - . .

LAMA/ DREDGE &FILLii ;1
No. 80283 A B C R
E N E RAL P R M IT Previous permit# 1�s ti(o '
(]V _ew Modification Complete Reissue -Partial Reissue Date previous permit issued ' I�?'ZUZQ
As authorized by the State of North lina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 01112.C.DO
1 ,, ,�Rules attached.
Applicant Name ' C\\c.. (21r 0\&�;I vi C. 1. o'fr^ o ect Location: County \3 r.,..)�-:c - _
Address �Jg2 Uir•t;.. 1)f. SJ Street Address/State Road/Lot#(s)
City • , a Stater'(C__ZIP ZS"R(c2 SA./vt&
Phone#(i(p) 4101 9S55 iiMail rt,,.A.bollax.kho 014..^4.4 Subdivision
Authorized Agent �t.-, ii,,l.. Lek, LLC City ZIP ( ----_----__ -
��� �4 CW pEW ( PTA ❑Es ❑PTs Phone# (__) • River Basin`.+.,-6,-✓_-_
AEC(s): ' OEA 0 HHF 0 IH 0 USA ❑WA Adj.Wtr.Body S�1\V (t v t ' —- Junkn)
PWS:
ORW: yes /‘7 PNA �/ no Closest Maj.Wtr.Body di v —t"'`I
Type of Project/Activity Y-tLo \ t 41, , _t, S c.-.NA_ .... C S.
C.kS�e_ Nitta" \u 1-�..lii t_4.,t. ia',aS (Scale: ) 3 C S )
Pier(dock)length y yi/ f
1 -
Fixed Platform(s) /(0 I �� I • 1 S Al ,t�7
Floating Platform(s)
Finger pier(s) .__H — , O
Groin length C I \ —Il.�
numberF-�.
I I -v.t)
Bulkhead/Riprap length ;
1 avg distance offshore
vt max distance offshore channel DTI I • _ _ _
Basin. annel . - .1 21 I
1 1
1
cubic yards -i--i- --- i i -- _ i,;I� :
�., Ci n,iy • ff
Boat ramp f 3�1Z V ( 1 i. I._ j i�
�/ YJ
Boathou Bondi � � u.. __ .- '. .
f 1
In i
Beach Bulldozing a ' I �'L_ _ -`— 1 r-. — .- ,-
Other r�. I f " IL r ` L i ' I ?` _ ~
Shoreline Length CPS- P t. i . 1
SAV: not sure ,Yes ` / _— _-._. I ! -------s ^r-e v p---
tki
Moratorium: n a yes 'tY1t - _-_. 3 s 6 2 N i,�...^ 6. S". •
I . .�
Photos: > tom, __ 1 i 1 ' -- . . . .
Waiver Attached: yes - +( - _ -- ----------___
A building permit may be required by: V)I v A.N...,:T (4:— • ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) + L
Notes/Special Conditions Cs. t)ocJt�. 1Ct.(I‘. k...t\_ �L 1 ,(Ai ,_ k•L�--. �r1 r..l k A\ f)C,O.. a A 1,br
•U 4Qe/,r r.,,,36,1SG'c.S. RA&A t�f' S' Vk6.•+-t- rn.t.._.L•s Sib S (0Ccl.j. rn, ..,-...1..
t' rk1� s. :V.,L. (Pcr Qr+e.,,, c P._,..:,'- Co rt;fie"
} r
Ben Brink (CPG, LLC) _ , vl.1
A
Agent orppli Printed Name Penn e' Printed Name
Si re '•Please read compliance statement on back of permit•' Signature
Z°U — g 2`I—z021 1� 'zy 0Zt
Appli •• n Fee(s) Check# Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Richard and Laurie Rumbold
3582 Norman Drive SW
Mailing Address:
Supply,NC 28462
336-908-4553
Phone Number:
[e-mail]
Email Address:
CPG, LLC
I certify that I have authorized
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: reconfiguration and additions to existing
docking facility
3582 Norman Drive SW
at my property located at
in Brunswick County.
I 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:
Signature
Richard Rumbold
Print or Type Name
Property Owner
Title
8 l 15 l 2021
Date
8
15 2022
This certification is valid through l l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to "h'rd Rumbold 's
(Name of Property Owner)
property located at 3582 Norman Dr.SW
River (Address. Lot. Block,Road,etc.)
ShaRomon . in supply!'arunsvock . N.C
(Waterbody) (City/Town and/or County)
The applicant has descnbed to me. as shown below, the development proposed at the above
location
%rn 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.
Rebuilding docking facility in the same footprint.
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 npanan 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
.,g1E. ,:1145 I do not wish to waive the 15'setback requirement.
1868 Windy Bluff Ln.SVU
(Property Owner Information) (Adjacent Property Owner Information)
lrtltht,Izr/NC_rA 6.o/t.tCo/re
Signature Richard Rumbold Signature' Clifton or Virginia Stone
Pont or Type Name Pont or Type Name
�Srt±Norman Dr.SW 1S6S Windy Bluff Ln.SW
Mailing Address Supply.NC 28462 Mailing Address
Supply,NC 28462
City/State/Zip rumboldauto@att net City/State/Zip 7p4-654-5676
clifstone�yahoo.com
Telephone Number/email address Telephone Number/email address
Date 08/16/2021 Date•
8/16/2021
(Revised Aug. 2014)
'Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to x,nard Rum bold
Norman Drive sa (Name of Property Owner)
property located at
s;nau,ure w«r (Address, Lot, Block,Road,etc.)
on , in Supply 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.
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.
Rebuilding docking facility in the same footprint.
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 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. 1892 Windy Bluff Ln SW
(Property Owner Information) (Adjacent Property Owner Information)
.C,,-R Scatt Aug 17.202109'0 E.'-
Sigrmturt' Ruhwrd RumM id Signature* Robert or Wanda Scott
Print or Type Name 1042 Norman Dr.S1t' Print or Type Name 1892 Windy Bluff Ln SW
Marling Address Supply.At:2846i Mailing Address Supply.NC 28462
City/State/Lo City/State/Lp 910-477.0540 [e-mail]
[e-mail] _
Telephone Number/email address Telephone Number/email address
Date 08/16/2021 Date.8/17/21
(Revised Aug 2014)
'Valid for one calendar year after signature'

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CAMA G /❑DREDGE&FILL ISrc 1 1c5 NO. 74546 A B C (j
ENERAL PERMIT previous
re permit r 7i'190
Blew ❑Modiifintion ❑Complete Reissue CPartial Reissue Date previous permit Issued 2 L• •
As authorized by the Sate of North Carona.Department of Environmental Quality �.r�� ' fQ O .
and the Coastal Resources Commission h an area of environmental concern pursuant to ISA NCAC -�J
� awdhed.
Applicant Name �1(`/ s G-__� %s� �1� Project Location! County ffillirsjiA.S..'�.--
Address S �e rMc.. c)f. S"4' Street Address/State Road/Lot#(s)-
City _.%)Eipy{ State/ZIP z 84(a2 Si"4- n5 ( #t tnl L AOO4E35
Phone( ) (� E.Mail Subdivision
th Auorized Agent 13LR.:cl•-a%on CityZIP f
qCW „WSW ,It PTA CIES OPTS Phone• (_) River Basin L��. !
Affected DOA 0 HI* ❑IN ❑USA ❑N/A
AEC(s): � Adj.Wtr.Body Shtile Qt••✓ lank„)
ORW: yes 1® PNA no
CIS Maj.Wtr.Body a v Lie'
Type of Projectl Activity f.SCK. s\a i a c�a.s•..h� Vv.....kt k% v 1 Sc.... Qadrpr.A— v.1"ay...e-• D/.Or' K.kb Ili -an y t S a,a.3 J (Scale: (J"T Z )
Pier(dodo)length S 1 . 1 t
FeedRadorm(s) 1(e•"b‘ �1
R i Pl*lonns) I■21 _11 --_ tl - -w ,■■■ ■■q__ n
Finger Owls) ■■■ ■" ■■■1 ■■1
Groin nhanber ��N . �� �, a1i1�11 /1
Bulkhead/Wprapiength _ - =11MI111 1
an distance cabs,*
rcnuabxi ct iysaardnse s Mwll.I , O,M_T qIte r,7'.'5i4 w‘e 6,'_.--•' M ■■o■ ■■■■■■■■■■
II
Basin.chancel ofrhae ■■ - '.._ j 3 r iI ice.'. M...■■■■:
1 `eil -I-MS ■ ■■al■u■MINUa■ :
. 111 1 , NM . Blemismimm
C.. f3
Beac,Bull dozing i �` iiMr�■i■■o� i ■M j■IN 1iiu ■ia�ii11■!i =
Other ■■u■■■■�1. ssoms■ ••� �■■ i�■■■■a■■■w■e
W■■■ ■■■■■ ■ ■■ , ■■ ■■ _
■■ u■■■■■■■■ ■ r'l�
__„5, ■■ u■■■■■ • 41111
..Li
Shoreine Length n«t—f4 _ __ 111118SAY )eoo■■ , r� + ■■ I�■■■■■■■■
Moreoriunn: Ns PI h® ■■ ■..�■■ a. i ■■■■■ ■■■■■■■■■
Photos: >� ,,. ■ ■■ ■■■■■_.■■■■U■■■■■ 1_ , _ ■■■■ N■■■
Waiver Atadnd: yes r -
A building permit may be required br t. ye,y - L • ❑See note on bade regarding River Basin rules.
(Note LocalPlanning jurisdiction)./ l 1 1
Natty Special Conditions ()i]act.., Qac:l v- .-.t‘\ oa. by.�{- t•. rqn... 4,44....t` et S
eKa s 1rc. pr s er' to 1..,�r. �� _ ewes - (, 4..r"H„ 4- ....s s, s, .r
SVIsn 1 oiwIIK al Mb s ..an cs.+ ,< t,a,. •ad0o� L r rlv...t ,1- Cpn,1
-2,,,a ,. \ ft.-, ..., 1-. ...-a c 4,,,_
Pernetple7
skrature "Please read compliance statement onbadtofpent*" Stooto-
ti-V e�A a 'ill 2crz.0 zaz I

iii NC Division of Coastal Management y A B D~%
Cashier's Official Receipt = R c) l -'-
Date: rt > I ( 20 2.4
---, , (_)v
Received From:
55 v2 `a, C~` r
Permit No.: Check No.: - J
i
(� 1 �
Applicant's Name: I )4 1/L_ -�i c IC-.,,4,�1 d County: i
Project Address: - 1 - 0_,-. (- ") ;,-�,. I �, (l.. G,..
Please retain receipt for your records as proof of payment for permit issued.
v 8/24/2021
Signature of Agent or Applicant: Date:
Signature of Field Representative: Date: 4
Scanned with CamScanner

Check
Date Received Date(+pnaited Check From(Name) Name of Pormlt Holder Vendor Check number amount Parmit Number/Comment. Receipt or MNndRwllocE.d
Columns Column2 Column3 Columnl Cok.mf6 Column. Cokunn7 Column. Column.
8/26/2021 AMW Docks&Marine Construction Raymond&Rebekah Watts BB&T 6428 $ 200.00 GP#80273D BB rct.15623
8/26/2021 'Rumbold Automotive LLC Richard&Laurie Rumbold Summit Credit Union 5902 $ 200.00 GP#80283D BB rct.15622
8/26/2021 •Jeny Ennett Dorsey Daniel Jr. Coastal Bank and Trust 4092 $ 200.00 GP#80288D JD rct.14092
8/26/2021 Southeastern Coastal Const.Co. CJ Bouchard South State Bank 12297 $ 400.00 GP#80304D BH rct.14125
8/26/2021 Carolina Marine Construction,Inc. Sarah&Ronald Seawell First Bank 13231 $ 200.00 GP#80275D KE rct.15732
8/26/2021 Camden Pander LLC same First Citizens Bank _ 1108 $ 200.00 GP#80252D JD rct.14921
8/26/2021 Coastal Marine Piers Bulkheads LLC Jay MHam Wells Fargo 23996 $ 200.00 GP#80150D JD rct.14919