80304D - Bouchard

W +AMA/DREDGE & FILL 9 8030�
ii-li
ENERAL PERMIT r A B C
" ❑ Previous permit#
ew 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 f 5A NCAC cry k .rzeo
CI Ftuleseci.
Applicant Name ` Project Location: County �c.1�3 v'k¢..t� '
Address 6-01 �^(J1 �C �A1 Street Address/State Road/Lot#(s)ZZO)
City 1c�k 1 State'T ZIP43k
Phone#( ) E-Mail- Subdivision��jj� �
Authorized Agent �� 1 City rtil0e,,,, i3etc.c�,� ZIP -.Z`� �
Affected ____
J]CW ❑EW Xi PTA DES ❑PTS Phone# ( ) �'�' _ River Basin__ ( g
AEC(s): OOEA ❑RIlE ❑IH 0 USA CI WA Adj.Wtr.Body M�I k ��/man /unkn)0 PWS: ,y�r�
ORW: yes /< PNA yes ,Cdg Closest Maj.Wtr Body PT-1-
Type of Project/Activity -+tk rtQi.i 1i)tikhaf
Pie (dock)length / •�'
Fbed'-tform(s} -� _!_ ��� Pj �� �i
allall - _..__ ----
Finger pfer(s}_ i . 3 _#._.-i...._4_4 4 r.-* _ t _ -_
■ �ismiia
Groin length - - ��� '1�,ic:�l t ! - ....,
=number itiprap lengdt r� , reig111117-011111CAP
_'et,
.1,� r
avgdistance oi t, 111 Et I r��u���t!! r
offshore I ; r j -
max distance offshore i i -I M a. III '�-" f } s--,..
_B,as 1.channel --�' -�---' *. r
_,`. _ . -_ R' ` ,
t
cubic rdc i €�/ ��Hr �
1
•
Boat ramp MBE I 111111111111111111111111; -i-t-r_'�
Boathouse/Boatlift
iI!F .: 4 t /-j
Beach Bulldozing a t-_i _ _-- t-
3t ■ate 1 , sl u aaa1l r- ;- 11 11~• * - •,--
Other Q� —_ i . MINN _---f- !Cat, .. ! i I i
Shoreline +��Dl Li _ i# . , j ; ' _ , l t 1 ,
jr _ ■�• qli. aaIF!:" iC s . 1 •
SAV: not sure yes Ca�O __ _' ' 1�i1��EARI 1l��._ � �
Moratorium: n/a es 1 !1 i f __. _,
Photos: yes '- ..- - � .. - +_ j .--
Waiver Attached' yesI I .�. r iR, t t
A building permit may be required by12 yL Yr.I Cas-kfnA s .aB .0 note on back
Note Local Planning regarding River Basin rules.
( ng Jurisdiction) M (�
Notes/Special Conditions i 0 t 1 t' � ^(� ),a r �,p�}
si-e-.L,,,, p,, c„t4,,,)a-y.,- --E
,v... i.--\--4,--._ g .Z.3'2.1
t or
PK s
I22321
Signature Maread compliance on bads of permit g*
- .. .. IzZ2` - 2c 17IZ'Stz k

,$CAMA /' DREDGE & FILL No 80304
0 A B C 6
GENERAL PERMIT Previous permit#
New Modification Complete Reissue CPartial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality ��� c ���
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
1__ ,,,� ❑Rules att ched.
Applicant Name S r�. C51)Cv�-` Project Location: County VDe-l.V �l�+C6-
Address �1C�1 cLJr (Cc GDP1/41 Street Address/State Road/Lot#(s)Z.3 i7oci�'lo AIR
City `�CVS State'T ZIPk
Phone# ( ) E-Mail Subdivision
_
Authorized Agent � Y� `�7Y�LJ9°Yy City ibt.t °� l cC /\ ZIP 2.-.8q713
Affected LiCW ❑EW ya PTA ElES ❑PTS Phone# ( CF_ ) n, River Basin h
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body V\1 Y &L(.3v6e:ociO/man /unk
❑ PWS:
ORW: yes / PNA yes / r o Closest Maj.Wtr. Body
Type of Project/Activity t0s) nsib.„ a'a_dA
(Scale: Ks-r' )
Pie (dock)length j /�
Fixed tform(s) } i v`yreSOOTNA i
i I
Floating Pla rm(s) s•
--
'6H1:-.)1 .
Finger pier(s)
Groin length •
I I
J
number r u -��' — . �.__ 1
avg distance offshore 1 � N ' I
max distance offshore ( i
fCt:Bas ,channel I 41
1
'\ , r3 f i i
cubic rds "V"...
Boat ramp >>#0
Boathouse/Boatlift LL 1
i I
i
I
Beach Bulldozing . d -.• i i 1 .1
Other 3'7 ZO' i
ACISI a) d Q26
Shoreline Length 4l 6© _
�n
SAV: not sure yes � _ _..1..
�fr�Moratorium: n/a yes 121 fPhotos: yes _ {t I)11!
.. t . '
Waiver Attached: yes 67) I 1
A building permit may be required by ( i4 <-Rj See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) (j ,(
Notes/Special Conditions IN)
�1 11� r'c' ,.60 (��1�� i9-�� _
J
iikr-c-crIclekt
j....) 1
N .-E__ __.t"... *---\----4-vi__L
ent or Applicant Printed Name Permit Officer's Pr d Nam
Signature **Please read compliance statement on back of permit** Signaturf I 1

41 E CAMA / '_:I DREDGE & FILL N9 80304 A B C
GENERAL PERMIT Previous permit#
>C 3New EModification Complete Reissue CPartial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality -7�r�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1 t--' .1--ZCC
❑Rules rtched.
Applicant Name (,.. k'I 001..) \O'Ck Project Location: County i' vC �l ` v10�6
Address 101 ((JA \rt <C ..,--)A` Street Address/State Road/Lot#(s)Z' f--6- ; G re
City !�V�k or. State 7r ZIP3"
Phone#( ) E-Mail Subdivision ,� .
Authorized Agent _-fie l'� ( wM) City i %'C NIc,- & \i\ ZIP Z -'(z6
Affected ❑CW DEW '®PTA ❑ES ❑PTS Phone# ( ) //River Basin A�CV R
AEC s : ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Wtr. BodyM (tk (mil roitc�t 'O Adj. Y a/man funk
❑ PWS: f� i 1
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body D"� 1`L)
Type of Project/Activity d__i. . L. . .Y
(Scale: I...5`7-S )
PieN(dock)length I'J_ h
Fixed ()() / Y k �l.& .7 c v� 111.1r'` l` I l
i t�
tform s i
FloatingPla orm s i �_ I
Finger pier(s) *' f : I ! ' all! 4....)
Groin length i I `�
number \j. _ .e.�.....! _—
iBulkhead/Riprap length '—
P P gt3 i ©' � --
avg distance offshore ( ' 1 I ©\ \ I I
max distance offshore 1 e`G a,�
Basin,channel )\g .. i
;,53 Vey 1
cubic ds f
Boat ramp -. _
t
Boathouse/Boatlift ----- :
— i i I I _ v
Beach Bulldozing e -
i v • I 1
Y�
Other s 7' 7 0 r Ni
Shoreline Length C GU I , _ A\]k\(r
SAV: not sure yes T. 1 tj
Moratorium: n/a yes no �` 1 t. I
Photos: yes C i . ._� ... _ —_ . . 1 -
Waiver Attached: yes !fio r Zi'ic *1 Pe(,A building permit may be required by:�ackk . (/&c e.QXt �ANs . I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) , \ I`
Notes/Special Conditions @��\'0 t o� 46 r C'_CI,`�� (, {( &S G-'ill -6 E-&
•
--g
�� vi
k . �rz �rtcC d
210 V•.- ALL
ent or Applicant Printed Name Permit Officer's Pr Nam
Signature **Please read compliance statement on back of permit** Signaturf i '

AGENT AUTHORIZATION FOR CAMA PERMIT APPUCATION
Name of Property Owner Requesting Permit C 7 4e- c.(
Mailing Address: W 4O\ Ai ay
{r ir•cr LiJc&/
4sn 75c S'7 a
Phone Number: ct(ct - q 31 9 s 19
Email Address: 9I20 t{eh A,d3 a pfai f.ezn,
I certify that I have authorized 500, e46sr (no-4J (`Q /E L�� y
y
Agent/Contractor
` /
to act on my behalf, for the purpose of applying for and obtaining aN CAMA permits
necessary for the foil wing proposed development Lij k crsi( ).c i`" t`4 `eck-i
at my property located at 0-'j or 4. 04
in IV ed i 4/1 v.e/• 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(der and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
liaChaesd
Print or Type Name
TRIe
Date
This certification is valid through - I 1 I r'

ADJACENT RIPARIAN PROPERTY 0WNgB STATEMENT
I hereby certify that 1 own property adjacent to C"5 [ 0 01/4C, 's
property located at 235` on (1'�'"'e of Property Owner)
on l' f©(rC. S01.4mo . (Address, Lot, Block, e10
, in Cott^a. ck,, Nam.: Ufa ov N.C.
(Wady) (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)
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.
C_R I do not wish to waive the 15 setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Si aer e Si e
Print or Type Name Print or Type Name
01 1",itty-co,t42.4,-- 1.0,ky /Q 0, A n ‘)
Meiling Address Meiling Add
iht... -* T L 76-73 b�f t
• a 3,TG
C 3I City/State/Zipa i— $-s 0 - 476
Telephone Number Tgpione Number
- - g a/
Date Date
(Revised&H8120-12)

IfiNficallADIMNiaskuumegurammw
# hereby certify that I own property adjacentto C-5" C3o 4a ---t
property located at Z'3S'. (N ne et Property Owner)
on
(Vtfatiwbody1 ( Canny)
The applicant has described to me, as shown below,the development Proposed at the above location.
I have no objection to this pry,
----- I have objections to this proposal.
DESCRIPTION ANDiOR DRAWING
{btdiivldfrral proposing rent OF PROPOSED DEVELOPMENT .
thscrtp#oa below o►attach a el draw in'
.(.►3t
wir-
I understand that a Imo, . mooring WA l�SECTION
distance of r, from ��, breakwater, boathouse, lift, or groin must be set back a
minimum setback, my riparian access unless waived by me. (If you wish to waive
you must Initial the appropriate blank below)
I do wish to waive the it'setback requir+emen#.
\-/- I do not wish to waive the 15'setback requ
(Property Owner Information)
Owner )
(4,1eit
(kOLutkariek 343( n le9)Ln.r+ (P 1144/5-
1171{1.1.1TYPeilaq-e-ekr-o._ 10e..7e PrtLar,triAlle3C)
cirTine Number #C- , `? _ �
— 1 T Number
DateDate
y
(Revised 6/1&2012)

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C/roek
Date Rocallod Data Dapoahad Check From(Name) Nam of Pam*Holder Vendor Check numb*. amount Permit NumMr/Commants Receipt or Rafund/Raaltocatad
Column) Coh mn2 Cofumn3 Column) Column5 Column6 Column? ColumM Column))
8/26/2021 •AMW Docks&Marine Construction Raymond&Rebekah Watts BB&T 6428'$ 200.00 IGP#80273D B8 rct.15623
8/26/2021 Rumbold Automotive LLC Richard&Laurie Rumbold Summit Credit Union 5902 $ 200.00;GP#80283D BB rct.15622
GP#80288D
8/26/2021 Jerry Ennett Dorsey Daniel Jr. Coastal Bank and Trust 40921$ 200.00, JD rct.14092
8/26/2021 ,Southeastern Coastal Const.Co. CJ Bouchard South State Bank 12297t$ 400.00 I GP#80304D BH rct.14125
8/26/20211 1Carolina Marine Construction,Inc. Sarah&Ronald Seawell First Bank 13231 $ 200.00 GP#80275D ,KE rct.15732
8/26/2021 ;Camden Pender LLC same First Citizens Bank 1108 $ 200.00 GP#80252D IJD rct.14921
8/26/2021 Coastal Marine Piers Bulkheads LLC Jay Milam Wells Fargo 23998 $ 200.00 'GP#80150D JD rct.14919