80274D - Osborne

0 CAMA / DREDGE & FILL ° 80274 A B C
GENERAL PERMIT Previous permit#
>C _.:)New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality //�� 1 i
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC V� In
'� j� ,, ❑Rules attached.
Applicant Name J Q e V S"✓U ✓� Project Location: County //�Sw
`� AI g
Address I,U�3 � j.{s ,lc Gv� �• � �`-V Street Address/State Road/Lot#(s) 5 y f // (p3
City . ,,lilt State NL ZIP 2 k A.tc cc.,CSt /
Phone# c IZ 915(p E-Mail Subdivision S-4.c. A,v.c rS(,,I S
Authorized Agent „ e C(„,. .� City ! e(I ZIP 2 oy(9 2_
Affected I Cw ❑EW ElPTA y ES ❑PTS Phone# ( ) River Basin L„,t--,,,--
AEC(s): ❑OEA ❑HHF ❑IH UBA ❑N/A Adj.Wtr. Body A S,^ (na/ . unki
❑ PWS: 1
ORW: yes / PNA yes /(nqJ Closest Maj.Wtr. Body A k�
•
Type of Project/Activity �LR- ( k n r. l�D �`,,.. . 5 1`/N.^ t" 5 IN A` , C t. C•
(Scale: )V j 3 )
Pier(dock)length
Fixed Platform(s) l ��, Q�
Floating Platform(s) I\ e7 11
Finger pier(s)
�,,(An�1 ry,,. _
f —
Groin length I
number _._...._. _.__._.... + ....... �......_._ ........_.._.._—�. _ - _._..
1111 )1
Bulkhead/Riprap length _ --. _ i _ f. ._.__._
j ,
avg distance offshore 1
max distance offshore i i
Basin,channel
i
W `
cubic yards r 1 ` r G�[r �1
Boat ramp ® N., ,� LitAV P. — l 1 Nv •H
NMI4,,, , , _,_ I _
Boathouse/Boatlift ..... - ' _�_ —._L
ri____ ,
4 , ,
, ,
, i , ,
I _
_: ,.,,..:„...
Beach Bulldozing O�-(`M1, �� ell I _ 4�C.©
x1�,- h. L-2 ( S Lt.., 1 c J N
Other 1 , ;'�`
S v
4 1 I 1 \,ye
V . , ., , .1. 4'• �- .tom ...� .{.. i -.$
lOvShoreline Length v
SAV: not sure yes no l j / f v
i
Slit ik �....SA_S.. :.
Moratorium: n/a yes no 4 t �� ._... .�
_,yam_ /_..
Photos: yesISM I COO(._ _Q .._V 111.E_.
Waiver Attached: yes no / F t
A building permit may be required by: 1 /��t S n i c (<- ( 0,,,- ❑See note on back regarding River Basin rules.
(Note Local Planning jurisdicti )
Notes/Special Conditions 1, Q 0\V. c ,\\ U)( v,\k , ,1 Q 1�C, A . n�
` c---bcAll
• n �. / \ •(‹..r• <2\. .... r ,, c1c,k(q.zt
Agent or Applicant Printed Name Permit cer not e
/ ' / `� \ ------144.q•21
atu Please read compliance statement on ak of ermit** Signature

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: <5-e QS erne
Mailing Address: 15 ° a (tt rC
run a-c1 a
Phone Number: I Q — 51 a — q 35(D
Email Address:
I certify that I have authorized CfActc YYtc-C)( (�
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Li.\`\ &r)
�eplCaCPYYIPJ'l�
at my property located at 1 XS 5 9 5 e a rt re_ anal S ( 1
arr
in RftilEISv,J.C.\\ 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:
f1107L),- -
/' Signature
o r ner
Print or Type Name
N/ft
Title
Date
This certification is valid through I I

(35 ea 0 .«C, Cet-ned 5 er /y IUC
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: e is\cytt n e
Address of Property: e
(Lot or Street , Street or Road, City 8 County)
Agent's Name#: Mailing Address:
Agent's phone#:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are pro osing. A description or drawing,with dimensions,must be provided with this letter.
— I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext_,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response Is
considered the same as no objection If you have been notified by Certified Mail.
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.
I do not wish to waive the 15' setback requirement.
(Property • •• =r Information) (Adjacent Property Owner Inf tion)
a/4k_ 04 6 ilk,k
Sigma • gnat are
1,ke t Dr Y rICMO MC- 1(-k1r
Print or Type Name Print or Type Name
1859 anQ1(r COrici nlerref Alit fed
Mailing Address Mailing Address
aryisraEe ipV ) Je � a citE`a e/1 es-in 10 LA,n Y Jc �$337
9 -51a -9 .5Lo 9io '1(a- .2 (ari-1
Telephone Number Telephone Number
a_�_ _ 19_(a 1____
Date -Dole
Revised 6/182012

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Qwner: cJL,.,�. 0 Sbc r r t C.
135 a' Qna � SQL.e�
Address of Pr,�� � ScCC_.
� t, rue.,
or Street#,Street or Road,City&County) C!
Agent's Name#: Mailing Address:
Agent's phone#:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing.A description or drawing,with dimensions,must be provided with this letter.
1 have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC,28405-3845. DCM representatives can also be contacted at(910)796-7215.No response is
considered the same as no objection if you have been notified by Certified Mall.
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.
I do not wish to waive the 15'setback requirement.
(Prope w er Information) (Adjit ent Property ,w er Information)
047.
Signalu Signature
Sty 0 S t' ttLt'. A\vn ut-xnsorm
Print or Type Name Print orType-Nenr.
dii) WV:4.
etA_Cli(C rcirak lxb Spa Q (e Cara
ailing Address Mailing Address
4coal akvoiti Day cot
City/Stat /Eipv City/State/lip
910 -51 - 35cv
Telephone Number Telephone Number
.11
Dale Dale
Revised 6/18/2012

ved DateCheck
Deposited Chock From(Name) Name of Permit Folder Vendor Check numfwr amount Permit Number/Comments Receipt or Refund/Reallocated
r Cokunn2 Column3 Columns CWwmrs Cowmns column? columns cokanna
1021 PFL Construction,LLC Craig Loslto NAW Federal CU _ 2304 f 200.00'GP 880247D `JD rd.14918 __
1021 Coastal Marine Piers Bulkheads LLC Joanne Simpson Wells Fargo 23988!f 200.00 GP7/60316D BH rot.14124
1021 Coastal Marine Piers Bulkheads LLC Kevin Walker WeNa Fargo 23989 $ 200.00 GP080317D BH rd.14123
1021 John McClure Sue Osborne BUT 684 E 400.00 GP*80274D BB rd.15619
1021 Parker Trace&Associates Joseph Thompson First Bank 1289.$ 200.00 GP 880255D _ _ PA rd.12849
1021 John Green same South State Bank 4701 $ 400.00 I GP 980186D - PA fd.12850