80316D - Simpson

"41 CAMA/ ❑DREDGE & FILL V d 803 �j A B C
GENERAL PERMIT Previous permit#
Cfr
New ❑Modification Complete Reissue CPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ff``
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC ©-0- •—C7
-C1
O Rule attached.
Applicant Name OOVAti2 '\ Project Location: County ( .C,t_,.., rkt+Yere '
Address rat Out W1. (1 'I roc + Pc Street Address/State Road/Lot#(s) 223 614.7 60 (
City 7'�t 51\ State-- ZIP 2-4606
Phone#( ) _ E-Mail Subdivision d Q ��-
Authorized Agent 6 ,..vv -\ (._\o. City Lam, ) ZIP efi-`c5qCr\
E CW W 't A ❑ES ❑PTS Phone# ( ) River Basin C-F2.
Affected ❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body `r .-p (etot&C (flat /man /unkn;
❑ PWS:
ORW: yes no PNA } i no Closest Maj.Wtr. Body vuk r et._ Clr✓e _'' \
Type of Project/Activity 1,�{ QQ �j0 1 i• t �LC --t r.. k t IFS
(Scale: tv ` )
Pier(dock)length
l` "`, I
Fixe•Platform(s)
Floatin: 'latform(s)
Finger pie s) 141 7,;�`i- a t
Groin lengt
number
O
Bulkhead/Riprap -ngth
avg distance o shore
max distance o ore
Basin,channel ?-ppoSPC1 i30a`4-
.5,_tPe.n.a
cubic yards y
Boat ramp 0 0 o a ^gg.kp n
oathouse/ oatlift if 2.r-I a
----------- -------H----------\ • v I _I 4
10 I I • II o 0
•
Beac Idozing
Other 1 J
w..ilia-1 d,,I/
Shoreline Length -i-L'"SRO
fik't 2 S
0ie2<klo Cit. TA3I`t i71., Nar-60, ccoi ci
SAV: not sure yes Eio +
IJwo,tr AscC. fprb,-
Moratorium: n/a yes n � ��{� `
ti11.-
Photos: yes net 71" L OaJ+tie 07a7G474I0_
Waiver Attached:ty,r. es no I I I • 1
A building permit may be required by: t k* See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions At( rules ` fe---506- 1S GLL�f9 &,ck Lq lJ (1'.2c
r-�
i, _, 0C' '- e'ttL- i•23-ZI
Agent or Applicant Print6d fVame Permit Officer's Print ame
/
Gan.t.in: " P2on ro,d rmm�linr rtnnamnt nn har inf.narmit� 12.23.2(

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �_����r�NC IAA
Mailing Address: I Z?) C L1 M i`L FDRcs1 R. t
ALE L(aL I it Z7(!i0(P
Phone Number: q - S Z 2 ` 9
Email Address: C S /�,Ps.,�r cam, Sii PS ON Ent 62. CO/Mt
I certify that I have authorized Ji M/'{ (N-'c'r2 TH
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 'Al LET Poi my- K' Root
at my property located at o,AT SL+ P '- CDisi"40/.1 D' t4. 2
in NE\At VER 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:
•
?AAP Ini L G
Sidnature
JoAiqH44-' M. S/AjPsoA.
Print or Type Name
ovuid E R
Title
7 , 2cp , 2 !
Date
',,
.,. t
This certification is valid through
' [ 3 -.4
,ITT
i Y alF.

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/VNAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Je..,A NAI& Sr M P6©A)
Address of Property: IOC 6,4-i?E eo Coc)R'l- u1/4/4lNoy l'a,u Ni6, z840 i
Mailing Address of Owner: (9'25 C.DLDE /A1LL 1 OR6-T bier Rp L-E/4t! /1.1 C. Z7eo
Owner's email: r Nf PSo� @ Sfrvt P,5o..1 ENC�R.co,vf
Owner's Phone#: 919' —5 Z 2 -'t59`3
Agent's Name: 3 Agent Phone#: (e— Z3I- E S 14-
Agent's Email Jt M wt t-lo 02 L. e
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property. The individual applying
p I in 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.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. 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. DCM representatives can also be contacted at
[phone]. No response Is considered the same as no objection if you have been notified by
Certified Mail.
I understand that an ro WAIVER SECTION
y p posed 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 (this
does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, si n the
appropriate blank below.) you must U
I DO wish to waive some/all of the 151-setback
-0R- Signature of Adjace,\t Riparian Property Owner
l do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Addres of ARPO: =
ARPO's email:
ARPO's Phohetlll: i
I'' -� �
"` *waiver is valid for
up to one year from ARPO's Signature*
RevicAri Aunt, ...

•
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL ' RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: JOAtiNE Moo RE
Address of Property: 10 0 &A �loo Cs>ei re-{- v.1 I LA,u,-J roki k C z.8 4 09
Mailing Address of Owner: (`123 oLbE ilA(LL F'R6sr- ©RI VC R,4L EC66 i Lt C Z 7 t,6
Owner's email: DSrwAP,5oa1 e5(M escr.1 cfR-c wner's Phone#: 9't 9-52Z-c:tS`19
Agent's Name JcAnr-it-( P Ot 'YE-( Agent Phone#: 9/Z) - 23 I - B 14-
Agent's Email: JrM' &'' °S.A #44:312TH ' iAIL . Co
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
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 descnptio or drawing, with dimensions, must be provided with this letter.
ve
I DO NOT have objections to this proposal. I DO have objections to this proposal.
if you have objections to what Is being proposed, you must notify the N.C. 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.DCM representatives can also be contacted at
[phone]. No response is considered the same as no objection If you have been notified by
Certified Mail.
WAIVER SECTION
I understand that any proposed 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 (this
does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign the
appropriate blank below.)
I DO wish to waive some/all of the 15' setback l
r C.
-0R- Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: / - 4 t_ „
Typed/Printed name of ARPO: AK1 12 c
Mailing Address of ARPO; 22-5
O L?tP-----
ARPO's email: V (IUCA 'VVCu(1OVn q
RPO's Phone: I D-2 4-31
Date: Z i
"waiver is valid for up to one year from ARpO's Signature*
DLit I:rtwdel lI—

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Chock
rad Date Deposited Check From{Name) Name of Permit Holder Vendor Check number emomt Parndt NumberlCommente Receipt or RafundNReallocated e
Calenn2 Column? Column4 Columns Column. Column? Column. Colorant
!021 _PFL Construction,LLC Craig Losito _ NAVY Federal CU 2304 $ 200.00 GP 680247D JD rd.14918
!021 Coastal Marine Piers Bulkheads LLC Joanne Simpson 'Wells
Fargo 23988 $ 200.00 OP 8803160 BH rot.14124
!021 Coastal Manne Piers Bulkheads LLC Kevin Walker 'Wells Fargo 23989 $ 200.00 GP080317D BH rot.14123
!021� John McClure Sue Osborne B88T_._ 684 $ 400.00 GP 4/80274D _ BB rct 15618
!021 Parker Trace&Associates Joseph Thompson First Bank 1289 $ 200.00 GP 880265D PA rot 12849
!021 John Green same South State Bank 4701 S 400.00 GP/80166D PA rd.12850