80241D - Gibson

0 'CAMA / DREDGE & FILL N° 80241 A B C d
GENERAL PERMIT Previous permit#
>C New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued f
As authgrized 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 ` \2 CL '
` CI Rules attached.
Applicant Name �j�� ,< <klun 6,to s°', Project Location: County 3 r`'^5-=.', LL,..
Address`3 G,L.k,.+c-3 i cn\(- Street Address/State Road/Lot#(s) q63
City C-�1\.0,.\t 5\Ts.. State Sc ZIP 2 91 0 j D 6 (eh 1 -, S\.
Phone#( ) (DO? C3'2..9 Email 1v\CA'ijO P 44.nck Subdivision
Authorized Agent 1 a^an use ./MA^ City „A s-A-A U c F c k ZIP Z l 4t L q
Affected ❑cw "' E`PTA ❑ES ❑PTS Phone# ( ) River Basin L„ ....'...-✓
AEC(s): ❑OEA HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body et,..' 4 (natc:iti /unk
❑PWS:
Closest Maj.Wtr. Body __Y..1r-S C -_ L—
ORW: yes /� PNA yes / no
Type of Project/Activity .a.... A-1,-, ne,.., L- S 1,e
(Scale: N S )
Pier(dock)length ( _
I
Fixed Platform(s) 9 r`t2 /� ,'--�{ G
FloatingPlatform(s) �dK 1'Z r � .r �A T .`„.. ,
Finger piers)
•
t ......:....
i
Groin length
number _.__.-._. ———__._.._.�. —
Bulkhead/Riprap length 1 . ......_ ._-._...... �.�__-._.... _ _
} �S1• p ` � 1 I
avg distance offshore i
max distance offshore 1
Basin,channel
s i .
cubic yards i 1 '
Boat ramp } 1 Ift - f 1 f
Boathouse/Boatlift . '-
:
i
•
Beach Bulldozing — - i {
Other tillC 304} -`*� ���
i W V\ I 1 I
i
Shoreline Length SU ylok Dok&t a lao /t (40
5 `
SAV: not sure yes no [t S % 1(/ ~ 5, t
��'lll
Moratorium: n/a yes n t�' V`` -t— b n(�r.A-Z 1 O 1-
Photos: yes o - '.
Waiver Attached: yes o 1 i
A building permit may be required by: . •'^(< 4 a< G( V, . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction),_
Notes/Special Conditions U oc 4ti t..,.\ ( t k t ,\\ n S.IN �.y.(.L.t_► CXr`;'N -,: "` 1--"r L,_fit
S. , A �e,d , Src-.1., ✓0, I< _. gz.zj
Agent or Applicant Printed Name Pe 's P'nted Name
"\7--- (2.314
Signature ,**Please read compliance statement on back of permit** Signature

QCAMA/ 0 DREDGE& FILL N� 80241 q B C
, ENERAL PERMIT Previous permit# /
New 0Modification DComplete Reissue ❑Partial Reissue Date previous permit issued
As ' ed by the State of North Carolina,Department of Environmental Quality 1
and the oastal R urces Commission in an area of environmental concern pursuant to ISA NCAC 1 \ -d0 •
` / ID Rules attached.
Applicant Name c `I�� ,c.t`t,So,, �7`co S.^ Project Location: County ('^S A.`‘c_k<.,
Address 3 G„t .W w c \w Street Address/State Road/Lot#(s) g o-3
City C ,,fit 1\0,, State SC- ZIP_2.2� LLq`'j 0 j I1 }_
32
Phone#0°4)(DOV C19 M E-Mail C C)Pt ,,tT.n4k Subdivision
Authorized Agent C5 t(-.••.ao,- Pt/Nw^ City Sy,.s.•) Q c Ft: k ZIP Z ''A L q
Affected ❑cw rPTA D Es OPTS Phone# (_) 1 RiverL—Basin "-v
AEC(s): 0 OEA eVI:IF 0 IH 0 UBA D WA Adj.Wtr.Body et...(...\ (natP/unkn)
0 PWS:
ORW: yes /Rj PNA yes Closest Maj.Wtr.Body J t•‘".-S Ci�`k.-
Type of Project/tt '' Activity V., (rwv t, P 11.45 •D AbC1,— a- NI te.aLl-- %-•-• n.4-' .L-s f re
&,r(.-.., •Lit• (Scale: N T. S )
Pier(dock)length i ! '
p - II Ilt
Faed Platforms) []''(Z► , 1—, I {- }
Floating Platforms) l C f2 = _\`1f _j♦jjjjjjjjii`. , (�r�jr �ij♦� ����
Finger piers) R �-1_ �o . 1 �m ._�1—t.
Groin length , 11 :� 111
�,1 „� 1
number —- MM A _ _ ________
Bulkhead/Riprap length —■_■ �i�■■■■■ ■_■—■j♦_
avg distance offshore *,111111Ma,"iniii i ,1
max distance offshore
Basin,channel II I j ,� 1I II IPj
cubic yards I I4
Boat ramp ______ I i
w__11.11_- : _ ____1111111111____11111_
Boathouse/Boadift 111111111111MMIll I __ _________________
• ;' _____________
Beach Bulldozing 1( g' f _I I J j `
Other I ', 2N (, r>1`Z` i i 1 i ', JP I i , ,
` \e.n 2 y, __________ (. 1 1 . 1 . 1 { • -
_
t ji ! 1
Shoreline Length 50 i ti"'• ! i ;1 ,'II
I uV C t m 1 '
SAV: not sure Yes no �654 _ _ ,t Q ___ i 11111 At0"JG 1 Ail_O I
Moratorium: n/a yes I111111_ i t
Photos: yes i {_�}- _ ___, _ ;--
Waiver Attached: yes ff
A building permit may be required by: c•-'^tt t GC h • ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) \ c
Notes/Special Conditions E L1 oC 10 t••h 'Sr-•C t k t5 �•,�� n OA ..RC�I1 C1Ct 13 C'C-�cci
Ci'.-Q b.- I/ ,A,,sr).1 J
Brandon fesperman 1 /1
�1S(� +c. 1 ✓ot_I
Agent or Applicant P ' iP' ed Name/ � -�
Signature "'Please read comp/' e statement on back of permit""' Signature
70 6 u 4 ( 0tZ 9--�-Zcrt,1 kZ-3-2oZt
Application F s) Check# Issuing Date Expiration Date

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rECEIVED
12. �k JUL 16 2021
4- 10-
DCM WILMINGTON, NC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: rc) ('i\1 C \\Dc \
Mailing Address: Do'V"r' r\
�n bCc,A,\ R( g\444Ac04
Phone Number: Icy ..C� - 2 D P\
Email Address: (Y1C,r' c G , Y1c-1-
I certify that I have authorized ((ar ✓1 "T�� �✓�
Agent/C ntractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Wi` P' G c .
°D C < C.k nG1
1 l
at my property located at L4d) cl;o5t 140:1.\ ,*►n Sc"
in 4>cv-n5u.r"luk County.
1 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:
�• RECEIVED
Signature _ `? (1 )P
1-kNedi 6-1 am DCM WILMINGTON, NC
Print or Type e
Title
I I I IA
Date
This certification is valid through 9 I I oW,

ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3. A. Signature %
• Print your name and address on the reverse X El Agent
so that we can return the card to you. ❑Addresse
• Attach this card to the back of the mailpiece, B. iv by(Printed Name) C. Date of Deliver
or on the front if space permits. r.
L T
1. Article Addressed to: D. Is delivery r�e�l�` J tt ❑Yes
Pb� do (AN If YES,e O I' ry address b w:i No
Mon.0 . . C0
\ ,11e, ' -,\\., ,?pc,`t°f` \c4 JUL 12 2021
III IIII'I Ill II I II III I II III III I I I I III 3. Service Typ l Express®
0 Adult Signature'
❑Adult Signature R Day S P istered Mail"
eg'steredlMail Resri
9590 940 5931 0049 2801 08 ❑Certified Mail® Delivery
Certified Mail Restricted Delivery 0 Return Receipt for
❑Collect on Delivery Merchandise
2 :*t0 Collect on Delivery Restricted Delivery 0 Signature Confirmation
l
7 D 2 D 0640 0001 9 618 8020 0 Signature Confirmationit Restricted Delivery Restricted Delivery
no M....OQ11 ,..,..rm.'c ne••,,ern nn nnn.,ne.,

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CERTIFIED MAIL RETURN RECEIPT REQUESTED ^ M
DIVISION OF COASTAL MANAGEMENT cLA 6\ori3r.
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM etvey.-5
Name of Property Owner: 'L t1 G1'A�
Address of Property: yo 3
(Lot or Street#, Street or Road, City&County)
Agent's Name#: ^ pf\ 4 (MCf Mailing Address: it&
Agent's phone#: 0\\D—(r,02•( A\ A,(* &\ S 1\ L
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.
V have no objections to this proposal. I have objections to this ro osal.
P p
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 RECEIVED
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15'setback requirement. . U L 1 6 2021
V I/ I do not wish to waive the 15'setback requirement. DCM WILMINGTON, N
(Property Owner Information) (Adjacent Property Owner Information)
,X
Signature Signature
"I V1 -I��.`��� c '1 Avropit S-6/9 D At t.\
Print or Type Name Print or Type Name n
'T0J 13p },� S� I Z'i ID )t I�tt1'Pt,- ¶&
Mailing Address,' Mailing Address
City/State/Zip City/State/Zip
7)0(1 -GA -9 2 1. -5 3et -b 2-e0
Telephone Number Telephone Number
- I I 710 jtz p —
Date Date
Revised 6/18/2012

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to . • s
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on , in , 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)
RECEIVED
JUL 30 _,
DCM WILMINGTON, NC
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 Owner
Information) (Adjacent Property Owner Information)
IA 4 J4-CU-so-, (jc .SUn
Signa)0(A.
ure Signature
Print or Type Name Print or Type Name
Mailing Address Mailing Address
City/State/Zip City/State/Zip
Telephone Number Telephone Number
Date Date
(Revised 6/18/2012)

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__ (all RECEIVED
JUL 3 0 (_ ;;
Y: `)- DCM WILMINGTON, NC

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