80232D - Black

to ❑CAMA / 11 DREDGE & FILL N° 80232 A B C a
GENERAL PERMIT Previous permit#
>( uNew ❑Modification .Complete Reissue ❑Partial Reissue Date previous permit issued
,
As authorized by the State of North Carolina,Department of Environmental Quality f
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 0, r ' . 1 ' °
❑Rules attached.
Applicant Name /14 40NA' 6GA- 414- Project Location: County CA/C101
Address 5 5.3 e21 Pr1'V G ic Street Address/State Road/Lot#(s)
City // L P1 • State // ZIP 7?4.0 3 4o% 1-± S( .
Phone#(9/t 2)570-c44-Mail Subdivision ,' r �+�
Authorized Agent �/f'% if/tir///6�/ City 2 t4t T ZIP `�"
CW ? 1 '
Affected PTA ❑ES ❑PTS Phone# ( ) River�^Basin �/
AEC(s): C OEA ❑HHF ❑IN ❑UBA ❑N/A Adj.Wtr. Body ( 4'V b l > G- ( /unki 1:
E PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body 1 A)
Type of Project/Activity V r'S T 4 !( j}� < ` � r 1 t ft - .
fiv,L_ �
(Scale: H 7 S )
Pier(dock)length 1
Fixed Platform(s) '"} —ai"'
! (--i— i1/4.)Ar ' i i I it
Floating Platform(s) I 1
Finger pier(s) ' I
Groin length . i
number _.
1
Bulkhead/Ripra length i — r--+ r ___ -I _ —.. _._�
-r- —iy of
avg distance Offshore i i
max distance offshore LJ/ _ I ( ?'I '
Basin,channel 11tt el -t'4"-
.� 1 1 I.
cubic yards I
Boat ramp i i —�� i 1 1
i
Boathous 'Boar7 A( —l T t
v/` -i.
•
Beach Bulldozing i - --
Other knIkk4�...� j .. j S l' vv i
Na
�.�// i I i I t i
Shoreline Length '�5
\iti4 l d `
SAV: not sureyes '�' '' // I � l
ilp �VI I { ! iMoratorium: n/a yes no — rt4.1:6444.1_
I .. �"t -± L--
Photos: iip
�j�-
Waiver Attached: n/o 4 6, ' 1
V v ��
A building permit may be required by: 4t't v(/AAy
9f , U See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
,TA-- I Nt)(4-4 TKIA 0 A ()----- PIA-2 l
Agent or Applicant Printed Name Pe Mit'9fficer's Printed Name
cv� IZ-14•Z
*maim **Please read compliance statement on back of permit** t re

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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date `sI 1or2/
Name of Property Owner Applying for Permit:
/i28' 1—Ci `e__ /ack
Mailing Address:
011,n Atr 76 iv itic 3
I certify that I have authorized (agent) T� r— - Ate' -(f (`t to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) or(k" l -gcter
at(my property located at) 4(24, 44% �'i Ju,r �'t �
This certification is valid thru (date) 30 3ep- D2 I .
'6-�
Property Owner Signature Date

HAND
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A.,11,n/M0ORIEW'. JLINGS/.804 TL(FT/8O T. "O U `E)
I hereby certify that I own property adjacent to f�oryk, J \ k is
• - • • (N4nae-.ofProperty Owner) , . _ .
property located at 1{-03()_ FQ rre—{ ,
(Lot,Block,Road,etc.)
on (ana_._ ,_.., in C► N.C.
(Waterbody) (Town and or County)
Applicant's pbone#: ?l d-.S20 S21(Z Mailing Address;.5553 ok III
/..)`‘,\reAh3kor\1 t\)C 78L3
He has described to me,as shown below,the development he is proposing at that location,and,.1
havo no objections to his proposal.I Understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen.feet(15.')from my rn ea.of riparian access unless
waived by me, (U-you wish to waive the setback,you lust initial the appropriate blank
b elms)
I do not wish to waive
0 I do wish to waive that setback requirement.
- D E SCl:2dPTIO AND/O;,,DRA:WIN.G OP PRO2080 DE-VTtor ENT: ..- . . .
• .( o befrlletl In b•y indivldiurl jroposttig de.velgprnettt)
1 CC
y o b Pier rto
Jet.) , 1;_-F
0
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: 903 (3 `ID3 Li
•
(X riiiatlon fax Ortexty taw oi'.Applying-. (l.2iparian Property©w Information)
.for l.'st'mit) .
5 6 OL ft/D Q ..Dk
Mailing Address ignature
(j/LP7/N&7 I\/ A/C- . 2 1 o r . 1 Ctu✓U
City/State/Zip Print or Type Name
9/0- 5'2D-524-2. . '3 > : Li BEY
Telephone Nu b,�•r, `z'elephotie Number•
A, /4F o ( t - ) I Q 1 ,
Signature Date Daft)

I HAND DELIVER . . . , ..... ' . .
ADJACENT RIPARIAN PRQPERTY OWNER STATEMENT
(FORA.. X,8./MOORINQ 1'XLINGS!BOATLrFT/BOATL DUi'E)
I hereby certify that I own property adjacent to pRp B 's
,,,, (NAtne.of Property Owner) . . _ .
property located at_ 46 4, 4 '_ T T,5,,�C -r�` MC. Z c ,
(Lot,Block,Road,etc.)
on ^, in 6 C..: . .,N.C.
(Waterbody) (Town ancijli Qo-unty)
Applieant'spbone#:10 S2.O-5192-Mailing Address;5,,S 53 0Ir?lk,Nd..eV C)r,
i,)(Iminitt,N , 1\1 •�, 2L3
He has described to me,as shown below,the development he is proposing at that location,and,I
have no objections to his proposal,I understand that a pier/mooring pilings/boatlift/boathouse
. must be set back a minimum distance a fifteen feet(15.')from my area.of riparian access unless
waived by me, (Ryon wish to waive the setback,you roust initial the appropriate blank
�
below.)+
l „.rf. I do not wish to waive
1 do wish to waive that setback requirement.
• DESCRIPTION ANI)/Oi,pS1A.'VS'I,NO OV PAOposb TS VTX;QVNILN'l'i. . ' • . . .
• .(To,befrlletl in by incNvldrial iropesl.tig daveluptnctrt)
:-i-*
Li'Xit t aw bbaflrl
p,er
L1D3>3 d- 19' - . Cki��'ikg zi- yU3q
(Intbriitatlon fo.i.-PNIArty Qwxteir Apply.ing-. (Riparian Property Owner Information)
for Permit)
5 6I3 ©L?T '- V D R. Lk ��-�✓a ci
Mailing Address Signature
(c LP7/N&7 A/ fik. . 2g-i-•o3 Cindy
L.- VaS.5 C tr
City I Late/.dip 1 Pita or Type Name
?IP- 52,0-524-2_, . qCO -353 - 4_B‘,LS
Telephone Nu b‘r 1 `1 elephonerN'umher
7--' 6 t 8- 14- Z
Signature Date Date .

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check number amount Penult Number/Commend Receipt or Refund/Reallocated
Column1 Column2 Co/umn3 Column4 Columns Columns Column? Columns Column9
8/20/2021 Lighthouse Marine Construction Bert Lewis _Coastal Bank and Trust 3891 $ 200.00 GP#80231 D JD rM.14090 _
8/20/2021 Patrick Antinori Mona Black First Citizens Bank 1113 $ 200.00 GP#802320 JD rct.14091
8/20I2021 Hardison Building,Inc. Eric Perry Branch Banking and Trust __ 50244 $ 200.00 GP M80251 D JD mt.14917
8/20/2021 McPherson Marine Services,LLC Kara 8 Jesse McPherson First Citizens Bank 4443 $ 200.00 GP#80211 D Tmac rct.15557
8/20/2021 American Marine Construction,Inc Ray Mitchell First Citizens Bank 89458 $ 200.00 GP#80212D Tmac rot.15558
8/20/2021 Maritime Coastal Construction,LLC Paul Dillard CresCom Bank 3404 $ 200.00 GP#80234D BB rct.15615