80227D - Marker

❑CAMA/ 11 DREDGE & FILL N° 80227
0 A B C eD
GENERAL PERMIT Previous permit#
Y= Chew ❑Modification 'Complete Reissue ❑Partial Reissue Date previous permit issued (' ''� -
As authorized by the State of North G,arolina, Department of Environmental Quality �� ���
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
" Ru^les t,t-ached.
Applicant Name '-•�,-� 0 Project Location: County
Address il i' 'f I f /10/u , i o a Street Address/State Road/Lot#(s)
City State NG IP iO �/� ,
Phone#(7o3)(o ei 9- 71 5—‘-Mail Subdivision
Authorized Agent "'/A-- City ZIP
❑CW ❑EW ❑PTA ❑ES ❑PTS Phone# ( ) __ River Basin
-� /• D
Affected ❑OEA C HHF ❑IH ❑UBA ❑N/A �/-/ 'j �j L/"
AEC(s): Adj.Wtr. Body 7- c?" /: 4C4,.f� at / an Junk
❑ PWS: ��'
ORW: yes / no PNA yes Closest Maj.Wtr. Body o �i�ip ,O,,,
Type of Project/Activity /M 514 /I S u//4,1_, /l-I ZI r
(Scale:
Pier(dock)length �
Fixed Platform(s)
Floating Platform(s) 11 i I l
I
Finger pier(s) I1
f —
Groin length
number ,� —j — -t r
Bulkhead/Riprap length A • i I 1
1--- ; 1 r ilIA—A AA'
avg distance offshore ttt — V/ I
max.distance offshore I I
Basin,channel K. 1 N I
cubic yards
f_ t51" ii I
Boat ramp } ; , ,
I
Boathouse/Boatlift — _..... ._. — „ ,
--, ,
f - -. _______
s , ,
•
U Beach Bulldozing --T - - , ,
I ��*l
Other ;
1
I
j i l j ( 4" I
11 �I 1 f j
Shoreline Length 7/ o 0 I
I ' •
SAV: not sure yes ( '(,t//f�`' i I
I•
Moratorium: n/a yes o
Photos: yes�fio) -- 1 t
$fJ
Waiver Attached: � no.L
,'
A building permit may be required by: ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) r Q''
Notes/Special Conditions 1 -0.I/1//— /40/ / ./l�e f' � _
G /is
M (/4 rt--- ...c--e__. e
il'
!M^ a lAI / � Lam.-- _S�Z(
o 'c t Printed NamPer's Prl ted Namere Please read comp fiance statement on back of permit,** Si ., v

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: (k9\(.) j'\ 4A-(Id ad.,c(
Address of Property: (G[9 Deer Qfpv-F , `--A-p y Si-es , M C 28443
Mailing Address of Owner. �Ov (�ze✓ C e, q k � �� 7 �(A
Owner's email: Owners Phone#: 'Q((() 5U`Lvi &7c 2—
Agent's Name: Agent Phone#:
Agents Email:
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
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 28405-3845. 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 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
SignaturelitAjc(7-410 Riparian erty Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: /
Typed/Printed name of ARPO: a yj 0 14- "` I/ju l.9-AID i1 l►�
Mailing Address of ARPO: ,/ 'o ��F�/e �;(��D!/E /�� /4#I<J'F' i) Ale p� �! 7f 3
ARPO's email:/in/ ,7 L& /�- y �� ���iRPO's Phone#: 910 . SOS - Q76, 2-
Date: 7- 3 D • I *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Qt Lam_ 6
j� JvN? , c u
Address of Property: '22 6 (C LO4 ( �l 'r/ n C k( 1_6(N 3
_ ` /i1 11 n 1�
Mailing Address of Owner: 2 2 IP (9 t ?&t&1A L( , C`D1-41 SJek �\llC- 245 4-4"3
��- �i
Owner's email: (CJJ11. l'P 1\; kUL 1 Owner's Phone#: 5I e) zkZ 5754/37
Agent's Name: Agent Phone#:
Agent's Email:
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
description or drawing,with dimensions, must be provided with this letter.
X 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 28405-3845. 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 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 sian
the appropriate blank below.)
I DO wish to waive some/all of the 15'setbac
Q.
Signature of Adj nt Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owne •• r
Typed/Printed name of ARPO: ? Lct (4 J 'p2S'
Mailing Address of ARPO: 2.2-6" (9L)e ?6,N..ct ,es4., , 1`�a .np5��/ fee
ARPO's email: PCtM0 20 Air: A(G T ARPO's Phone#: 6119 2 7, —S R'
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

Check
Data Received Date Deposited Check From(Nana) Named Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated
Column1 Cdumn3 _ Cdumn3 Column/ Column3 Column➢ Column7 ColumnD Columoa
8/9/2021 Full Rudder Creative Jordan Nason BB&T 1095 $ 200.00 GP#79939D BH rct.14117
8/9/2021 Land to Sea Construction,LLC Daniel Clements First Citizens Bank 494 $ 400.00 GP#80248D JD rct.14912
8/9/2021 J Marker same NAVY Federal CU 1236 $ 200.00 GP#80227D JD rct.14086