Anglers Bay HOA 80435C

DocuSign Envelope ID: C92F9C91-CE31-4374-B9A0-D163C2AF7207
4:�>x6AMA / DREDGE FILL A B C
EN ERAL PERMIT Previous permit #
New ❑Modification `-]Complete Reissse i Partial Relssue Date previous permit issued
As autho ized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resou ces Commission in an ar of environmental concern pursuant to 15A NCAC
0 ul attac
Applicant Name Project Location: County ...... .................
Address ` Street Address/ State RIT
s
City— _ tateLL ZIP ---�- —
Phone # )_` E-Mall __ Subdivision
Authorized Agent„W-j,WCity . _ ZIP _
Affected eW T
A D ES D PTS Phone # _ fiver Basin
AEC(s�: D OEA G HHF D USA D N/A Adj. Wtr. Body i net unkn�
-0PW —
ORW: yes / o • PNA yes / Closest Maj. Win Body -
Type of Project/ Activity
(Scale: 1630
)
Pier (dock) length...._
Fixed Platform(s) ``k'F�
__ r
Floating Platform(s) `Y~' ..._- ' � •
Finger piers) -
Groin length - -
number
t
Bulkhead/ Riprap fan
avg distance offshore
max distance o{fshore 3 i
j f�
Basin, channel I .. w W
1 — -
........ .. _.._ _.;
.......... _
cubic yards
Boat ramp _.
Boathouse/ atlift _' .. _...
i.. .... . _, g...._
�j__.._�✓ . ....... . .........
Beach Bulldozing..____ ✓�;__
Other -
Shoreline Length
SAV: not sure yes o b ,
Moratorium: n/a yes 0
Photos; yes I Waiver Attached: yes o '..--=—`— •- -j �-
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Srp}}} !al Cn�djiittiions rt
i; Vgh Bunted (Name
e eas,arsad compliance state
Fee(s) ^----
on b ck of permit
)f
ill
Expiration Date

L CAMA / ❑ DREDGE & FILL C% $04A g C
ENERAL PERMIT Previous permit#
New ❑Modification [-]Complete Reissue El Partial Reissue Date previous permit issued
As autho ized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resou ces Commission in an a�aof nvironmental concern pursuant to 15A NCAC
❑ ul s attac
Applicant Name Project Location: County
Address ` Street Address/ State Ro / Lot #(s
City _ tate ZIP
Phone # ) E-Mail Subdivision
1
'
-. _ L ..ice �:w [ i/L__
���y.ZIP✓
_
El CW W ItTA Ll ES 0 PTS
Phone #
iver Basin
rtw ,A
■
•
�o)
Closest Maj. Wtr. Bod
ORW: yes PNA yes
.
,
..
JO■VA
■
■
pp
10
MN
Boat ramp
Boathouse/
Beach Bulldozing
Other -
Shoreline Length
SAV: not sure yes o _....._..._._.-___ __.......... ___-- _. 1
I
Moratorium: n/a yes o j
_ .....
Photos: yes
...... ..... _....
Waiver Attached: yes o �-
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Spe 'al C nditions
�,) A r
Agent or Applicant Printed Marne f / l
A
ature lease read compliance statem on b ckof permit"
lication Fee(s) Ch ck #
9
❑ See note on back regarding jTjvpyBasin rules.
Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on howto comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
Washington District
400 Commerce Ave
943 Washington Square Mall
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ 1-888ARCOAST
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Ar�c,� r-s � 0 /� Is
�t� (Name o rope Own )
property located at 16 q f? JC �►rxc ,,. Ay i ,
(Address, Lot k Road, Blo tc.)
on (.�11� s Cd ( in c+�r_. ! ��,�L , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc2ti4
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)
--t-a 5 1-/0 S- q -- ! q
S A+4-c�,�
S G
(a u p
WAIVER SECTION
I understand that a 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
Pjvz(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 formation)
Signature
Print or Type Name
Maims Address
City/State2ip
Telephone Number/email address
'51a�zr
Date -- — --- -
"Valid for one calendar year after signature"
(A ' ent Property Owner Information)
(' ( rf
Signature* I
E(1'b-Cr4- W; L'e-.O`r-0.v
Print or Type Name
I ` o0 1r-e. w
L /wal4,vv,
M li g A dress
3
City/State2ip
T lee phone Number/email address
_4 —ZUzl
Date *
(Revised Aug. 2014)

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SHIP DATE;
Tues 4 May 2021
EXPECTED DELIVERY DATE
WED 5 MAY 2021 EOD
SHIP FROM
Sparkman Construction
1504 Sweet Meadow Lane
Raleigh NC 27613
[phone]
SHIP TO
Wrenn Johnson
205 ATLANTIC BCH CSWY
ATLANTIC BEACH NC 28512.7357
Business
SHIPPED THROUGH
THE UPS STORE 02967
RALEIGH,NC 27615.2115
[phone]
.'348 # 1
__,qSE SAVE FOR YOUR
SHIPMENT INFORMATION!
UPS Ground Commercial
0 lb 0.1 oz actual wt
1,000 lb billable wi
Dims 13.0040 , 004.00
DV=$100,00
Pack and Ship Guarantee
in S{ore Packed
Tracking Number; 1zF6246YO301690725
Shipment ID : MMSVREWY247U4
Ship Ref 1 : - -
Ship Ref 2; - -
DESCRIPTION OF GOODS
Paperwork
(Name o ropert
Lot, Block, Road, tc.}
(CityRown andloi
T below, the development pri
Mal.
SHIPMENT CHARGES;
Ground Commercial 10.49
Service Options 0.00 OF PROPOSED DEVEL,
CMS Processing Fee 0.22 in description below or a
A
Total $10,71
ho4PppLE%kheuLppesloreRcomNG(BeEeCtrTreckingdrenlernSyipmentbIDrgjser SHIPMENT
OUESTION57 Coniac SHIPPED THROUGH above. h
Everyone needs a helping hand now and then.
Join our FREE email program
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SEENODCEON
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_ _ _. inat a pier, aocK, mooring risings, boat ramp, breakwater,
must be set back a minimum distance of 15' from my area of riparian
M,% of 11^11 .uich tn wawa the �Pthack you must initial the appropriate t

0

Billy Sparkman
From: judy kluczykowski <[e-mail]>
Sent: Monday, May 03, 2021 1:43 PM
To: Billy Sparkman
Subject: Boat Slip Lifts
Hey,
This is the list of those wanting a permit for lift with size. Let me know if you need anything else please.
� ; ,P 5;W
Jeff Cunningham-12,500
8-Judy and Michael Kluczykowsk-12,500
9-Herbert and Wendy Daw-10,000
10-William Owens-12,500
11-Berry and Darlene Skinner-10,000
12-Chris Gauqlies-16,000
13-William Dansey III-14,000
14-William and HeatherJohnson-10,000
Best,
D
https://www.ncrec.gov/Brochures/­WorkingwAgents.pdf
STATEMENT OF CONFIDENTIALITY The information contained in this email message and any attachments may be
confidential and legally privileged and is intended for the use of the addressee(s) only. If you are not an intended
recipient, please: (1) notify me immediately by replying to this message; (2) do not use, disseminate, distribute or
reproduce any part of the message or any attachment; and (3) destroy all copies of this message and any attachments.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Aac, � s
`' (Name o rope Own?)
property located at I (`i f J y-,6 c,..-- A-,1 r. ti'c LKI
(Address, Lot, Block, Road, tic.)
on in , - cn z. f N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
I tion
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)
-t-o s1-1os
Ste- ,+4—c�,J '
o� S G �S��S
WAIVER SECTION
I understand that a 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
(If you wish to waive the setback, you must initial the appropriate blank below.)
P,J;JZ
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner formation)
Signature
Print or Type Name
/S"bLl Sj -,- ,, Jc, ,Lam.
Maims Address
IC - ( . ).) c_ -Z`-? C 1:3
City/State/Zip
`tt ci 3G Cr S,
Telephone Number/email address
s 2 r Date
*Valid 'Valid for one calendar year after signature'
(A ' ent Property Owner Information)
- '- L (
Signature * %
E a L&{ �4 ICJ, L
Print or Type Name
�1 00 r e L o/1 o 1
M li g A dress
11Y3
City/Sta te2ip
,�1CI S= I SS
T lee phone Number/email address
=Z 0�.
Date
(Revised Aug. 2014)

t
P

Billy Sparkman`
From: judy kluczykowski <[e-mail]>
Sent Monday, May 03, 2021 1:43 PM
To: Billy Sparkman
Subject: Boat Slip Lifts
Hey,
This is the list of those wanting a permit for lift with size. Let me know if you need anything else please.
7-Jeff Cunningham-12,500
8-Judy and Michael Kluczykowsk-12,500
9-Herbert and Wendy Daw-10,000
10-William Owens-12,500
11-Berry and Darlene Skinner-10,000
12-Chris Gauglies-16,000
13-William Dansey 111-14,000
14-William and HeatherJohnson-10,000
Best,
IN
https://www.ncrec,Rov/Brochures/WorkingwAgents.pdf
STATEMENT OF CONFIDENTIALITY The information contained in this email message and any attachments may be
confidential and legally privileged and is intended for the use of the addressee(s) only. If you are not an intended
recipient, please: (1) notify me immediately by replying to this message; (2) do not use, disseminate, distribute or
reproduce any part of the message or any attachment; and (3) destroy all copies of this message and any attachments.

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SHIP DATE:
Tues 4 May 2021
EXPECTED DELIVERY DATE:
WED 5 MAY 2021 EOD
SHIP FROM:
Sparkman Consiruciion
1504 Sweet Meadow Lane
Raleigh NC 27613
[phone]
SHIP TO:
Wrenn Johnson
205 ATLANTIC BCH CSWY
ATLANTIC BEACH NC 28512.7357
Business
SHIPPED THROUGH:
THE UPS STORE 02967
RALEIGH,NC 27615-2115
[phone]
-41de # 1 o f c 1
._NriE SAVE FOR YOUR RF(,ORI)`)
SHIPMENT INFORMATION
UPS Ground Commercial
0 lb 01 oz acival wi
1,000 lb billable wi
Dims: 13.00x10,00x1.00 in Siore Packed
DV:$100,00
Pack and Ship Guarantee
Tracking Number: 1zF6246YO301690725
Shipment ID: MMSVREWY247U4
Ship Ref 1: - -
Ship Ref 2: - -
DESCRIPTION OF GOODS:
Paperwork
SHIPMENT CHARGES:
-- ERTY OWNER STATEMEN
(Name o ropert
;, Lot, Block, Road, tc.)
A G r
(City/Town and/or
m below, the development pri
Ground Commercial 10,49
Service Opkions 0,00 OF PROPOSED DEVEL,
CMS Processing Fee 0,22 description below or a
r
Total $10.71
COMPhtiLETE ONLINE
TepcomNG(;seEec4rTreeking�Ahl�rent.raa nShipmenour lbIDro#�ser to
OUESTIONS7 Coniaci SHIPPED THROUGH ebove.
Everyone needs a helping hand now and then,
Join our FREE email program
For greed oiferu and ruuourcuu viuil www,thuupubioru.com/email
ih;pm,nuo. nrsVwEWY2+7U4 IIIII@!��NIIIIIIIIIIIWIN1tlIIV�IWM'I�IIIIIIIIIIIII�IYillpll
,7";; :: Pacific ,,_. the UPS Store
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IRTiS� Gusto ns�nspDnN�enulon�mntrar,tnlswb IOi0111
tnat a pier, aocK, mooring piiings, boat ramp, breakwater,
must be set back a minimum distance of 15' from my area of riparian E
.,r,P% /if "t%, i .uich tn wniviz the gpthar.k you must initial the appropriate t

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