85671D - Harris

it.
d`0AS'4 1CAMA DREDGE & FILL N9 85671 A B
GENERAL PERMIT Previous permit
0 Date previous permit issued
New n Modification n Complete Reissue n Partial Reissue
As authorize by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I 5A NCAC (3—+\ *\ LY) n Rules attached. E General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name k-(n�� �ti..S-\ T', ielrrt S Authorized Agent ;' (-;-^ ,:,_ ' . LIZ.-
Address U( (j J% ;,e� 4-r in •.- r� Project Location(County): 1 ,f -..,1- �-(+-s (-.- I
City b -\i \ 1r- State N..) ( ZIP Z 1S i 12 StreetAddress/State Road/Lot#(s) �1 �V •G.- `1 .
Phone#(�((a) 02O TU42
Email 0..\t‘.✓r� S--2_l.A1,0 ,^''4'(• Cc.-v Subdivision
City (1)(j .r�_ (Sic 1 C.c.c. .. ZIP Z Nu,(i
Affected 't• CW 0 EW ❑PTA gLES ❑PTS Adj.Wtr.Body % r.( ( —unk)
AEC(s): OEA n IHA n UW 0 SPIMA n PWS Closest Maj.Wtr.Body A-\ W l,c\
ORW:yes/no;', PNA: =11111P
Type of Project/Activity Dec C-C. C XfA►1� 12 AiG�'4 z A S-,,,t ... ,, t i•4
J (Scale:./) 7 S j
Shoreline Length
Mill
Access Length I yy dial% - �
-__ '—
Pier(dock)length f '` NW"
Fixed Platform(s)
_t_. , ,
,. , „. lir , , _ ,
uII a 1...,
Floating Platform(s)
Finger pier(s) I i I ` 1 II ll i._ .--- -.--
Total Platform area II MI11111 11111111111—
Gfoin length/# __ :��� ��. ...��_ _ I
! �.
Bulkhead/J�iprap length -.�--- ifirmimmi
Avg distance offshore i
Breakwater/Sill `
Max distance/length '�s ............. ....wwIIIII Fiala..,Ing.MM.A
. li...
Basin,channel a ' l NZ....
+
Cubic yards i. 1IS
Boat ramp I --measonummt ..
Boathouse/Boatlift g.J tt.� 4 ,
Beach Bulldozing y- -- ;I; i a ,
Other �i
4 Nib
!E G t i I
SAV observed: yes µ1', • l ' I t map: -' i
Site P Moratorium: n/a ji
'gag L ,-_--- � _.�...._A_. _� ...._ �.3 RirnWaiverached: o iIll r
A building permit/zoning permit may be required by: ilIMENEMBI ' G(h
ri TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions tit j `-]'"'''',, V--'("' w s\ tl-' 6,A-k c^ PI:I S1)'"- CO(. rl‘4�
) sIC...\ W n,, kk.(,,,,, N f . \ '"�-,C�u.t"LA, n See note on back regarding River Basin rules
nSee additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE I STATEMENT. (Please Initial)
;�/<ncj(.. .> ''acit.
Agent or Applicant PRINTED Name Permit-Officees1RINTED Na
Signature**Please read compliance statement on back of permit** Signature
/0C.) 41- ILI(1 ";V. C.1 '11 -202..I t 24 -20 .'.
Applica Fee(s) Check#/M ey Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit 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: 1) 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 from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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 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. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden,Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

le9"''`S CAMA DREDGE & FILL NO 85671 A Elsi
: GENE L PERMITit
permit issued
ate
7/New ❑Modification ❑Complete Reissue 0 Partial Reissue
As ' • • -, by the Sara of North Carolina. of Envir...x„a...al
Department Quality and the Coastal Resources Commission in an area of environmental cortcarn pursuant to:
I SA NCAC ( .\\(-1-) 0 Rules attached. General Permit Rules available at the(olowUg Ark
Applicant Name s it Aut}wrtzed Agent J`s
Address V r�e Pno)ect Location(County): r w d
City �-t State NI (- ZIP 2 141'j_ Street Address/State Road lot 0(s)
Phone 0(*I j /) 2vo 304 2
Email al,\n W r. S 2 l,69 jeMa.(, c Y - SubdMsion
KCky ncl,... toI, �6 c cx.ti z,P (AV.&e(
Affected CW DEW PTA ;,I PTs Ads.Wu..Body l/��^.c.l ` (r��)
AEC(s): OEA 0 IHA Uw IPIMA PWS C► t Mad.Wtr.Body Arty
ORW:ye st PNA: 40,
( 1 / (1
Type of Project/sty l 4(.t. L�(,S Il 1 7 J{t G(.e-c.4 .i, i h/YG. .,Q.Jr f r�t
l / le:)1/4)TS
Shoreline length . U' .
Access h 1 -! ! i irit l j ' t t : i+' i l i�, i
Piet(dock)length _ i. _ 1
�/ 3t. i i ! II
Fixed Platform(s)
i_,._.._ �_F-
i
t
FloatingPlatform(s) ._.. _� 1 i i --� �; + �w.Sct!t
r
—'� ) ( 1 1 i" ��1 _..-I ' t, 1 sfsrsw. _ i
Finger piers) j �._- _ i } ---:- - -- - - -- - _ � _
Total Platform area 1 �. ' _ i/.d,--
s-V J t. �j.�
i _ L
A distance offshore f� • -._-._ _'"`_6 ..-_. 1- i
� v � t ��� i I t. I i I i ! i i s.i i
Breakwater/Sill -t: ( s +. # ( `i 1 k{�pl7 i i ! i 1 I I • _t
Max distance/length • , } j - - ' Ne,�" 1 I—
Basin,channel i / . t L &,t, i-. C. ,
Cubic yards I . . (3 v,1 d ,w•lL*Q. • •.- •r. i _ ( �+C�.tCa C.t��C.
Beat ramp ` _..._ (/ 4J•at.c..} 20 t� r‘ 7 Mt tij;,\�lr:w'+.A 1
Boathouse/BoatiiftM ' tiO.r ltcA..c.r.�_._. _. (t t i - ;
Beach Bulldozing — • i . -. --{— '— --a-- --- -� _i__I t • -t-
Other _. : L.L.C. r --.t...1- tt { ' . 1 �i
l.obu �lo....,5 � _ 1
SAVobserved: Yes gt, -. \ .(•;p...ldY�. S`. ` _ i likes 5 ..\SNP _ _ {�' lis �'5. Ise_, _4
Moratorium: n/a yes r I1l 4 n e 4 S` T �t r I.I. rT ,
Site Photos: t •, 1-.t . I 1 1 t . t i --1 . .` i i
Riparian Waiver Attached: t �2no __ 1 i 1
t - t `nos' ___�-----..__. ___s
A building permit/xoning per may be required by •L,L _S)e_x_c I
i,vlAt��...e �k1 �.,�-k t 1 !t1'� ❑TAR/PAWNEUSEIBUFFER(circleone)
Permit Conditions ` �.a,, �`p1 Sir
(! Nu GA...t•l11 LA.J.t44 , A V a.•11ti.u.it.,, rj See note on back regarding River Basin rules
See additional notes/condltions on back
t
•
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATE NT. (Please Initial) lJ'•'\J
1
•- OklNCICA C"\� ! J rl.^d[-.. ( 'i tit,
nt Applica PRINTED 1-• w _ Perky RtNTEO NaaR I�\ 1
Signatur •'Please read compliance statement on back of permit" Signature T(/ (L�. �. _
YUU"" -f`f 93 q'Z:I -202.( 1 -2 -2-02.2.
Applica Feels) Check M/M Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 41 14 A /LI/ (5
Mailing Address: ��+ �L~ Li
tv s 12
Phone Number: 9 1J 3 t?LI
Email Address: it14 15,Z 3e C vbi AJL
I certify that I have authorized L. c ( 0✓t 5 171-v o Er c>>^
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: / e}vM :l /-
at my property located at ( v-z Gv,-
in R'v 1.Si„,, 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 Cfficer and their agents to enter
on the aforementioned lands in connection with evalua ng information related to this
permit application.
Property Owner Information:
// Signature
�'l�`-t7(+t. / ✓fir'!7
Print'or Type Name
Title
/ l'7 / 2
Date
This certification is valid through '. / 3 /

' u•++ 1 uuou UUUU 17170 l77.J
ecy.....44); cnta a o n
t..,..1 g g
4.o , ` 2. n1
rN ro m 2 8-8- 1, ¢p." m Cl) xi .
YJ m m E�. �. `1' In (� _ •
91 2 m asaD »co ,< n 0
5- Ti o c m 8 I—sr � -n ch
c
%�o ,Jn <- 1 o '•c CD
1 ' E C
6' `II T
.mac :n m
I' T.
o C)
m
ri y '1
:'y d
aC:i
r..! T
µ ,—,r.) 3 r
ReceIfved by(Printed Name) C. Date of Delivery
i-VA•--t ./Vz'k 7/2
s delivery address different from item 1? ❑Yes
f YES,enter delivery address below: ❑ No
trvice Type ❑Priority Mail Express®
At Signature ❑Registered MailTM
ilt Signature Restricted Delivery 0 Registered Mail Restricted
tified Mail® Delivery
tified Mail Restricted Delivery •%[ieturn Receipt for
lect on Delivery Merchandise
lest on Delivery Restricted Delivery D Signature ConfirmationoM
.•^-'Mail ❑Signature Confirmation
Mail Restricted Delivery Restricted Delivery
DO)
Domestic Return Rennint

VCru11CU IVId11 JCrvu!C F1rUv1UCJ WC IUIIUVVIII9 ucncnw.
•A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
•A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
•Electronic verification of delivery or attempted return receipt for no adelitional fel,present this
LISPS®-postmarked Certified Mail receipt to the
including the recipient's retail associate.
.0 C
tined by the Postal Service"' Restricted delivery service,which provides
I. delivery to the addressee specified by name,or
µ 0 = to the addressee's authorized agent.
0 U;y; tsirs: -Adult signature service,which requires the
µ so CD �•• trtified Mail service with signee to be at least 21 years of age(not
p st-Class Package Service®, available at retail).
a) CDD y co co mimomi ice. -Adult signature restricted delivery service,whicl
ii3 --13 1 is not available for requires the signee to be at least 21 years of ac
co 0 C o and provides delivery to the addressee specifier
(p rLl . C is not available for purchase by name,or to the addressee's authorized agen
--, Li) trvice.However,the purchase (not available at retail).
ice does not change the •To ensure that your Certified Mail receipt is
--.a. automatically included with accepted as legal proof of mailing,it should bear
items. USPS postmark.If you would like a postmark on
nth::: Ti
• • C r,and with a proper this Certified Mail receipt,please present your
,d"'' mailpiece,you may request Certified Mail item at a Post Office'"for
mru as: postmarking.If you don't need a postmark on this
s.s. vice,which provides a record Certified Mail receipt,detach the barcoded portion
O CD _a ;.a1 ing the recipient's signature). of this label,affix it to the mailpiece,apply
n ltl �� 1 hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
D O 0 m Q— �� For a hardcopy return receipt,
Iv 1n n 3811,Domestic Return
Z H N O S Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.

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: an 4J (N
Address of Property: + t C- r\CAr-4 s r OCQ-G,1,11S‘
Mailing Address of Owner: 63 S Q1,J a k w k 1 mu'rgd 1\ic 2' - t 2-
Owner's email: Owner's Phone#: Q10- 206 3 6`{1
Agent's Name: Agent Phone#: (6 619-(10y5
Agent's Email: W0. N.C\A'y () CCYVVIC I t
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.DCM representatives can also be contacted at
[phone]. No response is considered the same as no objection if you have been notified by
Certified Mall.
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
•
Signature of Adjacent Riparian Property Owner(ARPO)
-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: /2/ri Af
Mailing Address of ARPO: Plrwr/c/ C7- /��� t'e h /V
ARPO's emall:,464M/0/--/cr;1 y Ccicjrue iNC.(-ARPO's Phone#: 9/9 -369-7c/
Date: `�(i/ 1 *waiver Is valid for up to one year from ARPO's Signature*
Revised May 2021

•
•
.«� .� alp a� �p_yy� ,��?'��y e�� }�. i�
5 �,F F?= �9A ci P _� "5! '�.Y9;-f�7.ttetW . ff 1 X7:7.'.�' pi' s+'z¢` A'"A'«Y' F i4 3A (.-'.4
'.r •r q t .+." A ,". f'i. *. lf� Ts'Y =;ry re ;fit t � f j '•
t.
k,j{?.; l4 e, s• ae,. :otr� l ' �J 3, . '-j t?rt Ejlf �i. i1;.; r";t t�i qul)
t `
f
t .
,
k c t t' {• ,r {kt 1 '/ } 1``
2 t 71 r
: f, a 0/ y; YtR:'t�r;:r t; at a `a.'.•yse
i3(40, t :ts Y:' • j3 �;�i•r�'. t
.t• ( s�f ..r i "'.-1 . Y,.. rf.: Ct�¢'' (�tl rt t• ,.!F.. ._r 1''•v` ;m.) s!
•
sf7 �g r,t>j a4?,�`--?,1 vrs• .x _?"s',..1� -� i;y :{i
4104 wit: .,it t41 '110 1 tirt�c "' 1f f fd,cr {Cr;a 1:y4 i111 r, :t t1Y`l:";£ . J ,.. ti;
t
it►"%+A`vbt'It �,t
. `Y•t 3 tS"j-'!` u' wy i143',�a .t: ,t•*` t ':t�F�f#.Y•' .-. •,40.°�¢Y• :9..n,Ytl. 3 C ',t,.r .y�t, a'r r �1 $sE.t:"Y c"N U' I,I"!
i.•-••ti;3 £4tie4 tr111ti :.Si Y`t .. 'iS_., ;'`.� k' .•��'.,"'-`rc... :i {�.:.. .y>3'"- +.?r`: �.. �ipL{� V��`;s> ..
t4t4ti
¢, e Tt '•!tuz, iatf$.'? �; t': g,•.;
t
. .. .:i`i }, "+ i. P:tt 1i1 4:1'..10-4;:i
ttp s; tkAfIr • . ' - r ` it' 1.. t , i=:1 : yf!c+t.
•
\,40 `� . �r� ..,'fi I r . '.t 4tt''.,•t 3 «.
`.,•` ,ill# f' .r.t�;'�i sa. Z`;:1 4'44 too c.t"S
e.
.ti,. .. �?�,.. Y , •l .. Ot$A ; !s .:4itti': _ fi =
t?tT' .f+." � `s •—t L• _ 1 ..� .«.,\_ w4 -\
,. A -44 tu ... *°1� ;Y`t -'! +s' yP y$"}8 h. .. .. -a} k� � �# '# Ti..,
{tom}°16* l' i ' 1 3 i i. f!"ti f, f?" # aa:" t. .f ,
` i ,-.SL: tr it t .:+3 k� Y.
t`:-.'4 - _.

1. . •osta ervice
CERTIFIED MAIL® RECEIPT
I Domestic Mail Only
1
" For delivery information,visit our website at www.usps.com .
Ar (1'
Certified Mall Fee
$7, 60 0472
- $ 12 .rf.;5 08
Extra Services&Fees(check box,add fee )pmpt.)
3 D Return Receipt(hardcopy)
Return Receipt(electronic) $ in,fin Postmark
3 Certified Mall Restricted Delivery $ CLlXl Here
] Adult Signature Required $ 0 0 0
Adult Signature Restricted Delivery$
1 Postage
10.55
$
07/22/2021
) Total Postage and Fees
1 I..11
$
Se\%\e,o
1No.
a \-3
• tate tA+41 W:3—14752_
cinc

I A receipt(this portion of the Certified Mail labeq._V for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To rechive a duplicate
Electronic verification of delivery or attempted return receipt for no a iditional fee,(Sresent this
delivery. USPS®-postmarked Certified Mailreceipt to thi
A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service- -Restricted delivery service,which provides
for a specified period, delivery to the addressee specified by name,or
to the addressee's authorized agent.
nportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mails,First-Class Package Servicea, available at retail).
or Priority Mail°service. -Adult signature restricted delivery service,whict
Certified Mail service is not available for requires the signee to be at least 21 years of ag
international mail. and provides delivery to the addressee specified
Insurance coverage Is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear 2
certain Priority Mail items. USPS postmark.If you would like a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy retum receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.

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: On (1 LA 'Aar
Address of Property: \ 1 C'`�nC6 r4 s Ys` 0CQ-Q V1 4-�'��e l C\
Mailing Address of Owner: 0,3 Sh W d Irt-Al W 1 mc ny NC 2 Vu1 t Z- 3-S13
Owner's email: Owner's Phone#: ot10- 236 -3 dclZ
Agent's Name: Gt`tu) Cbr6T(Vic kis)n Agent Phone#: L6-S-19-ClOciS
Agent's Email: Wa'\dc3')r i(-1) fj CIA-V1 C t 'n 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 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.
XI 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 Mall.
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 )____ ----
•-,: ::::Lk.,:b
Signature of Adjacent Riparian Property Owner(ARPO)
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner: -,I
Typed/Printed name of ARPO: 4 ) Jf S T q I eK
Mailing Address of ARPO: 1 Cc"-rofc✓ lr 0 r ‘C 4 e n-hti �� 4,-,„.:4 , ( 2
ARPO's emali S' +41 le/1 j"7 04(0,31 ARPO's Phone#: - 0 -3 -b1/9
DateZ )/ 7l ) "waiver Is valid for up to one year from ARPO's Signature;
Revised May 2021

- hoL.Z I It
}I \x_6
r,,
wAD as rnu cD \\
s air` (\°-1
)311w\A)\\-rn c u \\t \ \ j
NO-a

• g •
•
• •
••••4. ••••.?"''.7"..

Check
Date Received Date Deposited Check From(Nam) Name of Permit Holder Vendor Cheek number amount Permit Number/Comments Receipt or Refund/Reallocated
Cdumn1 Column) Column.) Column/ Column5 Column(' Column? Column(' _ Column9
9/29/2021 Grice Construction Geoff and Linda Walker BB&T 14932 $ 400.00 GP#802370 .BB rct.15547
9/29/2021 Grice Construction Adam Nix BB&T 14935 $_ 400.00 GP#85672D BB rct.15545
_ -- --
929/2021 Grice Construction Betsy Upton BB&T 14933 $ 400.00 GP#85673D_ BB rct.15546
9/29/2021 Grice Construction Anthony&Krista Harris BB&T I 14934 $ 400.00 GP#856710 BB rct.15544
9/29/2021 Team React LLC DSNC,LLC ,Coastal Bank and Trust 2525 1_ 200.00 GP#85620D JD rct 15584._
9/29/2021 Claude Rogers same Wells Fargo 1393 $ 200.00 GP#856700 PA rct,15708
9/29/2021 Richard McCain same First Citizens Bank 12337 $ 200.00 GP#85661D _PA rot.15713 _
9/29/2021 H5 Construction,LLC John Harlin Truist 1001 $ 200.00.GP#85662D PA rct.15710
9/29/2021 H5 Construction,LLC John Werner Truist 1004 $ 200.00 GP#85663D PA rct 15711
9/29/2021 Aaron Perkins Duke Energy Progress LGFCU 405 $ 200.00 GP#856640 PA rct.15712
9/29/2021 McPherson Marine Services,LLC Dean Evens First Citizens Bank 4491 $ 200.00 GP#80354D PA rct 15706
9/29/2021 _Logan Marine,LLC Barbee Family Trust ,BB&T 7617,$ 200.00 GP#80355D PA rct._15707__
9/29/20219/29/20211 Logan Marine,LLC Albert J Brown Jr BB&T 7616 A 200.00 GP#803600 PA rct.15715
' Ruth Rushing same Bank of America 2367 $ 200.00 OP#80236D _..... BB rct.15541
9/29/2021 AMW Docks and Marine Construction LLC Patti Rubino BB&T 6496 $ 400.00 GP#80272D _-- --___._--_BB rct.15542 _
9/29/2021 AMW Docks and Marine Construction LLC Steven and Allen Williamson BB&T 8497 $ 200.00 GP#802710 BB rct.15543
9/29/2021 Donna Byrd Donna and Richard Byrd BB&T 1049_1 200.00 GP#802810 BB rct.15538
9/29/2021 McPherson Marine Services,LLC James Banko First Citizens Bank 4521.$ 400.00 GP#856690 _ PA rct.15714
9/29/2021 Allied Marine Contractors LLC Mark Long First Citizens Bank 10387 $ 400.00 GP#802080 PA rct.15701
9/29/2021 Allied Marine Contractors LLC Ronnie Hussey First Citizens Bank 10388 $ 400.00 GP#801970. PA rot.15702
929/2021 Drew Todd,Jr. Sandra Cochell Woodforest National Bank 1078 8_ 200.00 GP#801980 PA rct.15716— —
929/2021 Lighthouse Marine Construction Jose Gonzales Coastal Bank and Trust 3950 $ 400.00 GP 8856320 JD rot,16004