80272D - Rubino

CAMA/ ❑DREDGE & FILL . 80272
0 Ill A B
GENERAL PERMIT Previous permit#
)C New ❑Modification ❑Com Complete Reissue ❑Partial Reissue Dateprevious permit issued
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As authsrized 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 011-1 t Oc .
❑Rules attached.
Applicant Name ?�.� f 1�.Jj 1 n U Project Location: County 0✓-A 5..•:,.� -
Address 222 0 V 0 .r V e.,`Ve CAStreet Address/State Road/Lot#(s) L o f as
City C ki State ZIP`L:t 5 t 8 -V `„ �."ftdx. N::),...
Phone#(c111 I E-Mail ek-,(2.1)1/4. IQ AA S •A*Subdivision
Authorized Agent c\(_ ..J,(ACity . )n s c\ I -( c c ZIP 2 0 Lk L ('
Affected ❑CW ❑EW t PTA Ik � ,•.
ES ❑PTS Phone# ( ) River Basin L. . . /
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (� c�.
❑ PWS: t-� c``i C(.,,C o6anan /unkn)
ORW: yes / no` PNA yes / no Closest Maj.Wtr. Body - '^\- S (' -�1,
Type of Project/Activity I ,-\ ; .-- \\ i•-e s—J v`‘‘-1^ Q1G C•.-16— J1/, \ -
(Scale: N T • )
Pier(dock)length
Fixed Platform(s) i }
Floating Platform(s) 1 1
Finger pier(s) I T —; .. /. / � .... �._..
-
Groin length I ' I
I i 1
number Y._.........._.._ _..
i
Bulkhead/Riprap length TO i — _. ...._
avg distance offshore —
max distance offshore— (W-
Basin,channel I t.
ti ;.
cubic yards 1 �, I „ ,.. ""+—
Boat ramp � �� a ► , 4 .
Boathouse/Boatlift j { —h T-- — —,v
�..1 as .c,.,1(�.,11�1� ' IliAI c�..'i
Beach Bulldozing ♦r 4
Other f 1 Cjz o!
G�
,
a . j p,SF +i)G-C— ij i
Shoreline Length 7 U , T "w — T! —
1111
SAV: not sure yes no i 1 -1 4 1 I ;
+ #� J CAN 1.._......_ - _ J t i�G._ _.
Moratorium: n/a yes nIiii
7 .Q . i
Photos: yes n 'Lug1 , 11
—... pT �3�...._. —.....��{ D 1 i
Waiver Attached: ir no ,
J�. .AA building permit may be required by: � ,.,( I") . n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)__ 4 \-
Notes/Special Conditions �) \� \`LL .�- �,,, ‘�\ `r-7� . (s c, c.t...c� i c� t Y-1 S ^< ' '' -
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Agent or Applicant Printed Name
l D� Permit 'nted Name
SignaturAt
**Please read compliance statement on back of permit** Signature
�(0 (1 1.2:4 -2u2I (- Q-02z.
Application Fee(s) Check# Issuing Date 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 (252-946-648 I) or the
Wilmington Regional Office(9 I 0-796-72 1 5)for more information on how to 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/ I-888-4RCOAST 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 Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ecd--, , Robt‘i) o
Mailing Address: p1 0 v Q `
CC >' fuc, l'
Phone Number: I l - )j q-(p 17 7
Email Address: } K u 1 ems G e - ct-
I certify that I have authorized 0� ,v,(C c-
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 0 Ge an C V b
Y property 11�e r S i'�e (1 S J�1-�-fif , Ve�t!t` /N
at my located at / /
in Y )YU (),S(AA CA-County.
I furthermore certify that 1 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:
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Signature
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CERTIFIED MAI- ECEIPT
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PS Form 3800,April 2015 PSN 75,7.0-M-0003047 See Reverse for Instructions — OWPSForm q,,Reverse for Instructions
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3. A. Signature
■ Prin your name and address on the reverse X ('- ,,, ,Y'. 1 .i )(Agent
sot at we can return the card to you. I.et/VKO'" t 0 Addressee
■ Att h this card to the back of the mailpiece, B. R ved by(P4'n erne) C. Dat of very --,..,._ „..... \.2.....\..
or on the front If space permits. et -jr Jt V I ,1\. '1 IKO 0t - C .
1. Article Addressed to: D. s delivery address different from item 1? 1 s t ,tj >
.-I. If YES,enter delivery address below: ' No 1
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111111111111111111111111111 II I �'1' ��I O Adult 0 Adult Signature Restricted Delivery O Regisgnature 0 tered Mail Restricted ��'
111 III O Certified!t:3 Delivery T.'', `�
9590 9402 6016 0069 6504 14 ❑Certified Mail Restricted Delivery 0 Return Receipt for I 'J,1�
0 Collect on Delivery Merchandise
2. Article Number(Transfer from service label) 0 Col'ect on Delivery Restricted Delivery ❑Signature Conf;rmafonr',
Mail 0 Signature Comirmation
7020 1810 0000 1908 2690 'tail Restricted Delivery Restricted Delivery
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic ReturnrReceipt
•
SENDER: COMPLETE THIS SECTION CCM
PLFTC THIS SECTION ON DELIVERY ,
■ Complete items 1,2,and 3. A. Signature
IN Print your name and address on the reverse X /v I 00 Agent q ` '\
so that we can return the card to you. 0 Addressee '�,
• Attach 'as s card to the back of the mailpiece, 6• Received by(Printed Name) C. Date of Delivery
an t =front if space permits. '`� �.
.. Ar ;le A;dressed to: D. Is delivery address different from item 1? ❑Yes t,
‘)42 If YES,enter delivery address below: 0 No +tom,
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3. Service Type C Priority Mal Express
III!'I'111I 1 Ill
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(j I �' I j I�I I)( 0 Adult Signature Restricted Delivery 0 Registered Mail Restricted_"-
0 Certified Mail® Delivery
9590 9402 6268 0274 9878 32 O Certified Mai Restricted Delivery o Signature Confirmation 5'
0 Collect on Delivery ❑Signature Confirmation 7
2. Article Number Mender fmm.Pnrlrva Iai atf ❑Collect on Delivery Restricted Delivery Restricted Delivery
7020 0090 0001 5634 0827 I Restricted Delivery
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PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTYOIPT REQUESTED orNER IOHANDADEL VERRM
CERTIFIED MAIL • RETURN RECEIPT
(Top portion to be completed by owner or their agent)
Name of Property Owner: `
Address of Property: L- '5 e-a—L OE Suns k _ Li
Mailing Address of Owner: /) r N
Owner's email:
Owner's Phone#:
'1 � ���3 _ �
Agent's Name:
��Gk- \12i Agent Phone* +ti`1
Agent's Email: }",G2 y)eSf 50
ADJACENT RIPARIAN PROPERTY the Adjacent Pro I eICAOwner)
TION
(Bottom portion to be comp)
I hereby certify that I own property adjacent to the above referenced property.The individual applying for this
tt,,rrrr\� permit has described to me, as shown on the attached drawing, the development they are proposing.
%..k '1 A descri tion or drawin with dimensions must be rovided with this letter.
��
I DO NOT have objections to this proposal. I DO have objections to this proposal.
ft you have objections to what is being propo
sed, you must notify the N.C. Division of Coastal
Management(DCM) in writing within 10 days of receipt of this notice.e Correspondence
should be
d atmailed to 127 Cardinal Drive EXT,Wilmington,NC 28405.DCM representatives
[phone]. 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, r groin
must be setp Tyco a lminimum
or distance revetments).s) (If you wish rom my area of ptorian access unless waived by waive the setback, you must si n the
does not apply to bulkheads rip rap
appropriate blank below.)
1; t ` �I DO wish to waive some/all of the 15' setback
Sianature of Adja nt Riparian Property Owner(ARPO)
-OR-
I do not wish to waive the 15' setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:
1 y� TypedlPrinted name of ARPO: ,, L (� . 1 Q, (! ,
�Q r. S W/I S f/I t_J abin., 0(./a -J(c
Mailing Address of ARPO: ICI Q ' `�Vt✓fS-�IN�Q�����y •��` /�
ARPO's email: Cor nit jbhYlS'D►'1612` 1-ARM s Phone#: CI t�-"L SO- OSS(v
Date: 13 Za 2-I "waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

r
Cheek
Data Received _ Date Deposited Cheek From(Name) Name W Permit Holder Vendor Check number amount Permit Number/Comments Receipt or RelundrReallocated
Columnf Column2 Calumn3 Column/ Column3 Columns Column? Columns Columns
9/29/2021 Grice Construction Geoff end Linda Walker BB&T 14932 $ 400.00 GP#802370 BB rot.15547
9/29/2021 ,Grice Construction Adam Nix BB&T 14935 $ 400.00 GP#85672D BB rot.15545
929/2021 Grice Construction Betsy Upton B88T 14933 $ 400.00 GP#85673D BB rct.15546
9/29/2021 Grice Construction Anthony&Krista Harris BB&T 14934 $ 400.00 GP#856710. _ BB rct.15544
929/2021 Team React LLC OSNC,LLC Coastal Bank and Trust 2525 $ 200.00 GP#856200 JD rct 15584
9/29/2021 Claude Rogers 'same Wells Fargo 1 1393 $ 200.00 GP#856700 PA rct 15708
9/29/2021 Richard McCain same First Citizens Bank 12337 $ 200.00 GP#856610 PA rct.15713__ _
9/29/2021 �H5 Construction,LLC John Harlin Truist 1001 $ 200.00 GP#856620 PA rct.15710
929/2021 H5 Construction,LLC John Werner Truist 1004 $ 200.00 GP#856630 PA rct 15711
9/29/2021 Aaron Perkins Duke Energy Progress LGFCU 405 $ 200.00 GP#85664D PA rct.15712
929/2021 McPherson Marine Services,LLC Daen Evans '.First Citizens Bank 4491 $ 200.00 GP#80354D _ PA rct.15706
929/2021 ,Logan Marine.LLC Barbee Family Trust BB&T 7617 $ 200.00 GP#8035512 PA rct.15707
929/2021 .Logan Marine,LLC Albert J Brown Jr BB&T 7616 $ 200.00 GP#80360D PA rct.15715
929/2021 Ruth Rushing same Bank of America 2367 $ 200.00 GP#80236D BB rct.15541
929/2021 AMW Docks and Marine Construction LLC Patti Rubino BB&T 6496 .$ 400.00 GP#80272D BB rct.15542
929/2021 AMW Docks and Marine Construction LLC Steven and Allen Williamson BB&T 6497 $ 200.00 GP#802710 BB rct.15543
929/2021 Donna Byrd 1 Donna and Richard Byrd BB&T 1049 $ 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 OP#802080 PA rct.15701
9/29/2021 Allied Marine Contractors LLC Ronnie Hussey First Citizens Bank 10388 $ 400.06 GP#80197D PA rct.15702
929/2021 Drew Todd,Jr. Sandra Cochell Woodforest National Bank . _1078 $ 200.00 GP#801980 PA rct.15716
929/2021 Lighthouse Marine Construction Jose Gonzales Coastal Bank and Trust 3950 $ 400.00 GP#856320 JD rct.16004