80190D - Kersey

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'4 AMA/ ❑DREDGE & FILL No 80190 A B C GD
1 ENERAL PERMIT Previous permit#
------ , New OModification ❑Complete Reissue 0 Partial Reissue Date previous permit issued
As aut • .ed by the State of North Carolina.Department of Environmental Quality U _h
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCACCrl ` 20( J •
L'Rules attadxd.
Applicant Name Lk^,H \p r S_e _-- Project Location: County_ \✓%-,^3a-i C t4 —
Address ( )4 fv-.c.✓ ,c.) L)t Street Address/State Road/Lot#(s) e2.2.. { „fn.. •,"�"'�
City CA. k k _Statei3_ii ZIP 2 L__jp sV. --
Phone#A foil E-Mail _k1b,,n'' rnA..00 VI%%•-0%4-. - Subdivision
Authorized Agent (t. �.t`4-S City 0,4-, kt egi�k ZIP ZS tilt ck
Affected O it W li✓P A ES OPTS Phone# (_) River Basin_ L,..,. -r
AEC(s): t
"fFA D fHHF IH UBA ❑WA Adj.Wtr.Body e,A.�..,\ (nat Qi'=amn)
❑PWS:
f
ORW: yes l . PNA yes0
Closest Maj.Wtr.Body 11.1.E
Type of P roject/Activity l et tk-r-A,\ C _c s S n+c-r• c .ct -ri o z----
(Scale: K.1 1.$ )
Pier(dock)I h —-- — j —.
+O l r'-� i .
Fixed s __ .. __�r- ..._ _:hc ,.
Floating Platforms) f) l(D` �,/,
Finger pier(s)
l'
Groin _
number j j_ ,__. _ _;__ !
I
Bulkhead/sup w length —1-- ___ r___ 1._ { , ,
I j , _i�� -r- + j
avg distance offshore I r t
max distance offshore f 1 i , ! j
. -
i
Basin,channel i 1 t
r 1 - -4-- , ,, , - ,---
- - : , - -
Boat ramp L _.- — --_--
Boathouse/Boatlift _ . -j ri..._ _ �. .�+ - .. �. _ I_ i_ .._ 1 _.
i
Other Beach Bulldozingf f 1 , i_ f01 i , i i ��
f
1 1 i i r . .
- _
Shoreline Length v`•' 1 ! I ! ! i -.+-
SPY: not sure yes no C•' r ,..�„ -; 1_ :/i - > -ANidi 6 r _1(�i�V rn.oti -
il
Moratorium: n/a yesli /1�i t1 < I \�r.� w i '� I
Waiver Attached: no l i
A building permit may be required by: (Dua .. (c ic, E c,r ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction '� t
Notes/Special Conditions .. t srC1tA c cy c ,`,_) .-t\\ ,, s'k el..,,,s* t),.`s(i ts�_ e't v-
or c� Perm ate _- ._
7 r.) f/fLA'►S \_ N
s"Please reed compliance statement on back of permit If Signature
et __ 7 CSo2, _9,_ l5 -20L.4 - ' Is�z°�
es .. Fees) Check 0 Issuing• = — - — Expiration Date
• q-( S.-- 0-2 c
Scanned with CamScanner

0 CAMA / DREDGE & FILL NO 80190
A B C 66)
GENERAL PERMIT Previous permit#
)C New Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As autl sized 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 �J T v\ \L Ot, . .
f] ❑Rules attached.
Applicant Name tic,.. ,. \f v S e ETA-L. S Project Location: County \j✓-,,'S.r i (44,
Address (O4 ✓L�`< v ,,...co Z t Street Address/State Road/Lot#(s) '22 t-c,f,,,,,,,'}"'
City C Ac .t ( k• \� State)J( ZIP -21 C I 1p S'
Phone# )1 SS 6010 E-Mail �M^�y fv, & C��/a�-^<- ! Subdivision
� <�Authorized Agent t. t k r- S. City OCR-� .S\ %(cC k ZIP Z D t-iLt. ct
Affected CW CIEW 7cPTA ❑ES ❑PTS Phone# ( ) River Basin L s.-✓
AEC(s): OEA ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body CA 4` (nat nkn)
❑PAWS: �
ORW: yes nog PNA yes % no) Closest Maj.Wtr. Body A-L11J�
Type of Project/Activity \Q..-.s ("'• , f e s S i/ 1 ' €,- A -Ct a c-t''\n A,_Uc\C,o
(Scale: N"I- (--- )
Pier(dock)length tt0 I
Fixed Platform(s) ! � ►..�� I -
Floating Platform(s) P.))1,i(p / '' i
Finger pier(s) , .k• Q 1 a f i
___fGroin length i
number , —
Bulkhead/Riprap length �- ;. _ 1 �- __..- Ti
avg distance offshore '
max distance offshore I
I
Basin,channel 1 .
1 ,
•441.
cubic yards ` i —', .
r ,
Boat ramp . i f
Boathouse/Boatlift -+i i. ..4._ 1......_ ..
y
Beach Bulldozing i t r.
Other 0- j ' �0
i -I - -
so'
Shoreline Length I
SAV:
not sure yeserwaramme. AWI.AQSM '1111 "
Moratorium: n/a yes J ` + i J! L III `ftG �f.
Photos: ye E /► — 4- al
Waiver Attached: es no •' I
2.
A building permit may be required by: (��` (S'G < <<( 'k See note on back regarding River Basin rules.
Note Local Planningurisdiction `� I
Notes/Special Conditions ) e(Cc-. w', \—r ,\ , F'\ `,. ,\\ A ti't PKr-e.e.>.' X'S.,9 e'! ✓
k,,, k,,e_....
Agent or Applicant Printed Name Perm' \ ame ,.--- \ 2,..\,
Sign ure Please read compliance statement on back of permit Signature
2.0C)°c_1 - ( S 02 - '., -2 I -15 --20
p ion 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 (252-946-6481) or the
Wilmington Regional Office(9 1 0-796-7215)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: WANDA KERSEY
Mailing Address: 1802 MARION ST.
GREENSBORO, N.C. 27403
Phone Number: 910-755-8080
Email Address: [e-mail]
I certify that I have authorized I td rt I in S
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Replacement Floating Dock & Pier
at my property located at 22 FAIRMONT ST., OCEAN ISLE BEACH, N.C. 28469
in BRUNSWICK 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 Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
a24,74 A V
Signature
WANDA KERSEY
Print or Type Name
OWNER
Title
7 / 26 / 21
Date •
This certification is valid through 9 / 30 / 21

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RECE WED
JUL 21 202.
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DCM WILMINGTON, NC
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: JUic & 14'rsa..,
Address of Property: 9(91 fir m.On\ S' CA 6
(Lot or Street#, Street or Road, City & County)
Agent's Name #:lict i-Itlm5 ( Eatidatcr 4,*irv1ailing Address: i_ o c1'1 De=
Agent's phone #: elk)-1- y3.. q c 9 y 016 , NC 3SilLo
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 r ,propo ing. A description or drawing, with dimensions, must be provided with this letter.
h�
\�t� — I
� 'I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DC.M.) in wi;°tirg within 10 days of receipt of this r:otice. Contact information for DCM offices is
available at httpJ/www.nccoastalmanaaement.net/web/cm/staff-listinq or by calling 1-868-4FCCAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
Hid .--L7 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Ri ar'an Pjpperty Owner Information)
i.c./A4iye, ��* FEi )
Signature ( Signa u QU-4-
-11 A k\t(rY,5 CAGet-Tc-
Print or Type Name Print or T.pe Nam
�' t /�
Sc3 t�Poc.h �� , � ��
I �—
Mailing Address Mailing Address
OW) , KIC ,g8A1(09 -r-oL ' 00 VQA--) - NC
City/State/Zip City/State ip
q10- u43-ukc 9 71 /0 to,6 CI
Telephone Number/Email Address Telephone Number/Em it Address C p 42)_.c o,,
1a%I) i 7// s 0 / i L 2 1
Date Date
(Revis0 OZIVINttiTON, NC
\(0,( Coil o k 5 ) ei-v l c I 1') COY-
1 --IC 11 "'S QS aP6CL:1 \ . CO WI _ ' 1 hccn C_ \ou

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: >,r C(.. - i,,„-�'
Address of Property:
(Lot or Street#, Street or Road, City& County)
�� ti c �
I n h
Agent's Name #:T i `ri)mS ��<<I t� �� „��)Nlailing Address: 1
Agent's phone #: � - -- 3-Li 1
GCS , I\t 35 -. --
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described mrawirne as shown on the with dimensions
atmust betached dr ovlidedhwi he ethisoletter.t
1 they are proposing. A descri ton or
d
1 -3 __ J atr I have no objections to this proposal. I have objections to this proposal.
osed,you must notify the Division of Coastal Management
If you have objections to what is being pro p
(DCM) in writing within 10 days of oastalmanaceipt of ement.net/web/cm/staff-1 stins notice. Contact rnoorbycalling 1 888-4RCOAST.
No available at e i considered
No res onse is considered the same as no ob ection if ou have been notified b Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring 15' fprolmgmyboat area of riparian kwater,accessb�athouse, or less waived lift must
me. (If
be set back a minimum distance appropriate blank below.)
you wish to waive the setback, you must initial the ap pro p
,�Nt k�1 �� I do wish to waive the 15' setback requirement.
�
I do not wish to waive the 15' setback requirement.
(Riparian Pr pe Owner Information)
(Property Owner Information) � �r '
Signature (A.k-4—
Signature
\d ` ' G��T Print or Type Name Q
Print or Type Name ( fro 1(0��,- !4- A9
3,1 I�('fi t ______------_
Mailing Address
Mailing Address c _at
City/State/Zip City/State ip
Telephone Number/Email Address Telephone Number/Email Address
RECEIVED
_4_+a_q2-j----__________ -7 fo 04.21
Date il ,,?��
Dare (Revised Aug. 2014)
C(ul al SO �nl oo DCM WILMINGTON, NC
I Pts g5 i) get‘ .c©rr, ' r hc`n +� `�v�,,

Check
Date Received Date Deposited ' Check From Name) Name d Permit Holder _ VendorCheck number amount Permit Number/Comments Receipt or Relund/Reallocedd
Cdumn1 Column/ Column) Column/ Columns Columns Cdumn7 Columns Colo/nib?
9/28/2021 Gold One,LLC same Wells Fargo 2699 $ 200.00 GP#803430 BB rct.15532
9/28/2021 Backwater Marine of NC,LLC Wanda Kersey Branch Banking and Trust 1502 $ 200.00 GP#80190D BB rct.15604
928/2021 Custom Design Marine,Inc. Jack Rector First Federal 1399 $ 200.00 GP#802440 BB rct.15539
928/2021 Permit Pals Grey A.Saundra Hawley CresCom Bank 3652 $ 200.00 GP#80286D BB rct.15534
9/28/2021 ,John McClure William Charles Norris BB&T 691 $ 400.00 GP#80342D '[BB rct.15535
9/28/2021 I John McClure Kelly and Sharon Jarvis BB&T 690 $ 400.00 GP#80344D BB rct 15536
9/28/2021 Grice Construction(1 of 2) Alvin and Annette Odom BB&T 14928 $ 200.00 GP#80279D IBB rot 15537
928/20211 I Orice Construction(2 of 2) •Alvin and Annette Odom BB&T 14887 $ 200.00 GP#802790 I BB rct.15537