85629D - Antosek

e`°""` 1 ICAMA DREDGE & FILL iNo. 85629 A s C D
GENERAL PERMIT Previous permit
Date previous permit issued `
J I New Modification n Complete Reissue El Partial Reissue
s authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
1� L...
5A NCAC 1"• f C'C'' ❑Rules attached. • General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
applicant Name LL'()(<a y l Pc/0 t:.I-11 r� I-- e ' t 1t--- Authorized Agent f1 i 1 • 17 /14/(/(--"'ddress Glob-PIh 1 ( L /"" ✓ - 11 Project Location(County): -61-it-/1't;ity / C. /F (0 1 State N( ZII L,44'4'C Street Address/State Road/Lot#(s)
hone#( ) 7 /- LiCI 1G'3 I ✓
mail Subdivision
City ZIP
ffected CW s•""1 EW PTA n ES n PTS Adj.Wtr.Body GA v ► ,`' I :...)u 1`'i (nat/n an/unk)
,EC(s): n OEA n IHA UW n SPIMA n PWS Closest Maj.
I Wtr.Body �' ✓"A' !n .)i) J N /
,RW:yes/no PNA:yes/no
►pe of Project/Activity ,
r
AA__--, (Scaler -A )
horeline Length t/— z-�"c
ccess LengthT. / ✓ i f - _
(
Y I
ier(dock)length �U t
xed Platform(s) 1 1 ! 4 to
>-..... _.._. C5 -/tlak: **'''''' —4*--
oating Platform(s)
nger pier(s) L'7 * `� ( j f
� j
}
C , o wr-i --- _
rtal Platform area - I ,
roin length/U I I A
JIkhead/Riprap length fi j ._._--... ._,�_ _� �� ��----! ..
✓g distance offshore
•eakwater/Sill ; 3 . ��
j tN
lax distance/length I
isin,channel
i
)at ramp .,/
\\
)athouse/Boatlift I j, 4
aach Bulldozing
-` ; ., �}+
Cher
N observed: yes o` I 11 )_
oratorium: n/a yes 1
:e Photos: yes o ( ( 1 • i j
,,
parian Waiver Attached: �+€s�y ..- .� �N 1, ,It,_..-- l/I4 \JP(
building permit/zoning permit may be required by: .- : f. 1 '-'I i 1
rmit Conditions 0 TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee additional notes/conditions on back
iM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
•' ; ' i f-r Pr-----. i 4;►\ I #c u_.__---- 10 12• Z
:nt or Applicant PAINTED Name Permit Officer's PRINTED Name
'I -Ia' al

•
$`04 CAMA ❑ DREDGE & FILL11 9 85629 A B c
ENERAL PERMIT Previous permit
Date previous permit issued
,'Jew []Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the S of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC � _ Rules attached. rm General Permit Rules availabfe at the following link:vrww .ns ggv/CAMRrules
`�
Applicant Name el*•* T C bottle-
eloi f t E a/70� Authorized Agent iN 14 a;� __
r• ww * Project Location(County):_
City 4 u col State V _ZIP Street Address/State #(s)
f' )-Are-J
Phone# -i---- lit R�
Email Subdivision
City t- ZIP
Affected CW XliEW PTA ES PIS Ad).Wtr.Body �� P JVI)NI.1 unk)
AEC(s): 1:110EA ❑IHA UW [l sPIMA Li PWS Closest Maj.Wtr.Body ✓ P 5o It!Al D
ORW:yes/no PNA:yes/no
Type of Project/Activity NNI J?Pc IA-- 9t6) - S Qom' ►o ICE_
i 5 fG
Shoreline Len
gth 'f`(—*of
�_ { tale: A
AccessLength
Pierier(d(dock)length i / S0
Fixed Ptatform(s) . "‘"—'T' Wie4 w'l Qi'v"[J�t` �� NI
Floating Platform(S) 7
L l t
finger Pier(S) [4, )(Se
Total Plattarea '� lc 4
etrA
Gran length �'
.......;,
Bulkhead/Ripra ngth .�+•.•.—.1,.....,.„ _ ,�-'
Avg distance o
Breakwater/Sill feroti4 A kio
Max distance/length
Basin,channel
kid
Cubic yards
Boat ramp {L r ,
Boathouse/Boatlift f !�"
Beach Bulldozing ����„ �_ ..�„ !'igM
Other �N Rr•W-f/�
SAV observed: yes dic,
7
Mo'atorium: n/a yes ago
Site Photos: yes aip,
Riparian Waiver Attached: . 1,2,, eiagt `w,, 5
A building permit/zoning permit may be required by:
Permit Conditions I TARlPAM1NEUSE/BUffER(circle one)
JSee note on back regarding River Basin rules
LiSee additional notes/conditions on back
I A AWARE Of STAT ES,CRC RULES AND - DITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please in i
Asefrtor licant NTED N ff+cer's PRI ED Name
ide
ilia
gn ure ••Pleaseread corn e statement on hack of permit" Signat

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
g / /
Name of Property
Owner Requesting Permit: L /
S fJ I
Mailing Address: i Q 6 / 0 r � 'O Ci
lrl /S�/
Phone Number: e , 3 - 9,3 is P/<(.5
Email Address: is f4,An-f- 0-0 r-6
i certify that I have authorized e a r f in e �,L
�.S ru�i/Jsiv,
Age t/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my roperty located at °19v/t /�• �O c(. 34y
in County. G -7)/
i
I furthermore certify that I am authorized to grant, and do in fact grant permis on 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 In ormatio :
Signat
11/S 30 h/24, II
Print or Type Name
Title
Date
This certification is valid through i i

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T-' ' ------__~___ ---- --------_�

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 own or their agent)
Name of Property Owner: ,�Q �,1i ' a/l� lf"M '
�� zz�. � fase�
Address of Property: ©?6 1f oc Q Bay 4.)e 14 y^/
Mailing Address of Owner: 3 ? J2 '
� � �S��s�u�, �✓c �i�ic � �yJ/1/
Owner's email:al f rinP � Q/4'►'1'i-CO� Owner's Phone#: (1 � � Q6
9 �
'"o/, na. Yr. Corn
/
Agent's Name:47,9 e71.7%44rj'ip Agent Phone#:
Agent's Email: es-i rJ 7474 fj74 i.y'116 Co t2 5fr.—Lc G O r
� sYiQ �- GD yy)
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
descrip ' 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 400 Commerce Ave.,Morehead City, NC 28557.DCM representatives can also be contacted
at(252) 808-2808. 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'setb
Signet re of Adjacent ' : is d.perty Owner
-OR-
I do not wish to waive the 15'setback requirement(ini ' I the blank)
itt Signature of Adjacent Riparian Property O
Typed/Printed name of ARPO: KQ4k1 . -r1 C 5 .v r1.
Mailing Address of ARPO: 2© arbCC �a
ARPO's email: S!i�U1s r ,c _(& i t01.Co.,‘ARPO's Phone#: 33 42 C 0 i"ill(P
Date: Qt� qi 9% L 1 "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 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 140 a/5 t nd 6 rtnePra- -5e
Address of Property: Cf bi4' OC-tez..- a 1)& 5-1,/
Y 1.74
,,/C
Mailing Address of Owner: 5- Lane I ��/
� S,bu. �$l` �
Own email• n e /�L,t.-/n tQ 2
Owner's Phone#:ji_a_a_k____2_4_374 3Agents Name:(1.
r � 47 q Q/
r-»'1 e 1': f4.ftn"T/rl l U-r9kI i g -i"r' C--- —�O T�-3 / 4 fa.3
A ent Phone#:
Agent's Email: e ar-/,,,� s- U� ',©
7"/ . C O,''J
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom rtion to be com leted b the Ad acent Pro a 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
descri tion or drawin with dimensions must beprovided with this letter.
c_Trc._I DO NOT have objections to this proposal. I DO have objections to
/f you have objections to what Is beingthis proposal.
Management(DCM) in writing within 10 ays proposed,
e notifyyou must Division of Coastal
receipt of this notice.t Correspondence should be
mailed to 400 Commerce Ave.,Morehead City,NC 28557.DCM representatives can also be contacted
at(252) 808-2808. No response is considered the same as no objection if you have been notified b
Certified Mail.
Y
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 si n
the appropriate blank below.)
I DO wish to waive some/all of the 15'setba
e
-OR- Signature of Adjacent Riparian Property Owner
I do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 1
V`rl �� r
Mailing Address of ARPO: oQ 69 C Q
ARPO's email:oT Cat--1c,.a(� W��•{-rem,.•.��
ARPO's Phone#: . .9 Z 7 a 7 72
Date:_L - Q_ 1 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

j )if‘21° pi-))
RECEIVED
OCT 15 H2
DCM WILMINGTON, NC

Cheek
d Date Deposited Check From(Name) Name or Permit Holder Vander amok number amount permit Number/Comments Recelpt or Refund/Reallocated
Column2 Column] Column4 Co/umn5 Column! Calumn7 Column8 Column9
121 Ryan Cooper Kent and Kim Darrah State Employees CU 3863 $ 400.00 GP#85676D BB rct.15933
121 AMW Docks and Marine Construcbon LLC Leland and Karen Joyce BB&T 63661$ 200.00 GP#85335D BB rct 15932
121 Kim Loucks Kim and Carolyn Hurst Loucks Security Savings Bank 840 $ 400.00 GP#853370 BB rot 15931
121 Jerry Ennett Louis and Camelita Antoser Coastal Bank and Trust 42071$ 200.00 GP#85629D JD rct.14095
121 Wilmington Marine Construction James Asher Bank of America 1040 $ 200.00 GP#856500 BH mt.15645
121 Warren L Pate _ same State Employees CU 2296 $ 200.00 GP#85649D BH rct.15646
121, Benjamin Elliott same ITD Bank I 155 $ 200.00[GP#85607D ITmac rct.16828