85448D - Blankenship

.. .. 1(
iy
t; `r, 1 CAMA ` DREDGE & Eil. ... . ►_ �ttT
'++,erq --, GENE Previous permit Lit I ii-----
V GENERAL PERMIT Date previous permit issui:d._$_ ��(-1
"' ' t�"'ew ['Modification [7. Complete Reissue Li Partial Reissue
As authorized by St Ito :,nt to.tc el Neill)Caraknt•Ccp:utn+en;el E.nyac;::nc ut,a Qu.+.t,cj:a:d du,Ct.;cal R-�•.o:ares C[mrt•3nan::E ors area Of cu..ronnv:nWl un<r�r i r(trs::I SA hJC:AC )�j
/`L IRO nRui .,,ra.hs;t Grr ; r a •r 1 .1 L'... __. -...._
--..._.......__. .. � r. ,., , ..::4 vnn•rd,� rt ;•t:.,•.r4.rur:.
_. .._.__...._..__.. ._:J f;•nr:r R.h.:r+:...b�c�.et tF vrtA"r a ._. _....
'WPI Lu+t Mann Ce
S1v#�- kg.,sit !3 l�.ri i r' _ A., / p� 1, /!1/pn v.— ..?_f'�a't„..._.__ -__
AddrBSS ... ..65 ..I aTlJJ -Pl -..-- _.._.—_ Jiro• t oc r o t otnty) _ : ..tt_.......-.._ ...._. —_
�y,y A' f�
city_. 4f-va.onit.5tite____lYG.___-_'LIP_p�gb./9.�2_. ScrectAdtJr,.;,3eat!Pa; letrfnjP�a. !.L--____ .._......_.
51
Email S
+ 1�CetcSheLtt ,_ Sut d,:;:ci
Cite.._ /aI id___ _._____.____.ZIP.. .#A5�_.__.
Affected m t/j Eyy PTA C.115
PTS Ad Y✓tr Body '�""� n' „anfutdtl
A.ctU DOER LjMNA f,UW f lSPiMA i 1PW5 Closest M.y Viir Bc iy__ ��'f!aV__.- �-_- -•.__•.---_
ORW . '':1 1 PNA, 0
Type of Project/Activity_S_T ,Sg, _,_._ Cr __ /->ai„" 7,__ v a ,2.I -
(Scale:tJ )
Sh,elan;Length~,0,^
Ac:ces Length (I Jr3-2. II _ _
Pigs(di;:k)kw:Us .i...
'. ._L....~_.._..— ��. ^1L-�--.___'_ "'� ^�
IiecaPt.tto,e{)_44rY1�T _••_ �. • ,u..- t . ._;
E
PloannsPl.,Ka;m(s}JihlSa.r
_._._M...
i ! .
ru: ,•r: piCtf:I - • • .
P t�
I..,riatform,erm ^_._....-.. e
Crain len.rth/ol
Bulkhead/Rrprap l n41h •••••• _^ . . j '
Avg thsanceoffshore
I
3r.rakµatn+JSitl •+
RAaa distance/h•ntth ..... ._. �i �¢
Bens,channel 004� : 1- ♦♦t
Cutnc yards ..+
Boat ramp
Beach Bultdonng • i : _trlJ� � rOlhcr ....... . .., ..
— ) • i i .` may,. )sif SA`J°tower d yes Qra! .Moratorium n/a yes © *-2' r A-\ aril*__l lGLtmt.� �40a
Rlpanan Warier Attached: i') no '"`
XI �
A burldrng permit/mn:n rend ay be to fired by'._/ ' r •t I,5/QYii.
_`gu ,I /j��� ��_7 �C �'t� TAR/PAI NEUSE/BUFFER(circle one)
Pet met Ctxd•tin.•ts. .�Q���/, /-i-r (/(.�I/•rtl►�.r ..Q�V�7SiG�~., Ej
vv i� 0 See note on back regvdmg Rlver Basra rules
- --- '-`�— 0 See additional notes/cortaitions on back
1 AM AWARE OF STATUTES.CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. e;Iw Initial) '
MAX in e CArLs �fiei ? �; �c ►�lto yV -I(}-
AEent or Apt ant PRINTED Yame i�r� Tin r tr 11 INIe'D Name
•�L �>!' 51-1-22
s„...tirte"Please re id cornphance statement on back of Faleld•• SI:naturc
Apofication trots) Check n/Money Ceder :.tong Date Expiration Date

•
<CAMA/ DREDGE $ FILLi-ii;1
O 801(�l) A B C
GENERAL PERMIT Previous permit #
' New Modification Complete Reissue Partial Reissue NDate previous permit issued
As audwnied by the State of North Carotin,Department of Environmental Quality q
and the Coasttt Resources Commission in an area of emnronmental concern pursuant to I SA NCAC n//t•ar
Applicant Name_ SCO. & riSti R t1 WM11'11 ------..-_ Project Location County -� ---
Address_ LJ 1(!1 ij flatt/ Street Address!State Road/Lot#(s) f .__-14,40/t.. .__
City e,, ___. State itt ZIP Xi% . 3910 wAsr 1 /phin --
Phone#(7 7 ) 637 5061_E-Mall il,aimgspett \ SubdMsion '"" _. _ ____---
Authorized Agent CP6 L� city /ri�. ZIP�T 65
Affected -'CVII NEW ridPTA ES Om Phone# (______) Prier Basin l: —.
AECtsj: OEA HHF IN USA DWA Adj.Wtr Body di74, eg. _Al lea)
PWS _ �1 11
ORW es 4 PNA yes i 431
Closest Maj Wtr.Body r[L Ce' -.-___ .._-
Type of Project,Activity f/c 4 eilS4serrikdSdlOpti j A/2 .5,/,'
Scale:
Pier idoeki 6k/' //��(
Fixed Ptatinrm(s) ^' _.._ 1.' td �.,, �. T:7/a� �� f _ - _ ,
Floating Ptadon,i(s) IWire.J ;/PItw '_ 1 }-i
Futter owns) IL,.
.L „,..-."_!-._a. '• ., . ,r 'r/i i.ii ..i-:S..-�-..t- -4-4 t �--.�..0
•
Grout length 'm �
number "" _ ■ �.. ' J
Bulkhead'WpratpkJtigdi w ± f ._. _-iraill � 1"O )ir • - f - •----e-
i-a
avg distance offshore i - 7 ' F I 1 +_._r_•__ ,....-___-_t..1-_+-
max distance offshore"" i :- ► - t
Basin.channel P i �-.
i
r■�r i �_
cub.,yards
Boat ramp i i
Boath. ..4,,,,,. talk u I t —k
Beads Bulldozing. • 111 - l
Ocher KWIC> P. , , _ a _i_ I. IN 4 ' =OM
Shorekne Length �►�A� __ I-.. ■ ._ r. _ _,` ..r. ...-.r, __._ _� _ �._
SAV not sUr. -j-.
Mornri oum Na Yes r 111111 -d `
Photos yes ® . 2 i' 1' � t-4p *I 1 o - - --i- ._ ' ,
Waver�ork e no t 1} ( . __ eat rs► g4Gr
�1
A building permit may be required by I,wr Kati h iz See note on back regarding River Basin rules.
1 (Note Local Planning Jurisdiction)
Notes/Special Conditions /t `f 4'_flee) 71t2 .
Ben 6c-•4- C� LLC. . -
_ - 5�25-21
et oA /P����` Perm Officer's Pnntad Name
!' 'wtI�� 414 4fIm _ 12-25-2.!
*name aoure »Phase read compliance statement on back of permit e' Signature

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: scoff and Krista Blankenship
6513 Prestwick Place
Mailing Address:
Fuquav\'arina.NC 27s26
919-637-5069
Phone Number:
Scott.blankenship@ me.com
Email Address:
CPG. LLC
I certify that I have authorized
Agent r Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: no iv docking+acuity
at m r e located at Parcel ID 234PA011 t3910 W. Dolphin)
YPoP rty
in Bruns::ick 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:
iSGO ta/fkeef '
a
Scott Blanket:nip
Signature
Scott Blankcn,htp
Print or Type Name
Property Owner
Title
4 14 2021
Date
4 14 202`
This certification is valid through I 1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to laanl rn hIP
39in N I>td1•Am I (Name of Property Owner)
property located at Pu:el III:i r1'A.n
�7 ny..mrn u.u1 (Address.lot.Block.Road.Me.)
on ,in I ig Island bran%k► N.C.
(Waterbody) (CltyiTown and%or County)
The applicant has descnbed to me as shown below, the development proposed at the above
location
' -- I have no objection to this proposal
--- I have objections to this proposal
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVE..OPMENT
(individual proposing development must fill in descnption below or attach a site drawing)
Proposed docking facility with covered
gazebo, floating dock, and boat lift.
WAIVER SECTION
I understand that a pier.dock. mooring pilings.boat ramp.breakwater.boathouse,Mt,or groin
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 i
I do wish to waive the 15'setback requirement "'Ulu+nnit up k)3'Unt.1 wiba.k
I do not wish to waive the 15'setback requirement
(Property Owner Information) (Adjacent Property Owner Information)
,4.m21131a170
Signature ', t Islankenshnp Signature* Kerry Blanchard
Print or Type Name eS 13 Preuwkk Aare Pnnt or Type Name 4/bwrm Lane
Maii1ng Address Fuquar Vanna.NC 2732e Mailing Address New Millard.r:r 0n776
C4y/SteAe.2rp ,ct4iblankenshipirme.cam CAy/State?rp kerry.tianchaidwmrrckcom
Telephone Number 1 email addwsa Telephone Number/email address
D i 4/14/2021 pore' 4/15/21
(Revised Aug.2014)
'Valid tor one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
414t ttlanken+hgr
Hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at +'"w l.`1htn 14 N 1401 Panel 11,a r4P�.
k,d (Address.Lot.Block.Road.etc.)
On 1n ;..r_ .J,...' N C
(Waterbody) (City/Town and/or County)
The applicant has described to me as shown below the development proposed at the above
location
ft ®.,.*--- I have no objection to this proposal
I have objections to this proposal
DESCRIPTION ANDOR DRAWING OF PROPOSED DEVELCPMENT
(Individual proposing development must fill in descnptnon below or attach a site drawings
See attached drawing of new docking
facility.
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
me (If you wish to waive the setback you must initial the appropriate blank below
I do wish to waive the 15 setback requirement
do not :'.+sh to waive the 15' .iCk requirement
(Property Owner►nformationl (Adjacent Property Owner Information)
4i-41't
5tF,/,7!'ri'' I t..ren.r.a t 'Laren,I..rt,
4+'a nlanirn'h
Print or Type Name PreNtaxk(Tare Print or'4Pe dame ty x%% I►nlph,r
Marling Address I uaua% Vann..tit i-;us Mailing Address thk Island ♦t:23461
Gty/Stafeato a1uUhlanken.hrpeomeurm C4}'f p 28465
Telephone Number i email address Telephone Number/email address
parr 4.14 2021 An.' 04/29/2021
(Rev 7sed Aug 201 4}
'Valid for one calendx year after sgnattrc_''

3910 W Dolphin
IC.:7 � f�� a� l
PIMA :1
1Yrl2 1
Ilea kit
Head\\°e
45`ab`` redp\e' 71 , ,• -j
ti
____,. .... i
Cli
r lw mop l
....
I.. +t' N
ticEarth +' , '
3910 W. Dolphin
Proposed Duc l nq F oc in, • r
r
,co 1111111
v..
-- /1,1
15' '
ar
N.
J i
ii .
l
rlu
f ,
_/ r --IA
• •gle Earth _ f--I too N.
'Note:Approximate measurements based on aerial imagery(GoogleEarth).

r
•
•
•
•
,� ! •\ ks
tio,
f , ** _ ,,
d•,-
'.'•-.4*-t.s,",.0:.'L',,I..
1
.
..#l.lA'
IIINaif
d r
�4
Ik
' e .j•az ,76fi ± i .
,,
•
ro
� k`f f
s' /I p 'i 1'Y . '.
f ` , aar i
10-
AiloPt'y,:.. •r f at :. ; tit '��

Check
raised Date Deposited Chock From(Name) Name of Prmit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated •
of Column2 Co/umn3 Colum M Columns Cokrm,M Coknn7 Column8 Cdumn9
2022 Bud Sniff Money Order Libby Simpson BOKF,NA 2.0977E+10 $ 200.00 GP#85386D JD rct.16119
2022 Sea Dog Marine Construction rJR Huntley Homes LLC First Bank 1587'$ 200.00 GP#85475D TP rct.13484
2022 - Sea Dog Marine Construction Scott 8 Krista Blankenship First Bank 1603 $ 200.00 GP#t85448D PA rd.16529
2022 Sea Dog Marine Construction Mary Holmes First Bank 1580 $ 200.00 GP#t85455D PA rct.15675
2022 Vance Morgan Money Order !Mark Ward BOKF,NA 2.0981E+10 $ 400.00 GP#85457D PA rct.13482 -
n2022 Christopher Morrison Const.Inc. same First National Bank 1978 $ 200.00 GP#85444D PA mt.15670 _
12022 Ailed Marine Contractors,LLC Mark Wallace First Citizens Bank ' 10627 $ 600.00 GP#85445D PA rot.16526 _ _
2022 Sea Dog Manne Construction Jewel&Chnsta Owens First Bank 1585 $ 400.00 GP#85448D PA rot.16527 _
/2022 Brent Shive same F&M Bank 6340 $ 400.00 GP#856920 PA rct.15672