13-21 Oktavec, Michael

Permit Class
NEW
STATE OF NORTH CAROLINA
Department of Environmental Quality
and
Coastal Resources Commission
Vermit
for
X Major Development in an Area of Environmental Concern
pursuant to NCGS 113A-118
Excavation and/or filling pursuant to NCGS 113-229
Issued to Michael Oktavec, 213 Marsh Hen Drive, Wilmington, NC 28409
Permit Number
13-21
Authorizing development in New Hanover County at adj to Channel Haven Canal, at 213 Marsh
Hen Dr., in Wilmington as requested in the permittee's application dated 10/5/20,
including'attached workplan drawings (2), Drawings 1 and 2 of 2 both dated 10/8/20.
This permit, issued on February 3, 2021 is subject to compliance with the application (where
consistent with the permit), all applicable regulations, special conditions and notes set forth below. Any violation
of these terms may be subject to fines, imprisonment or civil action; or may cause the permit to be null and void.
Docking Facility Exnansion
1) This permit authorizes only the additional floating platform and uses located in or over the water that
are expressly and specifically set forth in the permit application. No other structure,' whether floating
onstationary, shall become a permanent part of this docking facility expansion without permit
modification. No non -water dependent uses of structures shall be conducted on, in or over Public
Trust waters without permit modification.
2) No sewage, whether treated or untreated, shall be discharged at any time from any boats using the
docking facility. Any sewage discharge at the docking facility shall be considered a violation of this
permit for which the permittee is responsible. This prohibition shall be applied and enforced
throughout the entire existence of the permitted structure.
(See attached sheets for Additional Conditions)
This permit action may be appealed by the permittee or other Signed by the authority of the Secretary of DEQ and the Chair
qualified persons within twenty (20) days of the issuing date. of the Coastal Resources Commission.
This permit must be accessible on -site to Department
personnel when the project is inspected for compliance.
Any maintenance work or project modification not covered
hereunder requires further Division approval.
All work must cease when the permit expires on
December 31, 2024
In issuing this permit, the State of North Carolina agrees that
your project is consistent with the North Carolina Coastal
Management Program.
Braxton C. Davis, Director
Division of Coastal Management
This permit and its conditions are hereby accepted.
Signature of Permittee

Michael Oktavec Permit No. 13-21
Page 2 of 3
ADDITIONAL CONDITIONS
3) This permit authorizes two (2) additional formalized boat slips for a maximum of four (4) formalized
boat slips.
4) The permittee shall install and maintain at his expense any signal lights or signals prescribed by the U.S.
Coast Guard, through regulation or otherwise, on the authorized facilities. At a minimum, permanent
reflectors shall be attached to the structure in order to make it more visible during hours of darkness or
inclement weather.
5) No attempt shall be made by the permittee to prevent the full and free use by the public of all navigable
waters at or adjacent to the authorized work.
6) The authorized structure and associated activity shall not cause an unacceptable interference with
navigation and shall not exceed the dimensions shown on the attached permit drawings.
7) Should the lot to the west be sold prior to the initiation of construction of the docking facility, the
permittee shall obtain a written agreement from the new owner(s) waiving the minimum setback, and
authorization to construct the portion of the docking facility within the property owner's riparian rights,
and submit it to the Division of Coastal Management prior to initiating construction of the docking
facility.
USACE Conditions
8) In order to further protect the endangered West Indian Manatee, Trichechus inanatus, the applicant must
implement the U.S. Fish & Wildlife Service's Guidelines, and strictly adhere to all requirements therein.
The guidelines can be found at https://www.fNvs. ov/ralei h/pdfs/ManateeGuidelines20l7.pdf.
General
9) This permit shall not be assigned, transferred, sold, or otherwise disposed of to a third party without the
written approval of the Division of Coastal Management.
10) The permittee shall maintain the authorized work in good condition and in conformance with the terms
and conditions of this permit. The permittee is not relieved of this requirement if he or she abandons the
permitted activity without having it transferred to a third party.
11) The permittee and/or his or her contractor shall meet with a representative of the Division prior to
project initiation.
12) All debris associated with the removal or construction of the permitted development shall be contained
within the authorized project area and removed to an appropriate upland location.
NOTE: This permit does not eliminate the need to obtain any additional state, federal or local permits,
'approvals or authorizations that may be required.

Michael Oktavec Permit No. 13-21
Page 3 of 3
ADDITIONAL CONDITIONS
NOTE: The U.S. Army Corps of Engineers authorized the project by way of Regional General Permit
197800056 (Action ID SAW-2020-02100).
NOTE: The N.C. Division of Water Resources authorized the proposed project by way of General Water
Quality Certification 4175 and assigned the project DWR Project No. 2020-1885.
NOTE: Future development of the permittee's property may require a modification of this permit.
Contact a representative of the Division at [phone] prior to the commencement of any
such activity for this determination. The permittee is further advised that many non -water
dependent activities are not authorized within 30 feet of the normal high water level.
NOTE: An application processing fee of $250 was received by DCM for this project.

DCM Coordinator: Curt Weychert
County:
Circle on( 'Bio Re Permit for:
Oversize Plans sent: YA f/l
Permit P 1VV
WIRO E-MAIL DISTRIBUTION SHEET
M&61,61 0 J&-NV-eV
DCM Offices:
Morehead City: PT (if oversize) via Courier
'cc Curt & Amanda on group email w/ bio.narr.app.drawings, deed, comment sheet _
'MHC documents (Curt & Amanda)
Wilmington: Original hard-copy�L
ONLY USACE & DWR (w ro): Recommendations, PN, Letter w/Site Card, Fee Chart and Agent Authorization
USACE Wilmington: Carteret Co): PN, CL, Reports, Split Sheet _
use both [e-mail] (NH/BR): PN, CL, Reports, Split Sheet
��eg Currey (NH/BR: PN, CL, Reports, Split Sheet_
Div of Water Resources: VRobb Mairs - 401 (BR/NH): PN, CL, Reports, Split Sheet _
401 (PN/ON): PN, CL, Reports, Split Sheet _
Div of Water Resources: en Montalvo for Karen Higgins: PN, CL, Reports, Split Sheet _ —
Marine Fisheries: \Anua�Daato me w/&do its � +
DCMPlannerNViRO:
MikeChristenbury_
Cultural Resources:
'vfter. Gledhill -Earley EnvironmentaLReviewata)ncdenr.gov_
Natural Heritage Prog.
\Rocjaey Butler_
DCA-Rural Eco. Dev:
Mark Ziegler_
NC DOT:
�,71 Harris, —
Wildlife Resources:
Maria Dunn w/Reports _
State'Property Office:
Tire Walton: DEED
r
hda i
nda Hilliard„Real Property Agent (Bio Reports only)
Shellfish Sanitation: _
4eremy Humphrey (Bio) /Ss -(Pt)
Gupton, Admin.
DEMLR:
1#6h ' tine Hall - Stormwater Section
n Sams - Land Quality Section _
Public Water Supply:
Wei ' ox_
City of Wilmington:
Thurston
Zeld
Enforcement:
Rep:
Co. LPO
✓� V14CLI ai vt'(cv
Agent:
DISTRIBUTED:
Updated 09/04)20
CAMA/Shaun majors docs/e Agency List

DIVISION OF COASTAL MANAGEMENT
APPLICATION TRANSMITTAL AND PROCESSING RECORD
APPLICANT: MichaelOktavec
PROJECT NAME: 213 March Hen Drive
COUNTY: New Hanover
LOCATION OF PROJECT: 213 Marsh Hen Drive, adjacent to Channel Haven canal, Wilmington
DATE APPLICATION RECEIVED COMPLETE BY FIELD:11-16-20
FIELD RECOMMENDATION: Attached:: Yes
FIELD REPRESENTATIVE: Amico
DISTRICT MANAGERREVIEW:
B) DATE RECEIVED BY MAJOR PERMITS UNIT:
APPLICATION ASSIGNED TO: Weychert
PUBLIC NOTICE REC'D: 12-1-20
ADJ. RIP. PROP NOTICES RECD:
C) 75 DAY DEADLINE: 1-30-21
To Be Forwarded: N/A
DISTRICT OFFICE: WILMINGTON
FEE REC'D: S250923573
END OF NOTICE DATE: 12-22-20
DEED REC'D: Yes
150 DAY DEADLINE:
HOLDS:
MAIL OUT DATE:11-25-20 STATE DUE DATE: 12-22-20
PERMIT FINAL ACTION: ISSUE DENY
AGENCY
DATE
COMMENTS
OBJECTIONS:
YES NO
NOTES
DCM—Field Rep
1REgTURNgED�,
1 77
DCM—LUP Consistency Determination
Local Permit Officer
Corps of Engineers— Regulatory Branch
DWR-401 Section
DWR— Public Water Supply
DEMLR— Stormwater
DEMLR—Sedand Erosion
DOA —State Property Office
WildlifeResource sCommission
IZ-) I 70
DMF — Shellfish Section
2
�)
DMF— Habitat &Enhancement
DNCR— Archives& History
DNCR— Natural Heritage Program
NCDOT
NC Dept of Commerce
(Z-

RECOMMENDATIONS FOR Michael Oktavec 11/23/2020
Shoreline length =-105 LF x 8 SF/LF = 840SF (maximum allowable platform area)
Existing access pier (8' x 8') = 28 SF (36 SF not counted due to access credit given)
Existing floating dock (6' x 35')= 210 SF (not counted due to access credit given)
Proposed floating dock (6' x 50') = 300 SF (not counted due to access credit given)
l
Total =28 SF
It is the staffs recommendation that the expansion of the private docking facility, resulting in the additional incorporation
of 300 SF of public trust waters, is CONSISTENT with the Rules of 15 NCAC 71-1.0208 (b) (6) Specific Use Standards for Piers
and Docking Facilities.
The application states that the expanded docking facilities would provide docking space for two (2) more vessels at this
location for a total of 4 slips in water depths of 2.0' @ NLW. The proposed floating dock would be located over open water
and within the applicant's western neighbor's riparian corridor setback, but the appropriate waiver has been obtained
and provided.
This office has no objection to the proposed work, provided it is consistent with all other state and federal permitting
requirements. it recommended that any permit issued should include standard conditions for docking facilities.

ROY COOPER
t Gorcmor
MICHAEL S. REGAN
SeCre/nn'
E:ORiH CAROM.', BRAXTON DAVIS
G
Director, Dirirlo+t ofComml Gn'iroam+nlal G•taliio Mmrngement
November 25, 2020
MEMORANDUM.•
FROM: Curt Weychert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11-12-09)
curt.weychertONCDENR cov
SUBJECT: CAMA
Applicant: Michael Ocktavec
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
retum this form to Curt Wevche►t at the address above by December 22, 2020. If you have any
questions regarding the proposed project, contact Patrick Amioo at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: _ C� This agency has no objection to the project as proposed.
"Additional comments may be attached" .
This agency has no comment on the proposed project
_ This agency approves of the project only if the recommended changes
are Incorporated. See attached.
This agency objects to the project for reasons described in the attached comments,
PRINT NAME LtnJct. C
AGENCY /jaw 1+owidged I UunTL
SIGNATURE GV1at o-
s e, 1.
Ma.
Stale ofNmt4 Cemlina I rmim®emnl Quality I Cmstalm mgammt
127 Cardinal Drive Ekt, Wilmington, NC 2MS 919196 7215
RECEIVED
DEC 16 1020
MP SECTION
DCM - MHD CITY

'..w • ROY COOPER
.,. Govemor
T
q TT(( MICHAEL S. REGAN
Secrerary
W.r
BRAXTON DAVIS
NORTH CAROLINA Director, Division ofCoaaral
Enrirunmenrol0whi), Management
November 25, 2020
MEMORANDUM:
FROM: Curt Weychert, Assistant Major Permits'Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11-12-09)
cu rt.wevchert(a)NC DE N R. gov
SUBJECT: CAMA
Applicant: Michael Ocktavec,
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Curt Wevchert at the address above by (December 22, 2020j If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: This agency has no objection to the project as proposed.
"Additional comments may be attached"
X This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
PRINT NAME Shannon Jenkins
gGENCY NC DMF - Shellfish Sanitation & Recreational Water Quality
RECEIVED
SIGNATURE cu_ �i<tlruifi2 au_ for Shannon Jenkins
DEC 11 2020
DATE 12/11/2020 MP SECTION
DCM - MHD CITY
State ofNonh Carolina I Environmental Quality I Coastal Managemrnt
127 Cardinal Drive Ezt, Wilmington, NC 28405 919 796 7215

Weychert, Curtis R
From: Sams, Dan
Sent: Tuesday, December 1, 2020 12:58 PM
To: Weychert, Curtis R
Cc: Pietila, Tanya K
Subject: RE: CAMA Major Application: 526 South Lumina, LLC
526 South Lumina, LLC: No comment
Double L Holdings, LLC: No comment
Aviron HOA: No comment
Scott and Lisa Diggs: If high ground activity exceeds one acre, erosion & sediment control and stormwater applications
and approvals are manitory.
Anthony Dombroski III: No comment
Robert Barnhill: No comment
Oyster Harbour Homeowners Association, Inc.: No comment
Tara Nucci: No comment
Kurt & Anna Taylor: No comment
James Brady: No comment
Kerry Svoboda: No comment
Lisa and Ned Danieley: No comment
Rodney Clark: No comment
Peter and Carole Kozloski: No comment
Michael Oktavec: No comment
dan.sams
From: Weychert, Curtis R
Sent: Tuesday, December 1, 2020 11:40 AM
To: Sams, Dan <[e-mail]>
Subject: FW: CAMA Major Application: 526 South Lumina, LLC
Hey Dan,
I was checking my file and I didn't see any comments from your agency on this project. I looked through my emails and
didn't see anything, but I may have overlooked something accidently. I just wanted to make sure that I didn't make any
permit decisions without getting the DEMLR comments.
Thanks,
Curt
Curtis Weychert
Assistant Major Permit Coordinator
North Carolina Division of Coastal Management
North Carolina Department of Environmental Quality
252-808-2808 x211
Curt. WevchertCa)ncdenr. aov
400 Commerce Ave
Morehead City, NC 28557

,«„«. ROY COOPER
Governor
= MICHAEL S. REGAN
Secretary
BRAXTON DAVIS
NORTH CAROLINA Director, Division ojComial
Ervit'onmental Oaalig. Management
November 25, 2020
MEMORANDUM:
FROM: Curt Weychert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11-12-09)
curt.wevchert(a)NCDEN R.gov
SUBJECT: CAMA
Applicant: Michael Ocktavec
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal,, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Curt Wevchert at the address above by becetnber 22,, 20 In If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: X This agency has no objection to the project as proposed.
"Additional comments may be attached"
This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
PRINT NAME Mark Brown
AGENCY
SIGNATURE
DATE
Public Water Supply
12-1-20
State of Carolina [ Environmental Quality � Coastal Management
127 Cardinal Drive Ezl, Wilmington, NC 28405 919 796 7215
RECEIVED
DEC 01.1010
MP SECTION
DCM - MHD CITY

•�..,,+ ROY COOPER
MICHAEL S. REGAN
�• .1e<ttlm}•
BRAXTON DAVIS
?.`F'Y :7V•!a Direcmr, Di'mm, ofCoaaal
.. Afmiagrmeur
November 25, 2020
MEMORANDUM:
FROM: Curt Weychert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11.12.09)
cu rt.wevche rtaNCDENR.aov
SUBJECT: CAMA
Applicant: Michael Ocktavec
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Curt Wevchert at the address above by Degem6er 22,,.2020 F If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: This agency has no objection to the project as proposed.
"Additional comments may be attached"
X This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
2 proposed slips and 2 existing totaling 4
PRI_NT`NAME Wanda Hilliard
AGENCJI Statd Property
r RECEIVED
SIGNATURE
DEC 2 9 2020
DATE December 23, 2020 MP SECTION
DCM - MM CITY
Stec ofNonh Carolina' Environmental Quality l Coastal M.inagement
127 Cardinal DH t Evf, Wilmington, NC 29405 919 796 7215

• ROY COOPER
f)O,'aT09!'
F* MICHAEL S. REGAN
BRAXTON DAVIS
I nnYarq :Jnvs:m nff ixund
1/Dirr}4'ak9;l
November 25, 2020
MEMORANDUM: -
FROM: Curt Weychert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11-12-09)
curt.wevchertonNCDENR.00v
SUBJECT: CAMA
Applicant: Michael Ocktavec
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat -slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Curt Wevchert at the address above by December 22, 2020. If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested. .
REPLY: , This agency has no objection to the project as proposed.
"Additional comments may be attached"
_ This agency has no comment on the proposed project.
This agency approves of the project only If the recommended changes
are Incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
PRINT NAME iM
AGENCY N L Of Of, t9 7 Go rA rN we t.
SIGNATURE' M � e, C, ✓ RECEDED
DATE 1 I �� n DEC 2.1 2020
MP SECTION
Stem ofNon6 Car0Ga2 I Fnviroomental QaailY I Coastal Management DCM - MHD CITY
127 Cardinal Driw Fz ., wilmington, NC 29405 919796 7215

."
ROY COOPER
Governor
}'
s 3
MICHAEL S. REGAN
Secretary
BRAXTON DAVIS
NORTH CAROLINA
Director, Dirision ofCoonal
Em ironalanhd OuaIny
Management
November 25, 2020
MEMORANDUM:
FROM: Curt Weychert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11-12-09)
cu rt.wevchert(cil NCDE N R. gov
SUBJECT: CAMA
Applicant: Michael Ocktavec
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Curt Weychert at the address above by December 22, 2020. If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: This agency has no objection to the project as proposed.
"Additional comments may be attached"
X This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
PRINT NAME Kimberlee Harding
AGENCY
NCDMF
SIGNATl1RE
DATE 12/29/2020
r�p
State ofNonh Carolina I Environmental Quality I Coastal Management
127 Cardinal Drivc Exl, Wilmington, NC 29405 919 796 7215

^., ROY COOPER
tin ........
i
MICHAEL S. REGAN
uw: tan
BRAXTON DAVIS
November 25, 2020
1 23 g�,,
`6
tia�o3;
MEMORANDUM.'
ti
DEC �p2D
" , A i
FROM: Curt Wevchert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
N 3
400 Commerce Avenue, Morehead City, NC 28557
1-12 09)
curt.wevchertCc9NCDENR.gov
SUBJECT: CAMA
Applicant: Michael Ocktavec
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project
and
return this form to Curt Wevchert at the address above by December 22, 2020,
If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: This agency has no objection to the project as proposed.
"Additional comments may be attached"
_ZThis agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
PRINT NAME
AGENCY NGt,1R(
SIGNATURE sLFi►
DATE
State ofNort6 Carolina l Ewimnmental Quality l coastalMxnagenmt
127 Cardinal Driw EeL, WilmingwN NC2g4M5 9197967215

DocuBgn Envelope ID: 73C637D4-2363-4629-8B73-A530A5662DO4
f
ROY COOPER
clm m
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Dfnac w
Michael Ocktavec
213 Marsh Hen Drive
Wilmington, NC 28409
NORTH CAROLINA
orv6amaarmf �Y
January 22, 2021
Subject: No Written Approval Required
213 Marsh Hen Drive —Wilmington, NC 28409
Dear Mr. Ocktavec:
DWR # 2020-1885
New Hanover County
)Ott"
a - "w
The Division of Water Resources (DWR) has received a copy of your CAMA Major application
request dated received by this office on November 25, 2020. DWR issues approval in the form
of a Water Quality Certification (WQC) in conjunction with the CAMA Major Permit and General
Permit(s) 198000291 or 197800056 issued by the US Army Corps of Engineers (USAGE). This
Certification allows you to use the CAMA Major Permit when the Division of Coastal Management
issues it.
In accordance with the attached General Certification #4175 (GC 4175), the impacts described in
your application do not require written authorization to utilize GC 4175. However, you are required
to follow the conditions listed in the attached certification. You should get or otherwise comply
with any other federal, state and local requirements before you go ahead with your project
including (but not limited to) erosion and sediment control regulations.
This Certification can be contested as provided in Articles 3 and 4 of General Statute 150E by
filing a written petition for an administrative hearing to the Office of Administrative Hearings
(hereby known as OAH). A petition form may be obtained from the OAH at htto://www.ncoah.com/
or by calling the OAH Clerk's Office at [phone] for information.
Within sixty (60) calendar days of receipt of this notice, a petition must be filed with the OAH. A
petition is considered filed when the original and one (1) copy along with any applicable OAH
filing fee is received in the OAH during normal office hours (Monday through Friday between
8:00am and 5:00pm, excluding official state holidays).
The petition may be faxed to the OAH at [phone], provided the original and one copy of
the petition along with any applicable OAH filing fee is received by the OAH within five (5) business
days following the fazed transmission.
Mailing address for the OAH:
If sending via US Postal Service: If sending via delivery service (UPS,
FedEx, etc.):
D � North Carolie ionartmeM of Environmental Quality Division I WimiWatrr Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wilmington North Carolina 28405
910.796.7215

Docusign Envelope ID: 73C637D4-2363-4629-8B73-A530A5662D04
213 Marsh Hen Drive - Wilmington, NC 28409
DWR# 20201885
Page 2 of 2
Office of Administrative Hearings Office of Administrative Hearings
6714 Mail Service Center 1711 New Hope Church Road
Raleigh, NC 27699-6714 Raleigh, NC 27609-6285
One (1) copy of the petition must also be served to DEQ: RECEIVED
William F. Lane, General Counsel ]AN 2,:2 1011
Department of Environmental Quality
1601 Mail Service Center MP SECTION
Raleigh, NC 27699-1601 DCM - MHD CITY
This letter completes the review of the Division under section 401 of the Clean Water. Please
contact Tyler Benson at 910-796-7336 or tyler.benson cbncdenr.gov if you have any questions or
concerns.
Sincerely,
E
oocusisnea nv3ADlDC
Morella Sanchez -King, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
Enclosures: GC 4175
cc: Curt Weychert, DCM Morehead City Office, EC
Greg Currey, USACE Wilmington Regulatory Field Office, EC
Jimmy North, Consultant, EC
DWR 401 & Buffer Permitting Branch file-LF
WiRO

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2020-02100 County: New HanoverCounty U.S.G.S. Quad: Wrightsville Beach
GENERAL, PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee:
Michael Okmvec
RECEIVED
Address:
213 Marsh Hen Drive
Wilmington NC.28409
Telephone Number:
JAN 18 2021
1
Size (acres)
Channel Haven Canal Nearest Town Wilmington
MP SECTION
Nearest Waterway
Onslow Bay RiverBasm Onslow Bay
DCM - MHD CITY
USGS HUC
03020302 Coordinates Latitude: 4.1519
Longitude:-77.8649
Location description:
The site is located in Channel Haven Canal at213Marsh Hen Drive inWit mington
New Hanover
County. NC.
Description of project
areaandactivity: The uroposal is to add a 50 feet by 6 feet floating dock ad 6acent to an existing floating
dock. increasing the slip
count at this dock from two (2) to four (4).
Applicable Law: ❑
Section 404 (Clean Water Act, 3 3 USC 1344)
®
Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional
General Permit Numberand/orNationwidePermit Number: 197800056
Special Condition: In orderto further protect the endangered West Indian Manatee, Trichechus maretus, the applicant
must implementthe U.S. Fish and Wildlife Service's Manatee Guidelines, and strictlyadhere to all requirements therein. The
guidelinescanbefoundathttli://www.fws.gov/nLes/mammal/manatee guidefnes.pdE
SEEATTACHED RGP GENERAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and yoursubm itted application and attached drawings dated October8, 2020. Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order,a Class
I administrative penahy,and/orappropriate legal action.
This verificationwi0 remain valid untilthe expiration date identified below unless thenationwide and/or regional general permit
authorization ism odified, suspended or revoked. If, prior to the expiration date identified below, then at ion wide and/or region a I
genera I perm it authorization is reissued and/ormodified this verification will rem a in valid untilthe expiration date identified below,
provided it complies with all requirements of the modifiednationwide permit. If the nationwide and/or regional general permit
authorization expires or is suspended, revoked, or is modified, such thatthe activity would no longer comply with th e t erms an d
conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or are under contract to
commence in reliance uponthenationwide and/or regional general permit, will rem a in authorized provided the activity is c o m pleted
with in twelve months of the date of thenationwide and/or regional general permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case -by -case basis to modify, suspend or revoke the authorization.
Activ ities subjectto Section 404 (as indicated above) may also require an individual Section 401 Water Qua lity Cert ific at ion. You
should contact the NC Division of Water Resources (telephone [phone]) to determine Section 401 requirements.
For activities occurringwith in the twenty coastal counties subject to regu la don under the Coastal Area Management Act (CAMA),
priorto beginning work you must contact the N.C. Division of Coastal Management in Wilmmgton,NC, at(910)796-7215.
This Department of the Army verification does not relieve the permittee of theresponsibility to obtain any other re q u ired Fed era],
State or local approvals/permits.

If there are any questions regarding this verification, any of the conditions of the Penn it, or the Corps of Engineers regulatory
program, please contact Gregory Currey at [phone] or at Greaorv.E.Currev a),usace.army.mil.
CURREY.GREGORY. Diyivny,i9awny
EUGENE.10510119 EUPPEY.GHEGOPVEUGENEI8518
1950
Corps Regulatory Official: _50 Datc20314138103355 05'CO' Date: January28.2021
Expiration Date of Verification: December31.2021
A. Determination of Jurisdiction:
1. ❑ There are waters, including wetlands, on the above described project area that maybe subject to Section 404 ofthe Clean
WaterAct (C WA) (33 USC § 1344) and/or Section 10 ofthe Rivers and Harbors Act (RHA) (33 USC § 403). This prelim inary
determination is not an appealable action underthe Regulatory Program AdministrativeAppealProcess (Reference 33 CFR Part
331). However, you may request an approved JD, which is an appealable action, by contactingtheCorps district for further
instruction. Please note, if work is authorized by either a general or nationwide permit, and you wish to requestan appeal of an
approved JD, the appeal mustbe received by the Corps and theappeal process concludedpriorto the commencement of any
work in waters of theUnited States and priorto any work that could alterthe hydrology ofwaters of the United States.
2. ❑ There are Navigable Waters of the United States within the above described project area subjecttothe permit requirements
of Section 10 ofthe Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean WaterAct (C WA) (33 USC §
1344). Unless there is a change in the law or ourpublished regulations, this determination maybe relied upon for a period notto
exceed fiveyears from the date ofth is notification.
3. ❑ There are waters, including wetlands, within the above described project area that are subject to the permit requirements of
Section 404 of the Clean WaterAct (C WA) (33 USC § 1344). Unless there is a change in the law or ourpublished regulations,
this determ ination maybe relied upon for a period not to exceed five years from the date of this notification.
4. ® Ajurisdictiondetermination was not completed with this request Therefore, this is not an appealable action. However,you
may request an approved JD, which is an appealable action, by contactingthe Corps for further instruction.
5. ❑ The aquatic resources within the above described projectarea have been identified under a previous action. Pleasereference
the approvedjurisdictional determination issued . Action ID: SAW-
B. Basis For Jurisdictional Determination:
C. Remarks:
D. Attention USDA Program Participants
This delineation/detemninationhas been conductedto identify the lim its of Corps' Clean WaterActjurisdiction forthe particularsite
identified in this request. The delineation/determination may notbe valid forthc wetland conservation provisions of the Food Securiy
Act of 1985. If you oryourtenant are USDA Program participants, or anticipateparticipation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, priorto starting work.
E. Appeals Information for Approved Jurisdiction Determinations (as indicated in A2 and A3 above).
If you object to this determination, you may requestan admin istrative appeal under Corps regulations at3 3CFRPart331. Enclosed
you will find a Notification ofAppeal Process (NAP) fact sheet and Request forAppeal (RFA) form. Ifyou request to appealthis
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division RECEIVED
Attn: PhilipShannin, Appeal Review Officer
60 Forsyth Street SW, Room 1 OM 15
Atlanta,Georgia 30303-8801 jAN 2 8 2021
MP SECTION
DCM - MHD, CITY

Phone: [phone]
In order for an RFA to be accepted bythe Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under3 3 CFR part 3 31.5, andthat it has been received by the Division Officewithin 60 days ofthe date ofthe NAP. Shouldyou
decide to submit an RFA form, it must be received at the above address by
It is not necessary to submitan RFA form to the Division Office ifyou do notobjectto the determination in this
correspondence.
CURREY.GREGOR 1 •E Digitally signed by
CURREY.GREGORY.EUGENE.105101195
Corps Regulatory Official: UGENE.1051011950 Date: 2021.01.2810:34:01-05'00'
Gregory Currey
DateofJD: Expiation Date DOD:
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at
http://corpsmapu.usace.arrny.miYcm apex/f?p=136:4:0.
Copies fumishedby email:
Jimmy North
Curt Weychert (NC DCM)
Patrick Am ico (NC DCM)
Robb Mairs (NC DWR)
RECEIVED
JAN 2 8 2011
MP SECTION
DCM - MHD CITY

Action ID Number: SAW-2020-02100
Permittee: Michael Oktavec
Project Name: 213 Marsh Hen Drive/Michael Oktavec
Date Verification Issued: January 28, 2021
Project Manager: Gregory Currey
County: New Hanover County
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Gregory Currey
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
RECEIVED
JAN 2 81011
MP SECTION
DCM - MHD CITY
Signature of Permittee Date

Fur UN U f1 9.1\ 1 I
To: Curt Weychert
From: Michael Christenbury, Wilmington District Planner
Subject: Consistency Determination, Major Permit Application, Michael Oktavec,
Wilmington, New Hanover County
Date: February 4, 2021
Consistency Determination:
This project.appears to be consistent with the 2006 Wilmington -New Hanover County
Joint Land Use Plan.
The applicant proposes to expand a private docking facility on the parcel with a new
floating dock, increasing the slip count by two, for a total of 4 boat slips within the
riparian corridor. The project is located at 213 Marsh Hen Drive in Wilmington, New
Hanover County.
Areas of Environmental Concern (AEC's) impacted by the proposal are EW-ORW and
PT. Waters at the project site are classified as SA and not open to the harvesting of
shellfish. The area is Primary Nursery Area.
I have reviewed this proposal for consistency with the 2006 Wilmington -New Hanover
County Joint Land Use Plan and offer the following comments.
The general area of the project is classified as Resource Protection while the AECs
impacted by the work are classified as Conservation.
In general, Wilmington -New Hanover County allows development in Conservation
classified AECs, which is consistent with the State's minimum use standards. The 2006
Wilmington -New Hanover County Joint Land Use Plan contains some policies, which
exceed the State's minimum use standards. However, none of these standards appear to
be applicable to this proposal.
This project appears to be consistent with the 2006 Wilmington -New Hanover County
Joint Land Use Plan
Cc: File RECEIVED
FEB 04 2021
MP SECTION
DCM : MHD CITY

NORTH CAROLIM,
C' nvironmenlal Oualut
November 25, 2020
MEMORANDUM:
FROM: Curt Weychert, Assistant Major Permits Coordinator
NCDEQ - Division of Coastal Management
400 Commerce Avenue, Morehead City, NC 28557
Fax: [phone] (Courier 11-12-09)
curt.wevchert(cDNCDEN R.aov
SUBJECT: CAMA
Applicant: Michael Ocktavec
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
BRAXTON DAVIS
Dlreclor, Division ojCo nal
Management
Project Location: 213 Marsh Hen Drive, adjacent to Channel Haven canal, in Wilmington, New Hanover
County.
Proposed Project: Proposal to expand a private docking facility by increasing the slip count from two (2)
to four (4) boat slips within the riparian corridor.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form to Curt Wevchert at the address above by December 22, 2020. If you have any
questions regarding the proposed project, contact Patrick Amico at [phone] when appropriate, in-depth
comments with supporting data is requested.
REPLY: This agency has no objection to the project as proposed.
**Additional comments may be attached**
This agency has no comment on the proposed project.
PRINT NAME
AGENCY
SIGNATURE
DATE
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects to the project for reasons described in the attached comments.
State of North Carolina I Environmental Quality i Coastal Management
127 Cardinal Drive Ext., Wilmington, NC 29405 919 7% 7215

DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Michael Oktavec
2. LOCATION OF PROJECT SITE: Site is located at 213 Marsh Hen Drive, adjacent to the Channel Haven canal, in
Wilmington, New Hanover County.
Lat: 34.152051 N Long:-77.864821 W
3. INVESTIGATION TYPE: CAMA
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit — 10/29/2020 Was Applicant Present —No
S. PROCESSING PROCEDURE: Application Received — 11/16/2020 (complete) Office —Wilmington
6. SITE DESCRIPTION:
(A) Local Land Use Plan— Wilmington - New Hanover County
Land Classification From LUP— Residential, Conservation
(B) AEC(s) Involved: PTA; EW
(C) Water Dependent: Yes.
(D) Intended Use: Private Community
(E) Wastewater Treatment; Existing- Municipal Sewer
Planned- N/A
(F) Type of Structures: Existing-. single family residence, bulkhead, platform on uplands, fixed pier:and
floating dock
Planned- construct floating dock expansion to accommodate 2 additional slips for a total of 4 slips on
the property
(G) Estimated Annual Rate of Erosion: N/A
HABITAT DESCRIPTION: [AREA]
DREDGED FILLED OTHER
(A) Vegetated Wetlands (Coastal)
300 SF
(B) Non -Vegetated Wetlands (Open Water)
additional
incorporated
PTA
(C) Other- Highground disturbance
(D) Total Area Disturbed: 300'ftl'(0:006 acres)
(E) Primary Nursery Area: Yes
(F) Water Classification: SA Open: No
B. PROJECr SUMMARY: The applicant proposes to expand a private docking facility on the parcel with a new
floating dock,increasing the slip count by 2, for atotal of boat slips within the riparian corridor.

Michael Oktavec
Page 2
9. PROJECT DESCRIPTION
The pr'oject site is located at 213 Marsh Hen Drive, on the Channel Haven Canal, in Wilmington, New Hanover County. The
property of interest is approximately 0.36 acres in size, and contains approximately 105 LF of shoreline which is stabilized
by an existing timber bulkhead. The property contains a single family residence, and the vegetation consists primarily of
ornamental shrubs, landscaping, and turf grass. The property elevation averages approximately 10 ft. above mean sea
level. Vegetation on the property consist primarily of live oaks, ornamental shrubs, landscaping and turf grass.
A search of CAMA permit history has determined that in 2007, a previous property owner obtained CAMA General Permit
49141D for construction of a bulkhead and original docking facility. In 2008, a different previous property owner obtained
CAMA General Permit 51318D to replace the bulkhead in the same footprint. In 2018, the current property owner
obtained CAMA General Permit GP-70878 to construct a 6' x 18' section of floating dock.
The property contains an existing private docking facility with two existing slips. Immediately landward of the bulkhead
in the northeastern corner of the property there is an existing upland decking area (8' x 32'). From the same comer of the
property, a fixed access pier (8'x8') extends waterward from the bulkhead, and from the western side of the access pier,
a gangway extends parallel to the shoreline, leading down to a 6' x 35' floating dock which is oriented parallel to the
existing bulkhead.
The 2016 New Hanover County CAMA Land Use Plan classifies adjacent waters as Conservation, and the adjacent high
ground portion of the project area as Watershed Resource Protection Area. The waters of the canal are classified SA by
the Division of Water Quality. They are designated as a Primary NurseryArea (PNA) by the N.C. Division of Marine Fisheries
and are CLOSED to the harvest of shellfish.
PROPOSED PROJECT
The applicant proposes to expand a private docking facility on the parcel with a new floating dock, increasing the slip
count by 2, for a total of boat slips within the riparian corridor. For this proposal, the applicant is proposing to
construct an additional floating dock (50"x 6')';extending_in a westerly direction from the existing floating dock, parallel
to the shoreline. According to the application'materials, the proposed floating dock would serve as two additional slips,
at water depths ranging from O.S' @ NLW on t_he landward side of the floating dock to 2.0' @ NLW on the waterward
side of the floating dock (See Drawing 1 of 2). These water depths were verified by NC DCM staff on site. As proposed,
the facility expansion would encroach on the western (209 Marsh Hen Drive)15 ft. riparian corridor setback, but the
appropriate setback waiver has been obtained."
10. ANTICIPATED IMPACTS
The proposed docking facility would extend 9 ft. ,into a waterbody measuring approximately 50 ft. across which would
meet the''/<width distance. The proposed structures would incorporate an additional 300 sq. ft. of public trust area and
estuarine waters. According to. the application materials, the docking facility would be located approximately 4 ft from a
docking facility to the west, and 9ft from aprivate docking facility to the east. The proposed facility would provide dockage
for two (2) more vessels for a total of four (4) vessels in water depths of approximately 2.0' at NLW. Minor increases in
turbidity should be expected during the construction.
Submitted by: Patrick Amico Date: November 23 2020 Office: Wilmington

RECEIVED
7
OCT 27 2020
DCM WILMINGTON, NC
l �i `i'_O_l.:y ei `O_`!� _.LX O� �GS _ 9 /on�S�ea vcL [ ,
/ 5C .S O r X-iJ i2 inD

APPLICATION for
Mayor Development Permit
(last revised 12127/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1, Primary Applicant/ Landowner information
Business Name
Project Name (if applicable)
Applicant 1: First Name
a C
MI
Last Name �1
(Dk IQ Jc
Appkant 2: First Name
MI
Last Name
Haddldaral applicants, please attach an additional pages) wlM names listed.
Mailing Address
PC Box -
Ctty
State
ZIP
Syo9
Country
u _
T'11/0-
hone No.
59(r3 65
FAX No.
Street Address (ddifferent/rom above)
City
State
ZIP
Email /
CLQGt/ g000.0eC 112 Sr-i0!./1C0 �l
2. Aylsnt/Con(ractbr %n/pnt>Ial(n
Business Name
Agent/ Contractor is First Name
MI
Last Name
Agent/ Contractor 2: rst Name
MI
Last Name
Melling Address
PC Box
City
State
ZIP
PSNo 3
Phone No. 1
LI'/o -;-3/ 85/y ext.
Phone No. 2
ed.
FAX No.
Contractor #
Street Address (f d flerent from above)
City
State
ZIP
Email � �
iHtt Y1rvo✓YL—.Cu.
S/4ar/•Ce✓ti
<Form continues on bacb rvECENED
OCT 2 7 2020
252-808.2608 1.888-4RCOAST .. www.nceoastalmanagem}4p�L, -r.,r, ,
l';4

Form DCM MP-1 (Page 2 of 4)
APPLICATION for
Major Development Permit
3 Project Loceflon
County (can be multiple)
Stre�Address
State Rd. 1f
Pw (-la..�oosr
a/su ('f e.-� I✓/.
Subdivision Name
(2k4 p�J
City
State
Zip
Phone No.
Lot No. (a) (Nmany, attach additional page with list)
9/0- SS5 - sN65 ext.
I , "1- 5y
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
/
co e �f'o r
cho�'�f Noe.>� c4No
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
[]Natural EdMarrmade ❑Unknown
f4450N bore ,Sdu'OI
e. Is proposed work within city limits or planning jurisdiction?
I. N applicable, list the planning jurisdiction or city limit the proposed
Yes ❑No
work falls within. / � e
eJ; r+r...g ry � N
4. Site Description
a. Total length of shoreline on the tract (ft.)
'
b. Size of entire tract (sq.tL)
/a >)
/s6s2 ss'F/'
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level) /O
I S Do - / ( o0 o SS{y
(I) many lot sizes, please attach additional page with a list)
taNHW or ❑NWL
e. Vegetation on bad /
La /-iAc4io ro/
I. Man-made features and uses now on tract ry
I
Iou
NpuSC'� /
g. Identify and describe the existing land uses adiacent to the proposed project site.
(`ems"de, ia( use
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
! _er /VI a /
v rJ
(Attach zoning compliance certificate, if applicable)
�r°5
.Yes ❑No ❑NA
j. Is the proposed activity pad of an urban waterfront redevelopment proposal? []Yes RNO
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes Wo ❑NA
If yes, by whom?
I. Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes U1810 ❑NA
National Register listed or eligible property?
<Form continues on next page> RECEIVED
OCT 2 7 2020
3a3-608.2808 .. i-888-4RCOA8T .. www.nccoastalmonagament.net

Form DCM MP-1 (Page 3 of 4)
APPLICATION for
Major Development Permit
m. () Are there wetlands on the site? []Yes RNo
(11) Are there coastal wetlands on the site? ❑Yes Mlo
(III) If yes to either (i) or (ii) above, has a delineation been conducted? ❑Yes []No
(Attach documentation, it available)
n. Describe existing wastewater treatment facilities.
CIDC'J/7 Sewe.
o. Describe existing drinking water supply source.
CFPUA-
p. Describe existing storm water management or treatment systems.
/r
SU 44CG PU�0-+-F
5. Activities and Impacts
a.
Will the project be for commercial, public, or private use? ❑Commercial
❑Public(Govemment
(7 ; )&Ur= j$Prtvate(Community
b.
Give a brief description of purpose, use, and daily operations of the project when complete.
/4//6 -> Jot: 0,5 -Poi b-aI/s.
c.
Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
�S 3�10/rp Ow> Si e
r�l0-'dC�oo
d.
list all development activities you propose. /
-� 1..(Y;" do C c
X, q& I1 o. S
e.
Are the proposed activities maintenance of an existing project, new work, or both?
r�Fw wO��c
I.
What is the approximate total disturbed land area resulting from the proposed project?
❑Sq.Ft or [:)Acres
(�ONL
g.
Will the proposed project encroach on any public easement, public accessway or other area ❑Yes o
DNA
that the public has established use of?
It.
Describe location and type existing and proposed discharges to waters of the state.
��off
f>(Ae e Cun o -C
I.
Will wastewater or storrnwater be discharged into a wetland? ❑Yes Eallo
DNA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ❑No
❑NA
j.
Is there any mitigation proposed? ❑Yes SNo
❑NA
If yes, attach a mitigation proposal.
<Form continues on bacio RECEIVED
OCT 9 7 2020
252.8J8.28u`8 .. 1-883-4RCOAtST .. vnww.nccoastalmar.agament.nat
..

Form DCM MP-1 (Page 4 of 4)
APPLICATION for
Major Development Permit
6. Addhlonal Mtonnation
in addition to this completed application form, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (f) are always applicable to any major development application. Please consult the application
Insbuotion booklet on how to properly prepare the required Items below.
a. A project narrative.
b. An accurate, dated work plat (including plan new and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A she or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENA.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
u5 5 S - Phone No.
Address (7 Mo. sLm li—le-,• 7 r ° /nin 3t/a AJ C `1lbfo 4
}-� ems, Phone No.
Name %Vea�MtA,b /rA(/�Y"P�rr-e T '/
Address A- i )-'-a,S(+
Phone No.
Name
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permtttee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
i. Wetland delineation, if necessary.
J. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10),rf necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
7 Certification and PennleWan to Enter on Land I II
I understand that any permit issued In response to this application will allow only the development described in the application
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date SAt o Print Name
Signature
Please indicate application attachments pertaining to your proposed project.
❑DCM MP-2 Excavation and Fill Information ❑DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
J09CM MP-4 Structures Information
OCT 2 7 2020
252.808-2808 41 1•888-ARCOAST .. www.nccoastalmanagarmemt.nzt

Form DCM MF-4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. DOCKING FACILITYWARINA CHARACTERISTICS
a. (i) Is the docking facility/marina:
❑Commercial ❑Public/Govemment Orivate/Communily
❑This section not applicable
b. (i) Will the facility be open to the general public?
❑Yes 5iIlo
c. (i) Dock(s) and/or pier(s)
d. (i) Are Finger Piers included? []Yes %No
(ii) Number r
If Yes:
r
(iii) Length y
(it) Number
(iv) Width
(ii) Length
(v) Floating SRYes []No
(iv) Width
(v) Floating ❑Yes []No
e. (i) Are Platforms included? ❑Yes SNo
f. (i) Are Boatlifts included? []Yes Oo
If yes:
If yes:
(ii) Number
(ii) Number
(iii) Length
(iii) Length
(iv) Width
(iv) Width
(v) Floating []Yes ❑No
Note: Roofed areas are calculated from drfpline dimensions.
g. (i) Numb�ler of slips proposed
h. Check all me types of services to be provided.
d.
❑ Full service, including travel lift and/or rail, repair or
(ii) Number of slips existing
maintenance service
❑ Dockage, fuel, and marine supplies
❑ Dockage ( wet slips') only, number of slips: _
❑ Dry storage; number of boats:
❑ Boat ramp(s); number of boat ramps: _
❑'Other, please describe:
-f- 2 '
I. Check the proposed type of siting: j. Describe the typical boats to be served (e.g., open runabout,
Land cut and access channel charter boats, sail boats, mixed types).
[-]open water, dredging for basin and/or channel �' (d boc.Ys
❑Open water; no dredging required
❑Other; please describe:
k. Typical boat length: �D r I. (i) Will the facility be open to the general public?
[]Yes 090
m. (i) Will the facility have tie pilings?
❑Yea 01,10 -
(i) If yes number of fie pilings?
OCT 2 7 P020
252-808-2808 I: 1.888dRCOAST :: www.nccoastalmanactament.ne!
-- revised. 12,2T 06"`

Form DCM MP-4 (Structures, Page 2 of 4)
Z DOCK/NG FACILITY/MARINA OPERATIONS ❑This section not applicable
a. Check each of the following sanitary facilities that will be included in the proposed project.
❑ Office Toilets
❑ Toilets for patrons; Number: _; Location: A2//1
❑ Showers
❑ Boatholding tank pumpout; Give type and location:
b. Describe treatment type and disposal location for all sanitary wastewater.
Iu/t8-
c. Describe the disposal of solid waste, fish offal and trash.
d. How will overboard discharge of sewage from boats be controlled?
e. () Give the location and number of *No Sewage Discharge' signs proposed.
(ii) Give the location and number of'Pumpout Available' signs proposed.
f. Describe the special design, if applicable, for containing industrial type pollutants, such as paint, sandblasting waste and petroleum products.
g. Where will residue from vessel maintenance be disposed of?
/y�1�
h. Give the number of channel markers and 'No Wake' signs proposed. --14
i. Give the location of fuel -handling facilities, and describe the safety measures planned to protect area water quality.
What will be the marina policy on overnight and live -aboard dockage?
k. Describe design measures that promote boat basin flushing?
� w
I. If this project is an expansion of an existing marina, what types of services are currently provided?
All Ad
m. Is the marina/docking facility proposed within a primary or secondary nursery area?
❑Yes XNo OCT 2 % ZOZO
282-808•Z808 :: 1.888-4RCOAST :: wwkv.nccoastalmanaaamani.ne+. 'revised: 12i27'4o

Form DCM MP-4 (Structures, Page 3 of 4)
n. Is the marina/docking facility proposed within or adjacent to any shellfish harvesting area?
[_]Yes �Ao
o. Is the marina/docking facility proposed within or adjacent to coastal wetlandstmarsh (CW), submerged aquatic vegetation (SAV), shell bottom
(SB), or oche wetlands (WL)? If any boxes are checked, provide the number of square feet affected.
❑cw N f$ ❑snv _ ❑SB _
❑WL _ None
p. Is the proposed marina/docking facility located within or within dose proximity to any shellfish leases? []Yes Mo
If yes, give the name and address of the Ieaseholder(s), and give the proximity to the lease.
3. BOATHOUSE (mcluding covered lifts) 04his section not applicable
a. (i) Is the boathouse structure(s):
❑Commercial ❑Public/Government ❑Private/Community
(ii) Number
(III) Length _
(iv) Width .
Note: Roofed areas are calculated from drfpline dimensions.
4. GROIN (e.g., wood, sheelpile, etc. If a rock groin, use MP--2, Excavation and Fill.) gThts section not applicable
a. (i) Number
(it) Length
(iii) Width
15. BREAKWATER (a,g., wood, sheetpfle, etc.) 2f-T his section not applicable
a. Length
c. Maximum distance beyond NHW, NWL orwetlands
b. Average distance from NHW, NWL, or wetlands
6. MOORING PILINGS and BUOYS C3Vl S section not applicable
a. Is the structure(s):
❑Commercial ❑PublidGovemment ❑Private/Community
c. Distance to be placed beyond shoreline
Note: This should be measured from marsh edge, if present
e. Arc of the swing
7. GENERAL
b. Number
d. Description of buoy (color, inscription, size, anchor, etc.)
OCT 2 7 2oza
232.808.2803 n i.sa8.4RCOAST :i mowv_nccoasfalmanaifemant.nel . r,'d`; �±'i;Y,eV33ia�1"1 2T. ln6

Form ®OM MP-4 (structures, Page 4 of 4)
a. Proximity of structure(s) to adjacent riparian property lines
Note: Forbuoy ormooringpiling, use arc of swing including length
of vessel.
c. Width of water body
Sir
e. (i) Will navigational aids be required as a result of the project?
E]Yes CdNo EINA
(ii) If yes, explain what type and how they will be implemented.
b. Proximity of structure(s) to adjacent docking facilities.
I � I
d. Water depth at watennard end of structure at NLW or NWL
� r •
8 OTHER $(Thrs section not applicadl
a. Give complete description:
Date
,
ProjedNate
APpltuvRName-
Aeeliard Sid
a
OCT 2 7 i020
252-SM-2808 n i-esa-4ROCAST :: v:tv�v.nccaast�lmanaaamznt.ne2 - ravlseii: 12i27�s7�

20Y COOPER
Governor
MICHAELS.REGAN
secMary
BRWON C. DAVIS
Dlmcror Jimmy North
6314 Wrightsville Avenue
Wilmington, NC 28403
Dear Mr. North:
The Division of Coastal Management hereby acknowledges receipt of your application, as acting agent
for'Michael Oktavec, for State approval for development of the subject • property locatedat 213 Marsh
Hen Drive, adjacent to the Channel Haven canal, in Wilmington, in New Hanover County. It was received
as complete on November 16, 2020 and appears to be adequate for processingatthis time. The projected
deadline formakinga decision is January 30, 2021. An additional 75day review period is provided by
law when such time is necessary to complete the review. If you have not been notified of a final action by
the initial deadline stated above, you should consider the review period extended. Under those
circumstances, this letter will serve as your notice of an extended review. however; an additional letter
will be provided on or about the 75th day.
If this agency does not render a permit decision within 70 days from November 16, 2020, you may
request a meeting with the Director of the Division of Coastal Management and permitstaff to discuss the
status of your project. Such a meeting will be held within five working days from the receipt of your
written request and shall include the property, owner, developer, and project designer/consultant.
NCGS 113A-119(b) requires that Notice of an application be posted at the location of the proposed
development. Enclosed you will find a "Notice of Permit Filing" postcard which raustbe posted at the
property of your proposed development. You should;post this notice at a conspicuous point along your
property where it can be observed: from a public road. Some examples would be: Nailing the notice card
to atelephone pole or tree along the road right-of-way fronting your property; or at a point along the road
right-of-way where a private road 'would lead one into your property. Failure to post this notice could
result in an incomplete' application.
An onsite inspection will be made, and if additional information is required, you will be contacted by the
appropriate State or Federal agency. Please contact me if you have any questions and notify me in writing
if you wish to receive a copy of my field report and/or comments from reviewing agencies.
Sincerely,
Patrick Amico
Field Representative
cc: Curt Weychert, DCMMHC Greg Currey, USACE
Robb Mairs, DWR Linda Painter, LPO
Michael' Oktavec, Applicant
DEQR
Noahcarol[mlieparunentoFFlnvimnmental Quality I DIVL5lonorCoastalMamgement
wilmingmnofflce I' i27Cardinal DriveExtensfon I W1lm1ngtonNorth Caro6na284o5
910.796.7215

\T()'1'IC1:
CAMA PERMIT
APPLIED FOR
tin 9%,v, na
County.
COMMENTS ACCEPTED THROUGH December2Z 2=0
APPLICANT: FOR MORE DETAILS CONTACT
THE LOCAL PERMIT OFFICER BELOW:
Michael Oktavec,
913'Marsh. Hen Drive G. Div. of CoastalManagement
Wilmington, a na r. Ext.
1 mmg on, NC 284
Agent: Jimmy North a rIC mICO
[phone]

NORTH CAROLINA
bivronote ntal Oaol ili
November 25, 2020
[e-mail]
2 Pages
Star News
Legal Advertisement Section
Post Office Box 840
Wilmington, North Carolina 28402
Re: Major Public Notice:
• Michael Oktavec / New Hanover County
ROY COOPER
Gavama
MICHAEL S. REGAN
seemmy
BRAXTON DAVIS
Director. Divumn afCorotal Marm.Cement
Hello Angie: Please publish the attached Notice in the Tuesday, December 1, 2020 issue.
The State Office of Budget & Management requires an original Affidavit of Publication prior to payment for
newspaper advertising.
Please send the original affidavit and invoice for payment to Tanya Pietila at the NC Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405, 910-796-7226. Paying by credit card to the
attention of Jarimy Springer, (Customer No.70100342).
Please email a copy of the credit card receipt to me.
Thank you for your assistance in this matter. If you should have any questions, please contact me at our
Wilmington office.
Ipport & Customer Assistance
cc: MHC file
Curt Weychert - WiRO
USACE
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext, Wilmington, NC 29405 919 796 7215

NOTICE OF FILING OF
APPLICATION FOR CAMA MAJOR
DEVELOPMENT PERMIT
The Department of Environmental Quality hereby givespublic notice.as required by NCGS 113A-
119(b) that the following application was submitted for a development permit in -an Area of Environmental
Concern as designated under the CAMA; On November 23, 2020, Michael Oktavec proposed to expand
a private docking facility from two (2) to a total of four (4) slips at 213 Marsh Hen Dr., adjacent to
Channel Haven Canal, Wilmington in New Hanover County. A copy of the'application can be examined
or copied at the office of Patrick Amico, N.C. Dept. of Environmental Quality, Division of Coastal
Management, 127 Cardinal Drive Ext., Wilmington, NC 28405, (910-796-7423) during normal business
hours.
Comments mailed to BraxtonC. Davis, Director, Division of Coastal Management, 400 Commerce
Avenue, Morehead City, NC 28557-3421, prior to December 22, 2020 will be consideredin making the
permit decision. Later comments will be accepted and considered up to the time ofpernrit decision. Project
modification may occur based on review and comment by the public and state and federal agencies. Notice
of the permit decision in these matters will be providedupon written request.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: P)'
l�1 I 1 �_�jlel,
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Agent / contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: t7/0JY, " caocic.
at my property located at '� I s Hou s � 14&&
in t�a oo— County.
l 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 Own Inf m ion:
Signature
/ Mm-eG
Print or Type Name
Title
lU , �/ I ZD
Date
This certification is valid through
OCT 2 7 7020

ADJACENT RIPARIAN PROWEM OfWNER STATEMENT
I hereby certify that I own Property adjacent to %� r G e. e. � �c2 a v C ,s
(
me of Property Ovmer)
13
property located l N5/� (Address, Lot, Road, etc.)
N.C.
l'f � ( i�eu<� latia J' . in,
on (Wa4rrbod>� (Cityrrown andlor County)
The Vp"A has deemed to as shown below, the development proposed at the above location.
v 1 have no objection to this ProP°sal-
1 have objecii"a to this proposal-
DEScRip7lON AND)OR DRAWING OF PROPOSED DEVELOPMENT
()ndlvidtrat proposing dsvelopraerrt must fill in description below or aHach a site drawing)
WANE— R— S— ECTiON must be set loads a
I understand that a pier, dock, moonng Al lxeakvrater, boathouse, lift or groin
minimum distance of 15' from my area of riparian access unless waived by me. (It you Wsh to waive
the setback, you mast initial the appropriate blank below.)
�J I do wish to waive the 15' setback requiremen t ( p l e a s e i N
YiG 1 `"�(�'f IJ l�✓✓ �
I do not wish to waive the 16 setback requirement.
(Properly owner Informadon) ( t Property Owner information)
ST l Nw. A /A! 1✓x l0.0 Sr�/ N2.. :1 W'r
Pmt or Pe
Name Prs+t or Type rTeme
3/
Ad rasa -
Afa*rg Address ,�,o 3
L r Mi
c;trrsmeerrin/o- ')--31- 85/y
/C
"
reiepNumber r
/$A
/- iL �n
Date
OCT 2 7 2020
f

• Complete Items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailplece,
or on the front R space permits.
61' (rCris/ / _S&S S s
III'lll'll'IIIIIIII'IIIIIIIIII I'llllllllllllll
9590 9402 6007 0069 9513 53
7020 0090 0002 0315 2144
PS Form 3811, July 2015 PSN 7630-02-000-9053
id Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailplece,
or on the front If space permits.
t_ Article Addressed to:
i'�o0t�%.•a r %%r'c�S... `'air
5�0.� 17•�.o�b"log
IIIIIIIIII'IIIIIIIIIIIIIIIIIII I'Illillllllllll
9590 9402 6007 0069 9513 77
7020 0090 0002 0315 2151
__-
PS Form 3811, JOIy 2015 PSN 753fY02-000-g053
❑ Agent
❑ Addressee
B. R f tl� ype 7e) V, a of Delvery
O. tsdeliveryaddressdiffemntfrom t ❑ s
IfYES,anter�dgjptewcaad i ❑No
DCM W�tMINGTON, NC
140V 16 2020
—�_ Service Type
❑ Priority Mail E%prem&
r•® Adunslgnature
❑ Registered Mail"
® Adult Slgnatare Restricted Delivery
❑ RBBgglsteretl Mail Restrleted.
:'� Caruried Mahe
Dallvery
CWTull Mall Restricted Delivery
❑ Return Recept for
Calbd on Delivery
Merchandise
'aEl1l=lt Collect on Delivery Restricted Delivery
Q Signature Congrmmlon-
etl Mall
❑ signature cmil Won
Id Mail Restricted Delivery
Restricted Delivery
x L
B_ Recelid by
Domestic Return Recelpt
❑ Agent
❑ Addressee
E.--Date ot➢elivery,
LI e rn
O. Is delivery address different from ite^rr1y,,I? Yet
665
.IfN �, Qrflgr dellvery addresspelz- No
VVII�� NOV 16 202B
3. Service7ype
❑ priority Mall Expires®
o Admtslanamre
0 AenntSignatureRestdicted Delivery
D Registered MaRTM
❑RegVat dMall Reshlcled[
❑ Ca WW Mail®
❑ Q lMed Mail Restricted Delivery
trail
❑ Return Receipt for
M Coeeclon Delivery
E3 Collect on Delivery Restricted Dallvery
Merehand1w
O Signature Continuation —
insured Mail
Inwred Mail Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
Domestic Return Receipt

Mail - Amico, Patrick J - Outlook
https://outloolLoffice365.com/mail/deeplink?state=D&version=20...
<E� Reply all 111 Delete Junk Block •••
[External] Re: ADDITIONAL INFORMATION REQUIRED- Oktavec Major- 213 Marsh
Hen
Jimmy North <[e-mail]>
JN Sun 11/15/2020 8:35 AM
To: Amico, Patrick J
CAUTION: External email. Do not click links or open attachments unless you verify. send all suspicious
email as an attachment to report. s am nc.gav
To: Patrick Amico
From: Jimmy North
Coastal Marine Construction
Oktavec Major - 213 Marsh Hen Dr.
The project proponent hereby certifies that all information contained herein is true,
accurate, and complete to the best of my knowledge and belief.
The project proponent hereby requests that the certifying authority review and take
action on this CWA 401
certification request within the applicable reasonable period of time.
Thank you,
Jimmy North
On Fri, Nov 13, 2020 at 6:50 PM Amico, Patrick) <[e-mail]> wrote:
Hey Jimmy:
Just sending this as a reminder- can you request a pre -filing meeting with robb
mairs/DWR?
This can be in the form of an email- it's because of the water depths at this project
site.
Also, can you send me the two statements in an email?
The project proponent hereby certifies that all information contained herein is true,
accurate, and complete to the best of my knowledge and belief r50r,=1
NOV.1
aCM WILh . _ _
1 of 1 11/20/2020. 4:10 PM

213 Marsh Hen Dr
Wilmington, NC 28409
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draws by 1.
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IIYY RECEIVED
OCT 27 2020
DCM WILMINGTON, NC
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awn eve., cuysa i,aa
BK: RB 6085
PG: 2794 - 2795 2017028654
RECORDED
091012017 NEW HANOVER COUNTY,
TAMMY THEUSCH BEASLEY
NC FEE 526.00
REAL ESTATE
01:13:46 PM REGISTER OF DEEDS EXTX $750.00
BY ANOREACRESWELL
ASSIsO ELECTRONrALLY RECORDED
a t lal
Parcel Identifier No. R07213-012-020-000 Verified by
County on the _ day
20_
Mail/Box to: Eugene B. Davis. Jr.. P.C. Attorney at law, 1612 Military Cutoff Road, Suite 301, Wilmington, NC 28403
This instrument was prepared by: Eugene B. Davis. Jr.. P.C.. 1612 Military Cutoff Road. Suite 301. Wilmington. NC 28403
Brief description for the
THIS DEED made this PLvl = day of M—A Av�B� , 20 � '( by and between
Jaq & Jeff LLC,
a North Carolina limited liability company
6305 Gadwall Court
Wilmington. NC 28403
Michael Green Oktavec, unmarried
213 Marsh Hen Drive
Wilmington, NC 28409
Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity. e.g
corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs. successors, and assigns, and shall include singular,
plural, masculine, feminine or neuter as required by context.
WTTNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by
these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot, parcel of land or condominium unit
situated in the City of Wilmington Township, New Hanover County,
North Carolina and more particularly described as follows:
All of Lot 54 of Channel Haven, as shown upon that map of said subdivision recorded in New Hanover County Registry in
Map Book 7 at Pages 59 and 60.
Property Address: 213 Marsh Hen Drive, Wilmington, NC 28409.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 5971 page 1706
A0 or a portion of the property herein conveyed _ includes or _XL does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 7 page 59-60
Page I of 2
NC Bar Association Form No. 3 0 1976, Revised ® 1977. 2002, 2013 This standard formm stioeD-oppro�by:
Printed by Agreemem with the NC Bar Association —1981 North Carolina Bar Association —NC Bar Facto No. 3
submitted electronically by "Eugene B_ Davis, Jr. P.C." OCT 2 7 2020
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the New Hanover County Register of Deeds.

TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple. that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful
claims of all persons whomsoever, other than the following exceptions:
ad valorem taxes for current and subsequent years; applicable zoning and land use ordinances, statutes and regulations; and
applicable restrictive covenants and easements of record.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
& Jeff LLC (SEAL)
(Entity Name) Print/Type Name:
By:
(SEAL)
Print/Type me & Title: Jeffrey L. Amato, Member/Manager Print/Type Name:
Print/Type Name & Title:
Prim/Type Name &
State of - County or City of
1, the undersigned Notary Public of the County or City of
(SEAL)
Print/Type Name:
(SEAL)
Print/Type Name:
execution of the foregoing instrument for the purposes therein expressed.
,20_
My Commission Expires:
(Affix Seal)
and State aforesaid, certify that
personally appeared before me this day and acknowledged the due
Witness my hand and Notarial stamp or sea] this _ day of
Notary's Primed or Typed Name
Public
State of - County or City of
1, the undersigned Notary Public of the County or City of and State aforesaid, certify that
personally appeared before me this day and acknowledged thedue
execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this _ day of
,20_
My Commission Expires:
(Affix Seal)
Notary's Printed or Typed Name
Public
State of North Carolina - County or City of New Hanover
I, the undersigned Notary Public of the County or City of New Hanover and State aforesaid, certify that
Jeffrey L Amato personally came before me this day and acknowledged that
_he is the Member/Manager of Jan & Jeff LLC —a North Carolina ei -
_.�I'mited liability company(
inappricablcj,-end that by authority drily given and as the act of such entity, _he signed the foinstnrtwor in its name on its
behalf as its act and deed. Witness my hand and Notarial stamp or seal, this � day 9f-�,re tog � . 1� , 20L�
My Commission Expires: I — /1 Zil c
y
(Affix Seal) ROGER C VVt1ffE
NOTN2V PUBLIC
New ttartot�er Cady
NaUt Carona
My Carmisdon Etmirea Fahtuary 11, 201B
Page ? of 2
NC Bar Association Form No. 3 01976, Revised 01977, 20D2, 2013
Printed by Agreement with the NC Bar Association — 1991
Public
Printed or Typed Name
This standard form has been approved by:
North Carolina Bar Association — NC Bar Farm No. 3
OCT 2 7 :-