85557D - Nicholson

10`°"rLICAMA I I DREDGE & FILL No 85557 AB CC
a P permit )-,
D
GENERAL PERMIT Previous
Date previous permit issued
;rK I New n Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC n Rules attached. n General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name , I i2!,; /f R ' Authorized Agent ,
Address /rr t f 6" '%: 0' /{t,/ Project Location(County): ,
City 1// C4 !•`-State ( ZIP ;',/ f, Street Address/State Road/Lot#(s
Phone#(') P"I / Ci< ,
Email r-4 _ #—.9'7„dig.�) ,4/G. .., Subdivision
City ZIP
Affected rim E EW ❑PTA n ES PTS Adj.Wtr.Body (nat/man/unk
AEC(s): n OEA n IHA ❑UW ❑SPIMA ❑PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity V-(y 16 L
(Scale: 4's )
Shoreline Length
Access Length 1111111111 : --- r -
Pier(dock)length I i'
Fixed Platform(s) L__. .___ �..
Floating Platform(s) IIIIIIIIIMIIIMIIIMIMIIIIIIMNIIIMIIIIIIIIIIIIIIIIMIIIIIIIII
IIHIIIIIIIIIIIIIIIIIIIMIIIIII
Finger pier(s) ,rs' •. 1
111.111.1111111111
Total Platform area
MMIMMIIIIIIMIIIIIMIIIIEISNINIIIIMNIIIIIMI
Groin length/# : •U�i/� IMIIIMIIINMIMIIIIIIIIMIMIIIIIII
Bulkhead/Riprap length .__.__ _..._
Avg distance offshore
Breakwater/Sill _ IIIIIIIIMIIIMIIIIIIMIMIIIBIPNIIIIIIIIIIIIIMIIIIPIIIIIIIIIIIIII
��
IIIIIIIIMIIIIIIIMMIIIIIIIIIIIIIIIIIMIIIIIIIIIIIMIIIIIMIIIIIIIIIIII
Max distance/length
Basin,channel
y HE _
�. I
Cubic yards j _
Boat ramp
Boathou3e/Boatl ft`)/:; / i`
Beach Bulldozing
11.
Other l. ....�Jf[� j i
SAV observed: yes no _ M ==�
Moratorium: n/a yes no
Site Photos: yes no IIINEMA/ ---
Riparian Waiver Attached: yes iio —, '_
A building permit/zoning permit may be required by: - ('/n--, ,' j�
Permit Conditions I I TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
l l See additional notes/conditions on back
-...r/I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initiafj•
,k;1' Pi , 'Z7�' u-
Ment:o�japjica t fgRINTE�N'mo ' Permit Officer's PRINTED Name
fir' _ .. 72.
Signatire**Please read compliavlce stat ment on back of permit** Sipnaturp

statement of Compliance and Consistency
1 t
Ihis permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
rhis permit must be on the project site and accessible to the permit officer when the project is inspected for
:ompliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
3ermit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
ocal land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
las been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
fhe State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
nformation and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
3roject area and disposed of in an appropriate upland location.
)ivision of Coastal Management Offices
Morehead City Headquarters Washington District
100 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
;Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: [phone]
2ounties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
101 S. Griffin St. Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
;Serves: Bertie, Camden, Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
/ /
Name of Property Owner Requesting Permit: ,
f t14-- / V tG :tic 7/v' \J/..
Mailing Address: ! / 2 / (,4(74 f) 6-
'rS4IL , /\1 K 2 0
Phone Number: CTi D & -- 5 C)
Email Address: V T f(-t-O-T-L A R-41) 11/44A-
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: ' CAT L( �=r
at my property located at A'- ' � , 6
in 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 ner Info ation:
f,. ‘--4"-77 �
ignatu ,J
T 4705 A/fe F; a A/ .Jim--
Print or Type Name
Title
CI- / \ I '20Z-D
Date
This certification is valid through I /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �iu,�5 G LGt i 5 / d 'S
(Name of ro party Owner)
property located at 2 r 9 /9 ye Jl C
(Address, Lot, Block,Road, etc.)
on , in 7D77X4 `;'c 1 , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
ufyla- I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
AA24-A• -
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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..
I do not wish to waive the 15' setback requirement
(Pro, = • - 1 a e n) (Adjacent Property Owner Information)
M
0,144�• - E Al te,h/OL o V2 E
Print or Type Name Print or Type Name
l/Z / C44,N4o Y' 4 v c=' U 3 )6 e l-c.y(. P c/
Mailing Address / Mang Address
-Zps 4c4- J3C464/ N G 2% s ("(rrJVYrrr 1 L
City/State/Zip Citytglategip
Telephone Number Telepho a Nu er
Date Date
(Revised 6/18/2012)

ttibiafignfirsiBialingeggaglEgUMMEK
I hereby cerWy that I own property a eowd toes-onYvThp Juwy 1 Jo-o ewe
p«ty loaned at U107 Ck 64
1tc_ is *
of Povse
t 1` ot.in
- �
on In' `
N.C..
( ) mown aaidler County)
The applicant has described to me,as shown balm,the deve opment proposed at the above location.
have no*scan to his proposal.
I helve objections to this proposal.
DESCRIPTION MOM DRAWING OF PROPOSED DEVELOPttttENT
Oradtvidisal proposing thavoispoistitawat 11111 i»dsaeitpMwr below or afloat t a at:e drawling')
t•sessAc.1\,a--0"o"N ` Z- �• s a- o ems-- A..J&'
.ate 0.,""/AirC.\"44rn;`CeA•AAJ
t
Wardaigglai
I understand that a per, boa. moan pines.breakwater,boathouse,WI,or groin must be set beck a
mini nrm distance of 15'from my area of rimiest access unless waited by me. Of you rash to waive
the s lbedk,you must MIS&the appropriate tank below.?
‘4 0.1 do wish to waive the 16 setback require merit.
I do not wish to valve the 15 setback rsqu irwment.
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Pack
Date Received Dote Deposited ' Check From(Name) Name o/Permit Holler Vendor Check member amount Perm(NumberiCommente ReoNpt or Refund/Reallocated
Cdumnf Co/umn2 I Column.? Columns Columns Column( Column? Column8 Column9
2/22/20221 Jayne Nicholson same — First Citizens Bank 6875,$ 200.00 GP#85557D JD rct.16812
2/22/20221 Chad Gamer same First Citizens Bank 70141$ 200.00 GP#85592D JD rct.16566
2/22/2022 Allied Marine Contractors,LLC Donald Caison First Citizens Bank 108841$ 200.00 GP#85593D JD rct.16567
2/22/2022 Christopher Gaddy same Suntrust 16668 $ 200.00 GP#85594D JD rct.16569
2/22/2022 _ Southern Envionmental Group Glenn Hodges Wells Fargo 8509 $ 100.00 GP#85409D BH rct.16262
2/22/2022 Robbie Hodges Glenn Hodges State Employees CU 1200'$ 100 00 GP#85409D _ BH rct.16262
2/22/2022 _ _ harry gross same BB&T 2430 $ 200 00 GP#85547D _ _ PA rct.16531
2/22/2022 Sea Dog Marine Construction Bridgewater POA First Bank _ 1640 $ 200 00 GP#85528D PA rct.16545
2/22/2022 Sea Dog Marine Construction Timothy Anderson First Bank 1642 $ 200 00 GP#85527D PA rct.16546
2/22/2022 Bledsoe Enterprises Inc. Ocean Dunes HOA Twist 20242 $ 400 00 GP#85407D BH rct.16263
2/22/2022 McPherson Marine Services Grubb First Citizens Bank 4911 $ 400 00 GP#85529D PA rct.16544
2/22/2022 H5 Construction Services,LLC Allen Westbrook Twist 1004 $ 200.00 GP#85526D _ PA rct.16507
2/22/2022 Bruce Marek,PE Bald Head Island Club Wells Fargo 2153 $ 400.00 GP#85548D iTmac rot.16278
2/22/2022 Bruce Marek,PE Bald Head Island Ltd,LLC ;Wells Fargo 2154 $ 400.00 GP#85549D I Tmac rct.16277
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