85538D - Khan

❑CAMA ❑ DREDGE & FILL N9 85538 A B
GENERAL PERMIT Previous permit
Date previous permit issued" � " ' �
❑New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue i i ' %1 7 ��Y Yw
As authorized by the 1ttheState of N�orth Carolina, Department of Environmental Quality and theVC
tal Resources Commission in an area of environmental concern pursuar
15A NCAC e 11kp❑ Rules attached. eneral Permit Rules available at the following link: www.dgq.nc.Yov/CAP
Applicant Name if %#I!(/1
Address �A -2. Ai e
City Mate �G ZIP
Phone # (W )11 G7 2. V�
Email SIA ry A o mal ivy. r) f+ f M 00
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑ OEA ❑ IHA ❑ UW
ORW: yes/no ' PNA: yes
iiiivvJJJJ
Type of Project/ Activity
C
rr 1 r
Shoreline Length T� LET
Access Length
Pier (dock) length
Fixed Platform(s)
i
Floating Platform(s)
Finger pier(s)
IVIES IYJ PTS
❑ SPIMA ❑ PWS
Total Platform area
GroiKLle h/#
BulkheaO Ri/xap length L F
Avg distance offshore 17
Breakwater/Sill
Max distance/ length
Basin, channel {_
Cubic yards
Boat ramp err/'.. ..... .....w.,
Boathouse/ Boatlift PfF
Beach Bulldozing t
..... ...
._ _..�........... .
Other
SAV observed: yes
Moratorium: n/a yes
Site Photos: yes JF--
Riparian Waiver Attached: yes
A building permit/zoni permii1t may be required by:
Permit Conditions J2 f '10 11.i 0
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
CityM ZIP
Adj. Wtr. Body 1 //�//,, j (natfn
Closest Maj. Wtr. Body
Y -*'
(Scale:
❑ TAR/PAM/NEUSE/BUFFER (circle of
❑ See note on back regarding River Ba,
❑ See additional notes/conditions on t
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. Please Initial)
t' Agent or Applicant Per cer' RIZED Nam

ment of Compliance and Consistency
)ermit is subject to compliance with this application and permit conditions. Any violation of these terms may
ct the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
)ermit must be on the project site and accessible to the permit officer when the project is inspected for
iliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
it, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
een obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
tate of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
nation and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules 1-1 Neuse River Basin Buffer Rules
licated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
ie River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
iivision of Water Resources. If you have any questions, please contact the Division of Water Resources at the
iington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
�S/Additional Permit Conditions:
ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
area and disposed of in an appropriate upland location.
n of Coastal Management Offices
ead City Headquarters
mmerce Ave Morehead City, NC 285S7
8-2808/ 1-888-4RCOAST Fax: [phone]
Carteret, Craven — south of the Neuse River, Onslow
>s)
th City District
3riffin St. Ste. 300
th City, NC 27909
4-3901
Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)

53C
CAMA V'DREDGE &FILL NC) 858 A 8
Preyfous Per -01
'GENERAL PERMIT Date previous Per-11 issued
4 w jModffication Complete Reissue ' ;Partial Reissue
by StAte of [N'l-troepi of f"..'on"4 tal Q�'Vtf And tl,e C tail kw,"" rvl S% Cf� A"
I �,A N(,A(- R06, ttahec e-era! Perms P,,k-% a�,- We f 0- f' 10-1,x I �k
0 7 ailtl
If L lid f I `OW-xlt Nat- A
Project Location (ComaT, 1
Street Add,es& State Road -Lot Oss) pit)
Moe 4 )-1
Enm,l 9, Subdilruon
Oty J111111—Nor
Alf,, (W Ew PTA XS 'PTS Adj Wtr Body
OFA' JHA Uw fSPIMA i J Pws clos.,,t Mal W1, 804 12,htUR\Vw-
PNA Vcs
Type of Project/ Activity oivlt i
(scale:
jr
L L L
S
(417 10 rn I v,
10 qu t 14 3 -TWTVI
0. t
T, 6,� �d b T1 W) &111-/,
6,51
OA51j I fil ,
"4q.L,at5
14 Turpziti
zi
TAKPAMINEUSE, BUFFER (curie ones
See note on back regarding KiveIr Basin rulers
ElSeeadiblional notes/conditions on back
APKV TO THIS PROUCT AND DANCE STATEMENT. Please Initial)_ A
pvtrwcom?
-3-24-22
Per c efr-'b RI fif i D N,) in
f 7-2-4-2z
400 3 1A
C h I, r 1 -0 Fm o Y Orri,r 15sumg Date EXPIFation Date

AraEN CAMA PERMIT AFf LICATJQN
Martha Khan
Name of Property Owner Requesting Permit:
143 TARPON DR
Mailing Address:
HOLDEN BEACH, NC 28462
'hone Number:
Email Address:
I certify that I have authorized Bea Dog Marine Construction, LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the fallowing proposed development:
replace bulkhead
at my property located at 143 Tarpon Drive, Holden Beach, NC ,
in Brunswick County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to eater
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Martha Khan
Print or Type Name
Owner
1
Date
Title
This certification is valid through

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL. MANAGEIIAENT
ADJACENT RIPARIAN PROPERTY OWNER NQTIFICA MNIWAP4ER FORM
Name of Property Owner- Martha Khan
Addrnss of property; 1,13 Tarpon Drove, Holders Beach, NC, Brunswick County
f Lot or Street #, Street or Road, City & Cmntyk
Agent's Name #; Sea Dora Marine Matting Address- I07 SW 9th Street
Agent's phone [phone] Oak Island, NG 28465
1 habreby comfy that I own property adjacent to It,"- above referenced
a,pp!yirr for this pop"� T` d
9 permit has described to me as shown on the attached daring the v M -1
they are proposing. A Oes ri tigrt or clrawi with dimensions must_t Dr4ywled with thm wetter
I have no objections to this ptvposal. I have nbjectimis to this prrTm--al
if yoU have objections to what is being praPosent, you must notify the Dwyision of CoaSW AAN YM"
(DCM) in wftting within 10 days of receipt of this notice. Contact infcmwtion for DCU olfic*s is
ava�lableat t :,.www.nccoast-glmanaae enL»eyx1eb1CMeSatf4rsbnacxbycaf ngf4ft4RCQAST
No rt+s onse is consrd¢red the same as no objection if you have beers notified by Certified "I
WAIVER SECTION
I understand that a pier, dock, mooring pilings, brut ramp breakwater, boathouse cx'',tl4 m�rst
be set back a minimum distance of 15' from my area of riparian access unless waived ft su(If
you wish to waive the setback, you must initial the appropriate bunk below I
I do wish to waive the 15' setback requirement
- I do not wash to waive the 15' setback requsrerrent_
(Property Owner
In�flormation)
"i�(iTI7z�J ! lY7Ar-, !
Signature
Martha Khan
YA _ er»e
f43 TARPON DR
va7, irg A dr-9sS
SUPPLY, NC 28462-1827
Clty�tate2i,�
i eieahone 1,rUM er/Er SJI AC resS
(R'paudan r CKyner Inforrrtmion)
Sr9�ctt re
Cody 8% MenZ drth Herrington
!rent or Tyvp Nart^
145 TARPON, DP
,4l OFT9 Address
SUPPLY, NC 28462-1827
L,wStateaiip
TMPtxxse Number rF�xad i!
_._
4 ZbfA
1-;dro
—
(ReV133d Aug_ 20141

■ Complete items 1, 2, and 3.
A. Signat, re
■ Print your name and address on the reverse
X ❑ Agent
❑ Addressee
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
B. Rteceived by (Printed !Name)
C. Date of Delivery
or on the front if space permits.
� T It C. • + r
r' 7 12 2
_
1. Article Addressed to:
D. Is 4livery address different from it4n 1? 13 Yes
If YES, enter delivery address below: ❑ No
I
(/Vla,r 10 fit., ►� 2� 2�1 g
I
3. Service Type ❑ Priority Mail Express8
❑ Adult Signature ❑ Registered MailT"
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I� III
ICI I
I' III
I�IIII
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O Adult Signature Restricted Delivery p Registered Mail Restrictedl
■I�{��
ij
0 Certified Mail© Delivery
9590 9402 7096 1251 $124 60
Certified Mail Restricted Delivery ❑ signature Confirmation"I
❑ Collect on Delivery ❑ Signature Confirmation
2. Article Number (transfer from service label)
❑Collset on Delivery Restnctetl Delivery Restricted Delivery
7021 2720 0001 5934 9541 [ail Restricted Delivery
PS Form 3811, July 2020 PSN 7530-02-000-9053
Domestic Return Receipt

W
Date Da
Check From !Name
Name of Permit Holler
V—d-
Check numbw
Check
amount
Permit N-6. iCwnme—
Recelat a Refun&RMDecafed
Columns
Cdumn3
Col-4
Column5
Co1umn8
Cofumn7
Co/umne
CokamnD
)22
'Pressley Wicker
same
First bank
2704
$ 200.00 GP #86079D
PA rct. 16525
)22
Terry Turbeville
same
BBBT
120
$ 200.00 GP #85456D -
PA rct. 17527
)221
Welsh Construction LLC
Stephen Settle
Corning Federal CU
1001
$ 200.00 GP #85704D
PA rct. 16519
)221
Sea Dog Marine Construction
Martha Khan
First Bank
1657
$ 400.00 GP #85538D _
PA rct. 16133
)22
Town of Oak Island
same
BBBT
87318
$ 400.00 GP #85539D
PA rct 16132 -
--
)22
-- -
Town of Oak Island
--
same
_
BBBT
-67317
$ _ 200.00 GP #85540D
PA rct. 16134
--
)22
'
- - -
PhillipSim son Jr.
same
First National Bank
1004
400.00 GP #85718D
j PA rct. 16135