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Al iiAMA El & FILL N9 85927 A B C (D
, PERMIT Previous permit -1s
GENERAL
+ Date previous permit issued S"':rZ 6
New ❑Modification Complete Reissue ❑ Partial Reissue
As authoriz byy the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC yN 1100 ❑ Rules attached. [,54 General Permit Rules available at the following link: www.deq.nc.goy/CAIv1Arules
Applicant Name kc.- X �
Address PG N-i (a0
City(. Jv.c cs^ I C '< b c. " State 1V ZIP 6 a -1 lD -t
Phone # rn2 7,3 L l'7.it
Email -N J1, 0'), 1 • I vt -a/GA cuh.
Authorized Agent
Project Location (County): l v .,...../. �G
Street Address/State Road/Lot #(s) .I � (/u
City
Affected ❑CW VJEW PTA ❑ES ❑PFS Adj. Wtr. Body %'`(V i---I /I rrar/QrarVUnk)
AEC(s): ❑OEA ❑ INA //'' �R�W ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body t^% L-J
ORW: yes/4) PNAYveslno
Type of Project/ Activity
c .;CI If /,
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s) f0 x� 2 6'
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/g
Bulkhead/ Riprap length
Avg distance offshore
Max distance/ length
Basin, channel _
Cubic yards
Boat ramp
Boathouse/ Boatlih
Beach Bulldozing--f.
Other W -( L, i ry. �•,y.,.e S
. cl e Jr4 (Scale:.Aj iS
Nit GS Q
+
SAV observed: yes ;,i "+ ;
Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: veg/ no
A buildingpermit/zoningermiit''77m� maybe required by: -
Permit Conditions (—'� N.4r i 'r- C L.,-(` s.+ eA""�
Agent or Applicant PRINTED Name
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
.. A. - Y\I
(Please Initial)
Signature••PI se read care ce statement on back of per ;N• Signature
�Znn" ; i(na t22V?-Z 1�23`2Z
Application Fee( Check k/Money Order Issuing Dalfe Expiration Date
Statement of Compliance and Consistency
This 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.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information 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 1-1 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
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(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: 910-395-3964
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021
�6AWJA / Ll DREDGE & FILL. No. 74784. A B C
Previous permit #
GENERAL PERMIT
ElModification El Complete Reissue EJ Partial Reissue Date previous permit issued
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_ ORuies attached,
) I (, Project Location: County--.
Applicant Name
Address•Street Address/ State Road/ Lot #(S)
State r�� ZIP
Phone # Subdivision ,--:---
I z -A
A City;ff I P-22L?
—
AuthorizedAgent
[,3 cw op-�EW r4 PTA I-JES 71 PTS
Affected n OF -A (--IHHF ON n- Ub A L'I N/A
AEC(s):.. o PWS: —
ORW: yes e4P PNA !nV no
Phone# River Basin - t—,
Adj. Wtr, BodyA-L�n/.-- ... .....
Closest Mal, Wtr, Body
Type of Project/ Activity (Scale; V"75
.Q=sLf� W" it
I F I i "' 1 13
Pier (dock) length 0 0
. . ........ 0 too
0
Fixed Platform(s) iple
Floating Platforn)(s) I i
-4
Finger pler(s) 0 0
t
Groin length
1
number
lU 1 6
4.
Bulkhead/ Rlprap length
wg distance offshore
max distance offshore--..-,.+...-..
Basin, channel
cubic yards.'
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length!
SAV:' not sure yes 6p;
Moratorium Iva
Photos:
Waiver Attached;
A building permit may be required,by:
(Note Local Planning jurisdiction)
Notes/ Special Conditions /1)
yes V^ I... ;. . I. - ; t "r�. ( 51 cz
w. .. 1 i , . wo
yes mgp,19. PkEY-f- DOLP, (ekliTlqo,�
A yes
liawet O.f Abb RQNT%N0 NL
I AtFLIVII It VA PIM
+ mh (.-P. eww&S
- Gtl, -
-i;-
Nbb ITtO 40WN W4Y,
(f Id I
_IX
Agent or Applicant Printed Na
Signatire "'Rase read compliance statement on back ofpermit
----1 Pip
00 ... ... ... . .. . I...
Application Ree(s) Check #
Sign
Issuing Da e
CAVwJ
RJypm
See note on back regarding River Basin rules,
YOUR AUTO INSURANCE CARD
At your convenience, please take a moment to verify that the information
listed on your auto insurance Card is correct (VIN, etc.). If there is any
discrepancy, please contact your local agent or Hagerty at
1-800-9224050, or email us at auto@hageny.com.
NORTH CAROLINA INSURANCE CARD
INSURANCECOMPANY: ESSENTIA INSURANCE COMPANY
NAMED INSURED: RICHARD SMITH POLICY NUMBER: I1`50e52
EFFECTIVE: EkPR1AT10N:
051 022 06022020
YEAR: 1998 MARE:JEEP MODEL VMANGLERSPORT
VEHICLE ID NUMBER: 1AFY29P1MPa01512
ACIDNC1221
NORTH CAROLINA INSURANCE CARD
INSURANCE COMPANY: ESSENTIA INSURANCE COMPANY
NAMED INSURED: RICHARD SMITH POLIDYNUMBER: 415 2
EFFECTIVE: E%MRATNNI:
08 2=2 08I020020
YEAR: 1998 MAKE -JEEP MODEL WRANGLERSPORT
VEHICLE ID NUMBER: IJ4FY29PI WP8N512
AC ID NC 1221
HAND DELIVER
ADJACENTRIPARIAN PROPERTY OWNER STATEMENT
(TOR A PILRWOORING PI.LIN•GSIBOATLI,FT'BOATHOUSE)
I'hercby certify that I owl) property adjacent to
(Natme•ofProperty Owner)
p) opetly located at _
(Lot, Block, Road, etc.)
(Waterbody) _ (Torun and/or County)
�) i' L� Z �� Mailing Address:
. A.p�llcant's phone #; �
He has described to me, as shown below, the.devclopmenthe is proposing at that location, and, ]
hive no objections tQ his proposal. I understand that a pierlinooring pilings / boatlift / boathouse
must be -set back, a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me, (Zf you wisli to waive the setback, you must initial the appropriate blank.
b Clow,)
_A �)Idopotwishtowaive
I do wish to waive that setback requirement.
7-7--- - -- --------------- ---------------------- --- - --------------
DESCRIPTION ANDIOIt DRAWING OF rROPOSED iIEVELOPMLN I`:
(To be filled in by individual proposing development)
RECEIVED
MAY 16 2022
----------------------------�---, ---
---------------------s��: JI Ott ItfifMGTON PVC
(Information for, Pr•oper.ty Owner Applying (R% w er Xn mation)
i'or k'ermit)
Mailing Address _PA v V' t=UJ
1') t E 1l- L c.,, "L: �`� �. �• I ~ -�.. - r —_
City/State/dip
Tc1r,phone N be(
Signature Date Date
i\i eu ow Ppk- 7-6 Z-'-
Hagerty Tip: Keep this card in the vehicle whenever it is being driven. However, o
prated your personal information, you should consider removing it when Me vehitle ie
unocwpied.
CLAIM REPORTING:
Visit our Claims page at www.hagenycom
or call Hagerty at t-e00-932-4050
Nagersy Tip: Keep MM card in the yell whenever g Is 0eing driven. However, to
protect your personal information, you should consider removing it when Me vehicle is
unoccupNd.
CLAIM REPORTING:
Visit our Claims page at www.hagelty.com
or call Hagerty at 1-e00-PII-a090.
US MAIL
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPER',IIY OWNER ST'AT—E MENT
Name of Property Owner: - 1 LH Nt2-b KAg-C I,.l - 1\ A I
Address of Property: LV-,i \JEQ I,T L-UQ 1/,LE �,E/��N, ��. , �QvN�thlluk (ovu,Th
(l.ot or Street #, Street or Road, City & County)
Applicant's phone #:�1 2 x ���- i �4_ _ Mailing Address: S ) CV-Av El•i -)T
I hereby certify chat I own property adjacent to the above referenced property. The individual applying for this permit
has described to me as shown on the attached drawing the development they are proposing. A description of drawing;
with dimensions, must be provided with this letter.
I have no objections to this proposal. 1. have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (.DCM)
in writing within 10 days of'receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Eat.
Wilmington, NC 28405-3845. DCM representatives can also be contacted. at (910) 796-7215. No response is
considered the.same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, bpathot�se, or lift 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' set back requirement.
I do not wish to waive the 15' set back requirement.
(Property Owner Inform- ion)
S igra t 're
R1 CK ( tZ-b _ 'S Y�nbs 1 --
Print or Type Name
S 1 C-Z Ay i--4J tiT
Mailing Address
City / State / lip
Telephone Number
Date —)-I O Zo
(Ri r an oer Own �-
a . •r .. _ i �L%
nn4u
'rii �rr Type N V -`C-
c�-�' 6, CaTON ��---
Jiling Addres ddresJ�
City / State / Zip
Telephone Nu ber G,G "D 36) f
Date G�
127 Cardinal Drive EA, Wilmington, North Carolina 28405.3846
Phone: 910-796.72151 FAX: 910-395.39641Internet: www,nccoastalmanagement,net
An Equal Opportunity 1 Aftlrmalive Actlon Employer — 50% Recycled 110% Post Consumer Paper
� ) C �-A� W
YOUR AUTO INSURANCE CARD
At your convenience, please take a moment to verily that the information
listed on your auto insurance Card is correct (VIN, etc.). If there is any
discrepancy, please contact your local agent or Hagerty at
1-ND-922i050, or email us at auto@hageny.com.
NORTH CAROLINA INSURANCE CARD
INSURANCE COMPANY: ESSENTIA INSURANCE COMPANY
NAMED INSURED: RICHARD SMITH POLICY NUMBER: 4P50652
EFFECTIVE: EXPIRATION:
OMO?12022 061021202a
YEAR: 20W MAKE: PORSCHE MODEL: 911 CARRERA4
VEHICLE ID NUMBER: WPDCA29932S650441
AC ID NC 1221
NORTH CAROLINA INSURANCE CARD
INSURANCECCIMPANY: ESSENTIAINSURANCECOMPANY
NAMED INSURED: RICHARD SMITH POLICY NUMBER: 4P50652
EFFECTIVE: EXPMIION:
OBOl11022 OalU111023
YEAR: 2002 MAKE: PORSCHE MODEL' 911CARRERA4
VEHICLE ID NUMBER: `NPOCA29902S650N1
ACIDNC1221
US MAIL. r'
CERTIFIED M IL — RETURN RRCEIPT REQUESTED '
DIVISION OF COASTAL MANAGENEINT
ADJ'Agr1,N ' RIPARIAN PItOi'Y ATY OWKER S'I'AT-1NIENT
Name of.Property Owner, iF' ll4J• i\1?-b - Y-AM J ' �M 1 ,fi�,,,,•_•
Address of Property: "ST CJf e J ISLE P,�gc.�1, NC.,., Q�QvrKWic k (ov►.•y\)
(Lot or Street N, Street or Road, City & County)
Applicant's phone it: Z�'L °) 3 �`� Mailing Address: S' i C.?-Atr F-W %T _
V3 iQ;N -ISLE Ott PC U4&0�
I hereby certify that I own property adjacent to the above referenecd property. The individual applying for this permit
has described to me as shown oil the attached drawing the development they are proposh% A llpscription ot'drawina.
w_.H di net, la j,�sl be Rr v'ded yj t is la to
� I have no objections to this proposal. i have objections to this proposal,
If you have objections to what is being proposed, you tnest notify the Division of Coastal ]VIAnagemout (DCM)
in writing within 10 days of receipt of this notice. Correa pondenco should be mailed to 127 Cardinal Drlve Ext.
Wilmington, NC 28405-3845. DCK representatives can also be contacted at (910)•79ti-7215. No response is
consider ad tho.same as no ob jec(ion if you hays been notified by Certified Mai!
WAIVER SEc�i ON
I titidentand theta pjgr, dock, mooring•pijig&s, breakwater, bpgthouse,�gT I ift must bo setback a minimum distance of
i 5' Fro y area of riparian access unloss waived by me• (Ifyou wish io waive the setback, you mtisi initielthe
p riate,!btauk below,)
Z V/ I do wish to waive the IS' set back requirement.
I do not wish to waive the 15' set back requirement.
(Property Owner Info rin ion) (Iti t ttn' 'o er Own 9011.
Stgnat re Sign thI ,• '
Print or Type Name Prit r Typo Name 7
S I ce tW P-Q 'ST 4) lel� ZJ 5 cl
Mailing Address M 'ling Addres
OLEAW ISLE f+ EMJ{ NC.. 1.46 ,,. Gr kt
City /State / Zip City /State / Zip
r IdTelephoneNumbor Z. 'Liz"� 3 �� Telephone Nu ber (lf.
Date z U l Data 11
, 1
1 14 1
127 Cardinal Drive Ext., Wilmington, North Caroline 284053845
Phone: 9t0-796.72151 FAX: 910.395.39641 Internet: www.nacoasta)management.net
An Eqval Opportunity I Afllrmattve Action Employer - 50% Recycled I Me Post Coosumer Paper
'4 ° C¢-nJ W
Y
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Re.Pnlr, PIEVL## V),ZLK (e:xlti-riU6� DflNIQ �S
Hagerty Tip: Keep the card in the vehcb whenever it b heing driven. However, to
proMd your personal information, you should consider hini it when Me vehicle is
umccapied.
CLAIM REPORTING:
Visit our Claims page at wvnvhagentp.com
or call Hagerty at t-900.9]]-4050.
Hagerty Tip: Keep this card In the vehicle whenever it h being drnan. However, m
protect your personal iMonnation, you should consider removing d when the "bide is
unoocupied.
CILIUM REPORTING:
Visit our Claims page at www.hagerty.cum
or call Hagerty at t-e00.930-Ne090.
�( Cj�i�s�on of Coastal Mara ement `
z:
r Cashte's O�ifcta� Receipt
CIS-
ReceivedFrojn �Mtrt �G
e'e N
s "
?c ..rIN"',
: -fir L LY . • tQ t . .,¢„GX f t �.
Permit.No w`„ 5 C3 }echo
x .. ff r� C l�G.r �i �J4 i1�iitJl �TiVr� C Y
, AppliCailt'S•Name � � � t
P.rojr
iect Address
-17
Ptease,Vatam„recryour records'as proof ofpayment:for perrnissuea.
z
Signature ofAgent or Applicant' Date'
Signature of Fietcl Representative. `' y Lpc�iz c ca�� stir .,
Hagerty Tip: Keep this card in IM ve0al whenever it is bell driven. However, b
protect your personal informal you should consider removing it when Me vehKR, u
un000u0ied.
CLAIM REPORTING:
Visit our Claims page at www hagertycom
or call Hagerty at 1d00-92240"
Hagerty Tip: Keep ihs card in the vMicte whenever it is Ming all However, to
portal your personal mforma0on, you Mould consider removing it when Me middle is
umsccumbd.
CLAIM REPORTING:
Visit our Claims page of www tragedy com
or call Hagerty at 1-600-922-4060
Dafe Recelved
Date De Ifed
Check From Name
NemeofPermk Holder
Vendor
Check number
Check
emounf
Permft Number/Comments
Recelctor Refundlft lloceted
Columnl
Column2
Col-3
Co1umn4
Cclumns
Southern Bank
Column6
5738
Column?
$ 200.00
ColumnB
GP #860001D
Column9
JD rot. 17670
5/26/2022
5/26/2022
Scott Brown
Patriot Boat Lift & Dock Maint, LLC
same
Hooper
Aquesta Bank
1202
$ 200.00
GP #85974D
PA rot. 17641
5/26/2022
H5 Construction Services, LLC
McInnis
Truist
10117
$ 200.00
GP #85756D
PA rot. 17526
5/26/2022
_
Kenneth Woodruff
same
Piedmont Advantage CU
1256
$ 200.00
GP #856851)
BH rot. 17572
5/26/2022
_
Coastal Outdoor Creations, LLC
Eanes
United Bank
1392
$ 200.00
GP #859891)
PA rot. 18028
5/26/2022
Allied Marine Contractors, LLC
K & L Real Estate Invests, LLC
First Citizens Bank
11033
$ 600.00
GP #67725D
PA rot. 17647
5/26/2022
_
Permit Pals
Anderson
CresCom Bank
3805
$ 200.00
GP #87727D
PA rct. 17646
5/26/2022
Richard Smith
same
Bank ofAmerica
1100
$ 200.00
GP #85927D
BB not. 18001
5/26/2022
S-eaDog Marine Construction
Bruck
First Bank
1702
$ 200.00
GP #85739D
BB rct. 16942
5/26/2022
Allied Marine Contractors, LLC
Cichan
First Citizens Bank
11032
$ 400.00
GP #87724D
PA rot. 18026
5/26/2022
David Devore
same
South State Bank
114
$ 200.00
GP #85796D
JD rot. 17673
5/26/2022
Charles Denton
same
BB&T
2329
$ 200.00
GP #85701 D
JD rot. 17665
5/26/2022
Overbeck Marine Construction, Inc.
mcNeely
SunTrust
5548
$ 200.00
GP #85551 D
Tmac rot. 16298
5/26/2022
Loretta Long
same
BB&T
348
$ 200.00
GP #87728D
PA rct. 17643
5/26/2022
Willis Bonkemeyer
same
First Horizon
2018
$ 200.00
GP #87721 D
PA rot. 17642
5/26/2022
Sea Dog Marine Construction
Facial
First Bank
1767
$ 200.00
GP #877830
PA rot. 18029
5/26/2022
ISea Dog Marine Construction
Rogers
First Bank
1777
$ 600.00
GP #87733D
PA rot. 18030