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Previous permitLPERM
Date previous permit issued
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DMOdificatio
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Y�t Q� mpe'qf North CVolina, Depaftcht of Environmental Quality and'the Resources �Pqr,ltes Commission In an area of environmental concern pursuant to.
Rules attached.
General Permit Ru I a s aval lab le at the following Usk: P- MW. dM- —ncjg_o� �CQJA- tI-
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Acq*Length
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Fingerr.pler(s),
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13reakwaterlsi
'Max -distance/
-W,bbserved: yes
Moratorium; ri/
Siie Photos:
R i p6i i q i f 1AM i v Mr, Attached -
TTA 9111MMEUSERUFFPCOOdone)
44 Mly, S efhqte�on back-regarding,hilopgafln rules
See additional ftoteiftpnditiiini on hack
Slpnp,ture,
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CAMA ❑ DREDGE & FILL N9 87785 A B c. Q
GENERAL PERMIT Previous permit ~
+ Zby
Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
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As authohe State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC i � ❑Rules attached.PU General Permit Rules available at the following link: www.deq nc.pov/CAMArules
Applicant
f .)1.. ;b rcrntt� tr, (.-.-1.C.a ame � y
Address V X : �/.':•%�•!/
City H"-n+esk-c! state M C ZIP Sf 4
Phone #
Authorized
Project Location (County): U ✓ un ,I -., . tt
Street Address(State Road/lot #(s) / (e c( g{A! Coe jS CV .S ttil
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Email Subdivision
City ZIP
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AEC(s): OEA IHA yLr] uW ❑ SPIMA ❑ PINS Closest Mai. Wtr. Body • ` "t / /o6
ORW: yes/Z- PN444/no
Type of Project/ Activity ( nA V, - c 1 n � -- �
(Scale: ` S )
Shnreline l encth 4
Access Length
Pier jclock) length
Fixed Platform(s)
LL
m
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Moratorium: n/a ye
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Agent or
U TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
ID REVIE EQ COMPLIANCE STATENIT. (Please Initial)
i
Permit Officer's PRINTED Name t
Sign ure"Please read compliance statement on back peTm i
za)C( y�o7��
AppIkAtion Feels) Check p/Money Order
Signature
�9'2�•ZZ- �CJ"ZC�-L�
Issuing Date 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 El 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
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 5/5/2022
Name of Property Owner Applying for Permit:
SH Village Green, LLC
Mailing Address:
PO Box 3167
I certify that I have authorized (agent) Southern Environmental Group. Inc. to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) two boat lifts and floating platform ,
at (my property located at) (L32) 1769 Star Cross Dr. SW, Shallotte, Brunswick Co., North Carolina.
This certification is valid thru (date) December 31, 2023
a a--Zt,
Property Owner Signature Date
Postal
CERTIFIED MAIL RECEIPT
m Domestic
I-n sha.11otPPPIIIVI A L U S E
rrl Certiflad Mail Fee
ru $3.75
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❑aa.. Rx.a LlwlcepA s
0 17R...0 R.a1+ W.WW,* $ $0 fill Postmark
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■ Complete hems 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 mailpiece,
or on the front if space permits.
1. Article Addressed to:
�IC,
0
�AMGViIIL, s��9
III'III'I IIII I'IIIII II II IIII I III'I I IIIIIII III
9590 9402 5834 0038 8940 17
30 0640 0000 2723 5350
PS Form 3811, July 2015 PSN 7530-02-000-9053
A. Signature
x� G RAc 0
B. Received b (Printed Name) I VDAP
D. Is deAery address different from item 1? Lr Yee
If YES, enter delivery address below: ❑ No
Sen ica Type
❑ Priority Mail Ezpress®
Wult Signature
❑ Registered MailT"
Wult Signature Restricted Delivery
❑ Registered Mad Restricted
;edited Mail®
Delivery
%rt lied Mail Restricted Delivery
❑ Return Receipt for
;ollecl on Delivery
Merchandise
)ollect on Delivery Restricted Delivery
❑ Signature confirmation'-
rainedMail
❑ signature Confirmation
inured Mail Restricted Delivery
Restricted Delivery
Domestic Return Receipt
SF.G�
Southern Environmental Group, Inc.
5315 South College Road, Suite E
Wilmington, North Carolina 28412
910.452.2711 (office) • 910.452.2899 (fax)
Transmittal Letter
Date:
5/10/22
To:
Brendan Brock
Of:
DCM
Attached you will find:*
Proposal Sketch(es) <Zt A licati Signed Wetland Map
JD Package Report(s) Plans Information Request
Photo(s)
Other
Copies
Dated
Description
1
CAMA GP Site Plans gent Authorizations, Certified Mail Green Cards
and Receipt and Filing Fees or Lots 28 & 32 Village Green,
Shallotte, Brunswick Co.
These are being delivered:
or Processing
Corrected and Returned
Other.
If noted items are NOT attached, please contact our office.
For your Records Returned for Correction(s)
For your Signature as Requested.
By: and Delivery Fed -Ex UPS US Postal Service Other
Signature and (Typed) Name: za
Dana A. Lutheran
Date: 5/10/22
Track your package
Data provided by USPS
Tracking number 70200640000027235435
Delivered QQ
June 10, 11:56AM
Shallotte, NC
View details on USPS
k. Call1-800-275-8777
l% Track another package
[External] RE: Lot 32 delivery confirmation
dlutheran@segi.us <dlutheran@segi.us>
Tue 6/14/2022 12:59 PM
To: Brock, Brendan O <brendan.brock@ncdenr.gov>
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to Reps
5Pam.
Brendan, I called the BC tax office, who found another address for Megan Bellamy, so I mailed it there (see attached). I spoke
to William Bellamy this morning. His number is 910.228.2231 and his email address is wkbellamy3@gmail.com. He has been
notified and I may have picked up some work. This time the aggravation paid off. LOL
I think you have everything you need to issue the pier permits. If not, do not hesitate to call.
Dana
Southern j-nvironmental Goup, Inc
5515 5outb College Road, Suite E
Wilmington, NC 28412
Phone: y 10.+52.21 1
Mobile: 910.226.18+1
www.segws
From: dlutheran@segi.us <dlutheran@segi.us>
Sent: Thursday, June 2, 2022 11:21 AM
To:'Brock,Brendan O'<brendan.brock@ncdenr.gov>
Subject: RE: Lot 32 delivery confirmation
Hi, Brendan.
Left you a voice mail. Call me when you have time.
5outbem Environmental Coup, Inc
5315 5outk College Road, Suite F
Wilmington, NC 28+1 2
Phone: 910.452.21 1
Mo6ilc: 91 o.228.1 841
W W W.5CQLU5
From: Brock, Brendan O <brendan brock@ncdenr.gov>
Sent: Thursday, June 2, 2022 10:32 AM
To: dlutheran@segi.us
Subject: Lot 32 delivery confirmation
Hey Dana just checking in to see if you ever got delivery confirmation for Lot 32's adjacent neighbor. I know you said
they had moved but somebody still owns that lot.
Brendan Brock
Field Representative
NC Division of Coastal Management
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to SH Village Green LLC _ property,located at ..1769 Star
(Property Owner) (Property Owner Address)
Cross Drive SW. which is located on Annv's Branch in Shallotte,'Brunswi& County, NC.
(Waterbody Name) (City, County)
_ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description: belowrvor attach a site drawing)_
The applicant has described to me, as shown below, the development proposed at the above location.
Installinga boat lift and a floating platform (see attached. site. plan)
t� I have no objection to this proposal.
I have objections to this proposal.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (if -you:-wish to: waive
the setback, you _must initial the appropriate blank below.)
NA I do wish to waive the 15' setback requirement.
do not wish to waive the 15' setback requirement.
Property Owner Information:
Signature*
Dana Lutheran for SH. Village Green, LLC
Print or Type Name
5315 South College Road, Suite E
Mailing Address
Wilmington, NC 28412
City/State/Zip
910.228.1841
Telephone Number/email address
4/26/22
Date
Adjacent Property Owner Information:
City, tate/Zip
To .-
Telephone Number/e ail ddcess
Date
*Valid for one calendar year after signature (Revised Aug. 2014)
111 Complete items 1, 2, and 3.
H Print your name and address on the reverse
so that we can return the card to you.
iN Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
l l i ll III � II i �l1111 111 IN11l1 II
9590 9402 6443 0346 7396 03
2. Article Number (rransfer from service labnfl
120 0640 0000 2723 5435
PS Form 3811, July 2020 PSN 7530-02-000-9053'
L, Z Ve - ,
❑ Agent
❑ Addressee
B. Received by (Punted Name) C.Pate f pelilvery
a -,
D: Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
0 Service Type
❑ Adult Signature
❑ Priority Mail Express®
❑ Adult Signature ResMcted DaDvery
&C" -Ol ed Mali®
❑Registered Mail-
❑ DRagi' or d Mail Restricted
�llivvee
❑ Certified Mail Restricted Delivery
❑ Collect on Delivery
❑ Signature Conrumatlon-
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
❑ Insured Mail
❑ Insured Mail Restricted Delivery
Domestic Return Receipt
1x
100
2:13:58 PM
JOKI
2
0 Fish icons
Date Received
Date Deposited
Check From Name)
Name o1Permh Nokler
Vender
Check number
Check
mount
Aumh NumberlComments
Receipt or Refund/Ree6acWed
Columnl
Column2
Cnlumn3
Column4
Columns
Co1umn6
Column?
Column6
Column9
6/23/2022
Dominion Land Corporation
SH Village Green, LLC _
Suntrust Bank _
990754
$ 200.00
GP #87785D _ _ _
BB rot. 18018
6/23/2022
_
Donald Barefoot
Oscar Charlies Chewning JR
Truist _ _
5138
$ 200.00
GP #87712D
BB rot. 18014
_
6/23/2022
_
John McClure
Omar Ramirez
United Bank
1040
$ 200.00
GP #85715D _
BB rct. 18013 _
6/23/2022
_
Sea Dog Marine Construction
_
Whignant _ _
First Bank
1790
$ 200.00
GP #87782D
lBBrct. 1818012
6/23/2022
_ _
Cohen Construction Inc.
Smith
Truist _ _
9691504
$ 200.00
GP #87713D _
BB rct. 017
6/23/2022
Coleman Buildinq Co.
_
Rap_
First Bank
3611
$ 200.00
GP #87783D
BB rot. 18015
6123l2022
Paleo Properties, LLC
Redmond
First Bank
591
$ 200.00
GP #87788D
BB rot. 17993