87681D,DIXON

�o1°``°ASr"1&❑CAMA ❑ DREDGE & FILL n-U DA
GENERAL PERMIT)I
❑New [:]Modification ❑ Complete Reissue ❑ Partial Reissue
N9 87681. � 8:,.. c (, EX
Previous permit
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality and the Coas 1 Resources Commission in an area of environmental concern pursuant to:
15A NCAC J -1 i-J _ I � f� ❑ Rules attached. General Permit Rules available at the following link: www.dgq.nc.Yov/CAMArules
Applicant Name r I Authorized Agent C. L r
Address Al 4 Project Location (County):
City i State Ci zip -3I .• Street Address/State Road/Lot #(s) y
Email Subdivision _
City Lkl %P1ttSLl _ zip
Affected ❑ CW ❑ EW 0 PTA ❑ ES ❑ PTS Adj. Wtr. Body �Tr% (natMi A/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes*
Type of Project/ Activity 17 , 7,0_S U`
& A
Shoreline Length
Access Length A!r_%4jl�4
Pier(dock)length ---+
Fixed Platform(s) 7 a (1
Floating Platform(s)
Finger pier(s)
Total Platform areal f C IF ( 1rVII
Groin length/# - "'
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill r
Max distance/ length
Basin, channel
Cubic yards .�
Boat ramp
Boathouse/ oa� k
Beach Bulldo'iing
Other
SAV observed: yes
Moratorium: n/a yes Q/
Site Photos: ye I
Riparian Waiver Attach d: no
IK I
A building permit/zoning permit May be required by:
Permit Conditions i . l L4 t G', o //
(Scale: N7S )
i
j
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (please Initial)
Agent or
LUL
Name
Signature **Please read c mpliance statement on back of permit** Signature
Application Fee(s) Chec #/Mo�c ney Order Issuing Date Expiration Date

CoVOW4', �CAMA DREDGE & FILL Nn 87681 A B Co
Previous permit
GE
NERAL PERMIT
Date previous permit issued
(@-[/New
U Modification L Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina. Department of Environmental Quality and the Cori 1 Resources Commission in an area of environmental concern pursuant to
I SA NCAC , 1� _� Rules attached. Vneral Permit Rules available at the followin link tL_ v Ics
g_�Aru-
Applica4(J).8k3_0_;L6A_
A It-
f
Addres.
ZL
City -_ 1 State ZIPPhone
Email MAAM&Yli)�trq i • fLitld� _
Authorized Agent C'J%- L.____----.— -_—
Project location (County) _,A17X5 k d C k -
Street A�d�drre'ss/St�ate�d/Lot #(s) ._ ---
�{
Subdivision _p_�
City__ W �_ D�(LLit.�► _ ZIP
Affected CEW PTA ES E] pTS Adl. Wtr Body_
FJyy
AEC(s) OEA INA D t1W SPIMA PWS Closest Mal Wtr Body
ORW vp,n PNA. yes/®
Type of Project/ Activity 7�7 CeJqSt7Vd Ofl.cT74
(nad�unk)
a I gn LAIr�
k- 1•f
(Scale: &/7S
Shoreline length I.Ir
Access Length 11116
Pier (dock) length - .-�+
Fixed Platfarmjs)
floating Platform(s) 4
,M r�► r"il
�Cllal�ll�
Finger pier(sl �^
Total Platform area its tAucw'y
Granlength/tr_ —
Bulkhead/ Riprap length
w
rr
Avg distance offshore r
evil-Jrwi
9
Breakwater/Siff
T
Max distance/ length
Basin, channel
1 C
Cubic yards
Boat ramp
C
Boathouse/ ail
�� IG
M
Beach Bulldozing
Other
.r ynt
P h t�
1 `r
k
SAV
observed yes
Moratorium n/a yes
1 �b%
1rySW7
Site Photos C
Riparian Waiver Atta 6 no
tin
��inon (),t%DlYon
L t ltK
/
l
be
by
A building pefmit/zonin permit m required
i'l
Permit Condi nz
IF.�
!�_. -.-
TAR'PAM. NEUSE'BUFFER (circle one)
_-
rpa
t_'iV^rr�--�-�i%Q�
�����y�=-Y-❑See
note on back regarding River Basin rules
-------
— --
See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.-Arease Initial) KD
Kyle Dixon __ D' trr[' Atlm
J"Agent or Applicant PRINTED Name �• 1Iyr- r/�t_l�
KYI. Din! (Sep 1, zo]'� =.:C E.7
gnature --Please reo dC npliance statement on back of permit"
Application Feels) Chec • N/Money Order,
Name
Signature
'e,11%�A z � �/Z 11.42
Issuing Date Expiration Date

*NOT A SURVEY (NOT TO SCALE) 8.3.2022
--5'to P/L
-19' to P/L
Established Pier Headline
Proposed Lift
14x14
Waterbody Width: 93'
1/4 Width: 23.25'
FT Bulkhead to end of structure
23' CW to end of structure
-24' to P/L
_ Coastal Wetlands Boundary
—P/L - — - — - — - — Aggrgx_5' off bulkhead to
edge of CW — - -' - —
CANAL =>
Existing Floating Dock
8X16
UP
>:xis�ng LAMA No. 74256
Issued (8/l/19)
struCIUMS
1OX12
Existing Fixed Platform
(CAIN) 121 Salisbury
-16' to P/L
— - — - — -Coastal Wetlands Boundary
m
(CANNON) 117 Salisbury 119 5aiisbury 5treet (DIXON) Existing Bulkhead w/
Waiver Needed* Hoiden Beach NO 28462 return wall (50' frontage)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Kyle and Mari Dixon
6375 TABOR CHURCH RD
FAYETTEV ILLE, NC 28312-7263
910-813-0262
moheiii!d embargmail.com kaldonii 1115((ticloud.com
CPG, LLC / Richardson Construction
Agent i Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
add boat liift to existing
necessary for the following proposed development:
at my property located at
Rn incv✓irk
in
County.
119 Salisbury (Holden Beach)
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 enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
,. zozz 07:22 EDT,
Signature
Kyle Dixon
Print or Type Name
Property Owner
Title
8 l 3 1 2022
Date
8 3 2023
This certification is valid through I I

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Kyle and Mari Dixon
Address of Property:
Mailing Address of Owner:
119 Salisbury (Holden Beach)
6 ',75 Tabor Church Rd. Fayetteville. NC28 , 12
Owner's email: kaldonia 11 15C icloud.conr
Agent's Name: C-PG, LLC (Ben Brink)
Agent's Email: benCa)coastalpermitguy.com
Owner's Phone#: [phone]
Agent Phone#: [phone]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that 1 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 or drawing, with dimensions, must be provided ,vith this letter.
tl A�91 z°_> I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC 28405-3845. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed 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 .,aived by me
(this does not apply to bulkheads or riprap revetments). iIf you wish to •:✓give the setback. you must sign
the appropriate blank below.)
I DO ✓ish to •naive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: F-1ACai,iAvge 2022­17EDT
Typed/Printed name of ARPO: Paul and Arun Cain
PAC
Mailing Address of ARPO: 1401 Barnside Ln. Apes. NC 27502
ARPO's email: pawl cain(e bellsouth.net ARPO's Phone#:[phone]-545-42 ',2
Date: Aug 6, 2022 =waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

Cain APO
Final Audit Report 2022-08-06
Created:
2022ae-05
By:
Ben &" MU41-Staipen itguy.00m)
Status:
Signed
Transaalat ID:
CBJCHBCMBMCGNyChgkxlEml8MXE4uNp5 14gD8tX
"Cain -APO" History
Document created by Ben Brink (ben@coastalpermitguy. com)
2022-06-05 - 5-05:51 PM GMT- IP address: 97.87.79.66
Document entailed to [e-mail] for signature
2022 W8 - 5:08:20 PM GMT
Email viewed by [e-mail]
2022-08 05 - 5:50:53 PM GMT- IP address: 104.28. 110.97
Signer paul_cain@beiLo Ah.net entered name at signing as Paul A. Cain
2022-08-06 - 12:17:36 PM GMT- IP address: 99.149. 127,17
Document e-signed by Paul A. Cain ([e-mail])
Signature Date: 2022-08-08 - 12:17:37 PM GMT - Time Source: server- IP address: 99.149 127.77
Agreement completed.
2022-08-06 - 12: 17:37 PM GMT

N.C. DIVMION OF COASTAL MANAGEMENT .
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIOMAIVER FORM
(Top portion to.be- completed by owner or their agent)
Name of Properly Owner: Kyle and Mari Dixon
Address of properly: 119 Salisbury (Holden Beach)
Maiiing.Addr�s of Owner: 6375 Tabor Church Rd. Fayetteville: NC 2M
Owner's email: kaldonial 115@iclou&cam ,s honet910-813-0262
Agents Name: CPG, LLC (Ben Brink) Agent Phone#'' 910-302-5725
Agent's Email: . benocoastalpermitguy coo
ADJACENT RIPARIAN PROPERTY OWNER'S CEI
DIMAL 1.hereby cw* that I own property adjacent to the.above rah nenced property- The individual applying forthis' .
permit has wed to me, as shown on the attached drawing. the development they we proposing. g
. dewrictlon or drewirm. with dinneru&w. must he provided with this letter.
I I NOT F nrei 4giabts plrrspcis I have obje Mwm to this proposal..
if you hwe o*ftWs to Wet Is beft pmPovsd ycw roast naft 09 M.C.,DMilon of Coasdd
Management (DCM) In wr/dng within 10 days of r+ecelpt of this no" . Cornrrspondbiwe alorlid be.
nmilad to 127 Cardinal Dr" Ext., Wiimingtm, NC 284054M DCM MPrsssMat] WW can -also. be
conGtclrrd at (910) 79&7218. No rosponso la considered dw same as no ob/ecdon if 1OU have bean.
naMW by CwtNF*d MnHL _
WAIVER SECTION
I understand that any proposed pier; dock, mooring plipga, boat ramp, breakwater, boathouse, lilt, or .
groin must beset bm* a minimum distance of 15'ttom new my aof riparian access unless watered by, me .
019 does, not apply.to buldwwds,or riprap.royetments).,(if you wish Umvalve the setback, you mini skin.
the apprropdate blank below.)
160wish fact "M ecbr�pi ,*p of ttre IV:c . ; r'
-OR-
I do not wish to waive the 15' setback requirement (Initial the blank)
Please sign
hm also
Typ*d/Printed name of ARPO: Robert and.Liss Caanon
Failing Address of ARPO: 527 Magnolia Ave. Charlotte, NC 28203.
I: .cannonbryan@Yah
-ARPO's emsoo.corn ARPO's Phon-aft 704-905-1111
DMr}: •wehnr Is valid for
up to on. year Thom ARPO's Signature'.
Reyis+eri July 2021

119 Salisbury (DIXON)
Proposed Boat Lift
Site Visit Photos 8.4.2022