85384D-JEWELL

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' ❑CAMA ❑ DREDGE & FILL a �� 'oi N9 85584" A B C D
GENERAL PERMIT I Previous permit
C ��� Date previous permit i ued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an ar a of envir e concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.decnc.¢ov/CAMArules
Applicant Name Authorized Agent
Address E Project Location (County):
City /{ f' ! State, ZIP Street Address/State Road/Lot #(s)
Phone #
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ uW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier(dock)length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area 11,
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore _
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
a
SAV observed: yes no
Moratorium: n/a yes
Site Photos: yes ' no
Riparian Waiver Attached: yes ho
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: N )
❑ 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 I'ca t PRINT Nam Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Feels) Check #/Money Order 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:
F-1 Tar - Pamlico River Basin Buffer Rules F-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: [phone]
(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: [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)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

CAMA ❑ DREDGE & FILL 1V" n511611 A B C/Previ�D
a GENERAL PERMIT Date r permit
{ Date previous permit issued _
New []Modification ❑ Complete Reissue [--]Partial Reissue
As authorized by the Statp�f North Car ling, Q�partment of Environmental Quality and the�stal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC --07 - _ 1/ U �] Rules attached. General Permit Rules available at the following link: www.4e-q.nc.gov1CAMArules
Applicant Name I or Gd / Authorized Agent,__ r
Address _&tK Project Location (County). _
City _ v e ZIP Street Address/ S a ad/L (s 4_
Phone #�)1 --- -- ke
---
Email Subdivisto_
Cityy/C�
Affected Cj CW EW PTA ES PTS Adj. Wtr. Body_(nat/ n/unk)
AEC(s): ❑ OEA �IHA ❑ UW r _I SPIMA L] PWS Closest Mal. Win Body
ORW: ye no PNA: ye no `
Type of Project/ Activity
Shoreline Length J 4 ' rV
t
Access Length K
Pier (dock)length
������--
Fixed Platf rVe
(�)
Floating Platform(s) 0 0
Finger pier(s) _
Total Platform area _
Groi\ae
ft
Bulk
rap length _
Avg offhore
Breaill
Max distanced fngt
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing _
Other
SAV observed: yes
Moratorium: n/a yes
Site Photos: yes go
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by:
Permit Conditions
( t(r
VO4
N-%
1 W RE OF ST CRC RULES, ° CONDITIONS THAT APPLY TO THIS PROJECT AND
'e Applirotlt PRINTED Name
IIJJ
Si, atu a —Pie e-read corn a statement on back of permit''! 10
/
Application Feels) Check tl/Money Order
(Scale: / U )
1
F
ff74�xYA. -
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❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
See additional notes/conditions on back
(Please
D Name
Issuing Wite Expiration Date

W_
Locality Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
�
Name �(L'�S J�Q�/�LL
Address
City C7 State (Y Zip Phone "l (� d ( Z 7 �Or N��
AUTHORIZED AGENT
Name ­�A tY1 a A 5 C)W QE�R
Address
City State Zip Phone
Email
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
((Z. t 2 t v � V oE-w Dr,-, BLt r-,G,nw . ,'N(L z84-zS-
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
AF_ u< F— LOA i ( klea bock
SIZE OF LOT/PARCEL: square feet / acres
PROPOSED USE: Residential (Single-family "ulti-family ❑ �ZCommercial/lndustrial E] Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact ydur Local Permit Qfficer if you are not sure which AEC applies
to yourproperty):
U
Z
N Z
N
O
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits otherthe CAMA 0
y
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or others wasteM
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energmnservadep, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, HighWy Conne!c ion, and
others. Check with your Local Permit Officer for more information. LU O
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STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a (�
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one) I
c�
�an owner or rec d title, Title is vested in name of Q K L S � , .1 � L� si G i,. L 1k
see Deed Book d page 283 in the j'� t4 County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in
County.
_if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners ofproperties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) MrLENs To RoGFK!s 3834 QrrD MAeo 20 Kra LIFLAnla 1 NC 2.84
(2) J p,ataS b , 1141 ey Paw . l ( c W aL-E lvt 5trr S r, UL r L (1 Ae.a . N e, 2 kk 46
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations conceming stabiliza-
tion and floodproofing techniques.
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.
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but U�J_
excluding non -load -bearing attic space)
Landowner or person
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: "O square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Manageme t Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES_ NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
This the � day of NO V , 20 2 2,
Ea
act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (thisform), a site drawing as described on the back of this application, the
ownership statement, the Ocean HazardAECNotice where necessary, a checkfor $100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
anypermit. Anyperson developing in an AEC withoutpermit is subject to civil, criminal and administrative action.

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you, if requested.
PHYSICAL DIMENSIONS
_Label roads
_ Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
_Label adjacent waterbody
PHYSICAL CHARACTERISTICS
_Draw and label normal high water line (contact LPO for assistance)
_Draw location of on -site wastewater system
Ifyou will be working in the ocean hazard area:
Draw and label dune ridges"(include spot elevations)
_Draw and label toe of dunes
_Identify and locate first line of stable vegetation (contact LPO for assistance)
_,Draw and label erosion setback line (contact LPO for assistance)
_Draw and label topographical features (optional)
Ifyou will be working in a coastal shoreline area:
Show the roof overhang as a dotted line around the structure
Draw and label landward limit of AEC
Draw and label all wetland lines (contact LPO for assistance)
_Draw and label the 30-foot buffer line
DEVELOPMENTPLANS
_Draw and label all proposed structures
_Draw and label areas that will be disturbed and/or landscaped
_Note size of piling and depth to be placed in ground
_Draw and label all areas to be paved or graveled
Show all areas to be disturbed
_Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• enclosed the S100.00 fee?
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner)
r�
M APPLICATION FOR
n
a
CAMA MINOR
z
DEVELOPMENT
Coastal Management
' ENVIRONMENTAL QUALITY PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CANIA) and set the stage for guiding development in fragile and productive areas that
border the state's sounds and oceanfront. Along with requiring special care by those who
build and develop, the General Assembly directed the Coastal Resources Commission
(CRC) to implement clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the
Commission's effort to meet the spirit and intent of the General Assembly. It has been
designed to be straightforward and require no more time or effort than necessary from
the applicant. Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
C
O
or she needs before you apply.
r
Under CAMA regulations, the minor permit is to be issued within 25 days once a r
complete application is in hand. Often less time is needed if the project is simple. The
process generally, takes about 18 days. You can speed the approval process by making
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Officer to determine
which of these you may need. A list is included on page two of this folder:
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast.
Coastal Resources Commission
Division of Coastal Management
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DCM Form EB1952-2015/Revised
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RECEIVED
NOV 15 201-2
DCM WILMINGTON, NC

Pender County
July 11, 2022LL 1:600
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0 0.0075 0.015 0.03 km

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: �1�� CW S
Address of Property 1 l��lZ 1+ j V,/ �!Z , (�i.(2G,,4W ,N ��?l1ZS
Mailing Address of Owner: �� (� F C)X l� L e i,( iZU „s,1J� Z 0 4Z.(
3
Owner's email: �� ��c' �'�C�G nna' Owners Phone#: 3-36 ' U% �� - �/ 67
Agent's Name: Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that 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 or drawing, with dimensions, must be provided with this letter.
tI 1 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. 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 15from my area of riparian access unless waived by me (this
does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign the
appropriate blank below.)
i
I DO wish to waive some/all of the 15' setback
Si natu a of Adjacent Riparian Prope Owner (ARPO)
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO: oLm Q 6 _ , 4 19 Q� r)
Mailing Address of ARPO: 116 Lk) Cl to eaf t l bigi oic, 966
ARPO's email: R,6kV1,n e-M4n 140 ARPO's Phone#: 91 D 'a1 ti- �ti'r3
&0 , Go ►n
Date: valid for up to one year from ARPO's Signature*
Revised May 2021

Date ReceNed
Data Deposited
Check Fran Name
Name of Permit Holder
Vender
Checknumber
Cheek
.mount
Permk Number/Comments
Rece/ t or Ref.nd/Realloc.ted
Columnl
Column2
Column?
Column4
Co1umn5
Columns
Co1umn7
C.I.—H
Column8
11/21/2022
11/22/2022
Gregory Holden
Roach
United Bank
5592
$ 200.00
GP #87597D
BB rct. 17915
11/21/2022
11/22/2022
B and B Marine Construction
Fleming 8 House, LLC
Wells Fargo
2008
$ 400.00
GP #85802D
JD rct. 17861
11/21/2022
11/22/2022
CD Jewell
same
USAA Federal Savin s Bank
1290
$ 200.00
GP #85384D
JD rct. 18737
11/21/2022
11/22/2022
Lighthouse Marine Construction Inc
Hilker
Coastal Bank and Trust
4474
$ 600.00
GP #87602D
JD rct. 18736
11/21/2022
11/22/2022
AMW Docks and Marine Constructior
Ward
Truist
8011
$ 200.00
GP #87500D
BB ret. 18691
11/21/2022
11/22/2022
1 Gregory Holden
Allred
United Bank
5690
$ 400.00
GP #85813D
PA rct. 17749