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HomeMy WebLinkAbout76204D - Conner� CAMA / DREDGE & FILL No. 76204 A B C CB� GENERAL PERMIT Previous permit # Ievv ❑Modification ❑Complete Reissue El 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 ❑ Rules attached. Applicant Name j �� VCATH/-1okq\O A.. c O N h e r Project Location: County �Qy Nsw'�C Addre//s��s \I A�� EJ Strreet Address/ State Road/ Lot #(s) L(� Cityl�A�NfcSV�I�E State �A ZIPZO t T�aS� %/�C��n Phone # y 0� r{�� E-Mail SAGE 53 Q ALIL_COM Subdivision pa /h �`. 0 ✓ e- Authorized Agent �Nc-\GS c.,IJ City 0A S E 1 �E'-Nr-)A ZIP Affected ❑ cW ❑ EW ❑ PTA 7kES ❑ PTS AEC(s): ❑ OEA ❑ HHF QQIH UBA ❑ N/A ❑ PWS: I ORW: yes /< no PNA yes / Phone # ( ) River Basin Adj. Wtr. Body ) \ "V- EFK.- nat man /unkn) Closest Maj. Wtr. Body A Tt-� N, c cc i` R ►'J Type of Project/ Activity GME2(aC'ooi L'4 ':�A NT�,R/%toS = 0 ea-0 T E Ll WA`x A mi6-4 RuAO (Scale: I-J 7 ) Pier Fixed Floati Finge Groir BulkF Basin Boat Boad Bead Othe Shon SAV: Mora Photo Waiv ■■!�S!!!�!�1�1�■ ■■■■■■■■■■■■■■■■■MEN ■■■WE ■� rn('!­=�' ■■wlength ■Ili■r■ ■■■■■■■■■■■■■■■■■■■■■■■ ►� r pier(s) Ma ■=1::�r■■■ ■■■■■■■■■�■■■■■■■■■■■■■■■■■■ number ■■OSE��`i■■■■■■■■■■_■■■■■■■■■■®■■■■■■■ ■■■■cra■■■■■■■■■® ■ ■■■■■■■■■■■■■■■■■■■ avg di tance offshore ■■■■i■■■■■■■■■■■■�■■■■■■■■■■■■■■■■■ ■■■N■■■■■■■■■■�■■■■■■■■�■■■■®■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■�:�.i:.�ll�/IID� li7,l■�ITn'�1■■■ ■■■■■■■■■C,T93:.OTT-17 ■■■�moo"101 '<�I�Irr �1'!"lilli!!�n�i'il■■t,�� ��■■ - ' ► ■■■■■■■■■11■1►T1f'hL3?lrtr'3_�.� � �! � �`L�.�tl=w��►�i�i�■�1RST�= �s5lt�rr■■11■n��i� itt�n!�!!'S'�►1RO■=�ta.�.�il����■w■■ri/.�■r ■■■■■■■■ ■■■■■■■■■■■■■■■■■c ■■■■■■■N not sure yes n■■■■■■■■ torium: n/a yes no yes no _ ■■■■■■�!l1:�l1Il1c■■■■■■ ■■■■■■■■ ■■■ ■■■■ ■■■■■E:��!l17l�l�l�l�!l� t�!�!WE ■■■■■■■■' ■■■ ■■■■■111s: ■■� ■■■■®■■■�■■ ■ ■ 07:4 A building permit may be required by: T[W N e F S'J Jv SE Z 66tyCA ❑ See note on back regarding River Basin rules ( Note Local Planning jurisdiction) UAAJ-tv%oRl At. Notes/Special Conditions( ALA AQ1QRAC' MvSt fit: 2EWOJIrQ Z(Z`A 1-6 S^NDW10 k"r.1h«AT16d ®IN ARIAS %#4"C F f OLNIAL "%%a 4MiEQ SJktJ4F1, aOAt tAWp- AA%N t�,,C OF SAAJbM1L> (AN/0117 C-aGt.%b 1b FFE't FOUL I L N %J4 Vi I LOJ U) U T Agent or Applicant Printed Name Signature *tpleasereadc mpliance statement on back of permit" Application Fee(s) Check # 7� r &C'e"/" \�rUI✓\?- 4-6«v\ PermitO ted ame r Signature 2 1 rk d 3 Issuing D e pirat n Date 2/12/2020 Mail - Brock, Brendan O - Outlook Doa Sign Envelope ID. 8W M8D-7846-4248-BFA9-EC I EO1338591' CERTIFIED MAIL •RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN %PROPERTY OWNER NOTIFICATIOMWAIVER FORM Name of Property Owner 0A/AJ 1! a -bD Al A,1 A \AJ Address of Property: "A- -1 (--o tl-i— 'Ra-� 24/81 A of n Clrowf • f�`1nw nr A+w++1 �yw. s I`n..+v� Agents Namer1f Tim Jackson Agents phone rt 1 951 S. McPherson Ch RD 10 Fayetteville NC 28303 FI I hereby certify that I own property ad)aoant 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. 1 have no objections to this proposal. I have objections to this proposal. a/ you love o4%cdom eo whet Is being Prod you must no�tf j� dN DMWon ofCa=W Mwwgwnarrt (UCH) in wrftbig wMA. 10 c*s o/ r>rceipt o/ OWS rlingk (:W1j i itniN, lig on for UCU offkes is arlNabi%at hCp1/www nccoastalmanaoementnet/wetycm/stafti* listngarbycoM g 14UN11- RCOAST. Ab response is oonslldlared On sa►rw as no objft-don H you hav+a bon rx*kW by Corti m d .tail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, 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' setback requirement. I do not wish to waive the 15' setback requirement (P rty Owner Information) Signmw+e Gwielz boAtAIA 1,t,( FlrW or Type Nar►re 32--19 aa-4, Al A�bng Address VA Zvl Ss cdy'�Staw Telephone Number/ mail Address ,a1W (Riparian Prope F Z-X Phbt or Type N bf 286R P--kfr1s94 dl.0 Mailb>'g Add►m 'bue�i 0%VV1. L 27-1U Telephone Raba r/ IWUsaat �ld 1�.z.�iC7 near (Revised Aug. 2014) hftps://outlook.office365.com/mail/search/id/AAQkADVjMzg3NTMyLTIIMTMtNGM5Yyl hNzQ4LThiOW M2N WZhNjc5YwAQADfsTF4RthIPjOHHrG9%2F... 1 /2 DMSION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFiICATIONlWAIVER FORM Name of Property Owner. ( Address of Property: J—� —1 13� w` de> Vr► 34/ 91 p.ot or Street Ifs Street tx � Cfiv b Camty) r Agent's Name I Tim Jackson t si nature aroo�rties Qom z! Agent's phone 951 S. McPherson Ch RD 101 910-309-2983 Fayetteville NC 28303 _ _ ■ i hereby certify that I own property adjacent to the above referenced property. The individuai applying for this permit has described th me as shown on the attached drawing the development they are proposing, I have no objections to this proposal. I have objections to this proposal. l► YOU bavVokacfloosto0Wisberngpropm4you mustna fyffieDlvlalono/CosadlAhrwgamant (DCM & m*h3e w>Ign 10 days of iecalpt of a& noflo& CWOW Nbrnaffon for DCH offices is W890dleat - orbyc tNAv 14MO-RCOAST. WAIM SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, 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 InWal the appropriate blank below.) t do wish to waive the 1 S' setback requirement. I do not wish to waive the I & setback requirement (Property Owner Infornumon) Signature 00"fialq1Z Piiht or Type Nome % 11ra 20 i SS 20r g�g� TafaAw* Number/EmetAftess (Riparian Property Owner Information) Slgnutune / Pratt or Type Name 1?- aU� 'I reS W uJogA t �k a ftw Cftq0 i i?:g-zo`� -7Jq 2 Tft*houte Number/ Address _-1- 2257-Z020 Dage !'I -- A -It, teU (Revised Aug. 2014) ,r - jws- \ CREEK - �� \--------- - ---------s�` \\!.. owsKi���r��.a waMxom. �n vAliYrrrl• 1rtM Mr n'MiM am.Wrllrl rwnrm.imu0�xxx nrrwiii�rrrrsrrr.�. N. e'�'icu� • .� sr •r rnur nw.m� / '' • �.`NxCAgQ� q,. i-tve ♦��~ rig `� '�. �, `� ` 1 mart :"nmi s�-eer�u� iiac ommwc uc •r, r¢ •, a m tm »o .nw+cw NaYM/IYhrYrtW_ n Wr.ve.w ¢YL • �•Nmrw.r�0q �Sop 0 meuNrrannw_ r bla••rMlrlr,rsl.Mri na .ie...eae„o.ucarn rw w< .wan,ra.nwar Meroi.sarr,.•wra m AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Conner Donna W. Mailing Address: 13279 Catharpin Valley Gainesville, VA 20155 Phone Number: Email Address: Tim Jacksonia I certify that I have authorized Agent t Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Install sand bags alone Fact hAain St_ Pr�('nye i'ihriivicnn at my property located at Lot 7 Palm Cove Plat 84/81 in Brunswick County. I 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, evatuafing information related to this permit application. Property Owner Information: ' l Signature Donna W. Conner Print or Type Name Owner Tate Date This certification is valid through 2/ I 31/ I 2020 NC DIVISION OF COASTAL MANAGEMENT SANDBAG REMOVAL NOTICE I, Donna W, Conner understand that sandbags are temporary erosion control structures that tnaY retrain in place for up to eight years aftor the date of approval if it is protecting a building and an associated sepdc system, a bridge or a road. The property owner shall be responsible for rotnoval of any portion of the temporary erosion control s� exposed above grade within 30 days of the and of the allowable limo period• Any portion of the temporary erosion control structure that becomes exposed above grade after the expiration of the permitted time period shall be removed by the property owner within 30 days of official notification from the Divisioa of Coastal Management. AIN In this case the sandbag alignment may remain in place up to: � Permit No. V Address of the Structure Being Protected: Lot 7 Palm Cove Plat 84/81 Sunset Beach 28468 Property Owner: Donna W. Conner (Preen, Corporation or ludividwil) If the property is owned by a Firm or Corporation give the name of the officer or authorized representative: Donna W ('.)nnPr 2/6/2020 Print Name Date If an agent is obtaining the permit, on your behalf the following section must be completed in full: Donna W. Conner give permission to, Tim Jackson Plat ownwor officarNome Print Agent Name to aaas my/ouragent in obtaining a CAMA General Permit to place sandbags on the property noted above. Tim Jackson jAa&e�= , — — -- owner ff sign=" Print Agent (5)- LIMITED LIABILITY COMPANY ANNUAL REPORT I0/2017 NAME OF LIMITED LIABILITY COMPANY: Finley Efard, LLC SECRETARY OF STATE ID NUMBER: 1403678 STATE OF FORMATION: NC REPORT FOR THE CALENDAR YEAR: gn9n SECTION A: REGISTERED AGENT'S INFORMATION 1. NAME OF REGISTERED AGENT: Triplett, Neal Finley 2. SIGNATURE OF THE NEW REGISTERED AGENT: Filing Office Use Only E - Filed Annual Report 1403678 CA202004101177 2/10/2020 02:00 Changes SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS 2808 Chelsea Circle Durham, NC 27707-5133 Durham County SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: hnmp rantalc 2808 Chelsea Circle Durham, NC 27707-5133 2. PRINCIPAL OFFICE PHONE NUMBER: (919) 383-6165 3. PRINCIPAL OFFICE EMAIL: privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS 2808 Chelsea Circle Durham, NC 27707-5133 5. PRINCIPAL OFFICE MAILING ADDRESS 2808 Chelsea Circle Durham, NC 27707-5133 6. Select one of the following if applicable. (Optional see instructions) ❑ The company is a veteran -owned small business ❑ The company is a service -disabled veteran -owned small business SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.) NAME: Neal Finley Triplett TITLE: General Manager ADDRESS: 2808 Chelsea Circle NAME: karen Williams triplett TITLE: Managing Member ADDRESS: 2808 Chelsea Circle NAME: TITLE: ADDRESS: Durham, NC 27707 Durham, NC 27707 SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity. karen williams triplett SIGNATURE Form must be signed by a Company Official listed under Section C of This form 2/10/2020 U7\111:1 karen Williams triplett Managing Member Print or Type Name of Company Official Print or Type Title of Company Official This Annual Report has been filed electronically. MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525 ■ To whom It May Conc(Irr); E.77_.- 1 hereby authorize Tim Jackson to sign on my behalf for any work pertaining to the Sunset. Beach Palm Cove Sandbag project and associated projects of such. Bob W Harrelson Witness Date Received Deb ed Check Fran Name N.— or Permit Holder Venda Check Number Check amount Parmh Number/Comments R-1pt or RMunaReallocated Columnf Coumn3 C9umn3 Column/ Columns ColumnC Column7 Columnil ColumnY 2/17/2020 Palm Cove Owners Association, Inc. Palm Cove Holdings, LLC First Citizens Bank 1014 $ 400.00 GP #762021) BB rot. 8819 2/17/2020 Palm Cove Owners Association, Inc. Benjamin & Cyndi Levine First Citizens Bank 1015 $ 400.00 GP #762031) BB rct. 8820 2/17/2020 Palm Cove Owners Association, Inc. Longleaf Pines, LLC First Citizens Bank 1016 $ 400.00 GP #762051) BB rot. 8821 211712020 Palm Cove Owners Association, Inc. Jill Marie Ronnion Rev. Trust First Citizens Bank 1017 $ 400,00 GP #76206D BB rct. 8822 2/17/2020' Palm Cove Owners Association, Inc. Howard Beach House_ LLC First Citizens Bank 1018 $ 400.00 GP #76207D _ BB rct. 8823 2/17/2020 Palm Cove Owners Association, Inc. Donna Conner First Citizens Bank 1019 $ 400.00 GP #76204D BB rot. 8824 2/17/2020 'Palm Cove Owners Association, Inc. Finley Efard, LLC First Citizens Bank 1020 $ 400.00 GP #762081) BB rct. 8825 2/17/2020 Palm Cove Owners Association, Inc. David Tendler & Susan S_pratt First Citizens Bank 1021 $ 400.00 GP #762091) BB rct 11451 2/17/2020 Palm Cove Owners Association, Inc. Tatiana McCuen First Citizens Bank 1022 $ 400.00 GP #76210D BB rct. 11452 2/17/2020 Palm Cove Owners Association, Inc. Ann Morales First Citizens_ Bank 1013 $ 400.00 GP #76201 D BB rct. 8817 211712020 Charles Ducksworth Money Order Christopher Miller Wells Fargo Bank 19-04611211 $ 200.00 GP #74891 D _BB rct. 11453 2/17/2020 H5 Construction, LLC Thomas Holland Jr. BUT 2473 $ 260.00 GP #74893D _BB rot. 11455 2/17/2020 1 Jerry Ennett c/o Enned Marine Construc6 Deborah Kalner Coastal Bank and Trust 2736 $_ 200.00 GP #74878D JD rct 10965 2/17/2020' Charles & Christine Boise Charlie Boise The Fau uier Bank 2635 200.00 GP #762141) JD rat. 10964