74655D - Forney

iCAMA / - DREDGE & FILL No. 74655 A B C
GENERAL_ PERMIT Previous permit # " -----�
kew DModification ❑Complete Reissue DPartial Reissue Date previous permit issued l
As authorized by the State of North Carolina, Department of Environmental Quality / e ' aO Q
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / 7 1 —
L]Rules attached.
Applicant Name_-�_ 6r Project Location: County_ R ru V"i w iC k `
Address `d��N t �^' Street Address/ State Road/ Lot #(s) 169
City1✓ kar State_ , ZIP-/#" 2
Phone # q E-Mail `r'+.«M Subdivision
�
-- - --- — ----- --- - -- -
-
Authorized Agent F— rAZ i C City . Qak ZS� _----_- _ zip J-SL .{J S
Affected
CW lltM
A DES 0PTS Phone # ( River Basin 6Q"
' El OEA HHF D IN D USA ❑ W��
A °
A.EC(s): Adj. Wtr. Body_ - _ _lnat m unkn
yes y,, Pw5
/ no PNA ®/ no Closest Mai. Wtr. Body --- ----- -- —
Type of Project/ Activity P t tX / DQ Gk —
(Scale.
Pier (dock) length i
Fixed Fiat(orm(s) �
Floating Platform s)
Finger pier(s)
Groin !
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basr ` T nel —
cubic yards
Boathouse/ Boa
Beach Buhdon
Other
Shoreline Length :t too`
SAV: not sure yes no
Mo.-atorium ti a yes no
Photos: yes
Waiver Attached, yes O
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signature * a Please re cornpliance statement on back of permit '
Application Feels') Check #
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po n e,ilGraa(,h 15 t
Permit cer's Print me
Signature
Issuin Date Expirat on Date

'XCAMA / DREDGE & FILL No. 74655 A B C
gENERAL PERMIT Previous permit# /
ANNew ::]Modification::]Modification❑Complete Reissue ❑Partial Reissue Date previous perm„it issued�/�
As authorized by the State of North Carolina, Department of Environmental Quality
7 rf
and the Coastal Resources Commission in an area of environmental
concern pursuant to I SA NCAC
County
nn El Rules attached.
F-1
Applicant Name
6,r
Project Location:
ru
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Address
/ r Street Address/ State Road/
Lot #(s)
City C, N't (off e StateZIP /;- � 2 I
Phone # (1-(19 E-Mail �or__�
z ®Td'C0M Subdivision
Authorized Agent f 7r e q � ra Z i fief Or
r �r ey� City dak Z S� d
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ZIP a-S11 b
❑ CW )<PTA ❑ ES
❑ PTS Phone # (
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AEC(s):
El N/A
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❑ PWS:
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Scale: 111 1
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Waiver Attached: yes
A building permit may be required by: yak - s Ind ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction), %
Notes/ Special Conditions " A ( t r uke- S p-C 7M- l Z oC� l ate`r , Ste, and Tom. C (d� u A
Pr.6� �o r�e�C ecq � (c' �row� ��,i mot- ►1 � lid tom, ci�'r war° IJo ny� P-NCT 66-C �'St
r i nb (\aY` b ICC2r nX ilA l\ nreY� nrnper. g e.r
S cc, A -if u-d
Xgent or Applicant Printed NamS /
(-c %�}-�al a/
Signature ** Please read compliance statement on back of permit*
f'tloo•oo _ I I
Application Fee(s) Check #
Permit Officer's Print
Signature
ZOZD Zo ZO
Issuin Date Expirat on Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Nt-# G -1-4DR41,,w
Mailing Address: ;� 3 % 11VW T GN _
G'h1*z G6TT7r /VG .2S2-1/
Phone Number: -76)V :S 4, � y ®19
Email Address: fO �>,/jl r Y Y02 ® 6104I G . CDA4
I certify that I have authorized (;Z4W A04S / ,9-a &(z 628-G P8-044r�
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: PLO),- l,---
at my property located at ! 10 q S4!5�- '� 2NO 57, 07�K
in R 2 JNsw IGI,-- County.
1 furthermore certify that / 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:
0 �f'
Signature
Print or Type Name
Title
Date
This certification is valid through 1 I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _I Val LT[C_�`f (4 �61��p ¢O+(nQs/ 's
��
S a
�2 sme of Property Owner)
property located at
(Address, Lot BI ck, Road, etc.A
) II
on j�QUI S Ccc,ti7� L , in � . -5 (� , N.C.
(Waterbody) (City/Town and/or County)
The applic has described to me, as shown below, the development proposed at the above
locatio
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
operty Owner Information) (Adjacent Prope Own Information)
S na Si ure*
Niatz. &-t ez �S
Print or Type Name Print or Type Name
q(enl G < D2 L Zs- (csin
Mailing A dres 1�rlr g Addres
C c ro?TP. 'q C 2 !! Cat -TS �iz ✓i c� . N C 2 9
City/Sta-tel7ip aAJVY C'�State/Zip
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Telephone Number / email address Telephone N tuber / er11ail address
. 2 . ozb 11�1�✓t c,2 22-d 2 O
Date Date'
(Revised Aug. 2014)
*Valid for one calendar year after signature`

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11OKTN CARDONA BRIIILWACk COUNTY
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BIG DAV15 CANALv
VICINrrY MAY - NOT TO 5CALE
Surveyed and Mapped By
Tide Water
Land Surveying
P.O. BOX I 1 5OG
602 North Howe 5treet
Southport. North Carolina 25461
Phone: [phone]
NOTES:
I NO GEO'VIC IAOIIUMEI.T LVA5 FOUVO VAIIIIN
2000''.
2. SURVEY DATE, PCOADNSY 13, 2020.
LAT
4. ALL DISTANCES AK ORIZOFnAL GROUND.
5. 1HE LAND 5IND41I 01, Tn15 FIAT 19 IN A FLOOD
JJA•ARDAFfAAC 11• ACCORDING TO FI LM
MAr f372020GCOOk.
G..ONCD: It'.
7. C. R.1):c"STING Pt
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15 ® TCLC RD.
I C N.n. V,. - NORMAL Hy^'1 V/ATCR
SE 32�ND 5T.
LOT 12 BLOCK 168
SECTION N4
PLAT BOOK 15 PAGE 12
DEED BOOK 1678 PAGE 1221
PARCEL IDN235NGO1004
11667.54 5Q.rf
0.27 ACRES
Surveyed and Mapped for:
N EAL
FORN EY
Town of Oak Wand
5mlthvllle Town5hlp
BrunSwlck County
State of North Carolina

4/14/2020
Neal and Katherine Forney
Isame
4/14/2020
F and S Marine Contractors, Inc.
Mark Chesson
4/14/2020
Grice Goristruction of Brunswick Counly
In John Acton
4/14/2020
B and B coastal Construction Corp
Palm Cove Holdings,
4114/2020
B and B Coastal Construction Corp
Benjamin and Cyndi L_
4/14/2020_
B and B Coastal Construction Corp
Ann Morales
4/14/2020
Donna and William Beck
same
4014/2020
Willie Clarence Richardson/Richardson
Cc Billy and Laura Sutton
Check
Permit Numtw/Comments
Citizens Bank
2987 $
20000 GP #75865D
Bbrink rct. 10w
Employees Credit Union
1391 $
200.00 GP #74655D _
Bbrink rd. td
Bank
8521 $
200.00 GP #75817D
Bbrnk rc 1W
r
13704 $
_
200.00 GP #76108D
BB rd. 10655
Fargo
1 1117 $
400.00 GP#75849D
BBrct. 10863
r Farm
1118 $
400.00 GP#75848D _
BB rct. 10862
c Fargo
1118 $
400.00 GP #75850D
BB rct. 10864
r
8342 $
200.00 GP#78113D
BB rd. 10861
r
1 76771 S
400.001GP#78112D-
IBBrct. 10859

Subject RE [Non-DoD Source] E-Mail
concerning 109 SE 32nd St.
From Beecher, Gary H CIV USARMY
CESAW (USA)
<Gary. H. [e-mail]>
To: [e-mail]
<glennfrazieroki®att.net>
Date Today at 9:16 AM
Mr. Frazier,
We met at 109 SE 32nd Street on February 12, 2020.
The purpose of the site visit was to view the property
for the existence of 404 Jurisdictional Wetlands. The
outcome of the meeting concluded that there are no
404 Jurisdictional Wetlands on the property. The end
of the property abuts Montgomery Slough which is a
Section 10 Navigable Waterway. A permit from either
the Corps or CAMA (maybe both) will be required to
instalUbuild a bulkhead, dock or pier.
USACE Project ID:
SAW-2020-00348
Please contact me if you have any questions about
this project or about the USACE Regulatory Program.
Respectfully,
Gary
81odi '- gIenn i-azi^rr a4- .corn
1ri--va 1-nore

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 1(Lk3!L z&rR /cam; ,vim TZ,e vev s
(Name of Property Owner)
property located at l D� SE �� ti S7'
(Address, Lot, Block, Road, etc.)
on ,g/6 DJ�(%/S C4¢Z2,o9'L , in d2z*5;� f:5Y7�,D N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locat' n.
✓ 1 have no objection to this proposal.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must flll In description below or attach a site drawing)
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 yo wish to waive the setback, you must initial the appropriate blank below.)
I h t w ' do wish o waive e the 15 setback requirement.
I do not wish to waive the 15' setback requirement.
(P =
ner Information)
SigIrtu —I
nWe; �V
Print or Type Name
-237•�rrF G.t�
Mailing Address
City/State/Zip
7D K I G Z yQI�2—&&a)Ay y z ® G•ti-f,
Telephone Number/email address • C-014t
Date
(Adjacent Property Owner Information)
C
anature
,t,k / t S a �oti�s
Print or Type Name
W- :5A 732 57"
Maill
O/9K ddS
Telephon Number 7 g
7111 Zo
ate
'Valid for one calendar year after signature'
(Revised Aug. 2014)