HomeMy WebLinkAbout74863D - MandCAMA / ❑ DREDGE & ILLNo. 74863 A B C
GENERAL PEAMIT Previous permit#
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality (� I 4
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC li
❑ R-les attached.
Applicant Name--�-C cy, i'NPNb Project Location: County—
Addresss \-nc h p Street Address/ State Road/,Loot #(s)
City 7ti � �' State NC ZIP V 1\ ' 1 � � c`-0 r
Phone #�) E-Mail Subdivision
Authorized Agent City ZIP
Affected ❑ CW SEW /W" ElES ❑ PTS Phone # ( River Basin % (�
AEC(s): ❑ OEA ❑ HHF ❑ IH [IUBA ❑ N/A Adj. Wtr. Body XU VV t p SOON D iflat /man /unkn)
Clncest Mai- Wtr. Bndv
ORW: yes / (ro� PNA ;yam no
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Agent or Applicant Printed Name
ignature* Please read compliance statement on back of permit **�
Application Fee(s) Check #
PeFm Officer's Printed Name
Sign#6je
�-f .3p, �l •Zc7
Issuing Date Expiration Date
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Jessica and Michael Mand 's
property located at 117 Anchor Drive
on
(Waterbody)
(Name of Property Owner)
(Address, Lot, Block, Road, etc.)
in Surf City, NC 28445 N.C.
(City/Town and/or County)
Th eapplicant has described to me, as shown below, the development proposed at the above location.
5 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)
See attached.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
ems_` I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) I 'r Property Owner Information)
iMit�t�r*�, �j(aC(cWt��tY
ignalure Si nature
Jessica Mand Michelle Blackwelder
Print or Type Name
117 Anchor Drive
Mailing Address
Surf
tCity, NC 28445
Q'M'a�Z�1001
Tele hone Number
TY20i2020
Date
Print or Type Name
P.o. Box 268
Mailing Address
Sanford, NC 27331
City/State/Zip
919 260-4082
Telephone Number
4/21/2020
Date
(Revised 611812012)
Water
Property Address:
Jessica and Michael Mand
117 Anchor Drive
Surf City, NC 28445
0
N
Adjacent Neighbors:
Topsail Cove HOA
Michelle and Chad Blackwelder
115 Anchor Drive
Surf City, NC 28445
Notes:
4'
Structure will be 3 feet above the water/ground
Structure will extend to the water's edge
Materials: wood + metal rust resistant bracketing
Water depth at low tide, at the end of the
proposed pier: 6 inches
Distance from the end of the pier to any federally
maintained channel: N/A
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
117 Anchor Drive
Jessica and Michael Mand
Surf City, NC 28445
443-244-1001
rimand9l@Iive.com
Jessica and Michael Mand
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: wooden kayak walking path
at my property located at 117 Anchor Drive
in Pender
County.
APR 2 4 2020
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:
LA
JV A. ut�
II Signature
�oK SS t ra � . iUaA
Print or Type Name
I�omPnU) Heir
Title
04 20 / Zo
Date
This certification is valid through / /
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to Jessica and Michael Mand s
property located at 117 Anchor Drive (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on , in Surf City. NC 28445 N C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
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)
See attached.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
K7 1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
IISi natureSignature
Jessica Mand _ Y ei - P" 5,6te4 Tf5aA Lure
Print or Type Name Pnnt or Type Name iA
117 Anchor Drive �,n, l (, ► } bA t u, 0, Aria {nor ��
Mailing Address Marking Address
Surf City NC 28445 ��' cl'}' m C 2Ay4 �
Crty/Stat�/Zin1001 City/State2►p
TelephoneNumberTelephone Number
4i20/2020 _ —� /
Date Dare
(Revised 6/1 &2012)
CJRV: TAB-E
C1 R=35.00' T=29,47' L=48.99' CB=S16'50'24'7 CH=45.08'
C2 R=35.00' T=3.41' L=6 BC' CB=S62'30'16'E CH=6J9'
111ECa
p
0 l
pHP, INC. AMEN
vP� DB 363C, ?G 93 4
%53'00'01'E 128.64' _.
]5-
4 I--K •-� _ __
`P f
LOT 2 WC/NITYMAP" NTS
DB 1532, PC It-
MB 47, PG 54 - NOTES -
V 1 . This plot pier ra of an
mLOT exstlrg parcel of tend
s 1,43 A2. Suoleettorestricuw
DB 1532, covenants easenlenta a
MB 7" record, zoning ordmanoe.8
; underground utilities. M arty.
3. No Me searcn by surveyor, 4 Referenoss; MB 47, PG 54
? 2 DB 1532, PG 155
a N55' 26":37"E b Flood Zono - AE
P 60.00' C.
Communrty Panel 0370186 4245 K
u,
o � 6. Weeands scele0 from MB 47 PG S•
r.
V ti� VCf�NI rS
HP, ;NC N Proposed location
to
DB 3630, PG 93 0 \
-
? Q ty E I
p KaEAt:ty1 0 ,�� S.f�3�
O -Y7 58'
CDN55'26'55'E
" CP S55.26'55'a 140 38' ET
y
c
rn
ri
N tASE/Eh+
-LEGEND-
SIR - 112' Set Iron Rod
EIR - Existing Iron Rod
r.P - Ceim latex Point
Certificate Of Completion
Envelope Id: C3A760B23F5A4C69AO2EE89DDC5F4A9D
Subject: Please DocuSign: Adjacent Neighbow-Blackwelder.pdf
Source Envelope:
Document Pages: 1 Signatures: 1
Certificate Pages: 1 Initials: 2
AutoNav: Disabled
Envelopeld Stamping: Disabled
Time Zone: (UTC-05:00) Eastern Time (US & Canada)
Record Tracking
Status: Original
4/21/2020 12:43:07 PM
Signer Events
Michelle Blackwelder
michelle.blackwelder@dhhs.nc.gov
Senior Auditor
DHHS
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Carbon Copy Events
Witness Events
Notary Events
Envelope Summary Events
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Holder: Michelle Blackwelder
michelle.blackwelder@dhhs.nc.gov
Signature
[oocusig-d by:
n1��t
BFE6B85201F3401
Signature Adoption: Pre -selected Style
Using IP Address: 199.90.157.13
Signature
Status
Status
Status
Status
Status
Signature
Signature
Status
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
Docu150M
0 SEC YR a
Status: Completed
Envelope Originator:
Michelle Blackwelder
695 Palmer Drive
Raleigh, NC 27603
michelle.blackwelder@dhhs.nc.gov
IP Address: 199.90.157.13
Location: DocuSign
Timestamp
Sent: 4/21/202012:43:51 PM
Viewed: 4/21/2020 12:44:02 PM
Signed: 4/21/2020 12:47:20 PM
Freeform Signing
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamps
4/21/2020 12:43:51 PM
4/21/2020 12:44:02 PM
4/21/2020 12:47:20 PM
4/21/2020 12:4710 PM
Timestamps
6E-n04/2531
1073
JESSICA L MAND
117 ANCHOR DR.
SURF CITY, NC 284459402
DATE OM
PAY TO N Cip 15 0, ,
THE ORDER OFF �}-
/ t h(4'hfkrzd d ���/(/ DOLLABS
State Em loyees' Credit Unions
Jacksonville, North Carolina
42
MEMO j/ i V► �m r IYP
1:2531770491:0864637085 11' 1073
RECEIVED
APR 2 g 2020
DCM WILMINGTON, NC
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Chock Numbs
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5/5/2020.
515,2020 Jessica Mand
same
State Emoloyees Credit Union
1073
$ 200.00 GP t74863D
JD rct. 10832
8/512020.
5/5/2020 Allied Marine Contractors LLC
_
AI Gribben _
First Citizens Bank
8911
200.00 GP F74815D
JD rct. 10833
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5/5/2020..Jerry Ennett 0 of 2)
Carton Dail
--
Coastal Bank and Trust
3088
200.00 GP t74877D
_. _.
JD rct 10333
_
_ 5/5/2020
5/5/2020 Je_rfY_Ennett (2 of 2)
Carlton Dail
Coastal Bank and Trust
_
_ 3038
_ _
200.00 GP i75877D
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5/5/2020
5/512020. ES Freedom, LLC
Eric Sabounn (ES Freedom)
Bank of America
1593
_
200.00 JGP 175847D
PA 10751
5/5/2020
5/5/2020 F and S Marine Contractors. Inc.
Tommy West
PNC Bank
_
am,
_ _
3 #76403D
1 PA ML 10432
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5/5/2020,
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5/5/2020 Jessica Mand
515/2020 Allied Marine Contractors LLC
5/5/2020 Jerry Ennett (1 of 2)
5l5/2020 Jerry Ennett (2 of 2)
515/2020 ES Freedom, LLC
5/5/2020 F and S Marine Contractors Inc.
coUmns
same
At Gribben
Carlton Dail
Carlton Dail
Eric Sabourin (ES Freedom)
Tommy West
CaOurrsnb
State Employees rr*M Union
First Citizens Bank
-Coastal Bank and Trust
Coastal Bank and Trust
-Bank of America
PNC Bank
Columns
caemn7
Columns
Caamns
1073
5911
S 200.00 GP t74863D
�- 20000 GP i74815D . _
200,00 GP t74877D
200.00 GP i!75877D
S 200.00 GP •75847D
S 200.00 GP t76403D
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JD n:t. 10833 _
JD rct. 10333
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3035
1593
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