20170663 Ver 1_Shellfish Lease Application_20170530

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North Carolina Shellfish Lease Applic 2017
1. Primary Applicant Information: *(Fill this out if applying as an indivi u_aa itat &Enhancement
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Applicant: First Name
MI
Last Name
JaMes
A
Race: 5 IV Gender: kMale ❑ Female /)
Eye Color: 2( 4w., Hair Color: Int'
Height: (o?h Weight: Z �i
Have you been a legal resident of the state of North Carolina for at least 6 months? ❑ No ❑ Yes
Check One:
Driver's License No.)l State I.D. No. ❑ Military I.D. No. ❑ Resident Alien I.D. No. ❑ Passport No. ❑
Number: 193 Expiration Date: &//(I Un -
Are you related by blood or marriage to any person now working for the North Carolina Division of Marine Fisheries? WNO
❑ Yes: Name and Relationship
Do you hold a Standard Commercial Fishing License? ❑ No X(es: SCFL k Ji M:' 03
Do you currently own a vessel with current registration? ❑ No Iles: Vessel ID# NC, 4190
Do you have four or more convictions of DMF fisheries violations in the past three years? ❑ No ❑ *Yes
*(If Yes you may not be eligible to obtain needed permits to work o lease other than cultch on bottom)
Do you currently have or hold an interest in any other shellfish leases? ❑ No Yes
_
List lease numbers you hold or have an interest in: a#!5&DZ, JNPi ViG 16ol-7 ,�C10?-"IS✓Fr 04—'7513
G.S. 113-202 (c): No person, including a corporate entity may acquire and hold by lease, lease renewal, or purchase more than So
acres of public bottoms under shellfish cultivation leases. For purposes of this subsection, the number of acres of leases held by a
person includes acres held by a corporation in which the person holds an interest.
Applicant Mailing Address
PO Box
City
State
213 Shell Ifi11
94 (aYelP
NI (
Applicant Physical Address
City
_
State
Zip codeDaytime
Phone No
Alt. Phone No
Email address
X11
1551-1 1-1aS2
Mill 0(4fflyko (-{1>� (dAl a;i. L4
Co -Applicant: First Name
MI
Last Name
Have you been agal resident of the state of N th Carolina for at least 6 months? El No ❑ Yes
Check One:
Driver's License No. State I. D, No Military I.D. No. ❑ Resident Alien I.D. No. ❑ Passport No. ❑
Number: Expiration Date:
Are you related by blood ore o any person now working for the North Carolina Division of Marine Fisheries? EDNo
❑ Yes: Name and Relationshi
Do you hold a Standard Comme I Fishing License? ❑ No ❑ Yes: SCFL N
Do you currently own a vesseywith krrent registration? ❑ No ❑ Yes: Vessel IDN
Do you have four or more nvictions DMF fisheries violations in the past three years? ❑ No El *Yes
*(If Yes you may not be of ible to obtain eded permits to work a lease other than cultch on bottom)
Do you currently havehold an interest in a other shellfish leases? ❑ No ElYes
List leanumbers yo, hold or have an interest
se
Version: DMF Lease App 2/2017

Page 2 of 16
Co -Applicant Mailing Address
PO Box
City
State
Zip code
Daytime Phone No
Alt, Phone No
Email address
2. Business Entity Information (Article 16 of Ch. 113): *Fill this out if applying as a Business Entity
Business Name
Type of Business Entity:
❑Corporation (Please attach copy of current articles of incorporation and list of corporate officers)
❑ Partnership (Please attach a current copy of your partnership agreement)
❑Sole Proprietorship
❑ LLC
* Please attach copies of the Articles of Incorporation, current assumed name statements, and copies of current business privilege
tax certificates with Employer Identification Number (EIN) listed.
Business Mailing Address
PO Box
City
State
Zip code
Daytime Phone No
Alt. Phone No
Email address
Business Agent/Responsible Party Name:
Business Agent Mailing Address
PO Box
City
State
Zip code
Daytime Phone No
Alt. Phone No
Email address
Are you related by blood or marriage to any person now working for the North Carolina Division of Marine Fisheries? ❑ No
❑ Yes: Name and Relationship
Do you currently have or hold an interest in any other shellfish leases? ❑ No ❑ Yes
List lease numbers you hold or have an interest in:
G.S. 113-202 (c): No person, including a corporate entity may acquire and hold by lease, lease renewal, or purchase more than 50
acres of public bottoms under shellfish cultivation leases. For purposes of this subsection, the number of acres of leases held by a
person includes acres held by a corporation in which the person holds an interest.
3. Applicant Qualifications (Optional) - describe your capability to conduct the proposed aquaculture activities
(including training, experience and education that you have obtained or will obtain)
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Version: DMF Lease App 2/2017

Page 4 of 16
4. Proposed Lease Site Information
Check one that you are applying for: *The designated, nonrefundable application fee must accompany each application.
❑ Bottom Lease ($200.00): A bottom lease primarily uses cultch, or low profile structures to cultivate shellfish. Cages
and gear are limited to a maximum height of 18" above the bottom. Rent: $10/acre per year.
)(Water Column Amendment ($100.00): A water column lease amends all or part of an existing bottom lease footprint.
Floating bags, cages greater than 18" above the bottom or any other use of the water column will require this type of
lease. Rent: $100/acre per year.
❑ BOTH Bottom Lease with Water Column Amendment ($300.00): This lease is a joint application for both the bottom
lease and water column amendment. Rent: $110/acre per year.
Lease Coun, ty:
Closest Town:
Watekbody,
Estimated total acreage: Note: Acreage allowed must be consistent with the Lease Vanagement Plan, prior lease
production history, public trust use of the area, etc.
Single lease acreage is currently
limited to 10 acres in areas where
oyster mechanical harvest is allowed.
All other areas limited to 5 acres.
Does the lease site contain known sea grasses or Submerged Aquatic Vegetation (SAV)? ❑ No Yes
Leases are restricted on sites with areas of SAV.
Approximate closest distance to existing shellfish bed or oyster rock? ft. Fyi'AV WtNCkit�
Leases must not be located on or within 10 ft. of existing natural shellfish beTs or oyster racks or seagross beds.
Approximate distance to marked navigational channel 11)00 r ft.
Approximate distance to any unmarked navigational channel 1000 ft.
Leases cannot block navigation.
Does the applicant or co -applicant own all of the shoreline adjacent to the proposed lease?* C)No ❑ Yes
If the applicant or any co -applicant is not the sole riparian owner of any developed shoreline within 100 ft. of the proposes lease, the
riparian consent form in Section 6 of this application must be filled out and notarized to proceed with application processing.
Riparian property owners will be notified of your proposed lease site.
Approximate minimum distance of proposed lease from shoreline 5Tft.
Approximate minimum distance of proposed lease from vegetated marsh ft.
Please list the coordinates for the proposed lease. The minimum number of coordinates required is three and the maximum is
eight: A survey is not required by law but is suggested as a best management practice. Any costs of a survey are the responsibility
of the lease holder. The lease site must be as compact as possible.
G
Corner Coordinates: A. SI D,#V)'.`^ J V O
J if tivreC.(G
1. N, W 5. N,_W
2. N, W 6. N,_W
3. N, W 7. N, W
4. N, W 8. N, W
Version: DMF Lease App 2/2017

Page 6 of 16
5. Lease Management Plan
Shellfish species to be grown: XOysters ❑ Clams ❑ Scallops ❑ Other
Capital Investment: Year 1: Year 2-5: $ ,JUO
, —�
Vessel Available: Vessel: ❑ N A Y Length:Power: 115
Trailered? ElN t Y
If other vessels will be used, please list here:
• What types of harvest gears will you use? PAIA 1A
S
• Will you require the use of mechanical harvest gear? (dredge, power rake,
tc.),0 N ❑ Y
*Mechanical gears are not allowed on leases located in Primary Nursery Areas
Shellfish Grow -out Method: Please check the grow -out method(s) you propose to
use on your lease and the estimated amount of
equipment and effort.
*Floating UpwellerSystems (FLUPSYs), tank downwellers, upwellers, raceways, etc...
are restricted to 18" maximum height unless
otherwise conditioned in the lease contract.
Bottom Methods Years 1
Years 2.5
❑ Cultch on -bottom only bushels/acre
bushels/acre
❑ Spat-on-shell/clam seed spat/seed/acre
spat/seed/acre
❑ Relayed oysters (Polluted or seed oyster bushels
bushels
relay sources)
❑ Predator netting/bags # of units
# of units
❑ Rack and bag system # of racks/bags �_
# of racks/bags,_J_
❑ Cage system # of cages
it of cages
❑ Tray culture # of trays
# of trays
Cl Solar Floating Upweller Specify
Specify
How is it anchored to the lease: Dimensions:
Material:
Water column Methods Years 1
Years 2-5 Sop
X Floating bags (Taylor float'", # of floating bags ,D�p
it of floating bags
mesh bags, flip bags, etc.)
❑ Floating cages (Oyster Gro'", etc.) # of floating cages _
# of floating cages
❑ Suspended system, long line # of units
# of units
❑ Rack and bag system >18" # of racks/bags �_
# of racks/bags
❑ Bottom Cage system >18" # of cages
it of cage s
❑ Type of Anchor used (screw anchors, rods, Type
Type
etc.) # of Anchors
# of Anchors
❑ Solar Floating Upweller
How is it anchored to the lease: Dimensions:
Material:
Shellfish seed source:
Do you plan to participate in the following permit
relay DMF activities?
(Circle all that apply)
❑ Polluted Area Relay
❑ Yes No
*Only shellfish native to NC may be
❑ Seed Oyster Mgt. Relay
❑ Yes No
cultured. Shellfish seed obtained
In-state hatchery: Hatchery Name:
o, va
from outside of NC will require an
0 N (fes Phone No: 352-3N2-,
fZ
Introduction of Species or Transfer
Out of state hatchery* Hatchery Name:
Permit from DMF prior to shipment.
Address:
This permit application must have a
❑ No ❑ Yes City:
pathology report attached and is
State:
Zip Code:
goad for 30 days after the report
Phone No:
date.
Version: DMF Lease App 2/2017

Page 7 of 16
5. Lease Management Plan (continued)
Planting/Seeding Datesagd Expected Harvest:
_
Planting dates Year 1 t 11 (month)
Expected first harvest date: 1,6Li 119 Expected yield per acre: bushels; or # 100 Wo
Do you plan to harvest oysters anytime during April — September? ❑ No ❑ Yes
Will you operate as a Shellfish Dealer? ❑ No XYes
*Closed oyster season harvest requires a Closed Oyster Harvest Certification. A Shellfish Dealer must have a Certification from
Shellfish Sanitation [phone], and a DMF Dealer License to operate.
*A Commercial Fishing Vessel Registration will be required annually for boats used to harvest or transport seafood. The registration
is separate from the NC Wildlife Resource Commission's registration.
Lease Marking
Type and number of markers to be used
Lease corners must be marked and proper durable
❑ Wood post (3-4 inch) #
signage attached including all lease numbers,
reflective tape, and the name of the leaseholder.
Plastic/PVC dia.
Water Column leases have
Other (composition and dimension):
must also yellow floats
# \tv,,a.(,.
marking each corner. Boundary markers should be
�IIG\\�"
every 150 feet.
*Markers greater than 4x4 inches may require a permit from the Division
of Coastal Management.
NOTE: Leases maybe conditioned to reduce or
increase the number of markers required depending
#The DMF has no duty to protect any lease or franchise that is not
upon location, navigational issues, etc.
properly marked.
Land/Dock Based Facilities: (check all that apply) ❑ Raceway/trays
❑ Dock ❑ Graders/Sorters
❑ Floating Upweller ❑ Tumblers
❑ Tank Upweller or Downweller ❑ Storage facilities, sheds, etc.
❑ Pumps ❑ Other: (specify)
* NOTE: These structures, if proposed, may require
a permit from the Division of Coastal Management
Lease Cleanup Provisions
*If your lease is surrendered, cancelled, terminated for lack of production or failure to pay rent, or you simply choose to relinquish
the lease, the leaseholder is responsible for removing all markers, posts, and aquaculture gear except planted cultch. You will be
given a 30 -day notice to remove all posts, markers, and aquaculture gear. If you do not remove the markers, posts, and gear after
the 30 -day notification, the Division of Marine Fisheries may pursue legal action to have it removed at your cost. These provisions
will be included in the lease contract.
The leaseholder is also responsible for collecting any gear that is displaced due to storm events. It is highly recommended that all
lease equipment is labeled with your contact information to facilitate collection in case of storm loss.
By signing I agree that I have read and understand the Lease Cleanup Provisions:
r,
Signature: zok-xk-�tlt bpi Date:
For Staff Use Only: Aquaculture Permits needed for described lease management plan:
❑ AOP ❑ ACP ❑ ASTP ❑ Intro ❑ Mechanical Harvest ❑ Polluted Area Relay ❑ SOMA
Version: DMF Lease App 2/2017
1'

Page 16 of 16
9. Final signature
By signing below, the Applicant hereby states that the information included in the application is true and correct, and
that the Applicant(s) understand the following:
1. The Applicant will accept the lease or franchise subject to all the provisions of the North Carolina Marine Fisheries
Commission Rules and applicable General Statutes 113-201, 113-202 and 113-202.2.
2. The annual Lease rental fee shall be $10.00 per acre for bottom leases and $100.00 per acre for water column leases.
Lease rent is prorated for the first year, and is due prior to the issuance of the lease contract. Annual rent shall be paid a
year in advance on or before March 31. Unpaid or delinquent rent will result in the termination of the lease.
3. The applicant agrees to use the lease for commercial production of shellfish and shall provide annual production
reports as required by the division. Failure to meet production requirements may result in the termination of the lease.
Applicant Name: �y
Co -Applicant:
M
Business Agent:
SWORN to and subscribed before me
This the - r day of
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NOTARY PUBLIC
MYComrnission7xpires: 2 d�
Version_ DMF Lease App 2/2017
Date: a�
Date:
Date:

Proposed Lease Site Diagram #1
Location map
Nelson F
Bay I�
i�
Proposed water column
amendment. Existing bottom
lease 9108.
OA atm,
North

Top View Diagram
�I
j Proposed water column
amendment. Existing bottom
lease 9108.
=p9lS�j North
Oyster flip bags �-�►� 97a=='�
(not drawn to scale)
r
Marsh
^_ --,
r
0 150 300(1

Side View Diagram
Mean Low Water (MLW)
01114111 RUM -muMfli3 Ui lm.:` - UH111H1IU 'l t---Cl�fl ; -
Oyster flip bags
*-- Shallowend Deep end —+