General Permits (8147)

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CAMA AND DREDGE jND FILL - ___
GENERAL
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Applicant N me
Address
City yL_
Project Loca
Ex(e/�APTV,_�� CdIIM
as authorized by the State of North Carolina,
Department of Natural Resources and Community Develop a d th Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC : 03
�n Phone Number (a:��L
PROJECT DESCRIPTION I SKETCH
'ier (dock) length
Groin length
number
Bulkhead length
max. dist�n offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
,�J
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be-
come 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) this pro-
ject is consistent with the local land use plan and all local
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
I
(SCALE
applicant's signature
permit orncerrs signature
issuing date expiration date
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attachments r
application fee,�J

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ADJACENT RIPARIAN PROPERTY C UNER STATaIENT
'ace t I • e a property adjacent
h reb • er if that I own e c t t
. •• ,Y. .Y P P Y 7
., ; �.:, �,• • '' �-r-`' ff �C • �. r s property located*at
•/.J-.-__�' lI +�. 'jof..PI�O/rty. CwMe_ )
icy'. �';�^ir �!-,fa ::1� � 4 • .. � b: V. LJ (� � LJ IiLJ ���'c ' .t
�•y Y
M _
'•K'` iY: i:�•• (LOt, Block, Road, etc.)
uS , J L'N , in 1V�cc� SER4.)* 1 Fa N.C.
(Waterbody) (Town and/or County)
He`has'-described tome, as shown below, the development he is
proposing at'that'location,.and; I have no.objections to his
`proposal:
• .YTS f • •1 r'•' '• • • ' •
DESCRIPTION AND/OR.DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual.. proposing development)
•!>, �Z I -------------
fit;. ;•,5: ••• _ :." �Jµ� •• � +
•:.•d.
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1 S
County of.Ge,d
State of
Notary: Public
My Commission Expires: i- 9a
WA
S gAKture
— Print or Type Name
'elephone Number

ADJACENT RIPARIAN PROPERTY C *INL7R STATEMENT
I,hereby.certify that I own property adjacent to
`ri= rn 6-64 ti r Is property located' at
��: �. .. ' ,(DTame'�;of;. � ProPerty. Owner) •
�� fr."��r^`,tif^••''x4 2�,t.v� `Mi�,� yr` f •
(Lot, Block,
Road, etc.)
us h;(JFLN' in
��Ly QF 1 4490£s� N.C.,
,
(Waterbody)
(Town and/or County)
'•`;He: has 'described to 'me, as shown
below, the development he is
proposing at'that'location, and;
I have no.objections to his
. `'Proposal:
-=---------------------------------------------------------------
A ='•.-DESCRIPTION AND/OR.'DRAWING
OF PROPOSED DEVELOPMENT:
:ti (To'be filled in by individual.proposing development)
43
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l! •
al-
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ignature J Of
,�
02
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Print or Type Name
County of �,�,.�
'elephone Number ,
S t a t e, of
Notary. Peb-1 1C . i
My Commission Expires: 9-��

GENERAL PERMIT APPLICATION INFORMATION
APPLICANT'S NAME: L4.
(First) (Middle) (Last)
Mt`..ING ADDRESS: O 8? j 9 u R U Ey F
(PERMANENT)
N FW G ig . STATE C ZIP
TELEPHONE: WORK (o ) 4.� (o(o . py y q HOME ( )
CONTRACTOR'S NAME: I "�a F,� a- �G ,E„ TELEPHONE NUMBER
PROJECT LOCATION: N.C. Hwy. # SR # Road/Street Name .109, ISUR(Nfia
Waterway Name A/ ,E0I fi P' o /P h County CifoU J'N
Town _%U Fcy r{ --ey Subdivision T;y )eK 1/;hw 14ig
PROJECT ACTIVITIES:
PIER: Total dimensions of pier from MHW to platform
(Length) (Width)
'T' or 'L'-head platform
(Length) (Width) (Number of Mooring Piles)
Water depth at end of pier Number of Mooring piles
F T HOUSE/BQrT LIFT: Length
Number of Piles
BULF.HEAD: #1
#2
Width
Water Depth
i
Total length (ob
Average distance waterward MEW (rayT
Maximum distance waterward MHW J�
Total length
Average distance waterward MHW
Maximum distance waterward MHW
RIPRAP: Total length
EXCAVATION: [MAINTENANCE 'ONLY']
Base width from MHW
Length Width Depth of Cut
Adjusted water depth on MLW Existing water depth(s)
Estimated Cubic Yards (length x width x depth/27)
Type of spoil: Sand Mud
Drigline Backhoe Hydraulic
cl•d�R s•.�ucrU�c�:s: