72147_07H.1300 Concrete Boatramp_20180521

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*AMA / DREDGE & FILL Nq 7214.7
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GENERAL _PERMIT Previous permit# AVA
❑New'❑Modification ❑Complete Reissue,' ❑Partial Reissue Date previous permit issued A//A
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 I SA NCAC o -7 4 , ! 3o
.' • KRules attached.
:Applicant'Name SIC}IQ (�. ' j-L� F Ur Project Location: County-Vo C©14a)`(
Address LAO& _ 12D Street Address/ State Road/ Lot #(s) 371 1 AA)bld I
City' &C JlAd 0u.Attn State&zip 85� RD Lis
Phone #(33 E-Mail
Authorized Agent
Affected 0 CW `�w KPTA j6ES PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA El N/A
AEC(s):
❑-PWS:
ORW: es / of PNA es [no
Subdivision
city SWAT► QL�ARTUZ zip � 788 s'
Phone # (33G) aZ 13 ' dGr; L River Basin PAM L i, 1( V
Adj. Wtr. Body FOO DP-Cl C i1(-7f V- na )/man /unkn) -
Closest Maj. Wtr. Body PA/It Ito 2 d In
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♦ �
Agent
or-Applicant Printed Name
Signature• . **Please read compliance statement on back of permit
Application Fee(s) 'jv , , Check #
PermitO fic7'sPrintgd ame
Signature
21 'MAY' Z019 91 Sill SOU -
Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to AA d'a,// g-c a 's
00,
ameof Property Owner)
property located at / a ar�� tdt
(Address, L'ot,'Block, Road, etc.)
on 1,a44, pf c (!f'/' e e , in wccm 6QK u &I7je P , N.C.
(Wa erbody) (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)
y GU�Gf °� S L ®14� �Ou
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.)
L✓ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sign, ature
/.
Print or Type Name
--3Z//,g 4 ,aw✓, X r�,
/fit t Mailing1 e- ,
City/Stat Zip
lire l-.-- -t// AV C- 7_ a
Telephone Number
33�- a/3
Date
5 -/ 'ze/�
(Adjacent Property Owner Information)
Signature
L.-y -r-- l3 tiu m 4AI `a 'x'G S
Print or Type Name
Mailing Address
'2S-C rz� 2-Yp ^' a'a
City/�StatelZip �D �
Telephone Number
1-7fS-©931
Date
(Revised 611812012)

NC Division of
Coastal Mgt® Habitat Impact Computer Sheet
Applicant: R/C''llll n'nre '_'_—
Date: Al �'�( po
General Permit #:
Describe below the HABITAT disturbances for the application. All values should. match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill,9 Both ❑ Other ❑
IJ
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10