71136_Susan Grinnan_20180827

�CAMA / ri.DREDGE & FILL No 71136 OA B C D
GENERAL PERMIT Previous permit # '7/ y i o A
uNew Modification Complete Reissue ❑Partial Reissue Date previous permit issued /Z811,9
As authorized by the State of North Carolina, Department of Environmental Quality r7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / !"i i J -t 7 A/, / Z o
791Rules attached.
Applicant Name $ U S a,x G t• i n A C% n Project Location: County -JD a r 0-
Address ] ,3 S J P o', + e Or j ✓- Street Address/ State Road/ Lot #(s)
City Q u ; n -� , ^' State ✓A ZIP Z 3 / L/ I a o -.A$ 0 ( D o / /o 4
L'C'-F g9
C +
Phone # (%A6) 3 / y - / %/ O E-Mail S u S a y r , /1^ a Q GO/, cy+Subdivi`s`ion d id � 4 � r1 ) C-0 V z Se 1 4
Authorized Agent L i q� +,n, A 4 Ii'n a � 1' 4 City �+ o. y S 14 oe U ZIP 2-7 5 s�7
Affected �$CW [NEW I tPTA`) )�ES [D*TTS Phone # ( - ) _ River Basin Po. S Ck U o -7,&^
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A C p� n G +
AEC(s): ❑ PWS: Adj. Wtr. Body (nat 6FLunkn)
ORW: yes no PNA yes no Closest Maj. Wtr. Body �, o ^ o �° -S o u
Type of Project/ Activity FS /� �^ / % ti e. �.' A c 1 " d', ^ q / R �. -+-.� n �..► o. 11 ) a 'N c4
L?< J .) a (Scale:
Pier (ArtrkLlpb
Fixe
Float
Fing
Groff
Bulk
Basin
Boat
Boat
Beac
Othe
Shor
SAV:
Mo
Phot
—
■■■®■■Ir
■■ME■■■MUM,
■■■■■■■■n■■n��sti����■■�■■��■■■■■�■■■■■■■
r pier(s)
■■C■■■..li.����!!�!�!���■NOWNFINE:::s:
NWOM
length
ME
■■■■■■■■!■Firm■�■w•��a■�1■■■�r■■■■■■■■■■■I�■
■■■■i■�A�l:.�:r��i�l.�s>r-.r.�
J■■■G11■11■■■■■■■■■■■■I�■
p length
■��l�rriiili■■�������■■■■�
■■11■■■■■■■■■■■■I�■
avg distance offshore 40
q�i�iiiiid�l.�ll�■■■■■■■■■■■■�J■■11■■■■■■■■■■■■I�
max distance offshore
■Yi"i���!■'�A1�:9[I!■ri��li■�■111■!1■IAI�■■■■■■■■I��
cubic yards
■■■■■■■■■■■■■■■■■■■■■■la"C7■
i1■G7rl�C■■■■■■■■
�i
ramp
■■■■■■■■■■■■■■■■■■■■■R��1■
11■■1:11"i■■■■■■■
�til1
■■■■■■■■■■■■■■■■■■■■■■rR■
11■�!!■■■■■■■■
is
■■■■■■■/:1r.�"i��:liE��J■,'�'.�!■■rail■
1!■�lt�'■■■■■■■■
■L�,
Bulldozing
■■■■■■■i■■�l■■■■■■■■■■■i
�l■
1!■1/ii■■■■■■■■Ir
i
���/.R'�4�1►7!'�11�1!■■l��J/!�'�:
=l���iu�i11■■�■■■■■■■
line Length '
notsure
■■al■�J
l �i�l7r'1�J'�nS:f11!I-�7■■■©'.��©'�L�OI���■■■■■
■■
yes
orium: h/a yes no
Waiv(--r2rbe =Ts
A building permit may be required by: At R s ! ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions A u T W a R/ 2 E D Lau L k H EA P LAN .Pub r4 2 D nT' AN 4—
/ I� oAsTA t- (J4-TLA d-D JL"R j A/G E G ST Q u c7-u E7 M u Sf 8
L" VAAi'L-' 7) A -r LE/1 5 r 3 A Ao ✓E W - LA /iS7-/10171.
4
Agent or Applicant PrintedVName
Signature **'Please read compliance statement on back of per it
Application Fee(s) Check #
YvD-7-1<? c a-r ki �4r
Permit fficer's Printed Name
Signs /
Issuing Date Expiration Date

;;rE
DGE & FILL N2 71410 q� C D
RAL PERMIT Previous permit #`
� ew LlModification EComplete Reissue 'Partial Reissue Date previous permit issued
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 1 SA NCAC ��f
attached• / ,
Applicant Name Sy` 5 n "1 T". A, t, t­ii Project Location: County !�k c
Address 3 3.5 *N A-4 4 --t-. ZT, �/ /� Street Address/ State Road/ Lot #(s)_
city/ a, t 1 rl`i > ,� State Y- ZIP .�' 3� `l ty a� VJ t )
Phone # E-Mai)
S rt r' t � � .c +Subdivision
Authorized Agent i y.t ; A 1L City c 5 11 ZIP...—.._
Affected�T` ES r�,(PTS Phone # ( } River Basin10<
. S E t ► L(
OEA L HHF C IH 0 USA n KIA �, � _._........
AEC('}: Adj, Wtr. Body - �'� � �-. i (nat &nko
L i PWS._
Closest Mai. Wtr. Body a '
ORW: yes /,6io PNA yes /4no� —v
Type of Project/ Activity
r
(scale:
Pier (dock) Length Y.
Fixed Platfor s
}
�b
Floating Futform(s) _
Finger pier(')
Gran kngthi3`
i.
8 Ikhe,4 Riprap length_ <�sr s . It
avg distance offshore
max distance offshore F �+
a
Basin, channel
t
cubic yards
Boat camp
r h
Boathousel soatlift i
fi
each sulkoIMgOther
-°i �� i �w j
a.>
° ! ( r'►^ _ ei � � fit'`'
j
Shoreline Length �i I c�t �} f i �1
Sl+V: not sure yea �_ °'• 5 �,' t�
Moratorium: 'ter yes no {
A
Photos: no
i
i
WaNer Attached: yes na -
A building permit may be required by: f f LA See note on back regarding. River Basin rules.
( Note Local Planning Jurisdiction) s
Notes/ Special Conditionsrrt•
j �
N He n' �^ �.' [ i 5 �" %iC 4 & t
Agent or Applicant Printed Narrie
Signature • *Please read compl ia#ce statement on back of permit ie
�t 5
Appticationfee(s) Check#
,.. . E C` -1�. r- v -- .
P. Oft eF"s Printed Hame
_....__........................ _.........
511 re V
z/ ! " fix_ _
Issuing ate Expiration Date

NC Division Of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Susan Orinnan
Dale: "28/18
Permit #:71414A
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
anlicipaled
restoration or
temp im cts)
FINAL Sq. FI,
(Ankipated final
disturbance-
Excludes any
restoration
andror temp
im ctamount)
TOTAL Feet
(Applied lot.
Disturbance
total inctudes
any anticipaled
restoration or
lafnp impacts)
FINAL Feet
(Anticipated final
disiutbance_
Excludes any
restoration andof
letup iropacl
amour►t
Shoreline
Dredge ❑ Fill 0 $olh ❑ Other ❑
46
46
Open water
Dredge ❑ flit ❑ Both ❑ Other ®
120
120
High ground
Otedge ❑ Fill C] Bath ❑ Other ®
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fiil ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ other ❑
Dredge ❑ Fill ❑ Both ❑ 01har ❑
Dredge ❑ Fill ❑ But ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Win ❑ other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Bath ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
2S2-808.2808 1.880-49COAST :: www.nccvastalmanagamvnt.net revisad:OZ.0310

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: G-r' ^
Mailing Address:���
Phone Number:
Email Address:
I certify that I have authorized
ent 1 Contra ctor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: _ , V-
at my property Located at oU to�- �"' ' ''z C4- "
inCounty.
l furthermore certify that 1 am authorised to grant, and do in fact grant permission to
i) vislon of Coastal Management staff, the Local Permit Officer and chair agents to enter
on the aforementioned lands In connection with evaluating information related to this
permit application,
Property owner information:
l^9"
Y
�1
signature
Print or Typo Name
Titre
Date
This certificalion is valid through _� 1-

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONtWAIVER FORM
Name of Property Owner: S to SA- -, &V-I ?,►V--0- V-N
Address of Property: 2-tUU 1i") - i-,) V � h t '--, UA- - fQ s Vte---&-4, GtrC-.
(Lot or Street It, St ree or Road, City & County)
Agent's Name 9-Le---
Agent's phone
Mailing Address: fo
�/ t 44-L-1 tAJN_A..) It
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or d(awlnq, with dimensions must be provided with this letter.
1 have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the DrOslon of Coastal Managemen t
(DCM) in writing within 10 days of receipt of this notice. Contact reformation for OCM offices is
avelrablAathlfa://www.�hcr:pasta/mananer�nerrt_rrel�ye+_+_.►�m/Sts�f-fl�tina orhyc�!,:ng t-8Q8•�,4wG'ASF,
No response is considered the same as no obJec tlon if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 1 5' 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.
(Property Owner Information)
Signature
��.$�✓� 6
Print or Type Name
3 5ti -�>v� ,r\ /
Mailing A ddress
Cltylstate/Zlp —
Uo � - t-I ' 1 �0 I C!
Telephone Number/ Email AddreSS
Dude
(Riparian Property Owner Information)
Riv,,,Aae
Signature
Print or Type Naft
Av 3� x, 1 �1
Mailing Address
10 , S la- "ItA
Citylstatellp
2-,:�-2 — L-f t; 1 f t- I . Lo 2-
Telephone Number/Email Address
-9-,20 -,WZ
Dale
(Revised Aug_ 2014)

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