70655_Pier & Platform_20180722

CAMAY DREDGE & FILL N2.70655':
GENERAL ' PERMIT � Previous permit # " %," `c l D
New ❑Modification El Complete Reissue.. ❑Partial -Reissue Date previous permit issued JJ 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 07)), ) Z O B
}��/V
A �) M _ 1 ules attached.
Applicant Name%1�/�' / I��� r �� F Project Location: County J2�Ite (
Address yli�, �� ����5 217 Street Address/ State Road/ Lot #(s) r< P, Of
City c ooA m9A State N(- ZIP � 7 Z 5
Phone # () - E-Mail
Authorized Agent
❑ CW
�4W
'VPTA ❑ ES ❑ PTS
Affected -
AEC(s): ❑ OEA
ElHHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes no
PNA
yes IQ
S2# IZ11
Subdivision );) Ur, 91V F Gib -
City (01W/ 1&A ZIP 27 r25"
Phone # ' 706J7' Ri�yeCr Basin K Q u 0 //-j;VK,
3uPPERw�,o
Adj. Wtr. Bodj4a4-'V& �(na /man /unkn)
Closest Maj. Wtr. Body Al 15- /" 1 i — � -
SCu PfP6f2n avc 240-rX.
Pier (dock) length 9l
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■IN:
RA
cray■AMMM
�M
KwMNMMMM■■11■■■■■'w
ma■■■■■■■
■■■■■■■■■■■■■■■
MEMO
■■■2111
Mm"aMME■■i■iE■
■■■■■■■■■■■■■■■■■■■■■■;■1,�■Y■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■�11■■■■■■■■■■■■■■■�
■■■■■■■■■■■■■■■■■■■■■E.■1.1■■■■■■■■■■■■MEMO
■■■EEO■■■■■EEEE■■■■■■E�■��■■■■■EE■■■■■EEEE�
ft
- �►����E�iE■■■■■EEO■■■■E■��±us■■■■EE■■■��■IEEE
Wd ►,
w
sue• _ .
i
Agent o App a t Printed Name
Signature, "Please read compliance statement onbackofpermit
4MID. 6'0 2G 1
Application Fee(s) Check#
PermitOf`�Printed Name
-
Signature
�z Oz. oJ 2v)' �9
Issuing Date "Expiration Date ­ :

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to �U-%Wa .J J�-AI IT l 14-r✓J-7FA,�i 's
property locateJ_.> 6F ,ter? 124 (Name of Property owner)
(Address, Lot, Block, Road, etc.)
on ,_C4/12 zll �Ja /1� .3k�aa,tc� - ,, In ��.� LZ �. � i N.C.
Nate ody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at ;rne anove,
location./
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual pigpasln8 dev lopmeni must MI In desedp�l on below or attach a s%te draw/ng0
%;
;? Jm7
7d `
,s„zn Zvi � t
r +NAIVER SECTION ' ` sr
' understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15, from my area of riparian access unless warred by
me. (If you wish to waive the setback, you must Initial the appropriate blanK oerow.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
�7
l
Ve�rre _ Prfnt or Time Name
Telephone Number/emer7 address
7 1Date
-i
Information)
w.` X6A.2 /YGA tD slv'
tuber/ma address
'Valid for one calendar year after signature*
(Revised Aug. 2014)

*k
ADJACENT ,RIPARIAN -PRQP -STATEMENT
ilveteby certify that 1pwr! pr
operty adjacent toA (NameofPro (Naarty'
Qwndr);
located at XI 1,
property /0 - - - * -
(Address, Lot, Bl_Qck, Road, itc)
on 4,443ainbbiZAZ - 0e=,I v, P, N.C.
(Waterbody.) (Cltyffown -and/or County)
The -applicant has described: tome, as, shown below, the development proposed at'the above
Jocatio I
I:haveno objection to this proposal.
I have objections to this -proposal;
:DESCRIPTION ,ANE)/.OR'DRAWING",OF'PRQPOSE-DDEVELOPMENT
cription,# W
fl;7dividu.stprgp-osingcfevelopment must, fill' M des below orattach .6 site drawing)'
10
IL
Z,
WAIVER SECTION
I understand that a- pier,, .dock; mooring pilings,; boat ramp; broakWatdr, -boathouse, lift, or groin
must be - setback a Minimum -distdi- 66! of 15'* from My area of riptitiah, acceVs,unless, waived by
me: ,(if you wish- to waive the, Wtb pk appropriate b1brik'below.)
q_,you'-musitinitialthe pr9pribte
do -Wish to -WAiviLithO 15'6etback requirement'.-
l-do ,notIWish,tb waive the 16, setback requirement
(P Info
rmation) (Adjacent Property Owner Information)
Name
m ing.,!q!urv=i
ule"
cifyz$talelzip Cl
lgddress T,elepftone Numbeitlethdil Te/- o'nc
V
Date 7—
-Valid foe orid,calendar-yearafter signature*
- S-XJA
email address
(Revised Aug. 2014):

Applicant:A%A7 A14N 4-MAF—Y
Date: a Z f U G[ ZO % g7
-General Permit #: ? ()6 SS- /3
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)
P
Dredge ❑ Fill ❑ Both ❑ Other
orZ_ Z
I —
/ Q� �-; 2
l� I _I
Dredge [I Fill [I Both [I Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ ' Fill ❑ Both ❑ Other [I -
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 ❑
rd