70685_Bulkhead_20180305

' CAMA C / XDREDG'E & •FILL.."-(,o 2,N2, 706�'S , "w ; .A:...
EN ERAL PERMIT Previous ermit # N A D
" �7 p
�ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued A/ 4
;ks authbrized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name CA�IOL. JJ ► 15 Project Location: County WAs71)
Address as - Alf 1 J VfZ'-Y ( MJ?J Ak, Street Address/ State Road/ Lot #(s) ZT3 A)E L-)f�4AY—l<
City �D��6� / State_ ZIP l 6 Z ij/` pp d
Phone #'(�sZ)gI'Q�55 E-Mail Subdivision %V)eln/y/ r
Authorized Agent
❑'
Affected CW AEW PTA VES YPTS
AEC(s): El OEA ❑ HHF ElIH ❑ UBA ❑ N/A
❑ PWS:
ORW:, yes / 7 PNA yes / no
Type of Project/ Activity
Pier
Fixe
Float
Fing
Groi
ulk
.j
Basin
I Boat
Boat
Beac
Oth
Shor
SAV
Mo
Phot
Wai
9V L1411rt&)
City ZIP1117d
Phone # ( ) River -Basin pXS�Or. AI4
Adj. Wtr. Body A u _l` oic 5elwu J n:5/man /unkn)
Closest Maj. Wtr. Body ZPWAX-C s6u
,"(Scaled
plength
■!■■■■■■i/iiiil■■■■■■■■■■■■■■■■■■■■■■■■■■■■
MEN
■■!■■■■■■:■®C■:■■�■:■■■■■■■MO:■:M■■®
ber
Am
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■a■■■■■■■
avg distance offshore 7-
max distance offshore 2-
■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
:■■■:■:■�■MEN
■::■::E::■■■■■■■
M■■■■■:C
cubic■■■■■■■■■■■■r�r��■■■■■■■■■■■■■■■■■■■■■a■■■
ramp
■■■■■■■■■■■��■■■■■■■■■■■■■■■■■e■■■■■■
■■■■■■■■■�a■■��>,■■■■■a■■■■■■■■■■■■■■■■■■
Length
®MEMEMEM
®,■■■■
■■■■■■■
■■!���■■■■■■■C�rr1■■�i
MEMM
■.M■■.C■■■■
Ifs■■.■■
....
ON
A building permit may be required by: IJAAAIG i6,A) ❑ See note on back regarding_River Basin rules..
( Note Local Planning jurisdiction)
Notes/ Special Conditions o7d. i/vo Pcrm I /
IJATI;714 A)W r_Al snA- DA C (- r
r o / -.). /,., (aw r S
pplica9 Printed Name
Sign tur ** Pleaseoad compliance statement on back of permit
-,;Application Fee(s) Check#
VEU 1/4 t1AIzT' r
PermitOfficer's Printed Name
Signature ;
' P,A L Y Z01 % f, Z O/ .0
Issuing Date Expiration Date

Applicant: C,004YA) 401�W S
Date: 6- /JARGH ZOI$
General Permit #: ?a 6 $
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 blame
DISTURB TYPE
Choose One
TOTAL Sq. Ft
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. FL
(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
.S 0 (( df
Dredge ❑ Fill. Both ❑ Other ❑
l Q©FT-
jDOF
ji 1(.1} P44tA
Dredge ❑ Fill ❑ Both ❑ Other
rD�0F�2
LXp0 0g
Dredge ❑ Fill oth ❑ Other ❑
0F1''7"
l oo r*'?*
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 ❑
r
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

21
u_ gou0gd laT
N�••�-�'�O ��rL�
—_) a, .
v '
V
•? V�l`Sd1•TCl�c� .i•�•-1��5 IC bi} ��:�L•f 0L Lp /twt 0P
_ roc C -q -- e ar_ r!
('Pi01��Icz
r %ni �a� s7cJ%U 01M
G1 4Su�.i �LJ. -I� u0G °S�i ; •���r ,; [! �� �u�.:0 0 ` Dop :G _cy=?—
-a o'q --s
-' U. 7.-10
n �, r r%•nii�.n �:{,:J��'•JS'.:_ �/� GJs �?�%�: a7��:,: i2i SCs "� f
f ,1
? � r�^. ^; 6:Y:^ ✓'C+- �� .��i7��.r'.' OL_{: _„r: G'.=i,•l:.. r_V1 ur'_' 1.•� ._ •' � sr -
.-
�^ ,'e7 ;�f�!f ''ist^.ri'•✓�� ii3 vi ��v'..=" _ � - _ ' a^. t a ��3 .S'r:i'-�L'/a�iS�v �!?1��=SC--ti O-
" ^ L"u a: i ;. i ��„ , a5uo Lr SJGS�rV •:� �i�-yGL% S'� .,�i•J- G�!•- -
2 � •�L.."�CCC�?C r� i�
_b jq �1 -f �.t.l�
�.{ A � �:s-°='� Uai�J�;� ��= SI�;,t ;11'='•,.i .. .'t� r � • ; `f;�, r•��-ate � �3
'fL2�tiOlan'u �� s�..• � �' 3d�n a_, OT •'tom=Jc��7 ,ai �=fip_ i Vr rj _ _ :,:- � ' ..U.
Car, ia+��s1�t �ujil
s fy a7 u '

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Ow
Address of Property:
(Lot or Street #,
Agent's Name #:
Agent's phone #:
Mailing Address:
',CJ'+ o,^
0 U riAq
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 o� drawing,. with'dimensioris,- must be -,Provided with this -letter.
)/I 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 Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http✓/www.nccoastaimana_gement.netlweb/cm/staff-listin_g or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
-Own
Print or T
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' -setback requirement.
Mailing Address
R6 p,_- v- Q 7.9- 7 e)
City/St te/Zip
Telephone Number/Email Address
15 - 3- lP
Date
(Riparian Property Owner Information)
Signature
,"�/
Print or Type Name
a 6,6` 117Q,)heYr
Mailing Address
J
ACo ,Ien Afe-, -7170
City/State/Zio
5 71 - a 759-0
Telephone Number/Email Address
`� -
Date
(Revised Aug. 2014)