70625_exuvate for manintence purpose_20180131

aY`w'knxfil�'AMA /DREDGE & FILL 0
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iGENERAL PERMIT Previous permit-*,
;., ew, -❑Modification El Complete Reissue El Partial Reissue Date previous pdrmi7 issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in a area of environmental concern•pursuant to I SA NCAC
XRulul�es attache .
Applicant Name i �L LQ//I f Project Location: County
Address �. IlkStreet Address/ State Road/ Lot #(s)
_City Gay%l!�/� (Xi',r� State)
Phone # Subdivision GU��
Authorized Agent ,/ "?le/ ,�i�/1%'1 City l ZIP
Affected [ICw [�EW APTA )4s f TS Phone # ( ) -River Basin �� �~ �—, -
❑ OEA /❑ HHF ❑ IH " ❑ UBA ❑ N/A /
AEC(s): Adj. Wtr. Body /� G(nat man),unkn
❑ PWS: r .
—� Closest Maj. 'tr. Body
ORW: yes / PNA yes no
Type of Project/Activity Ar 7-�9 /G_
(Scale:
Pier
Fixec
Float
Finge
Groii
Build
Basir
Boat
Boat
Beac
Oth(
Shor
SAV
Mon
Phot
Wain
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length
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number
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distance offshore
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max distance offshore-
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-i Bulldozing
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Mine Length
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A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
KSee note on back.regarding River•Basin rules.
62
&"C r��inted Name Per1'0,/ /.9
x x
Signature ** PI a read compliance statement on back of permits Signature_
Ad� ion Fee
plicas) Check# Issuing Date / Expiration Date
Ie

fNC ®vision of Coastal Mgt.
Applicant:
Date:�Gj%li�Gtfl +
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 finial
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge Fill ❑ Both ❑ Other ❑
r
Dredge ❑ Fill 0 Both ❑ Other ❑
?4-2:9
'
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.nccoastaimanacaement.net revised: 02/03/10

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 3^u �� v►`%.re C r`c� DuirOtir D,s l��)
(Name of Property Owner)
property located at T 1a. 44e,-, --n I &'- J Or ��..'P e Au R J,
(Address, Lot, Block, Road, etc.) IJ
on Cewin ka c Ge�w �u , N.C.
(Waterbody) (City/Town a d/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 frl% in description below of attach a site drawing)
WAIVER SECTION
I 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 waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
'1A,� I do wish to waive the 15' setback requirement.
TA I do not wish to waive the 15' setback requirement.
(Property Owner Information)
H,4y c- co—kY 1w,Gi Ake-
Sigp tuYe + F 6
Print or Type Na(�me
Mailing�ddre�ss � 0PP o,x
City/StateMp // 2%98S
.S lnrrt O na-o ieY 9C
Telephone Number/email address
ZS2 926" 7Z53
Date / — U — /g
Valid for one calendar year after signature" ,
(Adjacent Property Ow er Information)
Sign tune
Print or Type Name
Mailin ddress
d es/-z�-�✓�� `�.. ,V. C
City/State/Zip
Telephone Number/email address
Date*
(Revised Aug. 2014)

- - ♦�Legend
CAMA Minor
Bay Canal Excavation
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 3^M S4�we'�'^re C�,rec� ®OAr4,- �s I e��
(Name of Property Ownerl
property located at I I&
-gzeW 1 )-n 4% Q e -'J ®-r C'r@n-%
(Address, Lot, Block, Road, etc.)
on gay 6^vvc8 A CG« in HIA e cay.w 4w , V.C.
(Waterbody) (City/Town a d/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
Ndiviafua% pr_9po9r:f9 elopirtentpiu tus€ f dl ire des eg lion below or aifac1i a, site drawing)
SIN (VJqB .
WAIVER SECTION
I 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 waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
'1A� I do wish to waive the 15' setback requirement.
NIAI do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Hm, c- Lo__ky /west Q.-Pilev,
Signature
Print or Type Name
�in✓io e 13
Mailing (Address B�
e
City/State2ip� � � � �
3o•.r� Q�n�-��rrr IBC ���
Telephone Number/email address
252 92&"' 72.53
Date / — � — /g
I elephone NUMPer / email address
Rl17M-33:3(
Date* 1P,- /A3
R d
*Valid for one calendar year after signature*
j evise Aug.2014)

CAMA Min,
Legend
or
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Bay Can Excavation
al Excavation
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