O'Neal 71710 FLORENCE

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GJCAMA / LDREDGE & FILL
NO 71710
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GENERAL PERMIT Previous permit#
Yom= FA New Modification _Complete Reissue Partial Reissue Date previous permit issued
As aut on ed by the State of North Carolina, Department of Environmental Quality t=,�
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC .
❑Rules attached.
Applicant Narn-e-- )JINVIO L 1 L-t 4v- Project Location: County &AA-410 V\./C.41(
AddressD IStreet Address/State Road/Lot#(s)
Citi^` �y -4- State C. ZIP p9 4LQ
7 �� IVB _
Phone# (- .o ?i ,-Mailp� ,, �j Subdivision
Authorized Agent f/0 0 YT Y '(ii rVC1 City ZIP
❑CWEW )(PTA $ . ❑PTS Phone# ( ) River Basin CKtZ
Affected r'
AEC(s): ❑OEA ❑HHF 1=1 IH ❑UBA El N/A Adj.Wtr. Body CrIZ / � (nat /man /unkn)
El PWS:
`n f
ORW: yes / no PNA yes no \
Closest Maj.Wtr. Body VJ Y V
Type of Project/Activity q4 1 9k. {' _ci gtJ y� ,..,,a
I . , ' �' L20
Pier(dock)length
Fixed Platform(s) j. Al
Floating Platform(s) / ; l
I �, ii k
. 1
Finger .piers)
I ,J
Groin length j
number III
II 111 111 1111 10
/bulkhead iprap length
O
- —"avg distance offshore IAHhIIlII011hIHHh110hI_____Basin,channel P IIU11,III1I � _
cubic yards I mHuIIi!I rill
_ UUI M:WWi •a■U••■ mimmmo m
Beach Bulldozing I
ii '
Other �r ' 1 I 111°,410
, ,
toIilik •,OPA0101 A
Shoreline Length O 4 -
SAV: not sure yes 67", ! 10,410411r
6.? no
Moratorium: n/a }— \E_IE,r • ' I__
Photos: yes
I
Waiver Attached: ye no i
A building permit may be required by: l9 `‘. AI , l .•* I i See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions I;, / A / , 11-; et i A . 0 1, 1�' / / I ./J
y KY f # e1lAo,,frionS t -d _AV it
AIh ,5-,,, y toiAr— __ -"WO 1, 1 stin
•:ent or A • . Printed NAO' e Pe i�i�cerr''s Printed am.
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Signature 'lease read compliance statement on back of permit** Signature
pct ' aG I 9/&;"/ € 4) 1q
Application Fee(s) Check# Issuingo Expiration bate

it
Name of Propswty Owner Requesting Pte: Jame C 'Nth. : _
Marling Address: 1 0 cAsf set,
fiat-'hpr - NC 2 / 4
Phone Number: 3 3t,► 417 053 fr
Email Address; SOnC474 f A. h01,mA;1. cvovi..
uglify that I have aighortzed Ph ►,. #4\ " •wceS
Agent Manb ctor
to act on my tette ,for the purpose of applying for and obtaking aU CAMA permits
necessary for the Mowing proposed development elopment r Sv' 1411160,e0,1
Altiit Yip v 40 1-1Ws .rim. Flit
at my property located at 3 1 C Eel 1~ ,
an h co.*.
furthermore certify that I am authorized to grant, and do in fact want permission to
Division of Coastal Management staff; the Local Permit Officer and their agents to enter
on the `wed rr i in connection wilts evaluating information releded to this
peon*wipication.
Properly timet Itt#ocm■don:
O ,.
Primo'or Type
ftt
10 t ,3 f AGE, '
Dase
This ceryl is valid through 12- f 3 / f
1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J221PY\CS 0'Nem.l 's
property located at D E". (Name of Property Owner)
- � � (Address, Lot Block,Road,etc.)
on , in �C1�h�'�X)/�o 1 �vlc�n�t CSC , N.C.
(Waterbody) (Gity!T n and/or County)
ap! icant 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)
x
r
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.)
I do wish to waive the 15' setback requirement.
! I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjac t Propert • Information)
0417a lap 4seiparrit rt-\—_____-
Sig if e
e'rnCc O tiR . Si ature
�_ � (tel ,�v,e7'"" Y `�'��2r---
Print or Type N -e
315 - 06y .5-7—. Prrn ,ior yp
pAy s7
Meiling resstlTl`f�O�•T Mailing Addres, j �L �� ��
94, ©c9 fwd
City/State/Zip Clt ell'
NG '2'3 41'4
�e ' fB /foo
Telephone N �,/�'g, . Ty /mr
Date
Dat
!af 3 1 fr (Revised 6/18/2012)
i l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to jA1'nes Dt A 'lf�/1 's
1 (Name of Property Owner)
property located at SI &. �- � L-(p(,' 12 el
�� ��vasf� (Address, Lot, I3lock,Roar! a s�.)
on 1 in SD' OI
(Waterbody) ��/+�c , N.C.
itylTown and/or County)
�
The applicant has described to me, as shown below, the development proposed at the above location.
C-- L.) 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)
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.)
C- U I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Infopnation) (Adjacent Property Owner Information)
Sig rer Si nature
✓�ltP5 ()%/1 ✓� Crn,n r UJ Its
Print or Type Name Print or Type?dame
310 �-$4-y5 7, BAY -51--
Mailing Addre Mailing Address
oity iUC A$ / c,t-t 1-t Pt-xi (.J(
City/State/Zip 33G S[f �$c City/State/Zipb /
Telephone NumberTelephone um
bar
3.7G 17 - $f3'C. lu c{
Date Date
(Revised 6/18/2012)

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