63015_Add 2 pilings to existing wet slip_20180807

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GENERAL PERMIT Previous "ermit# A,, °"
i P
w " C N6W ❑Modification - ❑C'o'mplete Reissue . ❑ Partial Reissue Date'previo'us permit issued:`.'. " :1r t
?. As authorized b'y the -State of North Carolina,, Department of Environmental' Quality
and the Commission' in an area of environmental concern pursuant to 15A NCAC a7 r) / `� ``� "
.,. \•.
- - - - . ; Vsl Rules attached. -
Applicant Name "rl hn% , } z;1G_ • - Project Location: County'.
` . -Address 3 30. p � 1�;, qz-� �� •' Street Address/ State Road/ Lot-#(s)p c- F-F
city 3t , State H C_ - ZIP '2-7 <A , 4-
Phone # ," 2} ti +3- - 9 ?'S 2 E-Mail' ---
Authorized Agent' vice rw I, p. 'r �) au Ct>►^'�.'
Affected • ElCW 'O'EW PTA` ❑ ES'. ElPTS
❑ OEA O HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
ORW: yes / no PNA • yes / no '
Subdivision
City ���d a ' S. �YL��Z✓�.. ZIP 21 45 P
Phone # . ( ) -- River Basin; I A L : P�ti, � I e- u
Adj. Wtr. Body 3, i� i a C)a y7 L nat man"/unkn)
Closest Maj. Wtr. Body, ?A"AL'
■■■■■■■■■■■■■■i1■■■■■■die■■■■■■■■■■■■■■■�■
■■■■■B�!�11;®�1■■■■■■■■■i�■■■■■■■■■■■■■■■■■
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_ _ :
Agent or Applicaq't Printed Name
-�e_l c
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
s Printed Name
4(,�L%2,,
Issuing -Date Expiration Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ''h6 ma C A 's
(Narpe of Property Owner)
property located at -3r- Q t- c C"Shwo, le" f) Y-100,
�r n (Address, Lot, Block, Road, etc.)
on I LL reek , in 61 /-)t CYe&<J Ak' , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
!naliv aqua/ Jro osin ""rdetrelo menf- if. ti%L=inldesc � ion elor ar"attac7r a site= avrr n`` �AR - 9F — p-P - 9e
Newer Iles
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.)
I do wish to waive the 15' setback requirement.
L. I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
77�Dma.s /Zees
Print or T e Name
:3c30 /rE si 1 w✓+TE;2 ��..
Mailing Address
,�-av"vTS c,N�61e' ILA-, d VY/34
City/State2ipp
Telephone Num er/email address
Date
(Adjacent Property Owner Information)
ature * C
Print or Type Name
ding Address
14- . t4C Q`] (�l
UV/ tate/Zip
S' ((0 W ` 0 - 5 t'zt
Telephone Number/email address
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
H
W

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to :a Om GLS Ale- 's
(Name of Property Owner)
property located at c5c' A04'
(Address, Lot, Block, Road, etc,)
on Is Cl--ee KK , in ,Blea"91i 6'-w2 , /Uc- , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
t/ I have no objection to this proposal.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
Ind w ud al ro osin derielo mentmustllxin descri tion.Iieldw=a� aftasite dr iwa n
WAIVER SECTION
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.)
do wish to waive the 15' setback requirement.
do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjaiggrit Property Owner Information)
Signature Signature*
Print or Type Name Print or Typpblame
c3�0 F�isHW.4T�� l0e
Mailing Address Mailing Add,rress
0i0u/I XJ �reft, lU c a lij' l bU» i�
City/StatelZip City State/Z'
6a ��/�� 9 D �c cru i.l�er i c�duc0 cor, a`.��?-4%3.9-7e'l
Telephone Nuniberlemall address Tele h ne umber/email address
Date Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

Applicanr__r_A-o M R-.J A ee- fL
Date: r7 ALA tq K 4T 2 o I
•General Permit* 2, c7'2- ,
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 im ads
FINAL Feet -
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
w,q i—Y,
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑