71232A_Daniel Mugan_20181130

� CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
,XNew ❑Modification ❑Complete Reissue ❑Partial Reissue
No 71232
Previous permit #_
Date previous permit issued
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 !1 .1 tvv� '4 W .1»'
U Rules attached.
Applicant Name Do n t ' MA U c. G
Address Po (3o)( 1O1I
City 1'.A0 N L) L IL State 1d L ZIP )-4cAV 8
Phone # 06ttl) 567k- 34 9 $ E-Mail
Authorized Agent
Affected ❑ Cw ❑ EW X PTA ❑ ES 9 PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs:
ORW: yes /,t o PNA yes /�
Project Location: County Cv r r, � ' k
Street Address/ State Road/ Lot #(s) I y
5e*1>ici, Lot 1'
B C D
Subdivision _Ty%, pl 0('"Y
City 140 ZIP )-4GS9
Phone # River Basin
Adj. Wtr. Body r ,1 4, Kk ; i k" sf (nat /unkn)
Closest Maj. Wtr. Body C, I lkv 4 (C Sa"'d
INN
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r
Agent r licant Printed Name
Signatu*Please read compliance statement on 644k of permit **
$ scar). W �'-40
Application Fee(s) Check#
PermitOfficer's P ' Name
Sli ature
11110 j{avld 3)3o)aolg
Issuing Date Expiration Date

NC Division of Coastal Mgt. habitat Impact Computer Sheet
Applicant: k le- o be n, t
Date: 1 t) ,20%13
Permit #: :7 % a 3 -\. 4
Describe beIN the HABITAT disturbances'forthe 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
S
Dredge ❑ Fill Both ❑ Other ❑
�-
!p holt
Dredge ❑ Fill ,j Both ❑ Other ❑
(d
4 6-1'
Dredge ❑ Fill ❑ Both ❑ Other ov
3 f\ L-t O
3 d. %4 0
' w
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 n www.nccoastaimanagement.net revised:02103M0

DIVISION OF COASTAL MANAGEMENT
AGENCY FORM FOR PERMIT APPLICATIONS
of the property located at:
(proper-" w.:(_:_:�* cddrissj
(proper^:._ ...:: z:=ress;
do herebv authorize
cc-ing as agent)
to act as my agent for the purpose of obtaining an= new d a_�al Area Management Act and/or
Dredge and Fill Act permits, that may be n _c-e n-Ljosed development at the above -
indicated property, which entails:
(describe proposed developments"or ;:rich permits are being sought)
This agency authorization is limited to the specific activities described above, and will expire on:
—,%C/
(date on which agency authorization expires)
(s gnature)
(printek name of owner)
(date)
(title, if officer of Corp. owner or trustee for property)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: J ,6whl
Address of Property: 19t
Tjc!-. Z 7q
(Lot or Street #, Street or Road, 'City & County)
Agent's Name #: �- ) -� v� Sc Mailing Address: \ �1 tV (� C°�e-Vz=t
Agent's phone #: 3 33 - 03z� 2 1< �- ��C, -
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 or drawing with diinensiorts. r>atsihe
✓ 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 metro:!/wtirw.nccoasia.mar?aos�rerf. ^eJ�+eblcrr/staff isti�o 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
I 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Property Owner Inform tion)
tune
Print or Tyo Name
I IT � Peer-y yl,"
Mailing Address
00^' m -
City/ tat ip
9 -7-34��
Telephone Numbber/Email Address
Dat
r Information)
\ate
Signature
Print or Type Name
Mailing A ress
/
'City/State/Zip
Telephone Number/Email Address
Date
1J''Z
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, City & Cou
Agent's Name #: 21CL Lkca-)
Agent's phone #: 2-3T�
Mailing Address: _t 3IS la k dekzIrcl-
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 or drawing, with dimensions 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 ^:t,-:r/t(v�rvr. r as _ ace,YeT< ne�IWeblcMisbaff r or by calling 1-888-4RCOA S T.
No response is considered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION
I 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.)
I do wish to waive the 15' setback requirement.
/ I do not wish to waive the 15' setback requirement.
ro rty Owner Info ion)
gnature
Print or Tye Namb
I ®i YUI"
Maili Addrr�
� ��
C► at 'p
17-�'-;4
Telephone Number/Email Address
Date
(Rips ian Property Owner Information)
i tur
K 111'1 d S s e
Print or Type Name
ral
Mailing Address
City/State/Zip
Telephone Number/Email Address
1 I Z 9 I1Z
Date
(Revised Aug. 2014)

FOUND
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