Baxter Cheek 71752D

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urARtcANE�
LAMA/ DREDGE & FILL o 71752
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GENERAL PERMIT rLo1NCE Previous permit#
New ❑Modification ❑Complete Reissue El Partial Reissue 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 ISA NCAC D rJ Ft . 2 5 U 0
❑Rules attached.
Applicant Name 13AX i"E R C Nr_E K Project Location: County e R,A N S u I c K
Address 32. F A IRMONT STRtE 1 Street Address/State Road/Lot#(s) 32 FAtRu rt,,/r
City 0cEAAJ 5tE. grAcN State iC ZIP 29469 CSAMt.)
Phone#(el lo) S 12•(dL`I i E-Mail /J AA Subdivision A/IA
Authorized Agent iSz lcr. Co.41-ra IA c T toN City 5-A lAC-- ZIP 5AMr•
Affected 1; CW yfEW %PTA ;i(ES XPTS At,r,./-i Phone# (110 ) 5/(1 - 90. '1 5 River Basin LA 1.413KIR
AEC(s): El ❑HHF ❑IH El ❑N/A Adj.Wtr. Body CANAL (nab it /unkn)
❑ PWS: '�
Closest Maj.Wtr. Body A I W 1-1ORW: yes I 0 PNA yes /
Type of Project/Activity PEPLAct. E.t..LKNEAr AAtn ,CK.Iid C-z FA Ie.f-ry
IA/ F-x ► 3 i INc, AttGNMcA/-f (Scale: Irt : ZC')
(dock gth G ' X 4'
I I
Fixed Platform(s) s' -r. 1 __
oating Platfor •• ) t8'1 )( lb i
ger pier(' A' X 7 ' ! 1 I
Gr•in length . �./�:-% _/ t1 C A AlA
.umber
4 =_ rap length ± 40 i
avg• tance offshore #I
max dis: ce offshore S C.
Basin,channel r E R HA'12 f1 u 1-a/amt.",Mi=N T
g'
cubic yards 1 f
f
Boat ramp �� J
Boathouse/Boatlift f oO''' (6 ;•
0, t s*Wi_. got V� m `
Bulldozing � �,,,VC+�►r I
��� � �- � � � i
Oth R A M f /k /( ' , ,y—....�.-,... P� . , r
bW= IzF -P+ _ Y (f 1-"rrwr V Jo
EXIST nra 1'iu�KuieAo NM ` �/ ID' W LiaNMng-r •
'. r�oA 9:�� f'�FT�A Nfar .
Shoreline Length 5.0' �� \ \\\ , , I �/
L IM TS of VITURITANC,L �i
SAV: not sure yes � Y CA",r�hGi>'�.�.�w+e,t►
♦ \ }
Moratorium: n/a yes 0 \ CHEE
'' I
Photos: es no --- 3+ _ 2: Fjl t R M o N S-r, I. 30
Waiver Attached: yes no — - _ _- _ . _. - _
Pt.- Pt.
A building permit may be required by: T W/V Or OC r-AN 1 sty grA c vk • n See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions 0 7 .y . . 5 O C3 - A N.D A u. O 1.W£0. L o C A L Sr A-r L ' A N o
FE-r RAL RECt-1L.A-r ,4aNS APPL-Y.
'A__) :,,�, - , i i,Eg Mc CuIR
Agent or Applicant Printed Name Permit Officer's Printed Name
-.**11,6t/ Ac A
Signature **Please read compliance statement on back of permit** Signature c
N%A iv/A 12/ 17/2o1Fr 9 �20/2o1y
Application Fee(s) Check# Issuing dddate Expiration Date

10/24/2012 00: 55 9105799096 GRICE CON PAGE 01
_TA
rr-4iI ' ,
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pal McCrory Braxton C. Davis John E. Skvaria, III
Governor Director Secretary
AGENT AUTHORIZATION FORM AGENT i - • • ,---ON FORM
rT 1 .7fi •
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C.Davis John E. Skvaria, III
Governor Director Secretary
Date: 12 - 17 - it
"r fNaame of Properly Owne Applying for Permit: N of Authorized Agent for this project:
Owner's Mailing Address: Agent Mailing Address:
32 PAI.r"D,,7 51 '
�� C4L Pr' �
Oc� ale ReA r Ae- 2[MR C�� / N(
nCQUrl iS. u6L
Q r, .�
Phone Number(9i0) 5 i Z- SO(0 97 Phone Number j q)() Jc I �1 �9
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I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and • •r an CAM rm
A Peits necs ry to install orconstruct the fofloMring= oti j roetw_ ga...
•,,Aler //_. RAth,_41.11-444brA42-1-/‘‘' az tvi-14i2t-wk repAaL lit ,-.),Rfay-,
127 Cardinal DM*EA.WMnetseen.NC 26405
Phan 910-796.72151 FM:910-395-3964 Internet vela noxiadel nstegenrrl.nsr
M( a Com,* Ahab*Aar Drew

10/24/2012 00: 55 9105799096 GRICE CON PAGE 02
For my property located at 37-- •‘•'s-v,c^� S,G-,g-e- Oce, s/e it. AX 61
This certificaw is id tfiru (date) V .
✓
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