Jim Andrews and Jeannine SMith 72733D

, CAMA/
❑DREDGE & FILL AIrt, ._ 0 No. 72733 A B CO
GENERAL PERMIT /laIgf r r Previous permit#
)C C jew ❑Modification Ili Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality ry�/ /�,�n ry !/, SG
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / p(/c' ! /7
Je4tvro*E. IDRules attached.
( Applicant Name iI/►1 #i✓C!//I Pc✓_C 4" Ste'/h Project Location: County ! t/YDb/e //
Address !.1.4C/P.Z a/��-� t' , Street Address/State Road/Lot#(s) y6f/ # 4 3
City eA4rt 1 0 TT 4 State We ZIP .2 2 D? �/0k't!dl R66)0/
IPhone# (//2) ?AT- 1- 7 E-Mail JP') i°7177 @ Subdivisionsiio
Authorized Agent yeh00' coo, City ///f 7s76 .)) ZIP 79 --r
❑CW )`W � L
A XS ❑PTS Phone# ( ) River Basin �i/if O!gx
Affected
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. BodyIll ,��j/man /unkn)
AEC(s): / � f "
❑ PWS: Q
ORW: yes / o PNA yes / Closest Maj.Wtr. Body '/
1 Type of Project/Activity ZjJS%iu J/ /Yew it/0;4/4w 4.- re?,,,Ay, •e 7I'9( r
F / .o
-pc d -, Acc I/fief (Scale: )
Pier(dock)length )0b 'x jy' ,,,,. /Je 4'x' ) ' .
CY/
Fixed Platform(s) i O s '11
u
i � O � � W
Floating Platform(s) i _ =MI
Finger pier(s) , HP, ' f'� I Z I f
i
Groin length \ ,
I �.....u� �, i1
! number j
ulkhead/ ''prap length 3 i A , 1 J♦ 2 , /1 ,,�1 _ 1
avg distance offshore -� i I lb Al 1 1_III / I
max distance offshore -e yAn 4
/2
`{r Basin,channel '
1 id
A /
cubic yards 4, 71 � J
Boat ramp ;�� / IA
/ it _ 0 0 0 `f li 4 g °
Boathouse/:40 /2 X L X ,......"--- f
1jI'
'� U _ v
Beach Bulldozing Ih 3-7 / I 50 f j {4
Other 1 I 4
, : Mil
f . I
glir
Shoreline Length 3 9 a'- j e/ II SAV: not sure yes `[' -i----It .1 i _______ft, 43
;_4. _.
Moratorium: n/a yes C -. ( t i
'�
Photos: )0 no 4 I W i 4 7 Af(a Q w S Is-
- I
Waiver Attached: yes CIfj V
few; I.
A building permit may be required by: t w;e f Co . . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions No EX Pr!Q �J ['
/Y.f"O 0 r paCki ley -Pe c,1,4 Pf ly/aWL
,g41A14.4 (l "isr B6 I eN)wt9R. a 'It L'o9j/4L 1//1L94'o ,
-- I Pc RdreWS )e i e 6 p. hi/lsaa
Agent or Applicant Printed Name Permit Officer's Printed Dame 1
Signature **Please read compliance statement on back of permit** Signature
'too 1,3.12. i //iy V2,01/9
Application Fee(s) Check# Issui ggDDate Exn Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
��w►.l es /9-A-Cfr-e4.A/S
Name of Property Owner Requesting Permit:
Mailing Address: g LZ' Chu;
CG ✓w L- J rLv -7
Phone Number: '/ -7 re, g c) s v 7
Email Address: "1 / a ? 0 8- Q ` U•-� G
I certify that I have authorized J d' "�-5 � ���`-'✓S
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: /3 u-1t< 11 Q_a-c.i
d z Pe
at myroe located at 4/6 -�' �`{Y '`�� /21
p property
in P County.
I furthermore certify that / am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Print or Type Name
,�j Title
g" I 7 I / Ct
Date
This certification is valid through / I 7 / 3) /5/
I/ re..

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 'I2._O.-.i1 i tea.. Sitc.t_1-L.. 's
z (Name of Property Owner)
property located at
Z� (Address, Lot, Block,Road, etc.)
on , in /- -vt'c1-�e,--- , N.C.
(Waterbody) (City/Town and/or County)
The appli ant 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)
/- / 4 I E'1 -AL / // 4 0K7 )2 s--/- slelc t_Z-44I.
Co .1 rep✓ kA2-41 R-6---1 f 1-0 5�L4-r , ete-0-6$, r ev 4/43i
City rox ia �/. 4 't, $ �/'e1 7 t
. Con. h A e‘--) je&t/ C 47It 1/_ Cck 4,1/e,---e-cr45
#t63 e( i'2 ff V- aiwt, 4=. sit_ hU)--dEeYeif, ,.
.;
ilc. /2,2,0_,...".... -f-.-( ...„, cle..m.k5ov, t.„5-tt, 4e)../..5. ,...
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.)
l-' I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Ad' cent Property Owne nformation)
I,' ,,,,,,_
,...
Signature Signatu
P ' tor Typ Name /ti Print op'Twe IVeme
Mail' g Address Mailing Address
/- �twirl S�' _e_ce/ �G Z Y 9'4J ,! V: sue; ? /7c z
City/Stat 1p City/Slate/Zip
c Iv 3 L ZD_4 if 0 v )0 0 99.5--
Telephone Number Telephone Number
Date Date
(Revised 6/18/2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 6';‘- mot S 4it clfeW S 's
,, Name of Property Owner)
property located at 7�' / - ✓ e�S
(Address, Lot, Block, Road, etc.)
on G-kl , in 70/2S4(4
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
V 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)
1, ��c 9l� �e oD-�► �/- bc,(_k4eeLd 5/ e c f 6 f-
d
„t (..�� h sz� fk (oG{f 7`/_ c�It ���e� EcCzSS 6�
via( g .f� .`o� 5� s,{(�_- ©v/e•-/s4 '6 5
a$ 4ia- k e4 67 N14 •
/ � Sh 12 el oek-s
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.
I do not wish to waive the 15' setback requirement.
P erty Owner Information) (Adjacent Property Owner Information)
\i (') C irJ�r
�Stgnature Signature*
�J"T,ef-r3-2-/=5 .5 UUi Ei2 L1: 11-LP/J- 71Z ti
Print or Type Name Pam' t or Type Name__7
Mailing Address, g Address
Z�'1 7 �,� S �^�' l �n r --\^7 L I C.
Ci /St e/Zi g, o 7 City tat /Z 5
Telephone Number/email address Telephone Number/email address
Dad
Date / /
(Revised Aug. 2014)
*Valid for one calendar year after signature*
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I Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comments Receipt or Refund/Reallocated
Columni Column2 Column3 Column{ Columns Column6 Column7 Column8 Column9
2212019 .James L and Jone Andrews 'Jim Andrew and Jeannie Smith Bank of Amenca 1352'$ 200.00',GP#72733D OW rct.5870