Robert Lorenzen 70566D

ks "i\l-\', - �0(1l � LLL
�0GCAMA / ❑DREDGE & FILL Nro 70 t)Cl A B C
GENERAL PERMIT Previous permit# ti
liNew —Modification ❑Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality t: 7# , Z C�
and the Coastal Resource Commission in an area of environmental concern pursuant to I SA NCAC tom` ❑Rules attached.
Applicant Name ah /- �feA'7eo. Project Location: County /1 41 RZ:t a
Address O 2� Street Address/State Road/Lot#(s /
CityVIA (� 5v/ (! State N&ZIP " � 20E /L4 Ste!/ �q /11 •
'/7> Subdivision 'S 4f '7 �a�
Phone# qfq )-7 2)(-� E-M ' r 7�
ZIP ZAuthorized Agent j"►e ��`��^ City �-pw.e..e...ei �r.
❑CW W k,JPTA ❑ES ❑PTS Phone # (� ) Y V 9 7- River BasinP 64-
Affected ❑OEA 1-IF I=1 IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body ty5Gzt, /m n /unkn)
❑ PWS: i/ a.'rC
Closest Maj.Wtr. Bodyj
ORW: yes / no PNA yes / no r:52i9C
r r
Type of Project/Activity aZe--- %` ` ',-- - L.,
////��� ' J (Scare: / ri 3d )
Pier(dock)length (0 f� '��_� 1 I
Fixed Platform(s) f �". 1 "-- �' .....—L-� �` `.. ►�
1
Floating Platform(s) 1Z P r6 `l
Finger pier(s) `,r -- —.. - ./xi
T._
Groin length
number P
Bulkhead/Riprap length_ j
MIA*avg distance offshore l/K
max distance offshore \.�
11.0. K
Basin,channel *� ---- iii.4.. .tx_____1_,ii:,
cubic yards
Boat ramp
r / f I
Boathouse/Boatli / / Y 3 /'�' J jI/e (7 y/T' . 'lg.(
Beach Bulldozin f 1' * o' �' cr .4 �
Other ,
i 'ief/hici, ,
r,�7I._____� �.... _.......1. ?l�
fir .- - ��
Shoreline Length�� . agr
�T3�� I7- �� I s+ + ' _,
SAV: not sure yes t'..Y
c %
Moratorium: n/a yes 405 ��
Photos: yes 445 j
- - - - -
Waiver Attached: yes Q '',
A building permit may be required by: ,- CL_ W • See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
t L
r 1 jk I ° �� IN
nt or ppli t PrkekiName Perm' facer s Print Name
Si ature Please re compliance statement on back of permit Si n ure ''j 4." / ' /
nA' VV • /0 -- ( , Ig l(
AA
Application Fee(s) Check# Issuin Date Expiration Date

Ili / - !DREDGE&FILL N° 705 A B C./M)
%OF, ENERAL PERMIT #
'- , -Modification Cornpiete Reissue Partial Reissue Date previous permit issued
As authortred by the State of North Carolina.Department of Environmental Quality
and the Coastal Reactor Commtssxrn in art of environmental concern pursuant to 15A NCAC 0 . .
Apparent N , t€ &" Propect Location: County teel,Z-i-
Address L Street Address/State Road/lot#(s) ,!` /dj
CC. - _' ' !! L" State ZIP.j './ , t ,c61 �,�1'/'Lr �Z
Phone#p )7t 1C-E_ Subdivision 4 i cue/d
�{� C E!,r�,r ZIPAutl,on�d Agent rt!
CW 'ew A ES PIS Phone# fatt--� River Bassin dr
Affected OEA USA rva
AEC(s): Add.Wtr.Body (5,15,1 04L,Iti tunkn)
Closest Mat.Wtr.Body lelf
0RW. yes f no PNA yes I no
i
Type of Project/Activity {�i _
r / (om: ,✓ =f' o )
Pier(dock)
now si (Z r(46
E r+ger s;
,
1
Groinlumber
i� ,e, /Mi.,
Bulkhead/Riprap -,� i i av=destmce +�
j/4
max i '§I
Q.. ..1;' ..,-,.- n
Basin,n,chuwnel
tutus yaral i * =i
ir171 tellovA.if?'0/ . • 1
C71/ArLr41°`
1 ki-ife_ ._,- ,:
Usher I t.'t s y_„iL,� r! / / "L
(J l _------7 A
47 Jl'/ ii�M #r
1....44,_
yF _ plit,,, 'F€
SAY: net tire yes 45"P 16f,k2:11 ��►" jrMoratorium Wa yes . ,`�"+
Photos. rm.
Warner Atracfed- yes Pe*i ,�,r , _ .
A building permit may be required by- A C L� . . See note on back rev*ding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions
fiptf ,41
r
4 ,, ,--T,, ,..pkie--
,
or Name s Pn
,............_________.
��� f co rnplance statement on backofpermit" 41, (}-
flu
it — —7—
Feet's) " Check# tssut Date 4) Expiration Date

1111111
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date / a2 Y l
Name of Property Owner Applying for Permit:
£ e 74 72n
Mailing Address: 644ece t d
141,.71 cy 1, ,C. . 13
1 certify that I have authorized(agent) / i ig ii to act on my
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to

install or construct (activity) re 96l4 deel
Me
"
at(inyillreperty located at) 2i)6 /z A!f fit-`
Se.-4 6,3,tc . .,
This certification is valid thru (date) //2/ 3/ f
Property Owner Signature Date
1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to reii f-epi
, plume 0Property Owner)
property located at t 7;),121 41E4: ZUA _Y Z-A Le-4,P
(Address,Lot,, Road, „.
on ,/f/1.70 , in naiAr 7e4 a, Ni c
(Waterbody) (City/Town and/or County)
The applicant 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)
WAIVER SECTION

I understand that a pier, dock, mooring pilings, breakwater, boathouse. lift, or groin rnust be set
back a minimum distance of '15' from my area of riparian access unless waived by m+ ,;Of 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 with to waive the 15' setback requirement.
(Property Owner information) (Adjacent Property Owner information)
nature QLS
SiAndrure
Print c% Name Pont or Type NameMalay Address Ailorft Address
1
Qs
Crrlr{ loqig
laarz;R_12' ^ Co 5 7 S `t oa- `t 9 3 -b 2 2 v
T`epho,e Number Telephone Number
1 0- 27- f to e 21- l6
Dale Date
(Revised 611612012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
,,,eretr? ‘742r-ty IP-at I ow^ propel', ;11--,:!a-o4wr, teder-iL
Nia_me at Property Owner)
p7opertv ,it 7-4-X2-$21.11
(Address, 1.4,131oeck. f c /9-fillir kr 1' -
". -4-
(V4laterbody) (City/Town andior County)
TPcac:- -;:s. :n 7.re as shnwr. 7^r, evc,7,71rner1 P!OpObeC1 at tne abDve
.ric,.3Vcr
I< 1 havrn objeciiur tc,thTs propOsa
' navt3 a:let-horsi this oroposal
DESCRIPTION ANDiOR DRAWING OF PROPOSED DEVELOPMENT
rinaividual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION

Am. ......—
_noerstarld tnat a pa? doCK MOc-irt:1 '..: 11o1s zrealowater anatiottust :ft ,I.
:4 '71,rl'tnurn d;stan'-' or 1f5 .'''r)-"-- r area of r panan accest: 4.1.*, es -...Aivi.k.1 ny
vv.sr to or3;4e14i.e.sethary. ':),',.--must initiaI "..'te ks...07 oprio:e tiank. tet0w
. --.
Sotba:t retliwerile!1
v - -
I do not .-cr,sh 1.7.1 vo3+ve !f'te 1 te $40.-baCir. teglit-riltrCrti
(Property Owner Information.) fAdiacertt Prop rty Owner Inforrnattortt
.., ...
. 5 ke0 yeler
3214211V C?W`Orci 2-47#".‹.
./..1•''`7,: 411.trOL'..35,''.. ' ,
— 4104) - ‘,.) o VO
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