63427_Nathan Newsome Jr._20181106

CAMA / ❑ DREDGE & FILL
s r. No 72929 B� . c
GENERAL- PERMIT :� -%'" i�
,. � Previous permit # ��
y (xNevv [-]Modification., ❑Complete Reissue []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 15A NCAC
/ / ORules'attached.
Applicant Name OI/Ut�CElil�djrh�= J�. Project Location: County
city
Phone # Q) Z
Authorized Agent
Affected 0 CW -
y AEC(s): ❑ oEA
❑ PWS:
ORW: yes /(50
f State ZIP
!61E=Mail•
/ U %/'/G c/11'
( EW PTA ❑ ES . ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
PNA yes /16%
Street Address/ State Road/ Lot.#(s)
Subdivision 604P/��'
City J f _ 1. zlp�
Phone # ( ) 'r— River Basin
Adj. Wtr. Body ��in�Gi� /IJLf nat' man /unkn)
Closest Maj. Wtr. Body A"'.7,
i
■■■■■■■■■■■■■■''B1■■IJ3■■■■■■■■■■■■■■■■■■■■
■■■
■■■■■■■■■
■■■■■■ ■■
H■■W■■Ear■■■■■■
■■■■■■■■■■'N.■. l�cEMN■■■■■■q■■11■■■■■
■■■■■■■■■■■■
0 ...■ aG�lWWW
M0■■■/, WONAM■■■■■
■®■■■■■■■■■■■■3Ci.■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■
MW
■■`'■LJ41ii�(�■■■■■■■■■■■■■■■
■■■■M.
■■■■■■■■■ ■■/I■■■■■■■■■■■■■■■■It■■■■
■■■■■■■■■■■■■"I■■!■■■■■■■■■■■■■■■■�■■■■■
■■■■■■■■■■■■■■;I■I�■■■■■■■■■■■■■■■■/I7■■■■
•
■■■■■■■■■
�■
11�■■■■rSZI�,9�■■■■■■■■■■■■■
■■■■�
■r.E■■■■N■■■■■■
OEM i-i■■■■■■MEN
■■■■d■■■■■■■■■■■■
:®■■■�■■■
■■■■■■■■■
-
,
&netf�or ant Printe Name Permit(3ffice 's Pri Name
ySignatu * Please read compliance sta ement on back of permit Signature
Application Feels) Check# Issuing Date
117
Expiration Date ,

Authorized Agent Consent Agreement
i, herby authorize Tobin JayTetterton of
(Property vner(s) )
TJ's Marine Construction, LLC to act on my behalf in obtaining CAMA permits for
the location listed below.
PROPERTY ADDRESS:
PROPERTY OWNER'S MAILING ADDRESS:
77
Phone No. ,�
PROPERTY OWNER'S SIGNATURE:
AUTHORIZED AGENT SIGNATURE:
DATE: U
W/Authorized Agent Consent Agree.

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: /Ulir7L7 ,���i,
Date: 6 L/�r '9, &e
General Permit #: qe
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 impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑
1
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 ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimana-gement.net revised: 02/03/10