Jim Minett 72258D (2)

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0 ❑ MA C EDGE & FILL 0 722 8i
CA MA Li N A B C 6p/
GENERAL PERMIT Previous permit#
❑New Modification I Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ,t V� \ ,- t \
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC \ v UU
�❑Rul s attached.
Applicant Name \ I ICCAA Project Location: County (s
Address t 6� (l`�)A Y Street Address/State Road/Lot#(s), ,
Ci A" 1 State G ZIP �1 ` v'J
Phone# ( ) E-Mail �/� �A Subdivision
Authorized Agent \I 1i(.'.� J� S11� V t `(! A City ZIP
Affected ❑CW ft1 IJR` 'A >S ❑PTS Phone# ( ) y ,. River Basin,
AEC(s): ❑Ot?A ❑HHF ❑IH El UBA ❑N/A Adj.Wtr. Body ,t' k-V\ Ut/• ,I_ (flat /man /unkn)
III PWS:
ORW: yes /6o) PNA yes no Closest Maj.Wtr. Body
Type of Project/(( Activity t` f) 6U Ni_ lvv c I >L,,-'`-tiitild I2 uk lk-ini`k
k\) - /y1 f t(Scale: W-41) )
J 1 1
Pier(dock)length I
Fixed Platform(s) AL
Floating Platform(s) � ipr,• , 1 , �,�� '
r
Finger pier(s) o �/ ,,
Groin length 12, 11111111 _Ai
number H rA I '
, ulkhea�/Riprap length_ ��l / 11111111 i
avg distance offshore i I
max distance offshore O/ I
- _
Basin,channel II1IIIIIHIIii
M•111111111111111mimiri -
•■■■�Ii I IEWAh fpll► Ell
cubic yards I ON
ramp 11111111111111
i . Y
Boat 1111 I - -
Boathouse/Boatlift ',. i al rG'ua!�ni�.�'i 1 I11-S V ""i '�-
.... !�'�st>tlirw 1 I■ o `‹
Beach Bulldozi Iggriligille111111111.111111111.111.� � 1
Other ( y t
`1:
1111111 i
Shoreline Length 1-q1717 . MIIIu111� �
SAV: not sure yes o � ..■•",�'�.. _l
Moratorium: n/a yes no L— II1iIi
. � �wj� ��u 1r
Photos: yes /no h 1
Waiver Attached: yes i no P- L.
—
A building permit may be required by: f I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) (;
Notes/Special Conditions \J JISA(l)
' JC a N,J U f (/(g.,
IU/bkt�rki \
•- or Applicant Pri. -. Name Per tOfficer's Printed ame
L....‘
Signatur- **Please read compliance statement on back of permit** Sign ure
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Lk_\VeC1 1 1t �4 1 (i
'I e(s) Check# IssuirgDat Expiration Date

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: k►li e s - nr) 1 r1 cii --
0 .- 7 G4 ptaill /1 d k 0 S tOr ,i' ,
Mailing Address: (�••
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Phone Number: 7) ) --5 4-- -- /y3
Email Address: Cl ('1c key,Ci prct I Q (Ai,J ►'✓vv ,j MG r'1. Cc)ii,-,
I certify that I have authorized c s Sc Y e Pi0 d-�d in 11 ' Agent I Contractor
to act on my behalf,for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: (YV r,o c e e h c irtx-4 do/rPp4,'fs
loca4(4 A /J 2.? (epic?i i 4,-/kdir L),^,-,.� Sau44n o , tit< C5e4 oc l l 44)6ik
at my property located at /o. .7 r6e161/r1 6'ILIKiv,r nfr(/_) -cv`/pc)r /,1J
in (on s i,'ck County.
I furthermore certify that I 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:
dIA6(44) e 11/644,E(1,,
Signatu
�u v►n e S E. iii di e J f':
Print or Type Name .
OLUV)er
Title
11 / Or In
Date
This certification is valid through 6 / 3 0 ! I I

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CERTIFIED MAIL° RECEIPT
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Certified Mall Restricted Delivery $ $y(.00 He
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Adult Signature Restricted Delivery
co Postage i^,.50
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PS Form 3800,April 2015 PSN 1530-02-000-9047i See Reverse for Instructions

U.S. Postal Service-
CERTIFIED MAIL° RECEIPT
Er Domestic Mail Only
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:
pj• Certified Mail Fee _ .:.
$ = \\41
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D ❑Return Receipt(electronic) $i' I1 r 6 2 mark
• ['Certified Mall Restricted Delivery $�I fi I ( re
O ['Adult Signature Required $ 1) -
❑Adult Signature Restricted Delivery$
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Sent To rl
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PS Form 3800,April 2C 15 PSN 7530-02-000-9047 See Reverse for Instructions