63893_Stven & Judy Thompson_20190304

`1•CAMA / ❑ DREDGE & FILL
ENERAL PERMIT
New ❑Modification ❑Complete Reissue ❑ Partial, Reissue
N270657.:._A. C D
Previous permit #
Date previous permit issued/A '
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 d i'j • (Z® d
�/ j � Rules attached.
Applicant Name 1%[J•' I TU 1b I 11nU/4?S o1" Project Location: County VAsai�^"/-
Address Nib 1 b C 0 u d �Zy LAKE b 1 ` . Street Address/ State Road/ Lot #(s) � g
City r a State t ZIP l 7' 0& !3A,"
Phone # () E-Mail -
Authorized Agent
❑ CW
VIEW
"PTA
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH
❑ PWS:
ORW: yes- /(no
PNA
yes
❑ ES ❑ PTS
❑ UBA ❑ N/A
Subdivision
City RUZIP Z�I�ffi
Phone # ( ) River Basin j2A50 V An% K
Adj. Wtr. Body S0 In d) A(na /man /unkn)
Closest Maj. Wtr. Body AG 9 04A tW 3, &A"V
Type of Project/ Activity AV OICR IUV f-16(y " 1�I�.�y 1 Zi-A)` / p(,A'FrOgrI t IZ71x , 4t ` -
�`A'j1-iDUSa (Scale:
Pier
Fixes
Float.
Fing
li
Groff
Bulk
Basin
Boat
Boatl
Beac
Oth
Shor
SAV
Mo
ng Platform(s)
■■■��i►Z�.���■■■■■■■■■■■■■■■■■■■■■■■■■■■■
�7�Jt■`�i�■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
ti■■fiiri■■■■■■■■R�',!■■■■■■■■■■■■■■■■■■■■■■■
number
avg distance offshore
max distance offshore
■■■■■■■■■■■±►�!■■d■■■■■■�5
'"'�iil■!�■■■■■■■Gd■�!
■■■■■■■■■■■1a■I■■■■■■■`
IIL%
l■M!!■VAM0■■■■■
3 Z'FiTiUM
cubic yards
■■■■■■■■■■■■■1■■■I:1•■■■■■■■r7■■■■■■■■■■■■■■■
raimp
■■■■■■■■■■■�1■I■■3■I�■■■■■■■■■■■■■■■■■■■■■■■
mouse
■■■■■■■■■■■f■lli��■Il■■■■■■■■■■■■■■■■■■■■■■i
oatlift
■■■■■■■■■■■■■■■■ic■r■n�c�■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■�■■■■■■■n■■■■■■■■■■■■e
no
■■■■■■■■■■■■■■■■fl■■■■■■■■61i■■■■■■■■■■■■■■
yes
Phot
Waiyker Anarbed,
l e
A building permit may be required by: W A .01 14/ ON Gfi
'('Note Local Planning jurisdiction) !
Notes/ Special Conditions Sl' ILI 0711. 0 Z00 C d A/9 J" 9�
❑ See note on back regarding River Basin rules.
Ak' VO�+ i� LIBOr-, Z a V /,\c LIO0 > r) BG�Of t 2 JJAJO S la(,c V S OZV c � tef 1Z>
Agent or/,Applicant Printed Name
Signature -Please read compliancels'tatement on back of permit"
� 2 p4, Of, R 71K
w " ApplicationFee(s) Check#
PermitOfficer's rinted Name
Signature
LI pwi(d 26i°l `) alAt Z61�
Issuing Date Expiration,Date -

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to5T& ya dwzz J- d(9 Mom QeAJ 's
me of Pr perry Owner)
property located at 39 % &66e e gowx5 PJNa
nn )) (Address, Lot, Block, Road, et
onitl�& MAr/L° 5001V Q , in /i ri-erL- , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
j/ 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
/tidiv dual pe'opos ng+:tlevelopinenf must,fiil jn.tdes.trip'lion;befow or aftac"_shW,# aY ingg)
Prr per-y
4; fie:
Aouse-
6u l
UD V y
ig-x it.,
Pro !!Ay
,d-e-
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.
f ' I do not wish to waive the 16 setback requirement.
(Property Owner Information)
r
I
ature
eVe - 7AJ
Print or�yrve
f _
fling Address
—City�lZip '
s7
13-5�9--1�32 ey�af�d �-7
i etephone Iyumb r/ ea,dil address
Date '
*Valid for one calendar year after signature*
owner Information)
Name
Mailing A re_s
City ateOp
r�.n.�4' . �1 L • r r7W -
Telephonb Number/emai,ddress
2-4f
--�=131o-3
Date*
(Revised Aug. 2014)

Applicant:SJrUc JZAp� 1�0/If�S0N
Date: � /"IA2C14 Z6 /1
General Permit #. 7 DbS T — 9
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 Dame
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 im ads
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
V- 2 q,t,
Dredge ❑ Fill ❑ Both ❑ Other
�lo�r2
ybr- f
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other [I --
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 ❑
t1 b 0 -