64158_Michael Lee Moore_20190411

yiMi4 DREDGE ",,A FILL ., /G/ 2
GENERAL : PERMIT.... 1,�0`
Previous permit # i � :. �,15� -
-Aevv ❑Modification :❑Complete Reissue.' •- E]Partia['Rdissue Date previous permit issued
As autfiorized by the State of North Carolina, Department'of ,Environmental Quality.
S�
,.and the'Coastal, Resources C `mmissioh in an area of environmental concern pursuant to 15A'NCAC
' WRul s attached. .
Applicant Name: %!/l �� l G- ��Gt L Project Location: -County
Address �J X G% Sti eefAddress/-State Road/ Lot #(s), �/ �-7i��
City . �. State . ZIP
Phone #,(j`� E-Mail
Authorized,Ageht' '.J�
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E� CW
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�,ES -
Affected
EroEA
' AEC(s):
❑ HHF
_,APTA'.
❑,IH ❑ USA
❑ PWS:
zo
ORW: yes / no
PNA
yes /
Aots
❑ N/A
Subdiv
City_:::
Phone # (� "
Adj. Wtr. Body /GJ.'
Closest Maj. Wtr. Body
n
ZIP
River Basin
nat an u
Type of, ii"oject/ Activity
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VAN
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Age tro Applican nn ed Name
Signature Pleas�ireadcompliance statement onback ofpermit
Application Fee(s) Check#•
Issuing pate Expiration Date

A!"'awA
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date I" �3201q
Name of Property Owner Applying for Permit:
Mic�Ete) . L ec Movvc, 6y Amoindi► (,. 5vtInnbJej 6usVAl'oIn U F �► e Es}�(�e�
fmr MfckhcI Lee kouvv
Mailing Address:
VV rA I � ►'n J ve iN Ci 21 'S 8 y
I certify that I have authorized (agent) J 011 V) A • 3 n VI b1 40 n to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) v e P I a t e✓ 6 U I k b e Q 4
at (my property located at) -1 2 0 W° v f 1 e e f Sin v v e ,P 94 W h Ay e rn , WC.,
This certification is valid thru (date) V • 30 - 1011
Gt v� 1d) MrVYtt,, & u a v of I,c,yj
Property Owner Signature
1-t7,-1°I
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastaimanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOIL A PIER IW10ORIIVG PILINGSIB OA TLIFTIB OA THOUSE)
I hereby certify that I own property adjacent to h P P Lee My Dye, 's
(Name of Property Owner)
proper ty located at -71,o Nu'v Flee) SXVYpI RA Btl hnV er, NL
(Lot, Block, Road, etc.)
on Nngo 1kiVe r ,in Odheive-n, ge.WfWk Uoun� N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
1 do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
PtAr\ d r
vepl ate Vint! ► oykeAd &tpproy. . huff
'9►sn ei..rL_ b �37 n Arhv�l..$ C q4 NOy-1e&i AoreJ R
0
Telephone Number
Date: f

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/ROATLIFT/ROATHOUSE)
I hereby certify that I own property adjacent to Nei t h i P O L e e lvlo w +t, ,s
(flame of Property Owner)
property located at -72 u N u v flee) S N v Y e j p g Be I h ji v en � L
(Lot, Block, Road, etc.)
on ��go 1Ziy2 v ,in 0tavernCA14fVV fours N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
X1 do not wish to waive the setback requirement.
I do wish to waive that setback requirement. -
DESCRIPTION AND/OR DRAINING OF PROPOSED DEVEILOPIMENT:
(To be filled in by individual proposing development)
�, ✓✓ ice— r—lr
ar
vephnce vivwl %o\a1KhePd e4pprox • ho ff
N1 u n v e� j_y
��n WvtF�e�� 7Zu ivbY�)ee$ §qL1 Nor¢Oeel Aored p4
Eholrej P"4 Shvv�J Rol
NnP��eet S6� vP,! R
Signature -
Print or Type Name
/-)2—(76c/7-QZ'7
Telephone Number
Date:.�� % �j

C Division of coa tal Mgt. Habitat Impact Computer Sheet
Applicant:
Date: �/
General Permit #: �jd� �t1
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 21, 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2308 .- .s..-SVa..4RC'0, -S T ,. rev;s�--d! 02;03:l