64160_Richard E Geard Jr._20190418

H:�. • Via--. - , -. ;:..0 r - - : _ _ ;t.: y..: - ,, ., -, -11111 I
NIX ,C-AMA/,DREDGE,& FILL," �i-1 _ NO: 7303.7 ,,,,11 B ,c D.
EN'ERAL. PERMIT � Previous permit#'%F/w
New ❑Modifcation� ; ❑Complete Reissue ❑Partial Reissue Date•previous permit:issued
As authorized by the State of North Carolina,_ Department of Environmental Quality
and the Coastal Resources Com 'ssion in an area.of environ�}ental concern pursuant to 15A NCAC•
l�°�:r r� �T,Rules attached...
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4 : `Applicant;Name 2iGli� �'�� Project Location: County.!//�/�' !�
Address .. /(/6 / `� / T Street Address/ State,,Road/ Lot #(s) /.
City' yl ' -State/Uc-.ZIPa �d
Phone # " .7 E-M 'il
Authorized Agent.�l �y�l G�� f r�rli►y
Affected ❑ cw - JtW -kTPTA S ATS
AEC(s): ❑ OEA' ElHHF' O IH ElUBA ❑ N/A
❑ PWS:
ORW: yes /'Co PNA yes / on •,
cubic yards
Boat ramp
Boathouse/ Boatlift
L,
Ci`ZIP
Phone # ( ) '' River Basin'
/.
Adj. Wtr. Body ///1 dl`� nat_ man unkn
Closest Maj. Win Body
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Authorized Agent Consent Agreement
-6/0herby authorize Tobin Jay Tetterton of
(Property Owner(s) )
TJ's Marine Construction, LLC to act on my behalf in obtaining CAMA permits for
the location listed below.
PROPERTY ADDRESS:
A qZ 80V
Oc AQ d OnJ 4k, k' �/d
PROPERTY OWNER'S MAILING ADDRESS:
0�6 a tke+ E+
No's h ; dcky c, %ffy
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Phone No4q?J.2 y d c�
c
PROPERTY OWNER'S SIGNAT
c
AUTHORIZED AGENT SIGNATURE:
TOBIN TETTERT N
DATE: 20 6
W/Authorized Agent Consent Agree.

A P
PRO OWNER STATEMENT
1 hereby cerfffy that I Own Property adjacent to
ArIf
prop located at
N6 q? ©f P"OPeny Owner)
(Addreseg Ge a 0.
on in
M;MM N.C.
Materbady) �6
(CRY/Town and/or County)
The applicant has described to me'
location as shown below, the development proposed at the above'
I have no objection. to this proposal.
I have objections to this proposal.
J
DESCROPTOOM ANDIOR DRAW�MG OF pROPOSED DEVELOPMEMT
'd
ka
a�s� -
4.
WAMER SECTROM I.
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lit or groin
must be set back a minimum distance of 15, from my area of riparian access unless waived by i
me- (if you wish to waive the setback, YOU Mustofappropriate blank below,)
✓ I do wish to waive the i6setback requirement.
I do not wish to waive the 15' setback requirement.
pe CO&MOF onf Tmation)
(Adjacent PlrapgMj Owner Unfomation)
J
a we
Signature*
ype C P_ P_
Pdnt or Typ e- Name.
6
PIA
A
A Mailing Address
a-cit'I'Star9gip C-P-7-
itylStafe—M
Telephone-NWberl pfnaff address
_41f— 7— Telephone Number/email address
Date
Date*
Walid for one calendar year after signature (RevlsedAug. 2014)

,,9p[0,9 ' 9, 10;39a TJ's Marine Construction
2529433949 p.3
1 hereby certify that I awn property adjacent to (Q n�
Prope located at 0 / C �P Rome of p+oPe�y Owner)
,S .
on �rLo��IAkd�dress' i k, Roa , etc.
(Ullaterbody) m (CityiTown and/or County)N.C.
T a
has described to me, as shown below, the development proposed at the above
ti
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION dev ANDIlopm R DRAWINO OF PROPOSED DEVELOPMENT
(individual proposing development must till in descripfion below or attach a site drawing)
e
---=- WAVIER SECTION
= I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, Ii or _ -•-=- must be s 6 k a minimum distance of 15, from � grain
me- u o waive the setback, you enlist init l the appropriate blank below.)
ian access unless waived by
--I-do wish to waive the 15' setback requirement.
1 do not wish to waive the 9 5' setback requirement.
4�e Owner in rmation)
f, 'j� fro rr�
rl ype e
r �
Ad ess ,J
! d 2- 7�
Telephone Illu bert all addre
JDA
;Valid for one calendar year after signature=
(Aoifacent roperty weer Information)
Signatzu- �' ��
Print or T�i pa Name
tRevlsedAug_ 20IR

NC Dildsion of Coastal Mgt- Habitat J ppct Go puteir Sheet
Applicant:
Date:
General Permit#:
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
impactamount)
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 ❑ Fillj�j Both ❑ Other ❑Q
DredgVj�j Fiil 6 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 ❑
2z52--608-22308 <. 14$8L4R1-0Sew ' 41Y+t�i'�Ai rgCf,"'Jr',.i:;3if!»r'":r"iL,2;ik'.'.?d':a�F�c� revised. 02;0113:!0