63602_Kristopher Ware_20190114

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I LAMA/ ❑DREDGE & FILL Na 70654
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' -P GENERAL PERMIT Previous permit#�f -
"' --%'kiNew ❑Modification ' ❑Complete Reissue ❑Partial Reissue Date previous permit issued.
• As authorised by the State of North Carolina,Department of Environmental Quality/
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC
�/ 1J 4„.._
®Rulee attached./' .
Applicant Name K0'/S7 7,i 1e Project Location: County /J l/(- ��
' Address ,p/7� //,r(`r/o/7r ,241 Street Address/S to Ro,d/Lot#(s) gi<�jj /1 e./
//. / / ZIP(,T"�// / ... 70( ///pc_ /�c,%�[_,
City /,Gi�-1 ' State � /� //
' Phone# (71`) - `/3' E-Mail Subdivision 4 ,/G,,,S 4�c L-- .
Authorized Agent 7 '/ 2/� r/1ate City r'e/I ,- m ZIP a2 -���' .
Affected / )(PTA ES X1 PTS Phone# ( ) 'r-
❑CW ,;YEW River Basin �4'('../,,i7.--1
❑OEA ❑HHF ❑IH -❑UBA ❑N/A `` 11 1
AEC(s): Adj.Wtr. Body ��,�,,,e. ��� 47- nat-man /unkn)i
❑PWS: r
• . ORW: yes / PNA yes / no
Closest Maj.Wtr. Body ,4',t Z')
Type of Project/Activity ,t�Jc_ /4 7? C�,a1ru 71- . -, 4/k �`T. / e-,k 4" - ,
la r At a2& / .r9`y� �� •. (Scale: J //_ �• '
Pier(tilt)length 1 oc -
Fixed Platform(s) 41 .V t° i
Floating Platform(s) n(! p
Finger pier(s) '� _ .' - �.' r, ��
Groin length �.�"... ¢� r I
. i
•
number.
''. Bulkhead/Riprap length
avg distance offshore _ til *
max distance offshore /
-; Basin,channel %(e� I �'
f
cubic yards
-Boat ramp �' .. "4`
Boathouse/Boatlift ✓� -
Beach Bulldozing i� '
Other 47 •
I /
' 9012 , r eA
•
Shoreline Length T/fib ' '
SAV: not sure - yes no \ • , -' - - ��
Moratorium: n a.i es noie; � O' �
Photos: yes no
17r ✓,G� ' /_2 • / ;��C 1i 'S
' Waiver Attached: ��'"L./ no / ' l w/./2 P 1 • �irit f • •l C—� '
A building permit may berequired by: /'i,4—• ,- ,®See'note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) q7Notes/Specs I.Con itions �GG,, yG/,,.,�� �fl//r/ . �i7���/ //-,,/r � ��L
• ./7
Agent or p •can r•nted Name Per f Officers r'nte rNam'e
Signature **Please r ad compliance statement on back of permit Signature - .
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A plicaton Fee(s) Check# Issuing Date
Expiration Date

,
Authorized Agent consent Agreement
1, 4-_STtQ C , herby 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: ,
i -Z SkcgL if, e_ 1 .,
2,5U / NC- -2-- S 10
ila d t r 4,11'
la-r\-v'
kPl it(°;(14/
PROPERTY OWNER'S MAILING ADDRESS: iti
&ARV NC -6-7SIR
Phone No. a el I 3 0(0- qLi 3 3
R' SIGNATURE: 44,-- 6(11{V( —
PROPERTY OWNER'S
AUTHORIZED AGENT SIGNATURE: 16Wier
TOBIN TETTERTON
DATE: 1221 20 I8
W/Authorized AgentConsent Agree.

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ADJAdENT RIPARIAN PROPERTYOFlIf 9ER STATEIWIENT•
i-hereby certify that-I own property adjacent o /r/'i-5 l,Ipr-. (? f - -- 's
• .grope Located;at 7- f/'t ,n "!'e ofProperty Owaier�
t�i^�
on: n {Address [ I Road,
{ifiila ePbody) 1�-' Gut`v�-
(City/Town and/or COunty)
• - The applicant has-described to-me, as shown below, the-development prooposed at the above
location.
cin 1:haveno objection to this•proposal:
Frorsnp
aiT`ar [have objections to this proposal.
Crz dne
-DESCRIPTION AND/OR-DRAWg g OF PROPOSED DE!lELOPIVIENT-
-667.0 dvai-ptoposing►devefopmeri£`mustkl fir descrl €loci=i efow `"
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�'`' WAIVER SECTION,
cam;=.�, i understands that a_pier, dock, moorinrbreakwater, •
must-be-Set back,a minimum distance of 15'frmpmy area of ri •boathouse, lift-orwaived rosy
�tw= � p access unless by •
trzE - m r ,:q wish to waive the setback, o rragi5t mi
`.� /tit
11� Y :�a appropriate blank below:)
I do wish to waive:the-15`setback requirement.
q ent.
I d®-no Wish to waive the 15'setback requirement - • _
(Adjacent,Property.Owner Informatics*
Sid tore- s-be 1-
PnnrarType ame A—P:Ste'
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Uaflrn` dd ss 'linPAddress_ 1 , teA,tt 7�J p,� � �
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y{` t a 9 Jb- G •4 .vT(r /^
-• ' Vi `!rm 3,i� L y . 1 V7-elephoneNu1 2er egret/address Cv"� Telephon umber/email address'• 102Co
Date
[lt �a
• Dale* •
{RevisedAug.;2ta9.�J Valid for one calendar year after signature"-

•
MBAR �1;t';1HPA I[PROpE ER STATEMENT'
I hereby certify that I own property adjacent to ge- --5/74)Ii"E.YL. e � t
L� rt..RE 's
property located at t i 2- St#- P- L " °Pe �I 'I en-I
an RAN r. ddress, Lot, stock,Road ete
aterbndyj , in.,_______ �a_— k and/or , N.C.
•. • • The applicant has described to me, as shown below, the development proposed at the above
Ia fiort. .
Aaiseent - I have no objection to this-proposal. ✓ t ��
Pr pa ty
.D
°1„nitir I have objections
Cimene
DEScRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
OPMENT
(frarplthiatitytiroStii4 de oar en r�ivsI:a' ti1ri-Cesczf io :belowwor:a cbafte avvIog)
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$ 5e ,c Aff-ciche4 (1) (-1-i'ml ---
•
iksqt• troAl ER o E TIOI
,,gym-„ I umderstand that a pier, dock, mooring pilings, boat lift,
or groin r
Va z must be set back a min urn distance of 15'from my area of ripariant access unless waived by
-`," me.Of you wish to waive the setback,��� you ustinttial the appropriate blank below.)
(PIMA(Ibt. l do wish to waive the 15'setback requirement
I do not wish to waive_tl'a 15'setback requirement
(Propqty er information)
(Adjacent Fropad' OT d rirtailen)
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Pit or ce6mr7A et.6l .�' . -t c� �✓
. t( R Print peNCam.. / y
alrtl3 A dP+.ss Trle11,3
_ Name..
�41, �• Low-
cliyareczo oisfate/ 3
cm '306.-13ii3
Telephone Number s all address � ry l�T'e Q� ( 2 3�57
2 rf,�� C�,�r.ti . ephone Number/email address
*Valid for one calendar year after signature • (J4evFsed,�ug 2014}

C Division of Coastal. � n Habitat impact Computer .
Applicant: /l�$4„, (i•iffe—
Date: / :-.5-‘effel'at^V 9Or l
General Permit#: O 7
Describe below the HABITAT disturbances for the application. All values should match the name,and units of measurement
found in your Habitat code sheet. '
TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied far. (Anticipated-final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
0,4 jab.4____ Dredge El Fill❑ Both ❑ Other ( a �
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qab Dredge,❑ Fill❑ Both El Other A /� •
.
A Lic4her Dredge❑ Fill❑ Both IDOther ® 1y L/ Ti
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 ❑
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