64151_Don Osborne_20190405

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' CAMA/ 0 pREDGE:& FILL r • , F.--270 r-..4)2 617 —.1.7:0/4' ' , - -No,:' 73031 ' , '
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GENERAL... PERMIT , . 7i6# 0-4151 r . „ _ , Previous permit# . ', ' — ' AI/4
--).---:.-L'ZSlv,:.'.0 Modification DComplete Reissue DIPartial RetsS'ue., , Date previous permit isuecl. , ' . ,../ ,1 A
':• • .As authorized by the State of North Carolina Department of Environmental Quality.
and the Coast4ReSources Commissionin an area of envirorinfental concern pursuant to I 5A NCAC (--- '7',:-/, - 2 5-:. Q . • : • - : s:
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,, ' -'i;:r. --"-* a ' , ' • - - 12Rules attach0. _ , _.: , • ,
AP'Plicant`Nann6eo4 ,4-,: ,7,-.;-,,,, . N1E, .. , • , : Project Location County -,1J-1.c.-.4 4-?-.1„:--- i-r2.---r- e', c_.)
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• . .Address , . (3'i._--"X., 6;,_-.-7 , Street Address!State Road/Lot#(s) (:),7::1---,- ,:2'• /,,-7,•„,,;.-7, -- : •
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City /1.----fbi-- ' ,. -,,-:'' " State/-ti ZIP '2 '''2 .9(-7& • ,;;:-/ -4-2?-/Vil.7 ..- 1?_:.',• 9 , --,") -2,-2 '-/-_-=-7,c/ . •:. . ' ' • :•':-'
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: - Phone#(c2,',..7 ) ,;''."••`•7 --;;:'7>3 E-Mail : . .
, Subdivision -,;;.-.3' A y 1,/;rt.. ) /•_._/,?_-/3 e-/ /,,,2
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Authorized Agent Asi A._ • • _ ' . : • •, City "i-3,,9.7-?-1 '- - - , - : ZIP --2--7 ‘•.- 4 ..:•.,
Affected • CW; A EW ,;;R:1PTA 0 ES ' ', 1=1PT5 , _• Phone# ( ' • ) River'Basin-77,41 72 — ,>.--Z,-/L/,..-1,:_
0EA 1-IF O 0 0 IH UBA N/A •
,- • AEC(s): 0 0 11 ' Adj:Wtr. Body 2------";; ,-, '----/-2-',t' (?c. r.- /man /unkn) ."!
0 PWS:
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ORW yes / PNA yes Closest Maj.Wtr. Body --i,-/ ,--•--,
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i - ' "Ag-1 ---7 •—
,-• Type of Project/Activity ./.. rIc:6---• e....• 2 .i...c,i'--/C-j" 4 a,:...);/....41-. - .;;A.-• `,. ' i ,
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- • "- . ..' (ScaleYV :7:It:I, • '.- )`v, • :'
Pier(dock)length '
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2
Fixed Platform(s) / -
< / -,/ ,,, /'If-) 4-,''';Pie'li '''''''7. .,
Floating Platform(s)
(. ,. Finger pier(s) .
- . .
r • Groin length
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number / i i \
' Bulkhead/Riprap length --,.
avg distance offshore - — alticlEiI vED if
max distance offshore
Basin,-channel- * ..,, - -' 'APR 1. B, 2019--
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,...-„, I
cubic yards • / . ,
-73-.: -"C e,'-',/ -
Boat ramp • D6 MMARP
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Boathouse/Boatlift
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Beach Bulldozing
,-,---X,/,_,-; ' -i-.J.4 7.,,_.- ...k-'4,7-•-c-f"" 1 .
Other
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41
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Shoreline Length y9 77)/1/i..-,c-., li,::: ' ,. - . ,, ,,,,- . - ,-.' -',;Ii•''.,
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4-1,,: • SAy: i,,,- not gure , -!yes „no,. - __ , ___ __,' 1.I.I- , ' I: _ ; ' 'I il:;' A/__;•.,'I/'7.---17-- /
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Moratorium: n/a i yes no . , 4.5*,;,c5Z--'-f--•6- .',F.t!,:)i'-7 ;-
Photos: yes 41115 „
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Waiver Attached: Cy5) no ,
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A building permit may be required by: k.„,- ,/.../- --.0-- -7 ,---e.- • . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) -- - .,
Notes/Special Conditions /_..,n-7 , • ',/‘, , A...)A i ni7,J.-1,...1 --y-D Z--4 1-1.--,pti. .--,-2/r,:f.•<:7/,.---) -7--D Oc-- /10 / /4,,&--)Z: '
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Alerit or ppItcantArinted . ame I
: v II i Permit Officer'gI Printed Name
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Signattlre **Plase read compliance statement on back of permit" Signature,,J,----- `- .
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Application Fee(s)4 - Check# Issuing Date Expiration Date , " 2
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property'adjacent to DP N4.d e. 1Fe-Pr�f N. dS,BD,eW s
Name of Property Owner)
property located at Cps /i'Ii'.4)' ..6 747 q/
(Address,Lot, Block,Roa ,etc.)
on ,in 34771 / E44,14aie, 6P, ,N.C.
(Waterbody) (City own and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site
drawing)
.r ecsff 11Vd P14P447y t4 i', Pmfg07
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a mi imum distance of 15' from my area of riparian access unless waived by me. (If you
wish to ive the setback,you must initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Prop Owner Information) (Adjacent Property Owner Information)
Aatt-6 c7g /D
112( e.
ignature Signature
jA/44.p 1Q a ,Qf8oAAle' A/a:a 'N zeic7/ �5oeitq P lit
Print or Type Name Print or Type Name
P.o. 84v ,744$3 t1 s, zGs/ews7
Mailing Address Mailing Address

City/State/Zip City/State/Zip
0/40 Lys Goo9 ZS -Sal-iJ9S
Telephon Number Telephone Nu ber
'7( ��zo/4 V/it 744
Date Date
(Revised
6/18/2012)

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- Applicant: (i70,4 D580 .
Date: 5- .4 p2./L /
-General Permit#:
—73p3> .
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 for. (Anticipated final (Applied for. (Anticipated finat
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Harne 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)
51 ize,co
Dredge I: Fill[Both 0 Other El 5- s�o 2
Dredge❑ Fill 0 Both 0 Other 0
Dredge 0 Fill❑ Both 0 Other 0
Dredge❑ Fill❑ Both 0 Other ❑
Dredge 0 Fill 0 Both 0 Other ❑
•
Dredge❑ All❑ Both 0 Other ❑
•
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ All❑ Both 0 Other 0
Dredge❑ All 0 Both 0 Other ❑
Dredge❑ Fill❑ Both 0 Other ❑ {
Dredge❑ Fill❑ Both 0 Other ❑
Dredge❑ Fill❑ Both ❑ Other 0 _ •
Dredge 0 Fill❑ Both ❑ Other ❑ j
Dredge❑ Fill❑ Both 0 Other ❑
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