73768A_Mullen, Barbara & Kevin_20190625

CAMA / DREDGE & FILL
GENERAL PERMIT
New ❑Modification ❑Complete Reissue El Partial Reissue
No. 73768
/4 B C D
Previous permit #
Date previous permit issued
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 I SA NCAC ! %/7 / /
FARules attached.
Applicant Name 9j'}y!✓"l'fr l'/� % "/L/ �Uf/fAAl
Address Z/(� /L1�G�/ 2/Z0 /17Y &fiL
City 2 )ESL% L' ' State zip 1-1gll2
Phone # , ) %-CD ? E-Mail
Authorized Agent
Affected ❑ CW AIEW PTA 9ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / eo PNA yes /*'
Project Location: County L'-Azc/✓ ,Q
Street Address/ State Road/ Lot #(s)
1/� /ll riy /izLl
Subdivision L
City zip ll q3z
Phone # ( ) 5t444 C River Basin
Adj. Wtr. Body_ % liJ)2 (, fe /man /unkn)
Closest Maj. Wtr. Body
M.
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MENETIMEM
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Agent or Applicant Printed Name
1
Signature ** Please read compliance statement on back of permit **
lei
Applica�s)' Check #
/— i /Viy lt4'N-1-7fr L
Permit Officer's Printed Name ' �>
Signature
J" ZS 'a";i
Issuing Date Expiration bate

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: 14� u A f\ NA U � ` h
Address of Property:
Agent's Name #:
Agent's phone #:
210 v"vl\oefrL.,
(Lot or Street #, Street
City & County)
Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawin the develo ment
they are proposing.
"— I have no objections to this proposal. I have objections to this proposal.
ff you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response /s considered the same as no objection if you have been noted by CertWed Mail.
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 slan the appropriate blank below.)
(Property Owner Information)
Signat e
r` U tiv yl
Print or Type Name
Mailing Address
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Adjacent Prop" Owner Information)
�^ 04V 2"
Signature *
1Cc -,fd A �esG evl�h
Print or Type Name
jo Ajdli6ffn
Mailing Address
p� o I- i, 9--1q3 z 4- cd e ,I I r n , AJC 7 - 3 4
City/State/Zip b 144-Cad.e,1L7 a08
�II .Ca4i City/State/Zip
Telephone Number/Email Address Telephone Number/Email Address
(-�-19
Date Date*
*Valid for one calendar year after signature"
Revised 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
Name of Property Owner: I�
Address of Property: 7 (D vl "✓ PI
(Lot or Street #,
Agent's Name #:
Agent's phone #:
or Road, City & County)
Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawina the develo ment
they are proposing.
44�—I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Gr frin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response Is considered the same as no objection if you have been noted by Certified Mail.
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 sign the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Inf rmation)
Si/gnaure -- II
16
tt)i i, -- 0A
Print or Type Name
ailing Address
-i nL '7 C�,?z
City/State/Zip
?, S-2 - q e2 2,
Telephone Number/Email Address
l.---) ' 9
Date
*Valid for one calendar year after signature*
(Adjacent Property Ow'
r Information)
Signature *
,�;. i'l a rs.A'A
r
Print or Type Name
;UV<3 Mu
Mailing Address
E-4e,o ki
City/State/Zip
Telephone Number/Email Address
Date*
Revised 2017

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: �i IT
1 `V1 1U Aa (i, Permit #:
Date: J� / . _ 2 c(� 20 / 7
3 7Z6 4
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
amounnt
SINS
Dredge ❑ Fill ❑ Both ❑ OtherAd
C/
KDredge
❑ FiIlAj Both ❑ Other ❑
Z �Si
2�8
T I *
Dredge ❑ Fill ❑ Both ❑ Other j�[
Z(o Pj(j SF
Z(s Sr
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 ❑
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