74154_Mike Toker_20190930

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, 0 CAMA/ DREDGE & FILL 0 # (D No. 74154 A B C�
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GENERAL PERMIT Previous permit# /�A
> s lew !❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued 4,1
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 5A NCAC 0 711. I 100
❑Rules attached.
Applicant Name M 0:- 7O I(t R Project Location: County l_Ac4 FORT[
Address 390 /t'}ALL A 117 f) R.
Street Address/State Road/Lot#(s) 2 9 7-
City S Li M TR State / ,,cc� ZSLIP 2' /5 U 17A C P115 R 17 (R
Phone#(t3O3) t/OG /C 3P E-Mail Subdivision _ /
Authorized Agent PF RR'/ -ao Air 7 '43-I u.? City I r~L.i)A V W ZIP
Affected ❑CW AKEW XPTA aS (PTS Phone# ( ) River Basin /)34/'
AEC(s): ❑❑PE ❑HHF El IH ❑UBA CI N/A Adj.Wtr. Body V oG HTh CI E C )c. ,�man /unkn)
—. Closest Maj.Wtr. Body = '-"==? },?1 I),E/2 i
ORW: yes Fob PNA yes /9 -N 0
Type of Project/Activity A (A7)�0K I 117 190 ' Qu L.i kJ r AJ7
(Scale: /.?0 )
Pier(dock)length
Fixed Platform(s) j C ti/ C 1`c 4 „5—
Floating Platform(s)
Finger pier(s) G , ,
Groin length .. i i
.umber — I I l ISi1��
G
! tAif Di"'
Bulkhead/ iprap length 19 V / �"�" 1
I r
. g distance offshore ,A. 0 I I !
I i
max distance offshore /
Basin,channel
l
cubic yards 1
Boat ramp I 1 itU ox Hsi" /./l r
1 E q ' gi,r K,i" •
Boathouse/Boatlift s) - _ N, -i—
alr- vd L I k
Beach Bulldozing
g
Other f 1 D✓4)4 4 ila
6
1 1 I d el _ h I
OJ - — I _
Shoreline Le. . 9 I rj[ i ,
SAY: not su - yes no 1- -- - s. ._._� Xl— r
ReiVeSty
Moratorium: n/a yes 'coRh P O
Photos: yes \' t A/'�
L
Waiver Attached: yes _
A building permit may be required by: 13 LAU rog 1 C 01.4 Aril
/1 / I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions S L L Q?) . 1)0 0 COp)D 1.10 5, 1 At,V/J VI I K O} G p AS.ef
W aAao. S141Kitt0 U`I Oc-M 9�Z6 iS
7.
nt o Ap cant P Permit Officer's Printed me
s-7 r"
gnature lease read c pliance statement on back of permit** Signatu e
7D1100. 00 °Ij3D OI9 , ,
ApplicationFee(s) Check# IssuinDate piration ate
1f

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: N\ i)Cp
Mailing Address: D c ( 6 I--(k —Or lV Z
vyAle (-- iS—r)
Phone Number: 5 Co \- 5
Email Address:
I certify that I have authorized dl Gl 'L
Agent/Con for
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: `9 F'. L L4 k k c 4
at my property located at G 1.1) 1S 4
in- Y t County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
4i,t7
Signature
/
Print or Type Name
Nr-Ne (--
Title
I I IZOfct
Date
This certification is valid through i I 20/Z

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to -
property located at ti r,
(Name r perty Owner)
(Lot, Block, Road,ect.
�O l.
on 1'1� C �) , in
(*aterbody) (Town and/or County)
The applicant has described to me, as shown below, the development
proposed at the above location. I understand that any construction, excluding
bulkheads, must be set back a minimum distance of fifteen feet(15')from my
area of riparian access unless waived by me.
I have no objection to the project as proposed but do not wish to waive
the (15') setback requirement.
I have no objection to the project as proposed and do wish to waive the
(15') setback requirement.
I object to the project as proposed.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development.)
e 'L)'
+fir !/
Print orXype name Signature
1 z - � 2 - � G� ?- /-
Telephone Number Date

Applicant:11 l VC K
Date: 5130/Z©l9
General Permit#:
Describe below the HABITAT disturbances for the application. All values should thatch 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 final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
` '- 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)
$1-1()At(/J i Dredge El Fil-Both ❑ Other ❑ 1,6 F/ /co o r r
• ('f 16 1 ((20 wit Dredge❑ Fill
0 Both ❑ Other tc' 000 F%
Dredge❑ Fill❑ Both ❑ Other El
Dredge❑ Fill❑ Both ❑ Other El
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge 0 Fill❑ Both ❑ Other 0
Dredge El Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both 0 Other ❑
Dredge El Fill 0 Both ❑ Other El
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both El Other ❑
Dredge❑ Fill❑ Both El Other El
Dredge❑ Fill❑ Both ❑ Other ❑