MacDonald, Henry

❑CAMA / ❑ DREDGE & FILL 4 `l V , ,, i i -, i (L 4 I TO. 75262 A B C D
GENERAL PERMIT Previous Permit#
❑New ❑Modification ❑Complete Reissue " ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Res u ces Commission in an area of environmental concern pursuant to 15A NCAC '..
++ I Rules attached.
Applicant Name T r, L0. , Project Location: County
Address / '* 1_ J 1 ��'{ C\ i/� C rStreet Address/ State Road/ Lot #(s)
"'
City t / W State ZIP
Phone # (� 6_7 r;�) E-Mail Subdivision
Authorized Agent
0tw
pEw PTA
Affected
AEC(s): 00EA
❑HHF
❑ PWS:
ORW: yes / no
PNA yes /� no
❑ ES ❑ PTS Phone # L ) //
❑ UBA ❑ N/A Adj. Wtr. Body_[
Closest Maj. Wtr. Body
rxi
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Agent or Applicant Printed Name
Signature "Please read compliance statement Qnbackofp�rmit** I`
Application Fee(s) Chetk#
Signature
issuingDate Expiration [Sate

Hurricane Florence and TS Michael
Replacement/Repair Request Form
Date of Request:
Property Owner Name:
Address of Property:
Telephone Number:
Type of Work
i ko i-U /a-- . A�u/(4eeq .X-)c
NOTE:
• The Emergency CAMA General Permit 2500 is for repairs and replacement of water -
dependent structures damaged because of Hurricane Florence and/or TS Michael. The
replacement, reconstruction and maintenance excavation activities shall conform to
current standards and rules. All work under the Emergency LAMA GP 2500 must be
made in the same footprint of the previous structure with no additions, expansions, or
enlargements.
• If any portion of a structure being replaced is within the 15' setback of the riparian line or
access area, signatures of the adjacent riparian property owner(s) must be obtained
acknowledging the notification and waiver of the setback on the forms provided by
DCM.
• Any maintenance excavation or dredging requires signatures of the adjacent riparian
property owner(s) on the notification forms provided by DCM.
RECEIVED
MAY 2 S
DCM-MHD CITE'

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RECEIVED
uUG 0 7 2U19
)CM-MHD CITY

r�MA / ❑ DREDGE & FILL NO. 75258 A B 0` D
NERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ' ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources mmission in an area of v onmental concern pursuant to 15A NCAC
❑ les attached.
Applicant Name C Project Location: County
Address Street Address/ SXate Roa ,of�,# s)
City I, raw State � zip lVV • ' l
(fit S bd .. .
Phone # )
Authorized Agent
Mall
uv sion
City_ aPa
❑CW
'fA ❑ES
❑"S
Phone# ( )
Affected
AEC(s): ❑ OEA HHF
❑ IH ❑ UBA
❑ N/A
Adj, Wtr. Body_
❑ PWS:
Closest Mal. Wtr.
ORW: yes`/ no PNA
es no
Type of Project/ Activity
Pier (dock) length�ny t
Fixed Platform(s) �
Floating Platform(s)
Finger pier(s)
Groin length `
number
Bulkhead/ Riploffshore
--
avg distamax distQw
Basin, channe- -
cubic yards
Boat ramp
Boathouse/ Boatlift -- -
i
Beach Bulldozing
Other
Shoreline Length 1
SAV: not sure yes no
I "
Moratorium: n/a yes o
Photos: yes
Waiver Attached: yes no
A building permit may be required by. �6
( Note Local Planning Jurisdiction) �� .-
Notes/ Special Conditions U r
Agent or Applicant Printed Name
Silu pi a read compliance statement on back of permit read compliance statement on back of permit �r•
A plication Fee(s) Check#
Permit
ZIP
❑ See note on back regarding River Basin rules.

NIA / ❑ DREDGE & FILL No. 75258 A B � D
GENERAL PERMIT Previous permit#
ew« ❑Modification ❑Complete Reissue' • ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources ommission in an area of vi onmental concern pursuant to I SA NCAC
%� / ❑ ules attached.
Applicant Name �'� r 1 / �~ (� Project Location: County C i lC
Address AliUY 04c /w `' Street Address/ S to Road of # s)
^" I ��11
City / Fn/ our>� State /Ur ZIP ly A > <,✓
Phone # �( ) 8 — Sy Mail Subdivision f
Authorized Agent City ZIP fjl
Affected ❑cW /}AEW ,01 ❑ES ❑PTS
AEC(s): ❑OEA 'LJHHF ❑IH ❑UBA ❑N/A
❑ PWS:
ORW: yes //no 1 PNA
Type of Project/ /Activity _
Pier (dock) length_
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/Nprap lei
avg distance of
max distance c
Basin, channel
cubic
Boat ramp
Beach
Other
Shoreline Length I v
SAM not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions _
Agent or Applicant Printed Name
no
C r,-A
U C
Sign�tur ** Please read compliance statement on back of permit**
_ ;-VV
Application Fee(s) Check #
Phone # ()
Adj. Wtr. Body_
Closest Maj. Wtr.
❑ See note on back regarding River Basin rules.
1 C,./cc.vt'-�._

J�ieA ❑ MA / DREDGE & FILL No. 75258 A B : D
1---_-�9FENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue' " ❑Partial Reissue Date previous permit issued
r, �
As auttasrized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
/ ❑ ules attached.
Applicant Name 1 / 5 Project Location: County
Address / • ' l m Street Address/ State Road _Lot #(s)
{/ r
City I/ State �iC ZIP 7 (; % %iC,' j f
Phone # (%) l / S 3 G E_Mail Subdivisiont
Authorized Agent
City .I Zl
❑CW Ell EW f7 PTA El ES ❑PTS
Phone# O_
Affected
AEC(s):
❑OEA lI HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body
❑ PWS:
Closest Maj. Wtr. I
ORW:
yes / no PNA yes / no
ZIP
River Basin
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Agent or Applicant Printed Name
Si��ure *'s Please read compliance statement on back of permit
Please read compliance statement on back of permit**
Cl (f
A(iplication Fee(s) Check #
PermitOfficer'S Printed Name
Signatur /, Is su
in Date xpiratio ate